Permit (148) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2017-00041
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/28/2017
T l I` D9 Parcel: 2S1060001401
Jurisdiction: Tigard
Site address: 13240 SW ROY ROGERS RD
Project: River Terrace East Apartments Subdivision: None Lot: None
Project Description: Demo 2,300 sq ft house and 864 sq ft barn,on septic. Septic tank must be pumped and filled or removed. Upon
approved final inspection demo credits may apply to future construction.
Contractor: NORTHWEST EARTHMOVERS INC Owner: POLYGON WLH LLC
PO BOX 1609 109 EAST 13TH STREET
SHERWOOD, OR 97140 VANCOUVER,WA 98660
PHONE: 503-625-3100 PHONE: 360-695-7700
FAX: 503-625-3108
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 02/28/2017 $509.05
Demolition
Occupancy Grp: Occupancy Load: Erosion Control w/Development 02/28/2017 $107.60
Dwelling Units: Info Process/Archiving-Sm$0.50(up to 02/28/2017 $2.00
Stories: Height: ft 11x17)
Bedrooms: Bathrooms:
Value: $30,000
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $618.65
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-00 s rough•-r 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by call'.• .3.232.1987 or 1.800.332.2344.
Issued By: A• Permittee Sign.tures
Call 503.639.4175 by 7:00 a.m.for the next available inspe on date.
This permit card shall be kept in a conspicuous place on the job site . d completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application0,
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City Tigard ,lib W //// 7 � No.: %,
13125 SW
Ball Blvd.,Tigard,OR 97223 I Man Review
Oth1111 I Phone: 503.718.2439 Fax: 503.598.1960 y, Date/By: is Permit
I_1 r,It I, Inspection Line: 503.639.4175 i v" Dau Ready/By Page 2 for
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Internet: www.tigard.or.gov . (a Nodified/lvldhod: Supplementallaformation
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0 New construction ®Demolition fees*are based on the value of the work performed.
❑Addition/alteration/replacementIndicate the value(rounded to the nearest dollar)of all
rep 0 Other: equipment,materials,labor,overhead,and the profit for the
.._- ,€... __ ..''! _... .- ..- ---- a.. r -� Valuation:lA it Dn 41t1J app$
«l rive
�
1»and 2-family dwelling . _ ❑Commercial/industrial
®
❑Accessory building 0 Multi-family Number of bedrooms: -Q
❑Master builder 0 Other: Number of bathrooms: ,d4 a"`�'t
Total number of floors:
Job site address:13240 SW Roy Rogers Rd New dwelling area: square feet
City/State/ZIP:Sherwood,OR 97140 Garage/carport area: square feet
Suite/bldg./apt.no.: 1 Project name:River Terrace East Condos Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet.
Other structure area: square feet
'o ' ;t,_
Subdivision:River Terrace East Condos 1 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
_rel equipment,materials,labor,overhead,and the profit for the
-i , I." F 1 , t work indicated on this application.
demo existing structures Valuation: $
Existing building area: square feet
New building area: square feet
Fa.._.. `: t< < . Number of stories:
Name:Polygon WLR,LLC Type of construction:
Address:109 East 13th Street Occupancy groups:
City/State/ZIP:Vancouver WA 98660 Existing:
Phone:(360)695-7700 Fax:( ) New:
Business name:Polygon WLR,LLC :� r
Structural plan review fee(or deposit):
Contact name:Angela Grajewski
Address 109 East 13a'Street FLS plan review fee(if applicable):
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(360)695-7700 1 Fax::( ) Amount received
E 11 ; :'T a 1 r .G
E-mail:Angela.Grajewski@polygonhomes.eomm
,., prescrn
Commercial and residential insWlationf o
reaf tap mounted Photovoltaic Solar Panel System.
Business name:Northwest Earthmovers Inc. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 13600 SW Galbreath Dr Solar Installation Specialty Code checklist.
City/State/ZIP:Sherwood,OR 97140 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503) 625-3100 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:62761 il 30 I/ .. 1 Total fee due upon application: $201.60
Authorized signature: 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:2/28/17 Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Permits\BBUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
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I' iuilding Permit Application
Commercial yF FOR orflcl. l'SF:011.1
�' -� fir` Received
City of Tigard �i /�,w7-O /
Date/B ' Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503-718-2439 Fax: 6 j;t
III
Date/B
Related Permit:
'
T I G A R D Inspection Line: 503-639 41 Date Ready/By: ]oris: ® See Page 2 for
Internet: www.tigard-or. oy l T. fiGA s 1l Notified/Method: Supplemental Information
f�TiI�rr}���,�,
ti VLYl'�b8S1i,fN REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New constructio krDemolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/repl. ement 0 Other: equ• ment,materials,labor,overhead,and the profit for the
C TEGORY OF CONSTRUCTION rk indicated on this application.
X❑ Valuation: $ 500610
1-and 2-family dwelling 0 Commercial/industrial / r
❑Accessory building a Multi-family Number of bedrooms:
❑Master buildeerr/� /�FJCO l�J 0 Other: Number of bathrooms:
50 0 / JOB SITE INFO' •TION AND LOCATION" Total number of floors:
Job site address: I �- _
v- "''''',1s--iii-" ..--- - New dwelling area: square feet
City/State/ZIP: 77s, r
2� Garage/carport area: square feet
Suite/bldg./apt.#: (Project name: .' 'Or -oece ,7/y/4 „/fri Covered porch area: square feet
Cross street/directions to job site: S V) 541T, F.e . f- ✓ Deck area: square feet
SW sKe L F0 j IS 4 . —
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot#: / Permit fees*are based on the value of the work performed.
Tax map/parcel#: I"52.,41-0 / Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
ff DESCRIPTION OF WORK work indicated on this application.
�2h10 (c-a h a-P E(19/"IYl9 C ' 1-,eS •
Valuation: $ —
`LDUS t; ---r 02l 30D 0 J Existing building area: square feet
gA) "• g, O-tti , .„1--i-e-.: New building area: square feet
PROPERTY OWNER 0 TENANT Number of stories:
Name: W"'6, +— ' 'I S / •)'i)pmn
�^�l,I � _T ,�"`y�"f /{1 G, Type of construction:
Address: �3 5 J t/) Ls t-rt. -Q
h Kt./ Occupancy groups:
City/State/ZIP: 13.e#T V-t rit h 0 9 "700/_
to Existing:
Phone:(1jt53) .-A — i 2) Fax: �16u:3) —
I APPLICANT -: _
,,,ttt CONTACT PERSON BUILDING PERMIT FEES*
Business name: 0Q K ,c I. j /*c4-5 //4 C . , se er to ee schedule
1 Structu .+.elan review fee(or deposit):
Contact name: Wa4 n I a rot
' in lL r —
Address: Q$ .4_ FLS plan eview fee(if applicable):
City/State/ZIP: I". A -%,, o crnot Total fee i ue upon application: / //
Phone:�3) 4(c-- .12, Fax::(S03) i . .— 23 D •mount (��t0 ��
E-mail: Wa U NE. (/'Os PI't ra, p., Q.t-q i< . 60,11 PHOTOVOLTAIC So • PANEL SYSTEM FEES*
1 ! CONTRACTOR Commercial and residential rescriptive installation of
roof-top mo'•ted PhotoVoltai, Solar Panel Syste
Business name: SES Q,11.5.31,-vi
1.5 J ' h CI D K /'SCJ s� Submit two(2) - of roof plan,ith co 'on details
Address: �? 5 sW IS'Q -� 1 and fire department ac along , e 2010 Oregon
l L 74 VIM(1,Q_. Solar Installation Special 0'4"•checklist. _
City/State/ZIP: `/ Permit fee '• des plan revs
Phone:,5�3) aq.( - 2 JLU � �� :(�3) 641 - •nd administrative fees). $180.00
� ,�- 766/
Scharge(12%of permit fee): 1.60
CCB Lic.: (q .f-� 7'� glob.?
_ Total fee due upon application: $201.60
Authorized signature: W �t � This permit application expires if a permit is not obtained
LACI
within 180 days after it has been accepted as complete.
Print name: )oi n t Lips ill m kr—a.. Date: +2„ 15 r 17 * Fee methodology set by Tri-County Building Industry
J Service Board.
I:\Building\Pern1its\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
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City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Accessibility: Barrier Removal Improvement Plan
Commercial & Multi-Family Additions or Alterations
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five percent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS:• In choosing which accessible elements to provide under this section,priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014
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City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
.
" Plan Submittal Requirements
Commercial & Multi-Family - New, Additions or Alterations
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
1. SITE PLAN (3) copies - fully dimensional, drawn to scale and labeled with:
A. 0 map&tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Setbacks.
F. Parking,including disabled access.
G. Finished floor elevations.
2. EROSION CONTROL PLANS AND DETAILS.
3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of
plans required based on submittal type (no redlines or tape-ons accepted).
All details listed below shall be incorporated into the plans:
A. Scale (architectural or engineering only).
B. Foundation plan.
C. Floor plan(s).
D. Cross sections.
E. Reflective ceiling plan.
F. Seismic bracing detail for suspended ceiling.
G. Roof plan.
H. Exterior elevations.
I. Structural calculations,plans,details and specifications.
J. Accessibility barrier removal worksheet.
K. Deposit-based on valuation of project.
4. ADDITIONAL INFORMATION AS FOLLOWS:
A. Fire Department Building Survey with (1) additional full set of architecture
drawings.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014
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City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
° Plan Submittal Requirements Matrix
Commercial & Multi-Family - New, Additions or Alterations
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
Type of Submittal #of Plans
(Includes new,additions and alterations) Required at
Submittal
Demolition Permit 2
(site plan is required showing location and square footage
of all buildings to be demolished,erosion control plan and
tree protection,if applicable)
Site Work 3
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 3
Fire Protection System 3
Mechanical 2
Plumbing(building fixtures) 2
Electrical 2
Solar Photovoltaic 2
(Requires check list for prescriptive installation. If not
prescriptive installation,engineering is required.)
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,Washington
County, and Tualatin Valley Fire&Rescue),if applicable.
I:\Building\Permits\BUP_COM_PennitApp.doc Rev.12/18/2014
City of Tigard
" COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - With Land Use
Building Permit #: /13-I L A,b/ 7-006 VI $10 Po P-06e s fZ
l3a� Y .�
Site Address: - _ =- 0 • . Suite/Bldg#:
Project Name: Riv .c re r CI(..rt.., E riJ t- IV1 iii I h c e al i I
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: be 11T} Pe(rn t{'
Verify site address/suite# exists and active in permit system.
River Terrace Neighborhood: 71. Yes ❑ No
0 Land Use Case#: fDP,20 f(;, - 0OOo
pPlans Match Approved Land Use:
Site Plan ❑ Landscape Plan ❑ Other:
Urban Forestry Plan ❑ Elevation Plan
El-"Building Height: Maximum Height Actual Height
0--(3onditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issuance
'-Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No, stop intake
Notes: APP1tCiJilt 1U Ch.Citi Un 'Ort- 1;-ft tr€. vZ)t'C1)TE.7 0-I NOi --e-ti
kuueic/(ti' . 012 .ir- re trio vtom(- *13 i co i c -ect
Approved by Planning: A,'11)in, ;.4,_ 6,)0 Li i.- --" Date: 2)/.( / / 7
Revisions (after Building Submittal only) Reviewer Date
Revision is C-Approved - loot Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 01-(/5"/ 7
Site Plans: # 3
Building Plans: # W/-►-
Building Permit#: Enter b'
building permit#above.
Workflow Routing: G-l5$nning Engineering 'ermit Coordinator
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: III : .ai'g: o: • ,e appli :do sit- . ans :.• •'•1,,pia. eni.,eer a d
beam c. ulations and :et. ' ,i .ppli : . e, e .
Notes: l
By Permit Technician: .S . I . : Date: 447
I:\Building\Forms\BldgPermitRvw COM WithlandUse 060116.docx
Engineering Review
❑ Slope at building pad:
❑ PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP)
❑ 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 El No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: 4,,,,,i) Date:....70.it Z
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
® . . ;
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
DC Fees Entered: Wash Co Trans Dev Tax:
CI Yes ► /A
Tigard Trans SDC:
CI Yes := N/A
Parks SDC: ❑ Yes N/A
OK to Issue Permit /Y
Approved by Permit Coordinator:
/''r ,9 Date:
I:\Building\Fonns\BldgPennitRvw_COM_WithLandUse_070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13240 SW ROY ROGERS RD, SHERWOOD, December 27, 2018 at
OR, 97140 12:04:03 PM
Record Type: Record ID:
Residential - Building BUP2017-00041
Inspection Type: Inspector:
299 Final inspection Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor