Permit (22) CITY OF TIGARD MASTER PERMIT
. . COMMUNITY DEVELOPMENT Permit#: MST2017-00036
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/14/2017
TIGARD Parcel: 2S106DB12500
Jurisdiction: Tigard
Site address: 17441 SW SHADOW TRAIL ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 125
Project: River Terrace Northwest, Lot 125
Project Description: New SF. 4/12/17: REPRINT to add patio cover.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 948 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1130 sf Garage: 380 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2078 sf Value: $257,161.78 Rear: 10
I PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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: 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: 3 201-400 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 2078
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: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $31,917.48
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 95 -001-0090. You m obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ,r
Ir
Issued By: . ` i ' r Permittee Signature: cr7 kC.e0-dl'l
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
711 ag
Transmittal Letter
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
APR 3 2017
FROM: Angela Grajewski CITY OF TIGARD
BUILDING DIVISION
COMPANY: Polygon Northwest
PHONE: 971-212-2144 ByX.---
RE: 17441 SW Shadow Trails ST MST2017-00036
(Site Address) (Permit Number)
River Terrace Northwest Lot 125
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
'Vopiai -
Description: A 2.,t ies escrii tion• ,
,,00 � C'G�1fr'/'
0 Additional set(s) of plans. 3 Re lops: e�eck- /I
q 43,
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.
add de 1?due to terrain
pAA e> Cover
> CE ONLY i%,, f, Initials:
is ti.,_ �,:.`
Routed to Permi echnician: Date: yjSig
it it' ls.
Fees Due: es ❑No Fe Description: ount Due:
con r vc{.W $� 9o,
C
$
Special
Instructions:
Reprint Permit(per PE): A Yes n No ,] Done
Applicant Notified: 7-lam Date: 41/(j//7 Initials:.),- .
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
6
City of Tigard
11111 COMMUNITY DEVELOPMENT DEPARTMENT
■ •
I 1 G n R D Building Permit Review — Residential
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�r r„aa--- �.S_+ui'i�7asver14:w..v:.,..>. .,.st� ,e�*..v-:s2i��+:iif�rssxa;:i:.:.
Building Permit #: !�(� 72 a/7 00O3G
Site Address: 13.471.4)/ ai) (0,.,Aw --7,-.,” J
,-...
Project Name: e% - ' 7 rincL AJ iti f- Lot #: /Q,c--'
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Reviews -c]�.,,pp
Proposal: 1040 f,�— '1.- /111 ) r?csr''z 4— frtj 0 C 1r/
erify site address/suite#exists and active in permit tem.
River Terrace Neighborhood: 0 No lV Yes,See River Terrace Re,iew Addendum Attached
i
Si Plan Elements: '
ii:er (3)copies of site plan — •:sting structures on site
must be on 8-1/2"x 11"or 11 x 17"paper 1 ootprint of new structure(including decks)with finished '
lan
awn to scale(standard architect or engineer scale) -oor elevations
orth arrow
FA Utility locations(required for new,may apply for additions)
• e address,project or subdivision name and lot number ; q ii ation of wells/septic systems
..licant information(name and phone number) ■irk,sting trees to be retained with drip line,and tree
1V •t dimensions and building setback dimensions rotection measures
FA Lot area,building coverage area,percentage of coverage and street tree size,type and location
• pervious area(applicable if R-7,R-12,R-25&R-40) Street names
ropetty comer elevations(2 foot contour lines if more than
4 foot differential)
Alean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
Eilequired: 0 Yes,applicant was notified 8d No Received: ❑ Yes 0 No
ltublic Facilitipqmprovement(PFI)Permit:
uired: Qf Yes,applicant was notified 0 No Applied For Yes ❑ No,stop intake
d Use Case#: . — ,S S' �7� �" '
onrng /
R �� ,
Acquired Setbacks: Front 0 Rear JO Side .3 Street Side f)1 arage *QC)
Requirement ..2,n %
t Coverage Maximum: %
�y►� r
Building Height Maximum Height 07 Actual Height cQ 3 1 rj
a '' isual Clearance
rA Easements
ensiiive Lands: 0 Yes No Type
V Urban Forestry Plan
0 Conditions"Me"prior o issuance of b permit
Notes: 1. 0/7CYd i`c7n -c.„.. // 4-Q. ,?t21pa 2i ' 7/z) of/>4 /S.SGi iee.,_
Approved By Planning: c� Date: _____4a
t.
Revisions (after Building Submittal only) Reviewer Date++
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
l:\Building\Fonm\BldgPermitRvw RES 091216.docx
Building Permit Submittal
Original Submittal Date: /2/AO/17
Site Plans: # 3
Building Plans: # 3
Building Permit#: Enter building ermit#above.
Workflow Routing: Planning'Engineering (Permit Coordinator Building
Workflow Sign-off: 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.
0 Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: JA ./ e ...ALA..
cAt .•'7he Date: //Z7 7
rr+ % F.. ._'^.m' .Lia<a.:.ia:w e.t.......:_,'�'....... , .—,- _,.2kgs rsrr I.A.tr. .2..; .ara. :,.v.;04M.'r... .,.2_.dam,+ tiVii ,. kthr4' 1s�c•.
Engineering Review
Slope at building pad .42:
@Conditions"Met"prior to issuance of building permit .7 0�
❑ Easements (encroachments)per engineeringconditions of approval and plat
PP
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 0 No
Assess Water Quantity Fee in-lieu: 0 Yes 0 No
LIDA Facility on lot 0 Yes 0 No
O NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 4-22--- Date: _ •-
Revisions(after Building Submittal only) Re ' er Date
Revision 1: Approved 0 Not Approved k 41-�-/7
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
O Conditions"Met"prior to issuance of building permit r
Approved,NOT Released: 4fbate: 71'5'al '7
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: , Yes 0 N/A
Tigard Trans SDC: rM''Yes 0 N/A
Parks SDC: Yes 0 N/A
K to Issue Permit /J .
vz.?ii: ----
Approved by Permit Coordinator: Date:
/1/1 --- .4)4f)-.4--
I:\Building\Fonns\BldgPermitRvw_RES_091216.docx