Permit (29) CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT74
Permit#: MST2017 00007
TtGAR r 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/14/2017
Parcel: 2 S 106 D B 12400
Jurisdiction: Tigard
Site address: 17459 SW SHADOW TRAIL ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 124
Project: River Terrace Northwest, Lot 124
Project Description: New SF. 4/13/17: REPRINT to add patio cover.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 978 sf Basement: 0 sf Left 3 Parking Spaces: 0
Height: 28 Bathrooms: 3 Second: 1251 sf Garage: 380 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2229 sf Value: $274,261.21 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
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'500 sf: 4 201-400 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 2229
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: $32,292.71
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 952-001-0094. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
1
Issued By: 4 4 Permittee Signature: St-r Atiof{ebe, 0!7
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
11 - Transmittal Letter
T I 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 GrajewskiUILD TIGARD
BUILDING DIVISION
COMPANY: Polygon Northwest
ko
PHONE: 971-212-2144 By:
RE: 17459 SW Shadow Trails ST MST2017-00007
(Site Address) (Permit Number)
River Terrace Northwest Lot 124
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
pies iption ;,. ,Copies �, escr< tion: '
0 Additional set(s) of , 3 Revi- i � 4 /
plans. so s. � ley �
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 dcc�ue to terrain
I U Cvvzr
Routed to Perml Technician: Date: y/S' 17 Initials:
Fees Due: [ '\'es ❑No Fee escnption. unt :
Du
Abu r ? c
sof) C"��.`�ts.� $� /C .t*z .604
Special
Instructions:
Reprint Permit(per PE): [] Yes n NoDone
Applicant Notified: Date: L-`/13//7 nitial7V
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
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.7
City of Tigard
■
COMMUNITY DEVELOPMENT DEPARTMENT
T Building Permit Review — Residential
IGARD
Building Permit #: /7„S i-,mac%/ 7 -0vO0 7
Site Address: \146 S Sixun) T41 k Str�.t-
Project Name: -+,'( -Fr is N D We Lot #: VA
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: JCf'f S ►2' -f— /w rear- -75 fl o 6'64',/' '
Verify site address/suite#exists and active in permit system.
Pf River Terrace Neighborhood: ❑ No Ayes,See River Telma Review Addendum Attached
Site Plan Elements:
$Q ree(3)copies of site plan 'sting structures on site
..21Zte planus be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
)rawn to scale(standard architect or engineer scale) oor elevations
orth arrow '1 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) % • : ting trees to be retained with drip line,and tree
A •t dimensions and building setback dimensions protection measures
•t area,building coverage area,percentage of coverage andStreet 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: 0 Yes,applicant was notified No Received: 0 Yes 0 No
54 Public Facilities Improvement(PFI)Permit
Required: 0 Yes,applicant was notified 17 No Applied For. 0 Yes 0 No,stop intake
gLand Use Case#:
Zoning: -1 (PD)
Required Setbacks: Front 5 Rear ID Side 3Street Side KVA-_ Garagd.
Landscape Requirement A)
•t Coverage Maximum: gQ
'4,' Building Height Maximum Height N/A. Actual Height 2,3---
1::: Visual Visual Clearance
C Easements
Cce Sensitive Lands: 0 Yes PkNo Type
Urban Forestry Plan
Conditions"Met"prior to issuance of building permit
Notes: ih,,v‘S ti0,1,0",...) -7a
1 i 5 1�1c{
L:Pi�. r-PQO1nor r- - S'.
Approved By Planning: 4I/I. _ l:ill_'J, Date: 124/214 _
Revisions(after B ding Submittal I ly) Review to
Revision 1: l 1 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
1:\Building\Forms\BldgPennitRvw RES_091216.docx
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Building Permit Submittal
Original Submittal Date: /212-(V/k,
Site Plans: # _ 3
Building Plans: # '3
Building Permit#: anter building permit#above.
Workflow Routing: P--Planning - Engineering. P
❑ Permit Coordinator ding
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: e74)----4, 4 Date://;14//7
Engineering Review
Slope at building pad: o,
0 onditions"Met"prior to issuance of building permit- p// �j
❑ Easements (encroachments)per engineering conditions of approval and plat
' ❑ 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
0 NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: (‘---171 Date: l--4—/7
Revisions(after Building Submittal only) Rte' -r a
Revision 1: Approved 0 Not Approved J iv 44
Revision 2: Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
Approved,NOT Released: /` rnate: 04/.3-
.
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
C Fees Entered: Wash Co Trans pev Tag: , ,' es ❑ N/A ..
Tigard Trans SDC: p- Yes 0 N/A
Parks SDC: Yes 0 N/A
K to Issue Permit
Approved by Permit Coordinator. 4 : / 3
/ 1 ^
1:\Building\Forms\BldgPennitRvw_RES 091216.docx i jO/ l e
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