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Permit (49) • CITY OF TIGARD MASTER PERMIT II ii.,., COMMUNITY DEVELOPMENT Permit#: MST2017-00106 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/22/2017 Parcel: 2S106DB11500 Jurisdiction: Tigard Site address: 17382 SW SHADOW TRAIL ST Subdivision: RIVER TERRACE NORTHWEST Lot: 115 Project: River Terrace Northwest, Lot 115 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 978 sf Basement: 814 sf Left: 3 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 1251 sf Garage: 368 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 3043 sf Value: $366,136.99 Rear: 10 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 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: 1 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: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 3043 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 Fire Rated Eaves-Both STE 1 Sides SCOTTSDALE,AZ 85258 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $34,106.97 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 OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 5.3.232.1987 or 1.800.332.2344. / / 4.0_6_____ Issued By: /tV _ Permittee Signature: 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 ApplicationRycr, E -, FOR t)FFIC 1_ I S1:O\1 1 City of Tigard M A R l 3 21117 ' eD` :moi . P«mitY1,ST AP/7 /Cil f`, III v 13125 SW Hall Blvd.,Tigard,OR 97223 Plan R • Phone: 503.718.2439 Fax: 503.598.1 " r ..., Date/By: 3-fs_ J"7 Other Peng %L'Lx,,20/9 Inspection Line: 503.639.4175 t f � 1' t 1 T S G�a h E7 a y 3 ILLI.1.C.,1 Date Notified/Method: ^, /' orris. &'E Sec Page 2!or Internet: www.tigard-or.gov BUILDING I ON Notified/Method: // tF Suppleroentai[nformaEion -,,,,y,-,2,-.__ i�,7^�..._.o,.:.-: Ji..-:..w ....m... 3 a�a. ..r.r..}. , �=au1: a ,.z.:.Z .s rc . . :.<33 . c?P 6frj Aciktj' 4z r' 5 &Si(( ,L; ®New construction 0 Demolition Permit fees*are based on the value of the work performed.' Q Addition/alteration/replacement 0 Oar Indicate the value(rounded to the nearest dollar)of all Y equipment,materials,labor,overhead,and the profit for the �' m -v work indicated on this application. o r i [..a DrC t�.�t Cj fr'4� to 4t. xf£�1 - _._ x.,. ..:_ ..zm. 36 6, 13 6 la 1-and 2-family dwelling Q Commercial/industrial Valuation: , Q Accessory building 0 Multi-family Number of bedrooms: 4 Q Master builder 0 Other: Number of bathrooms: 3if 34II i.,,',*'''. tir:,.,,,----,-:,,..4:;��� � ! 4 t�;�-���'�.�`�: ........,.,��.�'�!1'C.�.a.ita:�g�x4,�j�'�4` _.. c. ' Total number Offloors: 3 t _ ' vim..+.•.._._v �.:1.. ' Job site address:17382 SW Shadow Trail St New dwelling area: 3043 square feet City/State/ZTP:Tigard,OR 97224 Garage/carport area: 3686 square feet Suite/bldg./apt.no.: Project name:River Terrace Northwest Covered porch area: square feet 1,0 j Cross street/directions to job site: Deck area: 1 4‘ square feet9 7g Other structure area: square feet S j Subdivision:River Terrace Northwest Lot no.:115 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 ,<, ., .,.... , .... .,.. ._..._.1....f.: 1, fad t reel -„ t-,•,,,,,:7.,;:j;,--.. work indicated on this application. Valuation; s Existing building area square feet New building area: square feet �..i r F') `_=','"t'5F'4e ‘,-t:i . __ �_ _. r,_�. _..... N,I�!W._ . r_.�.,;),-;::1,71:. .. .. Number of stories: Name:ADVL Laud Holdings,LLC Type of construction: Address:7600E Doubletree Ranch Road Occupancy groups: City/State/ZIP:Scottsdale,AZ 85258 Existing: Phone:(602)694-4031 Fax:( ) New: " ( " £2. £ { -_-,,';-.:7.,,,-,.,,� s £• c� �� t j- '� H, Business name:Polygon WLH,LLC ..�__ —.�.u,_ . .. ..i�,..._ ' w�„ ,��t__; .,. , ' Structural plan review fee(or deposit): Contact name:Nichole Thorpe Address:109 East 13*Street FLS plan review fee(if applicable): City/State/ZIP:Vancouver WA 98660 Total fees due upon application: Phone:(360)695-7700inffilli Amount received: E-mail:niehole.thorpe®polygonhomes.com s �r .r f _ s t �I . .3 .r.. 4,-,-.-,."•.J".'-., c+'", Commercial and residential prescriptive installation of __ __._ _ � ;._ s_a_._ _ ,.,a ',::.'',-!,,,-,,-,,,I.:_,_.� ,��_. .....G..`, ....,_,_:_ : roof-top mounted PhotoVoltaic Solar Panel System. Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 109 East 13th Street Solar Installation Specialty Code checklist. City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $18000 and administrative fees): Phone (360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60 CCB lie.:207247 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:Nichole Thorpe Date:3/13/2017 *Fee methodology set by Tri-County Building Industry Service Board. I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) , N RfilFiNT) A t,,`,..4 -*/.%4.' 4 Meehanical Permit Application roil(311 RI; I 1 0\I N , City of Tigard 9 7roi ,,t1P,,R 1 t) ,., Received Doleftly: Petmil 14°'.n57-20/7-00/e6, II,, 13125 SW Hall Blvd..Tigard.OR 97223 -Plan Review Phone: 503.718.2439 Fax: 503-5983960,,,, . I 0 t„,,,B.- Olter Permit. t ; ; 11,../1,MJ 3 ) 1 ,( 1) Inspection Line: 503.639.4175 tIt # `li, ,.. * - Date R,c,,,,dym5,,, .1P1+6 0 See Page 2 for ' Internet www,Hard-or.gov '5 r'-1C rt 1-V C'ci ION Nmifiedma.i: Supplemental learmatioit El New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the ncareat dollar)of all O Demolition 0 Other mechanical materials,cecina:Ruth labor,overhead,and profit Value:S. "E"42%.,-S?“-- ....X-A c,-.A.cfl44'i'Mr-.,;,,..,,, •tilf -',"?.."WCilAnlif/rVfft.WgrOirifrg=tT',"`.:;!" "-'7":',4 .:- - - - # --, - #... 8','.. .'aitg-.•'#'....t ., •144.-i'vrilz.161-tr.8,...6-:,*,k4Aler.it:.?&*...:11,lin'i,/a,=.0•2,..,„,s41.4.7t1#17.,,' --.i,.-*Il4g.ii'ftiIiSejrAtt.-filZf's, 4::."-,-;."-Ill".• ,)'7''' t 'b," ii 17:4 '•' 'leg'''. ' ),,,,., ,,1*:,,--.-,;',-,,,;-11;'=/-:e` ....-t ,".---.-" .-:•':-.4 =I':5''''.- = iga I.and 2-family dwelling 0 Commercialtindusirial 0 Accessory building Forspedal infointalfort'Ise oterifirr -1 Multi-family 0 Master builder 0 Other: Description f Qty. 1 Ea. I Totat asmsmg:r4P,::::::Iii7-7-17,75-1r117.4.-,7( :-',17.WT,V;a3M7&-,74W-I-f-%-rf.,4. /4°1611/m441El Air conditioning i 46,75 I Job site address:i s 14 S /...4.., t. ' Furnace/00,000 BTU(ducts'vents) I 46,75 City/Stale/7W:Tigard,OR 97224 Furnace 100.0004 BTU(ductsivents) 54.91 II61.06 Suite/bidalapt,no.: Project name': ? • t wutxes , 2332 I/uceati 1::: Cross streelfelireetions to job site: I lydronie hot water system 23.32 Resithmtial hailer(radiator or hydronic) 23.32 Unit heaters(fuel-type..not electric), in-wall.in-duct.tustantded,etc- 46.75 flue/vent fI or any of above 23,32 Other. 23.32 SubdiyisioaH Nitiy I i, ig We' Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 RztrIP':i7-_:,'-q?- 17-F-4,1"-r-Y.3,•:Ti-t41:07WITTig.rrf:171.rirM,W-i=47F-424Ar-gtrlf" -I'3.1i1FITtFi Oas fireplace/insert 33.39 , - Flue Vddl for water heater di gas fireplace 23.32 Loa lighter(gas) 23.32 . ..„, Woad/pellet slave , 33.39 , Wood fireplace/insert 23.32 Chimneyllinertiluetvent , 23.32 23.32 .. ."..I'L.,,x;.,...,,,,,,,,,,w...,,,,,...,%,....:',=:•--i-z.-.'/Thila .-..,,...,,zw....--...,...1f... .-6V..,.-a.a-- 1.z..44:.,,,,,, .14:-.1-'1,-:-.Zriii,,,-6--a,""' Erevirodratetal emit'int and ventilation; Name:Polygon WI,H,I„.LC Range hood/other kitchen i - equipment 1 33.39 Address: 109 East 13d.Street i - Clothes dryer exhaust 3 . 9 City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms, fI toilet COmotntiarnts,utility rooms) 23.32 Phone:(360)695-7700 Fax:( ) Attielcrenvispace fans 2332 -?-. 4,4,1.4i.:-q,,fr•-,':,,:..-,-;-fiis.;,-,'.,,,,,-yrt-,*,f;::,7,74..."::,-,....:4„-: ; ,..--.:4-.5Other 2332":',1-1,1Wiglifi,,,4,7..':<:„*..,,,i;iii„4`':Ji.--)....;,.,...'.:t.,441,414-arat:.41.: w:taatit:s„1..g.:t.L.R-.14:1:1.:,,,:;,::;:-.•,:::;.,:::11,:,-....,72:-.7',-1:,.' ' Purl nhainz: Business name:Polygon WL11,LIC $4.15 for first four:$4.03 for each additional Contact name:#IQ i that PaftoNfit Furnace.use. Address:109 East 13th Street Cos heat pump Wall/suspended/unit heater City/State/7.1P;Vancouver,WA 98660 Water heater Phone:(360).695-7700 Fax::(360)691-4442 Fireplace Range L.'-illail. I ., _11 . 4,4 r 4t, 4 °A Aka 14 *41.444, - palbecue •=iia,...--':_--.,,...,.;--,,,-.....;;.---=,-.-,rt.?a'7t,','ft,t';‘1,t.t.*.t'ftt P t,i C.-:C,277,..i.4-7-A.1::..-:-1:2,-.',...it;z,.-4.:Fg,-,..,:ti:,.:4-..ti i,;,,,,-::: Clothes dryer tea,$) 4,4,A...,•.'4,.., ...,V.....,..:,..........t..t.,.......tf4t:ttl.tt '','•tt....=$'•tt*.`11;,..''t'.. '....:b-:::1"...7....4.1,2,11"2... ...,L.."...___,,Ar,..:-.,7:.....:,: 111 OtImr 111i* Business name Apex Mr LIC 7 ,,i.,?!., _'.',P;r:'-'t1-s'S`f.,4.f.3.,!:,1-aiV21.,1".1C.i-V.P471-1'.:3Atl: Address: 18004 NE 72"Ave Subtotal City/StateiZIP:Vancouver,WA 98686 . Minimum permit(be(S90.0t3) Plan review(2,5%of permit fee) Phone:(360)3424109 Fax:(360)326-1769 State surcharge.02%of pemth roe) -- CCB lie.:203034 TOTAL PERMIT FEE - -Ws permit application aspires if a permit 4 not obligee()within tan days sitter ft lies barn autored as complete. Authorized signature' * Fee mrshodolea set•hy Tri.Ccsaily Building Industry servicc Board - IPrint name. g". ".1 Date: 4./1./t,... 4 LEW ilthricTor4i$,NIEt".prinwthilk.WO 1 la 4.: ;46-1601(i imiCOMAVE20 • I EC '01 Electrical Permit Application FOR OFFICE USE ONLY City of Tigard MAR I. �3 `i tl r Received Permit k`:AIS-7�'/7-00/0 4, .} • 13125 SW Bail Blvd.,Tigard,OR 97223 Review:Phone: 503.718.2439 Fax 503.59819 1)f,"d' i m t' III Inspection Line: 501639.4175 s i i 7± Daudl3 T1Gl1ILL? •eadyDatefay: El See Pae2 for Internet- www.higard-or.gov ,r i rs,x G rt II „d: Sb �, r ' a,0 M/ P b`opplemenhdllufor9naftoa .a a��• -;?..:-.2.,,,,,k4. -�l•'.1..•r .r ` ,a-,�rb:x ®New construction 0 Addition/alteration/replacement Please check an that apply(submit 2 sets of plana wftems checked): 0 Demolition ❑Other: Eisen/ice or feeder 400 amps or most ❑Budding over throe series. ti.., whore the available fault current ❑Marinas and boatyards. _,..,., ,,,„:::',,;-.03.-V.) 0:74vb ''- fl z)v z gr..-'24p z 4C p f;a ;' 'f t,. exceeds 10,ODO amps at 15O volts or 0 Fleabag buildings- El uildings ®I-and 2-family dwelling 0 Commerciai/iridtistrial 0 Accessory building lass to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑Multi-family J]Master builderamps for all other installations. beadier. a eta -� 0 Other. ❑Fite u ❑ n of 150 KVAor s x pump. Installation � `�' ,v J' '� :.....��$«`(�l.'S,t-.=g�� `a s ❑$ssmrgancy system. larger separately derived Job#: Job site address:n.b2 Sri �44-.,�.rtat c S_ 0 Addition of new motor load of system. 100fiP or more. j]"A",'E';"1-2"."I.3", City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy. ❑HHealth-care facilities. ©Recrea;onalvehicle parks. Suite/bldg./apt.#: Project name:Rile e TL eL,/ WG f,�, ❑7iaxanions locations. ❑Supply voltage for more thou Cross street/directions to job site: J� ❑Service or feeder 600 amps or more 600 volts nominal Description .. r al .l Ors. I Each ToMI New residential single-or multi-family dwelling unit. Subdivision:? V �Rr� I c N L Lot 11_1:1151Includes attached garage. Tax map/parcel#: 1.OW sq.R a 3ess 368,54 4 4 3i�`i0 ,' __I'' t a• 341 T.8..,.``iy] k )d`. , 1' Ea.Limitedaddene50rgy, sq.esft or portion 33.92 ► ._ y �� energy rcsideodal (with above sq.ft) 75,00 2 Limited energy,mnit[-family 75.1)4 2 ,•� residential(with above sq,ft.) r, 1'•S:s.��d'1 Z't"�wa s�•) '�*,,7,,`` yt,,v,.ir'. "`r• w �"'"'Z�.a. ;7 _5y .,,; y •,U, Re11eR'able Erre ❑ .Sec Paget 2)_ s Services or feeders installation,alteration,and/or relocation Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2 Address:7600 E Doubletree Ranch Road 201 400 amps 133.56 2 401 amps to 600 amps 20034 2 City/State/ZIP:Scottsdale,AZ 85258 601 to t,000 30L04 amps 2 Phone:(602)694.4031 I Fax;( ) Over 1,000 amps or volts t 55226 2. ...... Email: ' �" Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that J own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,4.49,670,and 701, 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 �µ ,,.ii* _y,rtris ••Vu tri.,:' ;z t ' .,f, q.. 4e�rd 4;)1.0 ,,.'... ' s Branch circuits—new,alteration,or extension,per panel >{ !Inert fur brooch circuits wtrk Business name:William Lyon Homes,Inc. above service or feeder fee, 7.42 2 Contact name: p�^l(,, each branch tamsth i(!Ao '_ B.Pee for branch circuits without Address:109 East 13th Street service or feeder fee,Furst branch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98660 Each add'1 branch circuit 7.42 2 Phone: 360 695-7700Miscellaneous(service or feeder not included) ( ) Fax::(360)693-4442 Each manufactured or modular dwelling,service and/or feeder 67.64 2 Email. i, C 4 ,$ OIL L ii+) it d l f i! l l l' .i/ _ Reconnect only 67.84 2 .'..i.r,.i a.:..i2� F:n2 v �l` 'M�,." Y iU 7 t s a;:;L-_ -Y F, 4.1 Pump or irrigation circle 67.84 2 Business name:Garner Electric Washington,LW Sign or outline lighting 67.84 2 Address;6101 NE StJ'ohns Rd Signal cirtx>}c(s)orlimited-energy penal,alteration,or extension. ❑ See Page 2 2 City/State/7�:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional Inspection(I hr min) 66.25/hr r Pie:(2 3)320-1657 Fax:( ) Investigation(1 hr min) 90.00Vhr y Email:bdaniels®gweusa.coin Industrial plant(1 hr mut) 78.18/hr Inspections for which no fee is 9CCB Lic.: C1158 Electriea1 Lic.: 208174 I Suprv.Lie:: 44965 specifically listed(%throbs) 0 ......% - •-- .. __..'.-.••• - .,' .,t_., µ`ere `w a -•,� S rv.El . X�M's,�`�r.�;:. it:%��p�yi36���r�: �e 34a�1 � �r;• up Electrician signature,required � r- j... �- Subtotal: Print name: Joan P Albert Date: 4/26/2016 0 Plan Review Required(25%of permit fee): --- -- -� State surcharge(12%ofpermit fee): Authorized signature: t- =- -- W--- TOTAL PERMIT FEE: This permit application expires if o permit is not obtained within 180 Print name: Bill Daniels Date: 4/26/2016 days after It has been accepted as complete. - ''` • Number of inspections allowed per permit. l' 5`` ••` AEnildingVemiitslEGC,Pemdippp ELE EREdee Rot osn n2o15 44055I57(17/05/031 /WLB • •' ry2.`-'11?-1V-(4% Plumbing Permit AppZicbVr.`" -` _ " Building Fixtures MAR i 3 , it City of Tigard Reuivetl 13125 SW Hall Blvd.,TigardOl .; >:,,t ' l,r. ` ) Dateer Feimit No.��11111.111MMI % i� ,��j�� i �r 3 Planiteview N-. Phone: 503.718.2439 Fax• 503:�S98s1960 OtberPerant No.: t,n Inspection Line: 503.634 41?S u 'l') , i f Day' a a a Date lteady/By: Anis: B1 See Pa 2 for Internet: www.tigard or.gov :� ) Notified/Method: �` . �{/ A» Supplemental .. . . . .. .. . ' . :.I ..,.SCiHEDiI11rT.;':%..:ar�.'_�::..,,;- ®New construction . 0 Demolition For special Ir1Jormailon use cheiklLw rt ❑Addition/alteration/replacement ©Other DnptioI Qty. I Ea. I Total New 1-2-family dwellings(includes 100 ft for each utility connection) .' 'CATEGORY•OP CONsrigicTlON" , .. , . SFR(1)bath 312.70 21 I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 0 Accessory building 0 Multi-family 50032 Q Master builder Each additional bath/kitchen 25.02 Fire sprinkler( sq.ft.) Page 2 • . . -JOB,SITE lNFORMA't 1ON`AND'LOCATION... Site utilities: Job site address: 113.s2 so/_... . ii A ik S1- Catch basin or area drain 18.76 City/StateeZIP:Tigard,OR 97224 Drywell,leach line or trench drain 18.76 ,(��/ Dtns. Footing drain(no.linear tt.: ) Page 2 , Suite/bldg./apt.no.: Project name: 4't/► 1 i til.. N c Manufactured home utilities 50.03 Cross street/directions to job site; �_• Manholes 18.76 Rain drain connector 18.76 . ' Sanitary sewer(no.linear ft.:_j Page 2 Storm sewer(no.linear ft.: ) Page 2 `r t tt) _ Water service(no.linear ft.: _) Page 2 Subdivision: V��eNUatt NI?Y �/1(JUG,f{' Lotno.:I Lc F1ltureorItem: Tax map/parcel no.: Backflow preventer 1 31.27 . ' . • DESCRIPTION OF.WURI£ • Backwater valve 1 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ' .®•I'RoFERTV OWNER • . 1. 0 TENANT . . Expansion tank 12.51 Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:7600 E Doubletree Ranch Road Garbage disposal 25.02 City/StateJZIP:Scottsdale,AZ 85258 Hose bib 25.02 Phone:(602)6944031 Fax:( ) i Ice maker 12.51 • �•APkLICA•NT © COlY1AC1 PERSON Interceptor/greasetrap 25.02 Business name:William Lyon Homes,Inc Medical gas(value:$ _) Page 2 Primer 12.5IContact name: w ,Cbu4L ^.► ' Roof drain(commercial) ' 12.51 • Address:109 East 13th Street Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 I Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail: �70'I /�" J0hh(rf,ell ►7 Urine! Waer closet 25.02 25.02" C • • Water heater 37.52 Business name:Matntedal Enterprises Inc. Water P zig/DWV $6.29 Address:PO Box 207 Other. 25.02 City/State/ZIP:Banks,OR 97106 Subtotal Phone:(50.3)324-0759 I Fax:(503-)324-0580 Minimum permit fee: $72.50 ' CCB Lie.:102535 'Plumbing Lie.no.:34-276PB Plan review (25%of permit fee) � -+ State surcharge(12%of permit fee) Authorized signature: f�__�... - TOTAL PERMIT FEE IPrint name:Carolina Malmedat Date:04/25/2026 This permit application expires if a permit is nut obtained within I80 days atter it has been accepted as complete. *Fee methodology set by Tri-County Building industry Service Board. I:tauilchnePermiutPlid}.Pem,itApp.doc 10/01/09 440.4616T(1ofo4/COMAVEB) City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT i II ■ T 1 c A R o Building Permit Review — Residential Building Permit #: /7S-TeJ/7 -a)/0 Site Address: 1 /3$2 SW Sho,dow Tro►',I SA . Project Name: R i ter Terrr1u. No rtin w2Ji- Lot #: 14S (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: KJ4Ani S FR_ / Verify site address/suite#exists and active in permit system. 7 River Terrace Neighborhood: ❑ No � Yes,See River Terrace Review Addendum Attached Site Plan Elements: Three(3)copies of site plan 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 Utility locations(required for new,may apply for additions) Site address,project or subdivision name and lot number 'BT 6cation of wells/septic systems Applicant information(name and phone number) Existing trees to be retained with drip line,and tree tot dimensions and building setback dimensions protection measures /tot area,building coverage area,percentage of coverage and Street tree size,type and location impervious 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) Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: E Yes,applicant was notified ❑ No Received: E Yes E No ' Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified E No Applied For: ❑ Yes ❑ No,stop intake yii Land Use Case#: yi Zoning: 2 -1 0 Required Setbacks: Front I '2_, Rear 1 0 Side £ � 3 Street Side 1\1/41 Garage Z1, Landscape Requirement: �- 0 ,.,, Lot Coverage Maximum: S 0 A Building Height: Maximum Height 11/4//A Actual Height C�. 3 AVisual Clearance 01 Easements 7 Sensitive Lands: ❑ Yes ❑ No Type 7Urban Forestry Plan pConditions "Met"prior to issuance of building permit Notes: Approved By Planning: NI 63"\--‘;..... I/\--_ Date: 3 / i 44 1 17 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_091216.docx Building Permit Submittal Original Submittal Date: 3//5//7 Site Plans: # `.. Building Plans: # 3 Building Permit#: a''Enter building permit#above. Workflow Routing: trPlanning '®` Engineering inPermit Coordinator C Building Workflow Sign-off: ,B'Sign-off for Planning(include notes from planning review) Route Application Documents: Er Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. DO Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: 411 By Permit Technician: i-I" 7-c—_ Date: 3//r//7 1.111011111111111111166, IIIIIMEN Engineering Review _ Slope at building pad: i'yl �� CPConditions "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 ❑ No LIDA Facility on lot: ❑ Yes ❑ No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: itii D Date: 3.0,./7 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: SDC Fees Entered: Wash Co Trans Dev Tax: Yes CI N/A3 CIE Tigard Trans SDC: Yes ❑ N/A r Parks SDC: Yes ❑ N/A M\ OK to Issue Permit A roved by Permit Coordinator: Date: 3 2 v I:\Building\Forms\BldgPermitRvw_RES_091216.docx ..` /_.4. 1 /J M City of Tigard 'I COMMUNITY DEVELOPMENT DEPARTMENT IIII 1 T l c A RD River Terrace Building Permit Review Addendum Building Permit #: AlS / ? - Caia 6 Site Address: 1-73'3 Z s w S1, vid,o v- Tiz,; 1 S4 . Project Name: R.i v1°-r -re cam.. t Or-1'1n Wri+ Lot #: 11 S (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of 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 iki ❑ ❑ ❑ ❑ 2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors. Percentage Shown: ' S 1 3. Entrances:At least one entrance must meet both of the following standards: Max. 8 ft. setback from longest street- facing wall Parallel to street,angle no more than 45° from street, / or open onto porch Entrance opens to a porch: Yes ❑ No If yes,all the following apply: C, '25 sq.ft.min. KOne street facing entry 12 ft.max. roof above floor of porch 5 ft. depth min. 4 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 mm. 5 ft.wide x 5 ft. deep , Recessed entry area min. 5 ft.wide x 2 ft. deep 71Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide Roof eave min. 12 inch projection gRoof offset min. of 2 ft. ❑ Roof shingles either tile or wood Gable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide ❑ Accent siding min.40% of street facade X1 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 bove the garage that faces the street with a min. area of 12 sq.ft. Width: (Check one) ❑ 12-foot-wide garage door 7f40%max. of street facade /`J 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: r9-17.,,_e'tDate: 3 I Ill / ('7 I:\Building\Forms\B1dgPermitRvw_RES_RT_062216.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17382 SW SHADOW TRAIL ST, BEAVERTON, September 21 , 2017 at OR, 97007 2:11 :54 PM Record Type: Record ID: Residential - Master Permit MST2017-00106 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS Comments: A/C installed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17382 SW SHADOW TRAIL ST, BEAVERTON, September 21 , 2017 at OR, 97007 2:13:54 PM Record Type: Record ID: Residential - Master Permit MST2017-00106 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS Comments: Water pressure = 50 psi Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17382 SW SHADOW TRAIL ST, BEAVERTON, September 21 , 2017 at OR, 97007 2:12:59 PM Record Type: Record ID: Residential - Master Permit MST2017-00106 Inspection Type: Inspector: 699 Mechanical final Aaron Cillo-Gobel Result: PASS Comments: A/C installed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17382 SW SHADOW TRAIL ST, BEAVERTON, September 26, 2017 at OR, 97007 12:23:55 PM Record Type: Record ID: Residential - Master Permit MST2017-00106 Inspection Type: Inspector: 299 Final inspection Aaron Cillo-Gobel Result: PASS - CofO Comments: Final erosion control passed Street tree certificate received Moisture content form received Moisture barrier acknowledgement form received High efficiency lighting form received Insulation certification verified Blower door and/or duct seal test certificate received C of 0 left on counter. Violation Summary: Inspector Contractor