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Permit (42) CITY OF TIGARD MASTER PERMIT 111 q sly' COMMUNITY DEVELOPMENT Permit#: MST2016-00527 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/23/2017 Parcel: 2S106DB11800 Jurisdiction: Tigard Site address: 17430 SW SHADOW TRAIL ST Subdivision: RIVER TERRACE NORTHWEST Lot: 118 Project: River Terrace Northwest, Lots 118 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 1254 sf Basement: 735 sf Left: 3 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1655 sf Garage: 464 sf Front: 8 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 3644 sf Value: $438,503.56 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 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 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'500 sf: 6 201-400 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: OTR SF VB R-3 3644 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 2 One Hour Fire Rated Eaves STE 1 Required at fire place SCOTTSDALE,AZ 85258 3 Geotechnical Inspection PHONE: PHONE: 360-695-7700 Required before foundation FAX: Total Fees: $35,774.59 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: .146 ° ,71-(__. Permittee Signature: ,'91-90/96--"/(7, -./'-/e)/(,/ Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project Approved plans are required on the job site at the time of each inspection. Building Permit Application® �. ' / / r • g$S)w £n RECEIVE FOR OFFICE t SE O\Ll RCity of Tigard 0 C T 11 2 016 Date/By,:: /A/7 2/7 /�' ,�'r•. Permit N S�r /1/�i ©(���! ■II ! 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review) tomer Permit:S 12�7CJ� Phone: 503.718.2439 Fax: 503.59 Plan Re: w)a.+�j .+)C f Inspection Line: 503.639.4175 i°'°" ° OF T)Gr R Date Readymy: Juns H See Page 2 for I R'\R I� g g BUILDING I LD I N DIVISION Notified/Metltod:7 j� Supplemental Information Internet www.ti ardor. ov i�!e.:i /� pp ,g//-. E •! " l : '� a + tfie ' lt €l ®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 ,� - - ' work indicated on this application. ® 1-and 2-family dwelling 0 Commercial/industrial Valuation:43 S o3$ t,.4-TTs-3t).„, c , ❑Accessory building 0 Multi-family Number of bedrooms: 1..1 0 Master builder ❑Other: Number of bathrooms: ] a . 'a'` :-7 : -. Total number of floors: ti/O f /� l/ Job site address: I1 u SW Shadow Trail St New dwelling area: 3c0 square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: 4 _����1 ' square feet Suite/bldg./apt.no.: I Project name:River Terrace Northwest Covered porch area: 'Tu`',t square feet Cross street/directions to job site: Deck area: I(r.0 s e square feet Other structure area: square feet Subdivision:River Terrace Northwest I Lot no.: ` I a 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 e profit for the _ - . € . work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet . r s a Number of stories: Tame:ADVL Land Holdings,LLC Type of construction: Address:7600 E Doubletree Ranch Road Occupancy groups: City/State/ZIP:Scottsdale,AZ 85258 Existing: Phone:(602)694-4031 Fax:( ) New: Business name:Polygon WLH,LLC Structural plan review fee(or deposit): Contact name:Angela Grajewski FLS plan review fee(if applicable): Address:109 East 13th Street City/State/ZIP:Vancouver WA 98660 Total fees due upon application: Phone:(360)695-7700 I Fax::( ) Amount received E-mail:Angela.Grajewski@polygonhomes.com Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic 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: $201.60 Authorized signature: _.24,` l i /1 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. t name:Angela Grajewski Date: eii -K I k *Fee methodolBoard.ogy set by Tri-County Building Industry *•\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit ADP 1,r--- k, it-- liCatilikE(a i7.71**4 t-".IIIIIIIIIIIMIIIEIOillIllM 'City of Tigard . ,,, ,,,4 r, Mealy: Penne NeMSlibiti)-1)6C52:1 ,- : 1312.5 SW Hall Blvd,.Tigard,OR 97223 n[C, 2 i, tu 1u pj,,Revicw ' Phone: 503.718.2439 Fax: 503.598.1960 '' Datenty: other Permit. Inspection Line: 503.639.4175• ' —00 Dote Rerviy/0Yz h.i.' 0 See Page 2 ktr 'mance werw.tigard-orpv CriN OF TIG1-1,ht . ficda4 ot Sapplenitmal latarrnation • SUILDING OMSIOW en' ,-•",''. .;"°--,..,i'i.,'''s;:".7 t.....,-05-1...,..„,,,'7" ,-''r...-:„.'; f,_"?.1,,,„...-:""n.,- 'i,..,iyi.:,.. -' ..„,„.„„,:.,„.'.,,,,,,,,,,_..,,t,„!„.:.,„,g,...,...„.1,...,.,-;',..-.,iii,...„'„3,,,,,;;1„.,“ ,,,c,,-ezig,„",„,.'„,,...„,-..,4,-,...044.,-„,„,--...,•„,„A.p47",...; ,,:„.,,„.„...,,,-„:„.,:„.....1„..--,"„........:„"?,„„.,.-_,-....----,s,„,..,...,-,,,,t...„,a. -„-art. ',...VIk i'..-!'...:•:•'*,-1,-.EPt'Z'';'''''..`-' -1..,-,I.'''''''741''''-'" '' -''''''''''"" '''*'°'''`' ''.&:'''-'''"' '''''''''rr.''2''-''''''''''.'-' ' '1.-r ' Mechanical permit fees*arc based on the value of the work El New construction 0 Addition/alteration/replacement perfonned.Indicate the value(rounded to the nearest dollar)of all mechanical materials,equipment,labor,evedread,and profit. 0 Demolition El Other Value:$ t„.",t57,02,:''.K.f1;1!:S,",13.'-...',.?..:',:'' ? I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building Far special Informailom MSC chedcast Multi-60111y 0 Master builder 0 Other: Dt.„.4eriation I Qty. ! Ea. 1 Total '''`''1" '-341''''''''''''f- Air conditioning 1 46.75 Job site addrms://14 61) S srfir.(Ated ((UI &h Furnace 100.000 BTU klaetrovents) 1 46.75 City/State/LIP:Tigard,OR 97224 Furnace 1001140+BTU frhyristvento 54.91 Heat pump 61.06 Suiteibldgiapt no.: I Project name:144t,r TetY? 14 Orttquje_t\--• Duct work 23.32 Cross strc.clidirections to job site: llydronit hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type.not electric), in-wall,in-duct,suspended.ale. 46.75 Flue/vent ler any of above I 23.32 Subdivision 1Z1VeorlberaCe., IQ artifItAk-St I Lot no.:1, kb Other; Other fad appliances: 23.32 Tax maptparcel no.: Water heater 23.32 1 33.39 Flue ventr hater or fireplace 23.32 Log lighter(gas) 23.32 , Woodlaelict stove 33.39 Wood fireplace/insert 23,32 CltimnevIlintattludvent 23.32 23,32 c':',..;'14.'..-;;.r.,',fr:2-a`,If";.;.`,,4..1,.'4g,f--vi:.':-7.1!..4,:....t±4";,k;ra.'-',E,?17::,--.;.T.:::'27,-'"',.'1.:,'.':t:', i-,-'1,t,41',,..;•;,-'4:":".f,L"t.Z....".1-. .,:. Eavira„maatal comas*.and yeatustiam Name:Polygon WIA,LLC Range hood/other kitchen 1 equipment 33.39 Address: 109 East IP Street Clothes dryer exhaust I ... 33.39 Sing1cAuct exhaust(bathrooms, i 1_ ChydSisder,CIP:.Vancouver,WA 9E660 toilet compartments,utility rooms) —1 23.32 Phone:(360)69S-7700 Fax:( ) Anicknovlspace fans 23.32 Other: 2132 Business name:Polygon WLII,LLC $14.15 far first foal$4.03 for tech additional Contact name:Angela Grille-wad Funiaoe.etc. 1 1 , Ons heal pump Address 109 East 13th Street .1 i,Yrdllsuspendediunit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695.7700 1 Fax::(360)693-4442 Fireplace I Range 1 E-nutil;Angeltalrajewski@potypnhontes.com Barbecue '.:1„:: clothes dryer(gm) _':,...".._,t,. ."__.:". .,...:-,1,2"::. „,-. -1„ .,:st.,... --Y -t-', ::-_ .. .....,..:::,-;!...L.:,'"!'.'-...-....!,'....i• '..::.._"-:I Other. Business naMe:Apex Air LLC 6:t.:-.c-c; Z;i173:1.';',1,-;-7.,,,,,,,,7-:.;,;77-N,-,:-T,,-;.„..,; Address: 18004 NE 72 Ave Strhurbd Minimum permit fee($90.00) City/State/ZIP:Vancouver,WA 98686 Flan review(25%of permit fee) Phone:(360)34124109 Fax:(360)326-1769 State surcharge(12%of permit fee) CCB be.:201934TOTAL PERMIT PEE This Peredr sago:ad=expires If a permit is der obtained vitbla 180 • days atter it bee been accepted air .°staple*. Authorized signature * Fee methodology set by Tri-Coutny Building hidestry Service Board .e.-*-------- 'Perri name: i t es,„ Date: ,I„tl,tr„. i‘auilo*r...004-c_pet,,,o.pp_pint is doe 44-4617TtlifOliCOMAVPX) , Electrical Permit Application FOR OFFICL I_SP ON L) 82.010 City of Tigard �E� ' ►,• a ► 1►', 1111 13125 SW Hall Blvd.,Tigard,OR 97223 - f',7:,„3,•A "ir.' Phone: 503.7182439 Fax 503.598. 9( , Inspection Line: 503.639.4175 `a 1 i t I n.N G D ' ' " passe 7'1 rn t:D Internet www.tig,ard-or.gov NotibedAderhod. T 2'..,:,("^- ::::, y-1; ( .citig7 n__, c R-7 r = -e rr,,' a sp . ,s- ; ®New construction [l Addition/alteration/replacement Pleas check all tlmt apply(submit Zeds of plans wfmms checked): a service or feeder 400 amps or more 0 Building over linea sickles. ❑Demolition Q Other: where the available fault owned ❑Marinas and. ✓ boatyards. ' : Y ^d:;r rzx j.Z^, 3 t3 41.7? ;li lc?, (ria r..,'?, .. ..--;`' os : sa „- exceeds 10,000aaxspsat 150 volts or 0Floatingbuildings. :• " c'I` less re ground,or exceeds 14,000 O Commercial-tme agricultand ..TA 1-and 2-family dwelling 0 CommercIal/iridsistrial ❑Accessory building maps for ell other installations, buildings.• Multifamily 0 Master builder 0 Other :Wire pump. ❑Jnsmllation of 150 KVA or `;"a ❑Emergency system. larger separately derived -'=.'�c• v;, Co 9 i,, .i�;'3P�—.a%�i`.'zQu i:re da. V1—ar °'U, c^'Kcr kms. >:�'f =5a_.�...�..rZ; �2��j 1,,,. ❑Addition of new manor toad of Job#: Job site address'',14 4) SjJ s 1 ad )rr[A,,,i S -. Iorep or morn. ❑"w",• ,`I-z•.�1-a". o Six or more residential amts, oocePB**y City/State/ZIP:Tigard,OR 97224 ©Health•-este facilities. a Recreational vehicle parks. Suite/bldg./apt#: ( Project name'R,w4' .�• ❑Hazcdass locations. ❑Supply voltage for mora thea r-T �, N�i vy��! a Service or feeder 600 amps or more 600 volts nominal. Cross street/directions to job site: 4 �n •� z-` s.'P s 1-.1 :r i 1.a'�{ 3,_ A':-�K ' owniptea Qty. Bab Total New residential single-or multi-family dwelling unit. Subdivision:RAI:IT-rt pftJlfe No(*tAJ It Lot#: I16 Includes attacbedgarage. 1,000 sq.R orless I 168.54 4 Tax map/parcel#: Ea,add'I 500 sq.8.or portion33.92 1 -;•,=',21,?, ,'., '� r isa As`'''i ''"A a p0' = _ ?::::k"..'":: '?' Limited'INTRA residantiai 75.01 2 (with above s4.RI , Limited energy,multi-family 75.00 2 residential(with above sq.ft) , 0--‘0,,,v cralenble Energy 0 Set Page 2 iyvyaaN .` mss,i� -•, . em t Fr-7••'$qvi 3 . .E+5x ., - . w,c � _r» ill, +x . 2 ,—, Services Or feeders Installation,alteration,and/or relocation Name:AVM Land Holdings,LLC 200 amps or less 100.70 2 201 ampatss400art$us 133.56 2 Address:7600!S Doubletree Ranch Road -401 amps to 600 amps 200.34 2 City/State/LIP:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 55226 2 Phone:(60x94.4031. Fax ( Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. .201 amps to 400 saps 125.08 2 Date: 401 amps to 599 amps 168.54 2� Owner signature $ranch circuits:inn::alteration,or extension,per panel s;:i4: . �Z1fY Z l'; k • x .? `` :� m.F.s ap` . ?•..'�., ma y A.Pce for breach caecums wide Business name:William Lyon Homes,Inc. above sexvit c or feeder fee, 7.42 2 each blanch circuit Contact name:Angela Grajewskl B.Fee for branch circuits without service or feeder fee,first 56,18 2 Address:109 East 13th Street branch circuit Each add'1 tunnel circuit 7.42 2 City/State/ZIP:Vancouver,WA 98660 Miscellaneous(service or feeder not included) Phone:(360)695-7700 ' I Fax::(360)693-4442 Each manufactured or modular 67.84 2 dwelling,service anditr fbeder Email.Angela.Grajewgki®polygonhomes.com Rammed only . 67 84 2 .?.'„ • .•• 1f.. _ pGI., '1-;:Jf „ - , . tamc a a; ; r Y ta.. __3"aar ` ., .Yti ,e ...1 ,-c ,. ,,z. Pump or irrigation e 6784 2 Business name:Garner Electric Washington,LLC Sign yor outline lighting _ 6784 2 Signal circuit(s)or limited-energy x,.,;, 0 Sec Page 2 2 Address:6101 NE St Johns Rd panel,alteration.or extension. Each additional inspection over allowable in any of the above City/S'Me11TP:Vancouver WA 98661 Additional inspection(1 hr mill) 66251 hr Phone:(253)320-1657 Fax:( ) Investigation(1 br min) 90.00/lir Westin/plant(i hr mut) 78.18/hr Email:bdatiiels@gwens a.comhrspecpons fix which as fee is 90.00/hr .. CBC Lie.: 01158 Electrical Lie.: 208174 3uprv.Lie.: 4496S s 3 , , listed(r/hr mice _ � ; 13 � 7 , t 1.r ,)yR r_ ', , : i Suprv.Electrician sighstore,teqaired• ` . Subtotal: fii Print name: Joan P Albert Date: 4/26/2016 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): ';«;s: TOTAL PERMIT FEE: �s•,; Authorized sitgoa(lre: ;:.-,: Tbts permit application expires if a permit 1s not obtained within 180 •'s:.,':i Date: 4/26/2016 days after It has been accepted as ramp/te. Print naive: Bill Daniels $ Number of inspections allowed per permit. e,,1 k.'laallt. PenoKsRELC PnmltApp..ET& Ldoc aev06t171So15 4404415701/a5/COM/wEa � w4. c-i:i:: Plumbins Permit Auplicatiol E Building Fixtures City of Tigard DEC 2 8 2016 ReceivedPermis No. 1111 13125 SW Hail Blvd.,Tigard, [OR 97223 p {� i" ') �`l`� l - IM ■ Phone: 503,7182439 Fax 503.598 ,•,`` S t :! ,A x Other PermitNo,: Inspection Line: 503.639.4175 4 ,NYew ei Sea Pare 2 for n i s n Internet: www.tigard.or.gov 0 9)I/._ / ;' i 7�'''YBp mt:•• Supplemental Information ®New COzukuction ' '©Deni lition For spade!faloraaaflon use checklist Description I Qty, I Ea, I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) •CATEGORY OF GQNS')R*JI'TION'" : . .. ' • . SFR(1)bath 312.70 j 1-and 2-family dwelling ❑Cornmereiallmdushial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 50032 r Each additional bath/ldtchen 25.02 ❑Master builder 0 Other: Fire sprinkler(„ ,,,sq.ft) - Page 2 'd0%SITE INFORMATION•'AND LOCATION•. Site utilities: lob site address: /-7 bO SU'} S b fJ [�om:res, Catch basin or area drain 1 76 Drywall,leach line,or trendy drain 1&76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bidgJapt.no.: Project name.•R6t/ r Ttnrace No filo est Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear it:__) Page 2 Storm sewer(no.linear ft: ) Page 2 aIV `� Water service(no.linear ft: ) Page 2 Subdivision. ,ive,Y¶f 1 iart Nv1Ivy 1 YIWesj I Lotno.:•j I Fixture or item: Tax map/parcel no.: Backflow preventer ( 31.27 • DESCRIPTION OF.WORK, • Backwater valve 1 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinldng fountain 25.02 Ejectorslsu p 25.02 I•yROPERTY OWNER • . • I • p TENANT Expansion tank 12.51 Name:ADVL Land Holdings,LLC Fixture/sewer cap - 25.02 L 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 CI CONTACT PERSON• Interceptodgrease trap 25.02 Business name:William Lyon Homes,Inc Medical gas(value:$ !) Page 2 Primer • 12.51 Contact Warne:Angela Grajewski Roof drain(commercial) 12.51 Address:109 East 13th Street Sink/basWtavawry 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)6934442 Tublsbvwedshawer pm 12.51 Email:Angela.Grajewski(a)polygonhomea.com Urinal 25.02 Water closet 25.02 • QONRACTOR Water heater 37.52 Business name:Malmedal Enterprises Inc. Water piping/DWV 56.29 Address:PO Box 207 Other: 25,02 City/State/ZIP:Banks,011 97106 Subtotal Phone:(503)324-0759 I Fax:(503-)324-OSSO Minimwn permit fee:$72.50 CCB Lia:102535 Plumbing Lia no.:34-276PB Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: (: ' TOTAL PERMIT FEE Print name:Carolina Mafinedal Date:04/25/2016 I This permit application expires If a permit isnot obtained within ISO days seer h Fres been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. 1:19uafing1PmmitoPLMU-PmnnApp.doc 1010IA9 440.4616T(I01021COM.WEa) la11, City of Tigard 0 q COMMUNITY DEVELOPMENT DEPARTMENT r 1 c n.RD Building Permit Review — Residential '. v664-,,,,,,,.... .....,,,..2..,....„......t-,.,1'. _;c.:.. -s. r. ^. -aaaxs "a.. �441,Vv Gera, _a. ..,.. 4,1 ,,,,ti,? k4 ., Building Permit #: /757-,20/4 -• (90...5-;2_.7 Site Address: /9L/ ) gtO 94,21 ) -770/1 S Project Name: ji/ef� rcc9 ee AJe2t-t Lot #: //8 _ (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: Ne. ) .2fie erify site address/suite#exists and active in permit stem. P River Terrace Neighborhood: CI No Q Yes,See River Terrace Review Addendum Attached Sit/Plan Elements: A xee(3)copies of site plan C sting structures on site fr e plan must be on 8-1/2"x 11"or 11 x 17"paper 1h ootprint of new structure(including decks)with finished rawn to scale(standard architect or engineer scale) or elevations rth arrow tility locations(required for new,may apply for additions) 1pto address,project or subdivision name and lot number 0'. cation of wells/septic systems plicant information(nae and phone number) '�,:sting trees to be retained with drip line,and tree t dimensions and buildinmg setback dimensions otection measures L�ILot area,building coverage area,percentage of coverage and eet tree size,type and location pervious area(applicable if R-7,R-12,R-25&R-40) Street names Property corner elevations(2 foot contour lines if more than 4 foot differential) �tlean Water Services-Service Provider Lett of platted prior to 9/10/1995): 1 0Pequired: Yes,applicant was notified e No Received: Yes ❑ No I=11=1ublic Facil,i�ti Improvement(PFI)Permit: [jequired: 12 Yes,applicant was notified CI No Applied For: l Yes ❑ No,stop intake and Use Case#: Phie.0Q1. -0000 ' Sl.i`F;.2G l S(�'')`O P} 3..Pi/Zoning: equired Setbacks: Front Rear /0 Side 3 Street Side AA Garage QO `X/Landscape Requirement: * 0/0 V.Bof Coverage Maximum: uilding Height: Maximum Height /4 Actual Height a-9- eisual Clearance asements 1! ensitive Lands: ❑ Yes /No Type 1A Urban Forestry Plan El Conditions "Met"prior� to issuance of buil • g permit Notes: (/1L�"/7 1)11.S -ch.(' 1/ mai- pt'��1-r-- 'Oh/- ISS'jL IC. Approved By Planning: "' —= 7014 Date: 42/0/ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_0912 1 6.docx a Pr Building Permit Submittal Original Submittal Date: (C7�////k Site Plans: # Building Plans: # Building Permit#: ®'Enter building permit#above. Workflow Routing: Planning E Engineering E ermit Coordinator I wilding Workflow Sign-off: R -Sign-off for Planning(include notes from planning review) Route Application Documents: g--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: Z 47 Date: r',..-3/7 .1 Engineering Review ze.Slope at building pad: ❑ Conditions "Met"prior to issuance of building permit � 7--- ■ 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 0 No LIDA Facility on lot: ❑ Yes 0 No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: te_.,J Date: aiz- Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved 0 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: SDC Fees Entered: Wash Co Trans Dev Tax: p'yes ❑ N/A Tigard Trans SDC: tai.-Yes ❑ N/A Parks SDC: ( 'Yes ❑ N/A OK to Issue Permit Approved by Permit Coordinator: Date: 1 /1 249 I:\Building\Forms\BldgPermitRvw_RES 0912 16.docx City of Tigard 'I COMMUNITY DEVELOPMENT DEPARTMENT IN e TIGARD River Terrace Building Permit Review Addendum Building Permit #: //-5-7;20/6) — 0 0 5 2- Site Address: /94/3b op) Adoo '77,41 1 Project Name: f ver ,�/wee c9 iia l-- Lot #: //c3 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of River Terrace Plan Distjfct Design Standards (18.660.070.1.): Is the project subject to the plan district design standards? Of Yes El No 1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional element required for lots with over 60 ft. of street frontage shall be provided every 30 ft. Porch min. 5 dee Balcony w/ access 2 Window Projection Vertical Wall Offset a p ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide Gabled dormer CIElCI ❑ 2. Eyes on the street: a minimum nF 19°/c Pesch street facing facade must include windows or entrance doors. Percentage Shown: /9 S`/D 3. trances:At least one entrance must meet both of the folio g standards: tai Max. 8 ft. setback from longe t street- facingwall Parallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porch: Yes ❑ No If s,all the following apply: 0.5 sq.ft.min. ne street facing entry ft.max.roof above floor ofP orch IV 5 ft. depth min. 30%min.porch roof coverage 4.ietailed Design:All buildings shall include a min. of five of e following elements on all street-facing facades: overed porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft. deep all offset min. 16 inches ❑ Roof eave min. 12 inch projection Vormer min. 4 ft.wide .of offset min. of 2 ft. ❑ Roof shingles either tile or wood I. able,hip or gambrel roof design El Roof pitch oriented south min. 500 sq. ft. qd orizontal lap siding min. 3-7 inches wide C7 Accent siding min.40% of street facade (Window trim min. 2 I/2"wide by 5/8" deep El Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep El Balcony min. 5 ft.wide x 3 ft. deep with inside access El Attached garage is 35% or less of street facade 5. Garages and Carports:May face the front or side lot line on a corner lot. Setbacks: N closer to front or side lot line,than longest street-facing wall. ❑ Yes No. If No (Check one): ay extend up to 5 ft.if there is a covered front porch andand the frontorch. p res e does not extend beyond Y 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 Virvi 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: �t� Date: / �Lj I:\Building\Forms\BldgPermitRvw_RES_RT_062216.docx 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. 71 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter T t G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tom H. DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Angela Grajewski AUG 2 3 2017 (TM OF T BARD COMPANY: Polygon Northwest 3C= LD N; DIVi JON // PHONE: 971-212-2144 By/ RE: 17430 SW Shadow Trail St MST2016-00527 (Site Address) (Permit Number) Northwest River Terrace Lot 118 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies. Desiip#S u. ';','"A':- Copies scription 0 Additional set(s) of plans. 3 Revisions: plot plan- Tree update 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. ' ... ' R U ' *in.„.... OR* ONLY te=n Routed to Permit Technician: Date: Initials: Fees Due: ❑ Yes ?`1110 Fee Description: Amount Due: q $ 44 $ Special Instructions: Reprint Permit(per PE): ❑ Yes ❑No I I Done Applicant Notified: Date: ,V 4/,9 Initials:/‘k_ l/4-1 DAle is : /'Iv7�70j4‘, 1✓//1 k� lrc ewr yv vio 64_ I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17430 SW SHADOW TRAIL ST, BEAVERTON, October 18, 2017 at OR, 97007 11 :16:43 AM Record Type: Record ID: Residential - Master Permit MST2016-00527 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS Comments: Water pressure = 55 psi Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17430 SW SHADOW TRAIL ST, BEAVERTON, October 18, 2017 at OR, 97007 11 :15:15 AM Record Type: Record ID: Residential - Master Permit MST2016-00527 Inspection Type: Inspector: 199 Electrical 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: 17430 SW SHADOW TRAIL ST, BEAVERTON, October 25, 2017 at OR, 97007 12:15:22 PM Record Type: Record ID: Residential - Master Permit MST2016-00527 Inspection Type: Inspector: 299 Final inspection Aaron Cillo-Gobel Result: PASS - CofO Comments: Corrections completed. 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