Permit (107) I
CITY OF TIGARD MASTER PERMIT
21, ',, COMMUNITY DEVELOPMENT Permit#: MST2016-00486
T( ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2017
C.
Parcel: 2S106DB17400
Jurisdiction: Tigard
Site address: 13250 SW AUBERGINE TER
Subdivision: RIVER TERRACE NORTHWEST Lot: 174
Project: River Terrace Northwest, Lot 174
Project Description: New SFA. Building/unit 5.5
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 91 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 37 Bathrooms: 3 Second: 646 sf Garage: 500 sf Front: 8 Smoke
Dwelling Units: 1 Third: 633 sf Right: 0
Detectors: Yes
Total: 1370 sf Value: $181,979.98 Rear: 5
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: 2 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: 2 201-400 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 SFA VB R-3 1370
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
STE 1
SCOTTSDALE,AZ 85258
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $23,280.12
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 9 -001-0090. Y may obtain a copy of the rules or direct questions to OUNC by calling 503.2322,1987 or 1.800.332.2344.4. ___f.
Issued By: .lili �j ,,�- j Permittee Signature: 4..cre'_,- �i L�L°!C /Coli!
Call 603.639.4175 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 ��T S
• �+
City of Tigard Received �//i 7// ' �,1• PemvtNW--(7-211/e.
o l /�-�3(���
lig i0 13125 SW Hall Blvd.,Tigard OR 97223 0 C T 1 2 016 p,�Review i )7—
Other Pe It e;20/6-OC/Ye/
_ Phone: 503.718.2439 Fax: 503.598.1960 DateBy: f� -�J')
Inspection Line: 503.639.4175 CITY O�+ AI�I}+ Date Ready/By: 7 rw;= ® See Page 2 for
' �» Notified/Method:/,� 0 / , Supplemental Information
Internet: www.tigard-or.gov
' ILDING DIVISION - '4
_: i"'� ,�`.�.,a�
M � ��Rr� j^ ��.�.
.» w k" s£ ., E r� .. v'•, .. "s'. i s..,.. .xis:«ka&..., .`r,.€w�.3 A A -,.w" ..:,«. ae3 . .narad
.��,.; x&�.£``�`as,�,�":` an"�:1:`;;:z,.s..' .;�».' . '.. � ,:^..;w�„a.:a°"� ,.-. x:. �n...�.:x:x...
®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
❑Addition/alteration/replacement 0 Other equipment,materials,labor,overhead,and the profit for the
, � •, ' : � + u work indicated on this application.
� f �"� ��, � F�rP,a
Valuation:1 gi 919 $
❑ 1-and 2-family dwelling 0 Commercial/industrial
Number of bedrooms: ;11-5."-19114-41.
❑Accessory building g Multi-family
❑Master builder ❑Other: Number of bathrooms:...""))"..c.,
e � P ;��, �� �1� ��`� - � Total number of floors:
Job site address: /3M S pi11 vx yri1N -T yo New dwelling area: 115-1O square feet
City/State/ZIP:Tigard,OR 97224 W,f" f� Garage/carport area: SIO square feet C 3,„
Suite/bldg./apt.no.: C).5.- I Project name:River Terrace Northwest Covered porch area: gpt,L quare feet f q 6
Cross street/directions to job site: Deck area: square feet q 1
{Jc-.c i� `. v
Other structure area: . square feet
tom- � ,C ' ` ,m
Subdivision:River Terrace Northwest I Lot no.: /7 / Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
it, 'i:, “17.-1.; work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
" ,:',-: '° ,a Number of stories:
Name: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
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 I Fax::( ) — .
E-mail:Angela.Grajewski@polygonhomes.com " -. - , , s : '
�a .. Commercial and residential prescriptive installation of
fE i ` , ` , • T 3L ° ��` , s •. ° roof-top mounted PhotoVoltaic Solar Panel System.
tie-�� €a ,,,:��� ��s`�. �»,��• �,r.,dd
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.
Permit Fee(includes plan review $180.00
City/State/ZIP:Vancouver WA 98660 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: $201.60
A • This permit application expires if a permit is not obtained
Authorized signature: /' within 180 days after it has been accepted as complete.
���,,,ewskV f *Fee methodology set by Tri-County Building Industry
-Print name:Angela Grajewski I Date: qi� (4j Service Board
I:\Building\Permits\BUP-RESPermitA.pp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
, BICEIV1
Mechanical Permit Applica 1(m(71 fit s i .i trv l l
City of Tigard Receivrtt 'S -/(
13123 SW Hatt Blvd.,Tigard,Ore 97223 0 CI I. 1 2 016 l sy: ' -'�y`� ,
Phone: 343.71 82439 Fax: 543.59111964 Plan ltevie�v
Inspection Lire 303.639.4175 DataOtho Permit:Internet www.tigard-or.gov YJSy toes 41 Seg Pale 2 for
1 l�toufKdiMsthod: Supplemental latornanoa
BUILDIN DIVISION
�, ,,, YO x F44 - .4 0131 C1Al E$CB Dt7LEi ,::i-•..e 1 a 'a:s.
lEj New construction 0 Addition/alterati0nhcplacement Mechanical permit fees*are basun on value of the wade
❑Demolitionperformed.indicate the value(rounded tP the nearest dollar)of all
0 Other: mechanical materials,equipment,labor,Overhead,and profit.
; DI,3�i
PtE7��bi'�MS.
F _,',,,,,'..f2.,',:'' .1;,,
❑1-and 2-family dwelling 0 Comnerciaimdustrial ❑Accessory buildingFor special information res}dasQttst,2 Multi-fmily 0 Master builder 0 Other: Dcssxipioi
CUy. Ea. Total.
, 5 IIMAI11iD 1 TION H Jrnalin¢:
iia
An condo:roam I 46.75
Job tate address: 13ZSTD SW Pill l tile,TexY�1� Furnace 100 000 87 t3(ducu vrnts) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(duetshents) 54.91
Heat pump r 61.06
Suite/bldg./apt.no.: S.S- Project name: Q i lifer.2 5t Ductwork
Cross street/directions to job site: Hydronic hot water system I 23.32
Residential boiler(radiator or 1
bydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 1 46,75
Flue/vent for any of above 1 23.32
►4t�r r r ct.� Nortv►weg1- /71./ 23.32
Subdivisi Loma.:
Other fuel appliances: 1
Tax maplpartxl
no. CitIPI ,. .._.:
Water heater ri
33 9 w� � a `DSfiObFR03t 4 f � ', �
Gasfirepla�inert
• 3
Flue vent for water beater or eas
new home construction fireplace 1 23.32
Log lighter(Sas) 23.32
Wood/pellet stove `- 33.39
Wood fireplace/insert I 23.32
Chir ncy/liner/fluefvcnt z 23.32
,•.a r e e i' a ;. � ,= Outer; i 23.32
-_a
i. .., g g,_- ,_ tI,, ' _2 .. En nmental exhaust and ventilation:Nam :ADVL E
Land Holdings,LLC lange hood/other kitchen j
Address:7600 E DoubletRanch Road ' _! 33,39
s
Clothes dryer exhaust 3339
City/State,Z1P:Scottsdale,AZ 85258 Single-duet exhaust(bathrooms,
toilet compartments,utility rooms) 23.32 ,
Phone:(602)694-4031 Fax:( ) Attic/crawispare fans i 23.32
:', 1 ,� .;`'>._ P,4 ' ' n., s U C CE2EBB h1, .. .<€.� Other: 2332
t
Business name:William Lyon Homes,inc. Fall piping:
514.18 for first roar,s4,03 for eh additional
Contact name:Angela Grajewski Furnace,etc.
Address:109 East 13th Sweet Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 water heater
Phone:(360)695-.7709 I Fax::(360)693-4442 FireplaceRange '
E-mail:Angst,Grajewski( polygonhomes.onm
�.._ Barbecue' i
x
z' ,
q -� fie.,... ._ �.�,_allatriltt w Clothes dryer(gas)
Business name:Andersen Mechanical.Inc Outer'
5 .
Address:1628 3W k..y y� . .,. l
&PI Ave
Subtotal
City/St'ate/ZIP:Tigard,OR 97224 Minimum permit feet(390.00)
Phone:(503)9197 663 Fax:(503)536 6615 Plan review(25%of permit fee)
vState surcharge(12%of prermit fee)
CCB tic:168214 TOTAL PERMIT FEE
This lit application expires if a penult h not obtained within 150
Attu izcd Sim: days after it hat bees aaxpted complete
• Fee methodology set by Tri-Cel my Bmldiolindustry Service Band
I Print name:Angela Cr aje+taki Date:8/22/16
t- _rermaApp-6rdt13:doe 4404617 (11421COMAT13)
ElElectrical %d
ectrical Permit Applicatio 1 (,t? (,t ! I( I I 'I ()\I ti
City o Tigard COT 11 2016 Permittw75 ,r6,.6
13I 25 SW Hall Blvd.,Tigard,OR 97223 yp r.,
Inspection3Line:�503,639,417439 Far 5t13,598�tp .1 OF 1!UAfe� lte '
paver
twit
Interna: .tigard-tug , T i SIO ! l+°°tiea'l °e:
lieeiERII
►_4 New construction 0 Audition/alteration/replacement Please chedt all that apply(spa s eats of pleas wines ):
13 Demolition El OtherCI Service or feeder 400 amps or more 0 Banding over three stories
where the available fault annul Q Marinas and boatyards,
.,w. x :"7--,_ 7 .. sa `. „ exceeds 10,000 amps at 150 volts a ❑Floating buildings,
1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to wand,or exceeds 14,600 0 Comm«ci l-use agricultural
l Multi-family 0 Master builder ❑Other: maps for . other�. Instabualdl e8s
tIy ❑Fire pump. ❑laatalfa6oa of 150 KVA a
' „i. �. te1 "_� L � �-;.:: €���,€ -,! . ,...a
03ncgoeysytern. largetsq
>aatelydorived
❑adlttior new moa load of system.
Job 1: Job site address:13 . W witrine Terr 100HPamore, 0
"A",-S;"1--,"13,
City/State/ZIP:Tigard,OR 97224
ask or more residential units, occupancy.
O 1ledhfiare facilities. 0 Reaatior d vehicle
le parks.
Suite/bldg./apt.0: S,c Project name: giv .�LY�'e_Ai O BaculaHadafiax
eedera500 amps x more, Os�,gply
"ottavdtaae
0°inalfar•maeoo
s
Cross street/directions to job site: ; °, '''"° x
ne,erirsaoa Qe Each T«at
New residential single-or multi-family dwelling unit
Subdivision rtieraee N vJ Lot 4:j 71-/ Ineindes attached garage.
l Tax map/parcel H; 1,000 sq,R.or less ( 168.54 4
-7, ...,):.,- ,A : Ea,add'1500 sq,ft or patios J 33.92 I
Limited energy,residential 75.00 2
(with above sq,ft.)
Limited ,multi-family
75.00 2
residential with above ft
Name;ADVL Land Holdings,LLC Renewable Energy 0 See Page 2
Address7600 E Doubletree Ranch Road Services or feeders installation,alteration,and/or relocation
City/State/ZIP:Scottsdale,AZ 85258 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Phone:(602)694-4031 1 Fax:( )
Email: 401 amps to 600 amps 200.34 2
Owner installation:This installation is being made on property that I own which is not 601 amps to 1,000 amps 301.04 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701.
Over 1,000 amps or volts 552.26 2
Owner signature: • Date:
- �� Temporary services or feeders installation,alteration,and/or
Business name:William Lyon Homes,Inc. 200 amps or less 59.36 1
Contact name:Angela Grajewski
201 amps to 400 amps 125.08 2
Address:109 East 13th Street
401 amps to 599 amps 168,54 2
City/State/ZIP:Vancouver,WA 98660 Branch circuits-new,alteration,or extension,per panel
Phone:(360)695-7700 1 Fax::(360)693-4442 A.Fee for branch circuits with
above service or feeder fee, 7.42 3
Email:Angela.Grajewski@polygonhomes.com each branch circuit
B.Fee for branch cheeses withor6
ti -„, s `.::. '. ...,..1 . R, ,, _. _,,. ;service Or feeder fee,first ,
Business name:alatneda electric branch circuit56,i8 2
Each add'i branch circuit 7,42 2
Address:3415 ne 44th ,
Miscellaneous(service or feeder not included)
City/State/ZIP:MINIS pj,lai„.40,‘/O1Z /07 7' /3 Each manufactured a or modular 67.84 2
dwelling.service and/or feeder
Phone:(503)3192192 Fax:( ) gaol only 67.84 2
Email:solarpdx@nie.com
Pump or irrigation circle 67.84 ' 3'
CCB Lie.: 199188 Electrical Lic.: c923 Suprv.Lic.: '/f7 I S Sign or outline lighting 67,84 2
Suprv.Electriciansignature,required:
Signal circuit(s)or firoited-enorliOi 0 S
Print name: 1C.;ft, /2. -C J Date: S1z3/f,�
panel.alteration,or extensiion te Page; 2V
Each additional inspection over allowable in any of the above
Authorized Additional inspection(1 hrmin) 66.23;to
I Print name: - DattelZ.3/74Investigation(1 hr
nun)
90 6o hr
r eux„yxt:.doc aa,awt7rot5 44046 15111 tmsrt 4/WEB
Plumbing Permit Application
ECEINTEI) IHR ()t l I( i ( ,t ()\I 1
Building Fixtures _ - f t
Received Permit No./y‘ / ,(i y,
City of Tigard p ceivx- s
13125 SW Hall Blvd.,Tigard,OR 97223 T 11 2.016 Plan Review Permit No.:
Phone: 503.718.2439 Fax 503.598.1 lure it See Page 2 ter
Inspection tine 503 639 4175 �1 h !` Date Ready.Bq rappk ,ta[information
Internet: www ttgard-or gov E Y 4J RD Nay icedaZi ad
„f x E .,
�y�.�� � �«� �r:,, special information ase checklist.
►'_New construction 0 Demolition Description For speI Qty. I Ea I Total
❑AdAddition/alteration/replacementiterattonit�place.-.rent.... ❑Other New 1-2-family dwellings(includes 100 R kr each utility
connection)
,,,,,,-;;•,1;., .r a � ::3,1.';',,, 7 �.�-� �� SFR(1)bah 31270 '
{{t
SFR(2)barb 437.78
I-and 2-family dwelling Q ommerciallindustrial
SFR
(3)bath 1 50032
Multi-family 25.02
Armory building MltiEach additional bath/kitchen
0 Master builder
0 Other Fire sprinkler( sq.ft.) Page 2
.Site utilities:
' e , r � � �.. „• s : .�� . _ drain 18.76
„;:,!E'.4''''''-'447: ,°= �� T-nCatch basin or arca
Job site address:/ 5\1.11)1nr vYf�l 1 L�QC� Drywell,leach line,or trench drain 18.76
City/StatetLlp:Tigard,OR 97224 Footing drain(no.lineal ft.:_) Page 2
Suite/bldg./apt.no.:S •s---- 1
Project name:f?4V ei/I "ryate, Manufactured home utilities 50.03
18.76
Cross street/directions to job site: Manholes
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Stam sewer(no.linear ft: 1 Page 2
Water service(no.linear ft.: ) _ Page 2
Subdivision; vP4/ ex{� Lot no../� Fixture or item:
Backflow preventer 31.27
Tax map/parcelno.: Badcwatea valve 12.51
E �T
1 7: '.( 1 1'. _n e.>;. p, Clothes washer 25.52
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
pExpansion tank 12.51
7:-/e4-4,.''.0::'":',„.• - , .: _ ,.. Fixttrrt/sevvtrcap
25.02
Milne:ADVL Land Holdings,LLC 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
Fax ( ) Ice Maker 12.51
Phone:{602 94-4031 ....,:40W":',.`c x c Interceptor/grease trap 25.02
t z uc P 2
� ,,-.. $ Medical (value:S )
Business name:William Lyon Homes,Inc Primer 12.51
Contact name:Angela Grajetvski- 12.51
Roof drain(commercial)
li/b
inasin/lavatory 25.02 '
Address:109.East 13th Street- S
City/State/ZIP:Vancouver,WA 9$6Solar units(potable water) 62.54
+60 12.51
1 Fax::(360)693-4442 Tub/shower/shower pan
Phone:(360)695-7700'' Urinal 25.02
E-mail Angela.GrajewskierE�YSoahomea.com ate closet 25.02
W
�x r s � Wats heater 37:52
Business name Alliance
Plambitag LLC Water piping/DWV ; 56.29
�, 25.02
Address:146 W Historic Columbia River Hwy Subtotal
City/State/ZIP:Troutdale,OR 97060 Minimum permit fee: 372.50
Phone:(503)492-3490 Fax:(503)912-6438Plan review (25%of permit fee)
CCB Lie 184601 Plumbing Lic.no.:PB732' State surcharge(12%of permit fee)
" _
Authorized signature: TOTAL PERMIT FEE
- This permit application expires tf a permit$act obtained within lN days
Print name:Robert Dishman Date:5/23)2016 after it has tees accepted as complete.
*Fee methodology set by Tri•County Building Industry Service Board.
t:taiu7dingU'umitetiPLMU•YainstAppdoc 10/01/09
440-46167(10/071COMlw1:a)
i g lig City of Tigard
II
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Residential
TIGARD.
ro,. 1 . s4 ,,,,,,-5,,,....aa'ar.A.t+ ,,.as a. ..0.-4.T,.�. _•. .r, ,«.a:- a.,. Adi,- _. ..1, " w°+
Building Permit #: -C7;2 / --009 f
Site Address: f ScQs1) , (t) h -Ter
Project Name: eitzer —7"cr,VGi' AkY4gi- Lot #: / --,Z
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: &) ` F4
ii erify site address/suite# exists and active in permits tem.
River Terrace Neighborhood: ❑ No 9a Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
' ree(3)copies of site plan 0 'sting structures on site
tri$ite plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
VP rawn to scale(standard architect or engineer scale) I oor elevations
orth arrow Ta Utility locations(required for new,may apply for additions)
to address,project or subdivision name and lot number I fi cation of wells/septic systems
kpplicant information(name and phone number) /1c sting trees to be retained with drip line,and tree
t dimensions and building setback dimensions protection measures
Lot area,building coverage area,percentage of coverage and ►A eet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street names
Ptroperty corner elevations(2 foot contour lines if more than
4 foot differential)
lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified V No Received: ❑ Yes ❑ No
Public Faciliti Improvement (PFI) Permit:
Required: IZ Yes,applicant was notified ❑ No Applied For: IYes ❑ No,stop intake
and Use Case#: Abe 0 'S 57 U aO/ c �E3
g Zoning: k—'i g Pl
Required Setbacks: Fron , go, Rear Side 0 Street Side 3 Garage QO
all
Requirement:
KJ Lot Coverage Maximum: —f� . �''�
PI Building Height: Maximum Height __ Actual Height 1
P1 isual Clearance
In/
10ensitive Lands: CI Yes I No Type
ve4
Urban Forestry Plan
❑ Conditions "Met"pj.or to issuance of building permit
Notes: J7fc1)1 g ._p /l be pg6r A 'i'/X iksS rce .
Approved By Planning: r ��__.___ 4c-A Date: // e)//1e
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: Cl Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
v
Building Permit Submittal
Original Submittal Date: /e//y//k
Site Plans: # 3
Building Plans: # __2___.
Building Permit#: Enter building permit#above.
Workflow Routing: Planning [Engineering ❑ rmit Coordinator [ - wilding
Workflow Sign-off: g--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.
M'Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ��' ���C,d-7yri---C---.._ Date: //�7/7. ,
�t ,y.,. }, . rte_ w 1a.�w:t 3_, ; - -
Engineering Review
Slope at building pad: i .dat
403 Conditions "Met"prior to issuance of building permit
❑ 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 ,y •ineering: Date:
Notes: I , — _ter
Approved by Engineering: ifidL Date: (t-_,Zi
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved 0 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: i�; es ❑ N/A
Tigard Trans SDC: It Yes ❑ N/A
Parks SDC: It: Yes ❑ N/A
OK to Issue Permit
pproved by Permit Coordinator: Date. it It `P
lie. ..././ /3
I:\Building\Forms\BldgPermitRvw REs 091216.docx
*
City of Tigard
11111 a COMMUNITY DEVELOPMENT DEPARTMENT
II
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: /`i-7 0/6, 49 ,-"J
Site Address: I2S &k) u4 `�..�,c
el -
Project Name: elver. ��ra cC� Ai f, 5=1.-- Lot #:
I'7174
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Dist" t Design Standards (18.660.070.1.):
Is the project subject to the plan district design standards? VYes ❑ 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.
Balcony w/access 2 Window Projection Vertical Wall Offset a
Porch min./5 ft. deepkal Gabled dormer
ft. deep min. 2ft.,5 ft.wide min. 2 ft., 6ft.wide
CICI13 ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: /4. 6770
3.Mntrances:At least one entrance must meet both of the follo g standards:
ax. 8 ft. setback from Ion st street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: Yes
CI
If es,all the following apply: sq.ft. min.
ctOne street facing entry ft.max. roof above floor of porch
vip
5 ft. depth min. 30%min.porch roof coverage
4.j�)etailed Design:All buildings shall include a min. of five ofe 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
Vi/Wall offset min. 16 inches CI Dormer min. 4 ft.wide
irdi Roof eave min. 12 inch projection W oof offset min. of 2 ft.
❑ Roof shingles either tile or wood V able,hip or gambrel roof design
0/Roof pitch oriented south min. 500 sq. ft. ❑)-Iorizontal lap siding min. 3-7 inches wide
101 Accent siding min. 40%of street facade ( 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:
Itycloser 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 and garage does not extend beyond the front porch.
em 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
e
above the garage that faces the street with a min. area of 12 sq.ft.
Width: (Check one)
2-foot-wide garage door CI 40%max. of street facade
1• 1,
50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: — -- Date: / mo, fc
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:
13250 SW AUBERGINE TER, SHERWOOD, December 1 , 2017 at
OR, 97140 11 :00:28 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00486
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
No A/C installed
Violation Summary:
Inspector Contractor
Plumbing Permit ApplicatiµpECEIVE�
Site Utilities
City of Tigard MAR 15 2017 Received r
Date/B 1 Permit No.Sri /�// .. 16 i f()C
II 13125 SW Hall Blvd.,Tigard,OR 97223 y 1 �! 7 !"` / �L/c[O (ii/if
11
111 Plan Review
Phone: 503.718.2439 Fax: 503.59�.:IT616 OF TIGARDII
Date By: t7^ AGU Other Permit No.:
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By:
Inas El Seeage
forInternet: www.tigard-or.gov
Notified/Method: -ffi` `2 Supplemental Information
,;31,-, TYPE,()Flow'
®New construction 0 Demolition For special information use checklist.
Description Qty. Ea. I Total
❑Addition/alteration/replacement 0 Other:
New 1-2 fa
mI Y dwellings(includes]00 ft for
each
connect)on)ratrtEG,Ral' i RtiC ION '';• i,- SFR(1)bath 312.70
0 I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building ®Multi-family SFR(3)bath 500.32
0 Master builderEach additional bath/kitchen 25.02
0 Other: ,
Fire sprinkler(1,370 sq.ft.) 111,- Page 2
40 4SITE 'oltt'I ATIO t �L9CATION , Site utilities:
Job site address: 13250 SW Aubergine Terrace Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
I Suite/bldg./apt.no.: Project name:Northwest River Terrace
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: 174 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
.r E��I� Off' o ,,iii, $� �, Backwater valve 12.51
4).; ,.,x:.:' Clothes washer 25.02
Multipurpose Fire Sprinkler System
Dishwasher 25.02
Permit#MST2016-00486 Drinking fountain 25.02
Ejectors/sump 25.02
P� PIt,OPE 1.'1'X PWN I+; ..I,,3. f - � NAN1 Expansion tank 12.51
Name:Polygon Northwest Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: Hose bib
25.02
Phone:( ) Fax:( ) Ice maker 12.51
;£i.: s l d t�A • PERSON ') Interceptor/grease trap 25.02
Business name:Alliance Plumbing,LLC Medical gas(value:$ ) Page 2
Contact name:Robert Dishman Primer 12.51
Roof drain(commercial) 12.51
Address: 146 W Historic Columbia River Hwy
Sink/basin/lavatory 25.02
City/State/ZIP:Troutdale,OR 97060 Solar units(potable water) 62.54
Phone:(503)492-3490 Fax::(503)912-6438 Tub/shower/shower pan 12.51
E-mail:robert.dishman@allianceplumbing.net Urinal 25.02
Water closet 25.02
,....; ., Water heater 37.52
Business name:Alliance Plumbing,LLC
Water piping/DWV 56.29
Address:146 W Historic Columbia River Hwy Other: 25.02
City/State/ZIP:Troutdale,OR 97060 Subtotal
Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50
CCB Lic.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee)
7� State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Gavin Thomes Date:3/15/2017 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule Residential Fire Suppression Systems
s fillip � ,, 'N�; ' _ e('ett, autal I t..':',444.':. pe t w'�.`
Footing drain 1s`100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52li ' ,
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
each additional$100.00 or fraction thereof,to
�tl!&l< ee and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees
t
that N ;
QuaItitb " xture �
uAded eac s � iI .
$ta toi�
Plan review is any of the following.
'Work r ormetpped ., Please check all pply
Baptistry/Font
❑ Any new commercial building with water service 2"and
Bath -Tub/Shower
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
Drive Thru 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic ® Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
) - ,., lrto s r" a 'am
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washerincrease of sewer EDUs,a sewer permit will be issued and
WaterrExtractor
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
\\up-dc2\home\gavin\My Documents\Fire Sprinklers\RT\City of Tigard Pgmit.doc