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Permit (176) Plumbing Permit entCEIVED Appli RE Building Fixtures City of Tigard JUN 6 2017 IIIIIIIIIIMIMIIIIIIII.t:r 4x4//7 40;21<r-PermItNn/48 :4'e5e;?..5? 14,- 13125 SW Hall Blvd.,Tigard.,OR l Illl Phone: 503.718.2439 Fax: . . Plan Review DIVISIONn'IteiRY. 1kGF TIAFDOther Permit No.: ,, ,., Inspection Line: 503.6394175 A Date Ready/By: Amu ei See Page 2 for A'''''' Internet: www.tigard-orgov Notified/Method: Supplemental information;IA,' 1 ,• '' 44. "-7-4 .,' i.0-11 .'..,4f.-'''.' .10it`t4"F.a.t.3:'ift i'ij,. 11,:,:gkIP,l; ,'"?:4*C *9-:,;•..;.,> -- 'f'"--it..--1,".".• '.''->,'" ',',..rIv -, ''' '', - ,,.w " .,.- ,, ,,i,,,,,,v; - , , .i.•.,*,,,''''''A gs, .;,--., ,SSX, , ,-.'''',St '- ,. ' `i- "` ' - - '''''-' ' For special in ormation use checklist. ill New construction I 0 Demolition Description Q-11T-Et-a-.-1 Total 0 Addition/alteration/replacement 0 Other. , wt, , New 1-2-family dwellings(includes 100 ft.for each utility connection) pF17,, v-ji-lxitrA';',.), -0-5.y41.:: ' ,: 7 ‘ ' ,WA, SFR(I)bath 312.70 SFR(2)bath a 1-and 2-family dwelling 0 Commercial/industrial - - SFR(3)bath 500.32 0 Accessory building 0 Multi-family -- Each additional bath/kitchen 1 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 Iiikl.',„, -!„ . ' Site utilities. 1,54.2 ;40!1!' ''.:'.11 l'';' 1'0*1)K,w4',,7 - • _ 4-1.... c',..., -47.--,-- , ::..v• , •,,..!• '---, '',....' A* f, Catch basin or area drain 18.76 Job site address:i 57 Sip SW Se,1 Pre., u r . Drvwell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2 1 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. 1 Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft,: ) I Page 2 Subdivision:Polygon at Bull Mountain Lot no.: 3 t Fixture or item: Tax map/pace!no.: Backflow preventer 31.27 4-P,--, 'I-n"t•,:e _2-7!.w. ; at,- .xiv,,.-,-,,, -.-_,A Backwater valve 12.51 It., . 4r--, -.14v4;r '"%'''''!ii 42,t;Pr'----i. --P" '-,/gr" ''''f''',"--" ''''''''''It-N ctothec washer 25,02 MSTWV-6 01.5% Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 $ ts• , :44,-, frch,,,j,t,.,w,,, ,,‘,. mewl*, IpaTitito, jit: ,;( ‘,,,41,,,,r Expansion tank * 12.51 Fixture/sewer cap 25.02 Name:Polygon WIJI,LLC Floor drain/floor sink/hub 25.02 Address:109 East 1.3t5 Street Garbage disposal 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone:(360)695-7700 Fax:( ) Ice maker 12.51 ''' 4' ' ''' ' '0- Inter,- torkri.ase trap 75 02 Medical gas(value:$ ) Page 2 Business name:Polygon WLH,LLC Primer 12.51 Contact name:Angela Grajewsld Roof drain(commercial) 12.51 Address:109 East 13th Street Sinkibasin/lavatory 25.02 _ ... City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62. 4 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 25.02 E-mail:Angela.Grujewski@polygonhomes.coln Urinal ,k*,_, .:•••:\4:...r..-;-**: fr,,,,,,,fijitc. ,L-1--,4,r,,,,,,,-,-,,,,--ire,,,!--;,/,,,,ine-,,, JE.,,,,,,,,,,,,,-4,r;-ciefi-;,,,,,..7:3e, .....-,, Water e.inset 25M2 -,1-w-Y4i,,44,23ii,..4.41& -.:•- •:.,:',•: '. ;,. '.. - 1;11'Tail ',1--ma• , < .,-, ,. ' ; Water neater 37.52 Business name:BBL Plumbing LLc Water pipitiwpwxt 56,29 i Address:PO Box 85 Other: 25.02 City/State/ZIP:Corbett OR 97019 Subtotal phone:(503)351-3903 Fax:( ) Minimum permit fee: $72.50 i Plan review (25%of permit fee) I CCI)Lie.: 180345 Plumbing Lk.no.:P131582 State surcharge(12%of permit fee) Authorized signature: irre....z.0.--- TOTAL PERMIT FEE ‘ , .....4.....00.. This permit application expires if a permit is not obtained within 180 days Print name:Brandon Larder Date: after it has been accepted as complete. *Fee methodology set by Tri-Cutinty Building Industry Service Board 1:13uildingsPermitsTLNIU-PermitApp doe 10/01/09 4404616rtio/ozTostwEin FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ,111 Transmittal Letter T i GA R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tom H. DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Angela Grajewski JUN 6 2017 CITY OF FIGARO COMPANY: Polygon Northwest BUILDING OIVISIO PHONE: 971-212-2144 By V' RE: /571 S SW SeI rc, (Site Address) ►"� ` ODZ� (Permit t Number) Pol9C)M at Bi Mour1-Eatn L t 3 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: op � tion: Copl '.3tescr ipti,on: 4 4- 4444AA' 0 Additional set(s) of plans. 3 Revisions: 0 Cross section(s) and details. �� 0 Wall bracing and/or lateral analysis. 0 Floor/roof framing. 0 Basement and retaining walls. 0 Beam calculations. 0 Engineer's calculations. 0 Other(explain): REMARKS: Please pay fees owed with Trust Account. /,////'7 AlozeAJ�- /'en-mss -sii/3,1.r/r7z —. � — a s A-2/,w ,. /4-7 "O O,FCEU Routed to Permit Technician: Date: Initials: Fees Due: ❑ Yes I I No Fee Description: Amount Due: Special Instructions: Reprint Permit(per PE): ❑ Yes I ❑No Applicant Notified: �E- Date: 61f7/7 ni Done Initials: 3:751,/ L\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 �; CITY OF TIGARD t 4; 4 {' 4 MASTER PERMIT COMMUNITY DEVELOPMENT6 i 'All /7 Permit#: MST2016-00258 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/17/2016 Parcel: 2S108DB03300 Site address: 15156 SW SEINE DR Jurisdiction: Tigard Subdivision: POLYGON AT BULL MOUNTAIN Lot: 31 Project: Polygon at Bull Mountain, Lot 31 Project Description: New SF. 6/15/2017: REPRINT permit to add 4th bathroom. BUILDING Floor Areas Required Setbacks Stories: 3 Bedrooms: 4 First: 1504 sf Basement: 826 sfRepaired Left: 5 Height 30 Bathrooms: 4 Parking Spaces: 0 Second: 2155 sf Garage: 740 sf Front: 20 Dwelling Units: 1 Third: 0 sf Smoke Right 5 Detectors: Yes Total: 4485 sf Value: $630,043.56 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Urinals: 0 Sewer Lines: 100 SF Rain Storm Sewer 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 2 Footing Drain: 0 Ice Maker: 1 Water Lines: 100 Drains: 0 Catch Basins: 0 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: 6 Natural Gas Clothes Dryers: 1 Heat Pump: Y Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Furn>=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'l 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: V BUILDING INFO Class of Work: Type of Use: NEW Type of Constr: Occupancy Group: SF VB44 Square Feet: R-3 4485 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: $38,153.11 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 throu AR• -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. 7 Issued By: ► / ,/dl� � Permittee Signature: 647 l7 /'°G 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. FOR OFFICE USE ONLY-SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT .IIz Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tom H. DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Angela Grajewski JUN 14 2017 COMPANY: Polygon Northwest CITY OF TIGARD BtJILL1lNG DIVISION PHONE: 971-212-2144 I B}y RE: 1519p 3W S I NF, biz MsTZO1 Doc (Site Address) (Permit Number) Pplipon a71- Buil M,Durtio, C Le+-3 ) (Proje t tame or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: 1 C pies: Description: X p �,� 0 Additional set(s) of plans. 3 Revisions: t-I i6 ' Ptacti lt)./) 0 Cross section(s) and details. 0 Wall bracing and/or lateral analysis. 0 Floor/roof framing. 0 Basement and retaining walls. 0 Beam calculations. 0 Engineer's calculations. 0 Other(explain): REMARKS: Please pay fees owed with Trust Account. Routed to Permit Technician: Date: v. 6- 1 4± - j 7 Initials. Fees Due: es ❑No Fee Description: Amount Due: � � 0, - PI G•. V cif , rry $ d C/ti ( f GfSc '7 " $4 X. P-9-G-- 's70 Si/e----- c.0-/ -,-",e-el/L7 $ Special 0/(E-7te L /1e..,9,1,) 5c7- Instructions: Reprint Permit(per PE): I k a e:Yes ❑No Applicant Notified: ,4-/v6i- ) 1)onet q/i1/7 Initlals.,e ` 4L.— 611,4)r c..- I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 Plumbing Permit Application Building Fixtures RECEIVE! t.()R 011,1( l: I'tit: ()`til l City of Tigard .I 13125 SW Rall Blvd.,Tigard,OR 97223 UN 14 201 C Dp ate/BY te/B � i�/ / �lrermii No/y�l /7—t Qr ' Phone: 503.718.2439 Fax: 503.598.1960 'lAt � Plan Review• Inspection Line: 503.639 41?S Date'f1v: Other Permit No:. I 1 C A,R t) nt vvcvsv ftgard-or got j}; T o ,iGA Gate Ready by runs: ., . fiedl vtetfiad S See Paget 2 r ' ' i . , .- of is, Supptementut In€orntation ►�1 New construction ❑Demolition For special information use checklist. Description ( Qty. ( Ea. I Total ❑Addition/alteration/replacement ❑Other:-.x, New i-2-family dwellings(includes 100 R.for each utility connection) r.. ;k A.,• r. t:., t• 1€ ! Cif-17-2-'1SFR(1)bath 2 0 Commercial/industrial �� 437.78 ►�� I-and 2-family dwelling SFR(2)bath 437.78 0 Accessory building SFR(3)bath ❑'Multt-family 500:32 ❑Master builder Each additional bath/kitchen 2 02 0 Cifher Fire sprinkler( s ft.) g _� Q .y t s a ► � s 4• Page 2 .c:-.; a,y . „. , >.,� � � � ,� �,� She utilities. / S/TLp Svc) Se roe, Pr Job site address: Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Drywell.leach line,or trench drain 18,76 Suite/bldg./apt.no.: f Project name:Polygon at Bull Mountain Footing drain(no,linear ft.: __) Page 2 Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 -__ Storm server(no.linear ft.: ) Page 2 Subdivision:Polygon at Bull Mountain Water service(no,linear ft.:____} Page 2 Lot no. 3/ - Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 t •0 0 4 Ot i1 1' t Backwater valve 12-53 l —d q /�,/, f_ v Clothes washer 25.02 /�/��^y-' ,\ n'1 Dishwasher 25.02 `S LJj ita-uU Drinking fountain 25.02 Ejectors/sump 25.02 . gtb, ,, . , ,.�gw; 0 ,; :1111R CITY OF TIGARD MASTER PERMIT 111/ . .. COMMUNITY DEVELOPMENT Permit#: MST2016-00258 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/17/2016 Parcel: 2S108DB03300 Jurisdiction: Tigard Site address: 15156 SW SEINE DR Subdivision: POLYGON AT BULL MOUNTAIN Lot: 31 Project: Polygon at Bull Mountain, Lot 31 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 1504 sf Basement: 826 sf Left: 5 Parking Spaces: 0 Height: 30 Bathrooms: 3 Second: 2155 sf Garage: 740 sf Front: 20 Smoke DwellingUnits: 1 Yes Third: 0 sf Right: 5 Detectors: Total: 4485 sf Value: $630,043.56 Rear: 15 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: 0 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: Y 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: 8 201-400 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 4485 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 A Geotechnical report is required before the footing PHONE: PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $38,008.97 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 0 R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: lb - Permittee Signature: /17)e 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. • REC Building Permit Application 0 T 3/ S-1/06 Residential ED a�Y FOR OFFICE t SE OMEN City of Tigard MAY 18 2016 Received �) /� .7 a Plan Re I�� :_ Permit Nc 52V /49 -e9, ; . N . 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie /�`(J Phone: 503.718.2439 Fax 503.5981 t 11 /� �Q ( B as R s Date/By -'Q� �� Other Permui" �L7�� ( I I G A h D Inspection Line: 503.639.4175 t l n r r r z A Internet: www.ti and or. ov ! ' � �+1„ 3 Date Ready/By: /� _�/ i•, kris See Page 2 for g g Notified/Method: Supplemental Information el L. . REQUIREDDATA:1-AND 2-FAMILY DWELLING TYPE OF WORK::; WELLING;. ®New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION ` work indicated on this application. Valuation: (i ' 1� U. ® 1-and 2-family dwelling 0 Commercial/industrial $543;;` 5. �) I ❑Accessory building ❑Multi-family Number of bedrooms: 4 ❑Master builder 0 Other: Number of bathrooms: . JOB SITE INFORMATION AND:LOCATION Total number of floors: M2 c" Job site address: 1 5 1 5(, cs/ , 1 s�(yN A �,. New dwelling area: 4485 square feet City/State/ZIP:Tigard,OR 97224 I/lJ I 1 C� Garage/carport area: 740 square feet Suite/bldg./apt.no.: Project name:Polygon at Bull Mountain Covered porch area: 273 square feet i.5-S + Cross street/directions to job site: Deck area: 160 square feet 7 Other structure area: square feel•i( REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Polygon at Bull Mountain 7n0:: 31 ot no.: 3 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, F WORK work indicated on this application. Plan 1911-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:( ) N APPLICANT 0 CONTACT PERSON' EES* New . . °� i BUILDING,PER�YITI F„ Business name:Polygon WLH,LLC (Pteasere/ectofeesctieif7�. , 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:SOLARFANEL SYS171VI FEES*'`:, ;; t ONTRACTOR tial prescriptive installation of Commercial and residen 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): hone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:204238 „ //� / _ Total fee due upon application: $201.60 Authorized signature: ,/�vJ�[`��/��/(//,,, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Angela Grajewski Date:5/2/16 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application r�)lz orl�l( E i. SE ONE) City of Tigard; Eew PermitNo.: 9/62313125 SW Hall Blvd.,Tigard,OR 9722t� 1V Phone: 503.7182439 Fax: 503.598.1960 MAY 1 O 2 0�6 Date/By: Other Permit: T I G:\K[� Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.govCiTY L_ r Notified/Method: Supplemental Information ,131,11141t1Ci1�P i td$ i lil COMDI�RCIAL FEE' SCHEDI3LE I sE CHSCIQ iST ;' ,, TYPE OF�VOI3K ;. Mechanical permit fees*are based on the value of the work ®New construction ❑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:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist ❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Beating/coohng: /..- n ,/.�;.le Air conditioning 46.75 Job site address: 15 I 5 tD 3(k) S ( , ')C Furnace 100,000 BTU(ducts/vents) ,{ 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt no.: Project name:Polygon at Bull Mountain Duct work 2332 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 Other 23.32 Subdivision:Polygon at Bull Mountain Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 MS I1Kt .DESCRIPTION OF WORK 0M M Gas fireplace/insert 3339 z* Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 2332 Chimney/liner/flue/vent 23.32 Other. 23.32 ..M.PROPER31'OWNER s Mig itAZHAVNiti:4671MitOtalia.PM.4.. Environmental exhaust and ventilation: Name:Polygon WLH,LLC Range hood/other kitchen equipment 33.39 Address:109 East 13th Street 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 _ t PIG t ` ` = 0:4O .CONTACTgPERSOI`T }r ' -:. Other. 2332 L Fuel piping: Business name:Polygon WLH,LLC $14.15 for first four,$4.03 for each additional Contact name:Angela Grajewski Furnace,etc. Address:109 East 13th Street Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace Range E-mail:Angela.Grajewski@polygonhomes.com Barbecue Y' k CONTRACTOR Clothes dryer(gas) ,,.. . Other. Business name:Apex Air LLC .,; • MEC ANICALPERMITFE$ . Address:18004 NE 72nd Ave Subtotal City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee) CCB lic.:203034 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 R��/� days after it has been accepted as complete. Authorized signature: ��/�,%I' - * Fee methodology set by Tri-County Building Industry Service Board Print name: ra e-W S'k j Date: 5 3 I t(p I:\Building\Permits\MEC PermitApp_040113`d6c 440-46 71'(11/02/COM/WEB) , • 1,,‘. r_1 I i it.,., .._ ..,::. .„. • ,,, .. . . , • ... , . El.... .Cic-A 11.f''!..rro4A A' f lien tia EL,t 1 V t D ' 4 cm of t-14-cr.t s-v. _ ..„, Cit*of Tigard 13/2.5 SW litall illvd,Tigard,OR Phone:: 501718,2439 rim: 96 440, 50159722tISEP 2 0 2 016 Received Dafel3y/e/Ae7/0 Plan ReViiW Datellr inspection Line: 503,639,4175 II Y OF TIGAHD Ready Datedaty Internet www.tignid-Or,g0v BUILDING DR/te tr.)),,.- Nottraed/1406,4 III Related Pawn tir; Jia. Supptementni inforination - - •• i?, ,,u'i ,,,,:,',LLI5j:4: iir77i?V;54$.0t--::Q,F,--W-011*.r,',.7-I't,i.:::, ;=:1-:i. ''... ,r:74--; .._-,,,;.;r: r-, t.•.:,.---;•,:,,,:-.-.'.,:yr-,,,•7_,?-7,i-.,1i.0,-g,ioivitiv-4 .,_:-.• - ,0 New construction 0 Additiontalterationtreplacernent Please check an that apply(submit 2.ws of plans Wilms checked): •CI service or rower 400 amps or snort 0 Redding over three stories, 0 De/WM.10R 0 Other: v.-irere e available:Theft martin 0 Matines anti boatyards ., , •, -.... . _. .,,, . . - , • :• .: .-rc-i,--,.,N,,,,r. --,;,.-;-:.*,-*fgAil•gooRy:r4..)r,„cti)NS1110CTIOIi... :7'","'".::_,_ '17,--ri en-cc&10,000 amps130 volts or 0 Floating buildings, . C.1 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building rei..s to ground,or exceeds 14,000 0 Commercial-mu agricultural amps for all other installations, buildings. 0 Mufti-familly 0 Master bulkier 0 Other: 0 Fire pump. 0 installation of ISO KVA or 400-'.$117t:INIttg.MATiti/9..,A/46.1beATIOlit-- -:-., .;._I'-,I•' a EinergtMY*stem- larger separately derived , . 0 Addition of new motor load of- system. Job site.addressiSicis sw se4 ofe arivc, 100.HP or more: .0 Six or more residential units, occupancy. City/StateIZIP:Tigard,OR 97224 r3 Recreational vehicle parks. . 0 Ilealth-care facilities. SUil; Project name:6500A 61,76/1—00 U A fite-v41 (0 flaxaMous locations, 1:1:110!) althita,for more than j -1 ' 10 r 4 4.' g °Sallee or feeder 600 amps or more, 00'..01t.nofthnaL Cross street/directions to job site: '„.„-, . Destription I Qt4'. 1 Each 1 Total i. New residential single-or arida-family dwelling unit. , Subdivision:P019610,11 eilbutil Fmkz,v_;at ,.., Lot#: Includes attached garage. Mx amp/parcel At; 1,000 so,it or less ( 168.54 4 ..f'.':-•,.V1'..'.1:4.-,'....-'•''i"....'ci•57-''..fa''n'r''''."':I/ESC-11-1krt'611•)00:r WORIC: :::'7-'::1±i'...':';::"f''Irf':';.. ''.:fr' '-- Ea.midi 500 sq:ft.or portion b 33,92 I 1 Y) , a el-Dr eihaAlle_- Limited ener&v,residential 75,00 2 (with above sq.IL) Limited energy,multi-family 75.00 • 2 t„...,..:.,.,,it...100101tty:Tivi -:•.tvio,77,:t.':7 T.T.c.,,:t:,..,7:„,-(7,,,,,.,-1,:,,,,,;:,24:11.01.11,4t,:,,r,.;:„ 7z1.,..:2:::, residential(with above sq.fL) Name:may!,Land Holdings.LLC Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Address:7600 E Doubletree Ranch Road. 200 amps or less 100.70 2 • City/State/ZIP:Scottsdale,AZ 85258- .. stops to 400 amps 133.56 2 Phone:(602)694-4031 . I.Fax;( ) 201 a Email: 401 ampsto 600 amps 200.34 2 Owner installation:This installation is being made on prOperty that I own which is not 601 amps to 1,000 amps 301.04 2 2 intended for sale,lease,rent,or exchange,according.to ORS 447,449,670,and 701. Over 1,000 amps or volts 552.26 Owner signature: --,.. . Date: . • ,. ' Temporary services or feeders installation,alteration,andior K-51 ',...:, : -,!ii!,:;t1'710.t.Alift,--!.",':::',..,:: '..-.7-1L''^:_.::.1::*-'1":.:-:_'.'!E141-iofTAtVrEAdt1 ' "'•-•-;-:.• rtioniton Business name:William Lyon Homes,Inc. 200 amps or less 59.36 1 Contact name:Angela Grajewski 201 amps to 400 steps - 125.08 2 Address:109 East 13th Street I I 401 amps to 599 amps 168.54 2 •City/State/ZIP:'Vancouver,WA 98660 • - Branch circuits-new.alteration,or extension, .er panel Phone:(360)695-7700 . I Fax::(360)693-4442 A;Fee for branch circuits with above service or feeder fee, Email:Angela.Grajewski@polygonhomes.com each branch circuit 7.42 1 , bout , f'ffg.t., 4f,iav,x,,*Qt;=pf.itittij..itiutrzito,iT %-",.:-.74,;7,-5,*7:1}:v7F;--,5T.,,,,„ zi B..„Ferevf,oerobrrancieehdecrire circuits : 56.18 2 Business name;alameda electric branch circuit Address:3415 ne44th - Each add'ibrailch circuit _ 742 : 2 . . . . • , Miscellaneous(service or feeder nritincitided): City/State/ZIP: Thr,1 jait„. / -40/Z- /4, 2 iz2--"3 '• Each manufactured or modular --62,4 .. 2 -dwelling,service andlor feeder Phone:(503)3192192 I Fax:( ), • - • Reconnect only 67.84 - - II, • Email:solatpdx®Ine.com :,.. , „ , . ... Pump or irrigation circle 67,84 ' -f i :1 11,'-' ,2---, CCB Lie.: 199188 1 Electrical Lie,: c923 Sum,.Lk,: yir7/...5 - , . ,. , • . ,. -.: sign-or outline lighting :. -67.84 , -2 ....,. Strprv.Electrician signature,required: . ,.. , Signal circuit(s)or limited-energy - Print name: /c.iit, /20,24.,,C, I Date: 5-/Z.1//,/ panel,alteration,or extension. t_d See:Pagallir.' ..q.. Eath additional inspection over alloyiable in any ofthe.1664..---' Additional inspection(1 hr min) - ] 66.2.5i hi Authoriied signature: hr min ' •.:•••..., „. .:- Print name: i Al. -' -------- 1 Date a// I Investigation(1 / 1 90,ocv fir ../. ,.--- ,..:....fc......-- ,... . ' l'auagtio0m.6,11Vg.C_Pennit.App ELR ERE.doc I:4,06/1712013 44046f no rrosecoww-en • . • . : • -- ' .. ,, . ., . ., • Plumbing Permit Application Building FixturesRECEIVER' FOR OFFI( F; ESE O\L1 City of Tigard 12016 RDiTved MAY PennitNo.:/1_f7,20/6•-90,,75."i II Iii 13125 SW Hall Blvd.,Tigard,OR 97223 _ Plan Review V u Phone: 503.718.2439 Fax: 503.598.1960 P 1,Plan Re Other Permit No.: Inspection Line: 503 639.4175 1� (^ j /` - T I G A R D 1-�e[ "f"` -^yy d= to Ready By: furls. 0 See Page 2 for Internet: www.tigard or.gov jl Li_i't e m, ,•..P'c�1s,.r1 tiieldeatthod: Supplemental Information Z ` :t OY WO F_E :SCHH } ®New construction 0 Demolition For special information use checklist. Description I Qty- I Ea. I Total ❑Addition/alteration/replacentent 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CA'11 GORY OP CON1-1101ON SFR(I)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 0 Accessory building 0 Multi-family SFR(3)bath i 500.32 Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 1t,1B.'STt'>la*13OR)4t(ti 4 D t>i 4'tlON ` Site utilities: Job site address: t 5 S W �r. Catch basin or area drain 18.76 Drywell.leach line.or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: ( Project name: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.:_) 7 Page 2 Water service(no.linear ft.:_) Page 2 Subdivision:Polygon at Bull Mountain Lot no.: 51 Fixture or item: Tax map/parcel no.: Backflow preventer „....1.--------31.27 Backwater valve I 12.51 ;,. Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 n sa iPEII:E bW,E1 a 'f>�lkiAfExpansion tank 1151 Name:Polygon YeLH,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:109 East 13`"Street Garbage disposal 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone:(360)695-7700 Fax:( ) Ice maker 12.51 x ,n *�z `a4,''Pi.ICz4tT1P) r t`Ol'4T1�ACT t'EI2St1N �...",. Interceptor/grease trap 25 A2 Business name:Polygon Yr LH,LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Angela Grajewski Roof drain(commercial) 12.51 Address:109 East 13th Street Sink/hasin/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.Grajewskifapolygonhomes.com Urinal 25.02 , , Water closet 25.02 r s- r.._.., . .. ,,s s.,_ Water heater 37.52 Business name:BDL Plumbing LLe 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: 572.50 Plan review (25%of permit fee) CCB Lie.: 180345 Plumbing Lie.no.:PB1582 State surcharge(12%of permit fee) Authorized signature: r�� t ,,, r^" TOTAL PERMIT FEE I Print name:Brandon Lancer Date: 513 1 I c This permit application expires if a permit is not obtained within i80 days I after it has been accepted as complete, *Fee methodology set by Tri-County Building Industry Service Board. I Building'Pennits\PLT4tJ-PermitApp-dor 10/O1i)9 440-4616Tt10iO2/COMAkE13) Plumbing PormitAppliot. ilii'l"ECF '.' Building Fixtures .,, . . .. .. .. . City Of Tigaycl AUG 1 6 2016 ,-.Rotelvea Pertuittqc.: , . *f 13125 SW Halt Blvd. Tigard,:0R 97. .\1 i ,,,.. , Li piZt"'i.ew. IN I_, ;# Rhone: 50718.2439 Fax:: 503:59 . •' '' i . : OtherFermirNa.: T G A R D Inspection Line: 50.6394175 i - - B DING DIVISIO Date Read Anis I Fa See Page 2 far Internet www.tigartVorgov .. isiCtitIciimeihod: . Supplemental Information • ., :::•• •;••3'•';'.4: '.'i:'•?j,N......,, '•'?4•1•Zi'''',,'. 1•1•t1,10'.'rL':::t•-•,bi*011it41.;,,,t4r,- .,g; •.:;.. .71r...,.--- . ,':;i',.. .,.41::: ."''R.,•:'!:'•;Iti'?•'.1'::17:,•cia.iiiiCikjiiii•ag: 14:,';• •'7,7n:..t• •': -',.t.q.e,,LL••-sx-i,-,,,m,t,.4.:i-:',.7,,;-:,:.?„:,i,iz,,,:- ,-:,:..-.:;:,....,... :,,,... .7,-,...,f4.1 ::Al. -z!-In- --,---..,. -:,..;:.::... -.:: ", -,-..: -. : •;..-:::,,,t,-,:•-..,-,-..,,,,,,,:, .,-;,...,, ,,.-:,],,,,,f,-.- :-,:%•:.,-.:' -,:::' • . . .0:New construction I 0 DettiOlitiOn For speeidinformaiipn use Owen& . - • - Description I •Qty I Ea. [ Total • 1 0 Addition/alteration/replacement 0 Other . New 1-7-,famfly dwellings(includes 100 ft for ditch:utility connection) ... ... . iji.„:7,.::<7,;,-.;, ::,Lfin.,,, ,-•;;i,.,,,,,,.:::.94p4k.9 ,341440I,KTs14:u.,,-,::,..,7.-!-::• t-:::,. -4, F (1)bath 31230 El i-and 2-family dwelling 0 Cimunetelailinchtstrial • SFR(*bath • 437:78 . • -. •• : SFR l31 bath 50032 0 Accessory biiilding 0:Multi4'arnily. . - .Each additional bath/kitchen. 25:02 ' 0 Master builder 0004: _ . Fire...sprinkler( sq:ft,) MN Rage2 40jitgil'041r"{..k4E0211144?4*ik,,Cd&Aiiii1NZ-14.:;.>-N-t.,;14-W.:'•:-'.- Site utilities: . • .. .. . Job site address i SID S W Set ' e_ D'- - : Catch basib•pearca draiTa-1 I 18,76 Drywilljeacirlinc,.or trench drain . 18.76- • city/State/ZIP.Tigaed,OR 97224 i . ... Footing drain no.linear ft.:. ) • Page 2 Stitelbhig./apt.nil: Project name:Polygon at Bull Mountain .... Manufactured home utilities .50,93 • . I • • Cross Street/diteetiOnt to job site: ' Mtudieles I 8,76 Rain drain connect or 18.76 . 4..,.... -.-. ,..... . Sanitary sewer(no.linear IL 1. Page:2 • " • .Storm sewer(no.linear.ft:.. . ) I. Page-2 , . . • „ Water service(no.linear IL; ) I Rage2 Subdivision:'Polygon.At Bull Mountain • J Lot t104.. 51 FiXtfite or item: • -•• . Tax mapipareelno.:. Rack:flow Preycnter 31_27 I . •- -- - " -- • ,-- - Backwater valve r'I.F.94-7 :iltnlit'OVIA'::-4)**4P.....470#44A:'''1.'fi-•• •?. ';:Mr.,•. . ',. ,'. :. Clothes: -. . • •. "•• Dishwasher -25 -: - `. . 25.0„. 25.02 f . i . . Drinking fountain EjectbrgiSurap• • 25.02 25..01 . . . jii0.4*,51i.•',: .;..'ii'L : '':;5t'"';-.f•T...:,';:i::•'5':::E:14t.g4J4-4••4:i'-:;•''''-'' Expansion tank - . .. Name:Polygon W4L,LL-C . . Address::109 Eat 13th Street CityiStaterLIpt Vaneauver,WA 98660. Phone:(30)6954700 • Fw,.( ) , Fixture/sewer cap - 1 2.5,02 ' . . . ... FloordrainAlcorsinktfutb . II 2152:::21•I • 1 Oarhaae disposal i 25.02 I Rose bib Ice Maker ,,,.3..,- , mt:044.:.. w;..-,-,*::.:...i :t,t7,::.,,-.4i. ..j-...a41:)84,0-.t:,,,ix $01$74.:. i.i:, 4:ite!ceptpoge4kic trap 25_a2 " 12.51 MESI —i Justness name;Polygon W.L11;•LLC Contact.name:Apge.la.Graleiviki Address:.109 East 13th Street- - City/StatVZTP:.Vapeouy,er,WA-98660 [.. Phone:(360)695-7700 . - ... . • I Fax:.:•060)694-4442 . . -Medieaigas(value:$ , .) —. Rage 2 :, . Primer • 12.51 •- - Roof.drain.(eorrynerciaf) 12,51 Sintribasiritla.vaterV -. . . ,Solar'intit.S.(potable*watery .Tub/shower/shower pan 25.02 . 62.54 .._ .. , .12.51 .1 E-mail:Angela..qrajeyeskireopolygonhomeskcont -Urinat . . . . .. .. ,•,.!,,,.--:• -•,.-,--:.,... ....-;v4,-,-,-,-:-,,,,,E.-4 -k-::-.;••.,M,--._ .__,--:i;•:,...:•'zli,,,h4ii,e,..::::',,,.4-1,,,e,P:,‘,4-::`_'..P.e '',4i.,:r.,:;'!,,,,.'„,',.*321. : Water closet Ati.. r '".:0)MAH::S9 .*: ir:_ --:-.4.2.444:1'..W.•:4§..:'R'411ri lAki.-/Itei.ij6ater. Business name.:BDL Plurnlifog-11.4. .. . .. .. 2502 . ' ' • . „ 25.07 ...... • I ._31.52 .ST 62) . 4...,,- . .Water pipingMWV. -... .. • • 56.29*. r ..Iis0.2t5ot.0424:Address:PO Box 85 . Other . . . .. • • , I City/State/ZIP:Corbett OR 97019 .... . _ Phone.;04451,3903._. Fax ( : ) • ... • Minimurti permit fee $7250 - : -- - Plan.teview p.sy,i of perm*fee) i C .11.1.;ie.f 180345 ' :Plumbing It: no P111582 - .. . . .. ... . . :State sine:barge(12%Of permit fee) ..• . . . Authorized Signature: • 140.6e— TOTAL RERMITr.FEE I . .. . . . . Print name:,Brandon Linter pate: 8 it, This permit application expires If a permit is net ah(hingil It!OM ISO days .. - /110 . ... itt2er illtax.bgen accepted as iontplete. *Fee methotMluev Set kt,,Trt•Countyf3yilding Industry service Beard. 1,:slikOldin4,,PormitsTLMET,Permit.AppA .cc 10/01/09 440461611fOlaigaMM511) Mechanical Permit Applica 'On FOR OFFICE USE ONL1 i4 ffi EEL ' nWgar ,® ' D �O ( 14) PermitNo.: de13125SWHall BlvdTigard,OR 97223 l plO Phone: 503.718.2439 Fax: 503.598.196 U DateBy: Other Permit: TIGARD Inspection Line: 503.639.4175 G 2 2 2016 Date Read B Anis: Internet: www.tigard-or.gov r` �y Ready/By: Supplemental See Pen2 Informationfnt tr��1�'� Notified/Method: BUILL3j `ARD o TYPE ETF YoItit :CiO .RCIAlr IEW SCHEDULE— IS"E ('iti CST Mechanical permit fees*are based on the value of the work ®New construction ❑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 $ =,__.^ C4LTEGQRY OF CdDIVSJBtfLJJ[Q71T RE W TIALEQilICME1VT(SYSIEM pJES*-_ ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. I Total 30B S1TE INF RIti_ r13t t:0 ,tom T,pCA.T OI1) Heating/cooling: 'sisU V Air conditioning 46.75 Job site address: Q 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.: I Project name:Polygon at Bull Mountain Heat pump 1 61.06 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 I Lot no.:3 I Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 Gas fireplace/insert 33.39 - _,�- F...-. II�5CR1PT1'OI`T Q�R++OIi ,-_:., .._.:- °a Flue vent for water heater or gas Change 2 furance for basement to Heat Pump fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 cr4 4e _ .__.. _ ._ T...__:iA.._. .' 23.32_ , _ _ EN� - Environmental exhaust and ventilafion: Name:Polygon WLH,LLC Range hood/other kitchen p e ui 33.39 Address:109 East 13th Street equipment 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 l- .. ' NT i' _ Other: 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 I Fax::(360)693-4442 Fireplace Range • E-mail:Angela.Grajewski@polygonhomes.com Barbecue . , .; .. *; ,{fN-V:itq B : r ..P,, Clothes dryer(gas) Business name:Apex Air LLC Other: Address:18004 NE 72"Ave Subtotal City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00) Phone:(360)342-8109 I Fax:(360)326-1769 Plan review(25%of permit fee) 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 Tri-County Building Industry Service Board Print name: I Date:8/22/16 1 I:1Bu�7ding\Permits\MMEC PeneitApp_0401(3. oc 440-4617T(1i/02/COM/WEB) . Al:echaltital Perfilite.. FOR OFFICE 1 SF:(Y\LI Of Tigard CEIVEE) •:: R,.-,-.4 ..... ,, Dalats1r ;21312$$W Hall Blvd.,"lipid OK 97223 SEP 20 2016 1111 PIan.Reviaw ptionc.: $03.713.2439 Fax: so-3398.1960 offi.Paaufi: Data,11y ...:: . „.. _ _ T/GARD qnsriclion tja.e: 303,639,4175 CITY OF TIGAIip Date Ready91,,:. , l'arir , :RI Sea Page'2,'car ._„ .. ....._ Iiituraut.: www.tigard-ocaov BUILDING DIVISInt, WatikilNiethaci: Supplamtatainfortaatiari. ... • . -- TYPE OF WORK . ...- •- . -: - •• . • :::: •CONINIPU7141,FEE*$ctriefirtE •115E'CHECKLIST • .., ., . . .. ,• Mechanical permit fees*are based on the i'aluc of the work NeW&in:Stfiction 0 A tlditionlaiterationfregiacement • perfOrtnott Indic-me the t*Ine(rounded to tho=test dollar)era 0 Demolitfon 0 Mon mechanical materiale iii anern„labor,osvibta(1,and .mat, : .:' ' -•:' . ' •••. . 't TkIBRY (4 CoNgiiitiCill3N ;':.•' ''' '':1 '-::•• ' ' '1 aillillIllIlliIllMSIIIIIIIIIIIIIIIIIIIIII -.:. :.: ..: ', : . - - - -:,• 4 • ' . ' '• ', ,•••• '. .• - - .,•':: : ,: . RE, 11)ENTIALOilirtleVilSYSTEUS iiES* EI i-and 2-family dwelling 0 Commerchillindwifrial 0 Accessory building j For sped&iilformation mYe chey:04-4 Multi-linnily 0 Master builder 0 Other; i f...)mifitition ' .0-Y- La. 11111211 .. .. . ,.-., . . . ,. .. , Mall*kaolin•r I : • ,y.•• :'". . _ JOE SITE WFORNATIQN ANDAQCATION ' . : - , • ' •- nil 1 ,,-- . Air eoaditionin Job situ address: I, 5%f 6 • . • . ronaiii00,000011J-docuhm6 1111111=1=11 ii," cityistatezip,i:iptril,OR 97224 . Furnace IMMO+BTU tiltichvvcautl: IMMIIIIIM ...— Suitufbidgiapl no.: Projuct name,:Polygon at Run L.Nfouritain 1111,1111111111 Duct work Crass /directions to job site-: • lbodionia.kotivater yam IrEU11111 Residential boiler'<radiator or . - Ellall inidronicl Unit heaters trbei4yoe„..not etectricX 1111 in-wati,tri-ilud su.....tdcd etc. i rnlffrrrEMEIIIIIIIB 1_, iIIIEIIIIIIIIIIIIIIIII „ . . Oiliar • 71:32 Subdivision:Polygon at Ball Mountain Lot no 3 1 - . ....,Mel* ilixtmess Tax ituipipafW au,: REMEE1111111111111111111111111"45 :'23ALJ ••••• .'". . ::.. .. :,. ,. .::: .. DESCROT11324F'OF WORK :- . -::-j ':: -. -: :,:!, i ' Gas Ike 1•liceillnerl kill 4339 ./ h COntrartnir ar)96 Flue vent the niter heator ragas t /1,olace in lit,ferreast . 13...."•,; ' : . \ . Ci ___ . -: renffersimm ..,,,,,..,:n.....s,. alii 7 ..32 .: I ...... Chiraneviiiinalfluelveni IIIINICEI iiiiji.i.Eifk'bitttf,. .. , 1 • '''--- r.I•tE.NA7..4T ,: - . IrEal11111111111111.Namurome rm„...,toi exhaust and sylitilutiont - Name:EttWon WLIE LEX i Ranee heedloftier kitchen I IIIII V-- _ . .. , ; • 1 fliVII Atittres's:Itt East 1r Street I 33 ' .V Clothes Myer exhaust .3- City/Statuf4P:Vanteuvur,WA WO 1 Simehlbet exhaust(batbroonts, flf taut coo_amoirls„.•arks,moms) 2132 V Phone:(36069$-7700 Fax:( ) •Allieferawis 'ec rang 2132 • ' -':f' '''':'P.,* APPLICANT,:'1- " '''•' ' ' ':0 CONTACi:Pt/1SO ,„:„.„N' l.,• . • ' •'-'wer: Business:name:1'04%00 W141,1.4,,C i k t , ....." „ .. , $14,35 for that haus$4-d0 for each additional ''' Contact name:Angela Grajewski .. rnt!UNIIIIMIIIIIINIIHIMIIIMIMIIIN Address:14)9 East 1301 Street : • Ges f101:' :' lIllnllnrllnNl . . : mall ode nit beater Cty/5tate/4P:Vancouver,WA 98660 MIMI Phone:<360)69S-7100 f 1ax::(36.0)69--.34442. ! , -,E11111111111111111111111111111111111111111 . Ill 13-vaiit:Angela:Cr ajewskrkpolygorthuntes.enin Burhoota ' -..'-.:',':„.:.:::••••.-.. -,-.'•:::1.: '-:''.. ,.." '.'.: :'. ,•::::•fttllyfifft,ACtOti :.-.-. : . :• ': ‘..... . ' ': ' ••• , ' : CIPthes Ow teRls:•• • 11111111111111111 Bualness name:Apes Aft LLC • '•' ".: NEtlIANitAL.PERMIFFEt4', •: '••, • Address:'18094 NE..7r4 Ave Subtotal 111111.1111 CitylSiuteZIP:Vancouver,WA 98686 Mama nermittee($90,00) , Man review(25%urptuatit feu) , Phone:(360)3424109 I Fax:.(360)326-170 C OB 0.0,:;.203034 - . Statesureharge 02%or permil fee) 1 ' TOTAL PERMIT WE I 31ãpiontit optic:Allan evira if&l*aait•-.4 eat ataaia ell 14.6661 150 dmesaitarithas&art air:440 at rotapicia. Authorized signature: - * Fee roe logy seil*Iii-Ciaisty6ildiag aula4ay Ser board Plrtnrt i!"--------- 1 4",.. - -.,1- . I Ii Dam: 4'1114*, . 1 tuhadir,57p,,,,,,i,,,..mrtiymeitApp TAW f3,4mt 444-16:',7T i ir,'..2X.IYMACEn.i City of Tigard it COMMUNITY DEVELOPMENT DEPARTMENT T r c n rz D Building Permit Review — Residential Building Permit #: /i,S-% ,f 6 7 Oe, ?- Site Address: S 1 S(0 Sw r-e i ne, D r. Project Name: pot y o n v,+ 1:3 U I 1 K4 co v nt,cl',v h Lot #: 31 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: Nem.) S c- 12 Verify site address/suite# exists and active in permit system. l River Terrace Neighborhood: ❑ No IZT Yes,See River Terrace Review Addendum Attached Site Plan Elements: ?Three(3)copies of site plan -1;1-Existing structures on site /Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished /Drawn to scale (standard architect or engineer scale) floor elevations North arrow tility locations (required for new,may apply for additions) Site address,project or subdivision name and lot number Location of wells/septic systems /Applicant information(name and phone number) /Erosion control(including drainage-way protection,silt fence /Lot dimensions and building setback dimensions design,location of catch basin,etc.) %Lot area,building coverage area,percentage of coverage and c2t treet names impervious area (applicable if R-7,R-12,R-25&R-40) /Street tree size,type and location /Property corner elevations (2 foot contour lines if more than ❑t,xtsting trees to be retained with drip line,and tree 4 foot differential) protection measures gr Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No gi Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake Land Use Case#: S Lig 2.o I S - 00002- Zoning: 000ZZoning: R- Setbacks: Front tO Rear ( 5 Side 5 Street Side I S Garage Z.0 Landscape Requirement: 0/0 7 Lot Coverage Maximum: Building Height: Maximum Height 3 0 Actual Height 3 0 ee Visual Clearance —Easements -EI—Sensitive Lands: ❑ Yes ❑ No Type Zr Urban Forestry Plan ❑ Conditions "Met"prior to issuance of building permit Notes: Cpnclit uns -h' be ret- priOf' --o sIssv nc.., oc- bviloUnc� Perm.-F Approved By Planning: 11/1 o n� 131 t o o(.e_ t-. Date: S� I c3 / I (o Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Forms\BldgPennitRvw RES 012116.docx Building Permit Submittal Original Submittal Date: �/4f7%fo Site Plans: # 3 Building Plans: # 3 Building Permit#: ®'Enter building permit#above. Workflow Routing: [Planning [I -Engineering L -Permit Coordinator Building Workflow Sign-off: g-Sign-off for Planning(include notes from planning review) Route Application Documents: -'Engineering: (1) copy of permit application, (1) site plan, (1) building plan and , original plan review routing form. [ /Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. , Notes: By Permit Technician: Lely Date: 6//7/,,� Engineering Review Slope at building pad: .Z: 11,:. 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: ili- __.1J Date: 11-go-11:, 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: 11SDC Fees Entered: Wash Co Trans Dev Taxes ❑ N/A / Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A OK to Issue Permit Approved by Permit Coordinator: Aff< Date: ///°/% 1:\Building\Fonns\BldgPennitRvw_RES_012116.docx 11111 City of`Tigard 4 COMMUNITY DEVELOPMENT DEPARTMENT River Terrace Building Permit Review Addendum um. - .T 4 :: < ... .. - .. is $, Building Permit #: orif7,2cr/6 -eQ, Site Address: 1 5 I S C:, SW ..i(IQ, Dr. Project Name: Po 1.. yo oi-1- (3v11 Moorli-ri; r Lot #: 31 (New dwelling=subdivision name;addition or Alteration=last name of owner) Planning Review River Terrace Plan District Design Standards (18.660.070.1): Is the project subject to the plan district design standards? ❑ Yes /No 1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional element required for lots with over 60 ft. of street frontage shall be provided every 30 ft. Porch min. 5 ft. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft. wide Gabled dormer ❑ ❑ ❑ ❑ ❑ 2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors. N/A- Percentage Shown: 3. Entrances:At least one entrance must meet both of the following standards: CI Parallel to street, angle no more than 45° from street, CI Max. 8 ft. setback from longest street- facing wall or open onto porch Entrance opens to a porch: ❑ Yes ❑ No If yes, all the following apply: ❑ 25 sq.ft. min. ❑ One street facing entry ❑ 12 ft. max. roof above floor of porch ❑ 5 ft. depth min. ❑ 30%min. porch roof coverage 4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades: ❑ Covered porch min. 5 ft. wide x 5 ft. deep ❑ Recessed entry area min. 5 ft. wide x 2 ft. deep ❑ Wall offset mm. 16 inches ❑ Dormer min. 4 ft. wide ❑ Roof cave min. 12 inch projection ❑ Roof offset min. of 2 ft. ❑ Roof shingles either tile or wood ❑ Gable,hip or gambrel roof design El Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 ft.wide ❑ Accent siding min. 40%of street facade ❑ Window trim min. 2 1/2"wide by 5/8"deep ❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft. wide by 2 ft. deep ❑ Balcony min. 5 ft. wide x 3 ft. deep with inside access ❑ Attached garage is 35%or less of street facade 5. Garages and Carports:May face the front or side lot line on a corner lot. Setbacks: No closer to front or side lot line,than longest street-facing wall. ❑ Yes ❑ No. If No (Check one): ❑ May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch. ❑ May extend up to 5 ft. where the garage is part of a two-story building and there is a window at the second story above the garage that faces the street with a min. area of 12 sq.ft. 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: M 0 m 1 A3 i( O 612 ci Date: S/ 19 1 ( So I::Building,Forms,BIdgPeantR,,_RES_RT 031416 docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15156 SW SEINE DR, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2016-00258 Inspection Type: Inspector: 699 Mechanical 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: 15156 SW SEINE DR, TIGARD, OR, 97224 August 22, 2017 at 11 :25:02 AM Record Type: Record ID: Residential - Master Permit MST2016-00258 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Corrections from previous inspection complete. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15156 SW SEINE DR, TIGARD, OR, 97224 Record Type: Record ID: Residential - Master Permit MST2016-00258 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS Comments: Violation Summary: Inspector Contractor FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building depai bnents in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT . Transmittal Letter 1111 TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tom H. DATE RECEIVE,p• DEPT: BUILDING DIVISION l t i P MAY 17 2016 FROM: Angela Grajewski/Chris Walther CITY OFTIGARD COMPANY: Polygon Northwest BUILDING DI ISION PHONE: 503-312-6213 Byt RE: 15156 SW Seine Drive MST2016-000 ? M -1-2,\\q-C (Site Address) (Permit Number) Polygon at Bull Mountain LOT 31 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: F , , a i 4. npti®n• 't j opies;, 'i'.Dec ph/ &, t. , ,,, mss :!. 4,- 0 Additional set(s)of plans. 3 Revisions: WIC/4th bath change 0 Cross section(s)and details. 0 Wall bracing and/or lateral analysis. 0 Floor/roof framing. 0 Basement and retaining walls. 0 Beam calculations. 0 Engineer's calculations. 0 Other(explain): REMARKS: Removal of 4th Bedroom bathroom into Walk-in Closet Routed to Permit Technician: Date: -7_0: 4 Initials: Fees Due: !1 Yes ❑No Fee Description: Amour aye ," J P1G� r .vr.�,! $ Gid txli Special Instructions: Reprint Permit(per PE): ❑ YesNo ❑ Done Applicant Notified: Date: Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012