Permit (141) liCITY OF TIGARD MASTER PERMIT
2..v COMMUNITY DEVELOPMENT Permit#: MST2016-00482
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2017
Tt �'� Parcel: 2S106DB17100
Jurisdiction: Tigard
Site address: 13226 SW AUBERGINE TER
Subdivision: RIVER TERRACE NORTHWEST Lot: 171
Project: River Terrace Northwest, Lot 171
Project Description: New SFA. Building/unit 5.2
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 97 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 37 Bathrooms: 2 Second: 562 sf Garage: 453 sf Front: 8 Smoke
Dwelling Units: 1 Third: 562 sf Right: 0
Detectors: Yes
Total: 1221 sf Value: $161,423.52 Rear: 5
PLUMBING
Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 2 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF RainStorm 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: 3 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: 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 Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA VB R-3 1221
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: $22,829.73
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: .1� . Permittee Signature: 4SV l/CCf e I
olit" .--.:P Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit ApplicationilECEIVEP 1
..a.. .
Ci of Tigard 77 yy C EL($'
7k / Permit No," -7 /13125SW Hall Blvd.,Tigard,OR 97223 OCT11 2O 6 p
' I Phone: 503.718.2439 Fax: 503.598. Yry�TIGARD
))-c,1 -) �) �erPer f� /,4.�p /
r 1c,\RI, Inspection Line: 503.639.4175 OF l AGAR Date Ready/By-. f, Juris_ H See Page 2 for
Internet www.tigard-or.gov
BUILDING DI ISION Notified/Method:/2. 6 /6Y' Supplemental Information
L 1
a x �.. c�.s a •�^� '�'. ,g�,.� �--a�� rr� d x... •�*r-x•,. � r-..� -�=I�"'�' �, •,��., xs"a•^',.c�a �� -R.:;.� � �^ �n, '�d t.:�z� .,�..r�'�sxs�•c�a� >.�a,�,,.a:�
®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
0 Addition/alteration/replacement ❑Other. equipment,materials,labor,overhead,and the profit for the
4,, ; •
ca
work indicated on this application.
, � -'-� ., r. . a ,,- ' .,, , -
❑
1-and 2-family dwellingValuation: t $
❑Commercial/mdustriaI 6�,�d•3
1-17T147-114 4)-4
0 Accessory building ®Multi-family Number of bedrooms: Z
❑Master builder 0 Other Number of bathrooms: '2.,‘y; -j'' y ''+ -
� a E ��� R Total number of floors: j ( ! "7"-
Job site address: /3221 S pi u,ve rriw e Te.rya cZ New dwelling area: ,'21 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 4t square feet‘t�--'(
Suite/bldg./apt.no.:S,L I Project name:River Terrace Northwest Covered porch-esep) square feet s.(2,--6 "l
Cross street/directions to job site: Deck area: square feet
S, j<<x •ter 2 -
0 1,er structure area: square feet
'bra � �` n a•:.3- N��,.
E €ms`s
Subdivision:River Terrace Northwest 1 Lot no.: I/ l 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
a r 1 '" !, I ,s: -— work indicated on this application.
s't� w$6a -` >ta-}:.Po..n.k n�m_s, %•ZM,✓.sa'as,�t-..—3�ra�`il' �Ay.,;. R ,,, 'fii k: 4 .
Valuation: $
Existing building area: square feet
New building area: square feet
• �� 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
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Amount received:
Phone:(360)695-7700 I Fax::( )
-` n ��-ARE
�� , r x �
E-mail:Angela.Grajewski@polygonhomes.com „� ..,��,:w, «n �,,a���.,., �x;, ��,,w� �.v,.:.
r — Commercial and residential prescriptive installation of
,, W T_�,� - ' ':. .,, . . ; 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 $180.00
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: $201.60
Authorized signature: LAA This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Angela Grajewski Date: al) r Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit AAp 1CSt N1,� 1 tilt(J1 l it i t ',[_(,.1.1
City of Tigard ,l A 11" Received
Dued3Y Permit Na j- `6.-e.o L
II_ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
k• Phone: 503.7182439 Fax: 503.598.19600 CT 1 1 2016 DItlBy: Other Permit:
F,i, Inspection Line 503.639.4175 Date Ready/By Agit: ta Ser Page 2 for
Internet www.tigard,or.gov CITY
y]OFTIGARD Notifed/N1alaod: �.11 Supptentental Information
: ',0 „.` ° ,,,i-4 o p t.. � NW ate ;,,.. hill- 1:� D r i `-
to New construction 0 Addition/alteration/ lacement performed.
nt e•WC based de x the of the work
�P Performed.Indicate the value(rounded ter the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,Overhead,and profit
x
a Value:$
..: 1i1�lmQ . tior#- „
0 Accessory building For��
❑1-and 2-family dwelling 0 Commercial/industrialinformation �,�,,�i..
®Multi-family 0 Master builder 0 Other: Description City. Ea Total
ui-I r QB<S lh'FO MAi1C ,at1ND 7;.S T1s 7 n Hei""//coo ing
m ...div. � ,
Air conditioning I 46,75
Job site address:
1 )/`lam SW I bCAIIJI L�T (OC Q Furnace 100.000 BTU(duets pts) 46.75
City/State/ZIP:Tigard,OR 97224 J Furnace 100,000+BTU(decta+w ats) 54.91
Suite/bldg apt.no.: (5,L Project name: / Duct p" 21,06
/.(tl/ . Duct work
k t 2332
Cross st eet/ditections to job site: Hydros»c hot water system 2332
Residential boiler(radiator or
hydronic) ? 23.32
Unit heaters(fuel-type,not electric), `
in-wall,in-duct,suspended,etc; 1 46,75
I Flue/vent for any of above 1 23,32
Other:
1� 23,32 ICING4VW hW l. Lot no.: , Other fuel appliances::
i
Tax map/parcel noWater heater i 23.32
) R ' DE F10N O.F_woi2K. Gas fcreplaceiinsert • 33:39
' Flue vent for water heater or pas
new home construction fireplace I 23.32
Lon lighter(gas) 1 2332
Wood/pellet stove i 33.39
Wood fireplace/insert 1 23.32
Chimney/liner/flue/vent 23.32
:: a- A i 0 e b',. 2 gt 4 K ''''''"''''''''''''''1"
ti Other: 2332
a' F''.
s Environmental exhaust and ventita6ertc.
Name:AD VL Land Holdings,LLC Range hood/other kitchen
Address:7600 E Doubletree Ranch Road eA�P t 1 33,39
Clothes dryer exhaust 33.39
City/State/ZIP:Scottsdale,AZ 852511 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) ` 23.32
Phone:(602)694-4031 Fax;( ) Attic/crawispace,fans i 23.32
>sr 7 W ''74 i. 43, ACT g'1Other: 2332
Fuel piping:
Business name:William Lyon Homes,Inc.
514.15 for first that;s4.03 for!itch additional
Contact name:Angela Gra jewskl Furnace,etc.
Address:109 East 13th StreetOs heat pump
City/State/ZIP:Vancouver,WA 98660 W
aunit beater
er heater
Phone:(360)695.7700 I Fax::(360)693.4442 Fireplace
E-mail:Augela.Graj ia?polygonhomes.com B
angeBarbecue
"�`` ,- i a 0 I 'P .., r ,a , ,- Clothes drye (gas/ j ,
Business name:Andersen Mechanical,Inc. Outer I
1;1244e
:���� � �� L'3�!;� ;�`E� ...�... 141
Address:16285 SW 85°Ave
Subtotal
City/StateftIP:Tigard,OR 97224 Minimum permit fecIS90.00)
Phone:(503)942-6664 Fax:(503)536-6615 Plan review(25%of permit fro)
s State surcharge(12%of permit the)
CCB lie.:168214 (7
TOTAL PERNOT FEE
This Penult application espires if a permit is not obtained within tali
j),/,(
days atter it has been accepted complete
Authorized sl • Fee methodology set by Tri-County Bw1diaeIndustry Service Board
Print name:Angela Grajewski Date:8/22/16 t
I'ruadad JP +an_dati11f:aoe axo.asarrtld=oticora sl
, •O cEivEn _, .
Electrical PermitpApplicat , CEIVEPt i t n« (,i 1 U I I ,i nvI t
City of TigardV Pamir w/�l Sj 00�''LSO e/��
Received
13123 SW}tall Blvd.,Tigard,OR 97T 1 1 2016
Phone: 503.7182439 Fax: 503.598.1960
lnspectioa Linc: 503.639.4175 CITY OF TIGARD ` dy D By'. ' liiiigigEN
interact: www.tigard-or,gov Naabed/sehod,
t. New construction 0 Additionlalteratiork'replacement Pierre chock as that apply(submit 2 sea• plasm w ns ):
0 Servkc or feeder 400 amps or more 0 Building over time atonal.
o Demolition ❑Outer' where the available fault event Q Mains sad boatyards,
'*,. P,-,,,,,,,:L. ,`,';7',"::, , ..> camels 10,000 amps at 150 volts or 0 Hames braidings.
1 and 2-family dwelling A.u0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use.aiiaatUAl
amps for alt other installations. bm'Idings
.4 Multi family ❑Master builder 0 Other D Fire pump. ❑lauriatioe of 150 K VA or
larger., a.'
cleaved
w�^ t g �... .mss--;eF„„):. ' i4. ',:L.'°-',.', .0 b t; �, v.„.�..`�. 0 - !TM'�"^�
❑Addition of new motor load of sYs
Job#: Job site address:132,2(D SW (line-1-err ,0„,,,„.,„ ,: 0"A-,—-,"1-r','i-
0 Six or more residential mots, ooh.
City/State/ZIP:Tigard,OR 97224D xea►et case facilities. ❑Reaestio al vehicle parks.
❑Hazardous locations. O Shy vet for more than
Suite/bldg./apt.$: .2 Project name: i> V' /, _ Q Service or feeder 600 amps or more. 600 vola nominal
Cross street/directions to job site: $ " 7.- 3,::,''' —5-7- , te r
nesripriw Qty. Each Teed •
_ New residential single-or multi-family dwelling unit.
Subdivision 1P ~ • ' i ice, N of I Lot#l: IIncludesI Includes attached garage.
Tax map/parcel#: 1,000 sq,ft.or less ( 168.54 4
;,' t";',/3,7:'
,/,7 ' a „. 1": Ea add.'500 sq:ft or potion ) N. 33.92 1
Limited meg',residential 75.00 2
(with above sq.ft.)
Limited energy,multi-family 75.00 2
_ {, m z residential(with above sq.ft)
Name:ADVL Land Holdings,LLC Renewable Energy 0 Sec Page 2
Services or feeders installation,alteration,and/or relocation
Address:7600 E Doubletree Ranch Road
200 amps or less 100.70 2
City/State/ZIP:Scottsdale,AZ 85258
201 amps to 400 amps 133.56 2
Phone:(602)694-4031 I Fax:( )
401 amps to 600 amps 200.34 2
Email:
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 or volts 552.26 2
Owner signature: Date:
_ Temporary services or feeders installation,alteration,and/or
relocation
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 2
Emaii Angela.Grajewski®polygonhomes.eom each branch circuit
- B.Fee for Ixanch circuits wi1ho .
�. m, r _ u %1.,. F. �w _�M,s r service err feeder fse First 56.18 2
Business name:alameda'electrlc brartcii circuit
Each:midi branch circuit 7.42 2
Address:3415 tie 44th
Miscellaneous(service or feeder not included)
City/State/ZIP:ARM ii0r,./J ,11 /" 2.2'/3 Each manufactured or modular 67.84 2
dwelldwellim service ardior feeder
Phone:(503)3192192 Fax:( ) Reconnect only 67.84 2
Email:solatpdtr@ntecomPump or irrigation circle 67.34 ' 2'
CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: y(7 jS
Sign or outline lighting 67.84 2
Suprv.Electrician signature,required: Signal circuits)or limited-energy ... ,'
panel,alteration,or extension
0 &r Page 2
Print name: /c;1tr JLapOd( Date: /L3/f,1h
Each additional inspection over allowable is any of the above
Additional inspection(1 hr min) ' 66 231 hr '
Authorized signature: '
i Il 7
Print name: ,,/."'~'' DatG S)/Z,y/�- in` (t hr min) 90,001 hr
t�+aii{digYswinis si,C H.H AB.doc Rev 0607'3015 440.4615711 brosteOe. WEB - , ,
Plumbing PermitApplicato
Building Fixtures 1 HI: HI 1 1 i i t >1 (1\1 N
City of Tigard 0-CT 1 1 2016
Recei�zd Penni'Noi /(�f(.jO��
13125 SW Hall Blvd.,Tigard,OR 97223 plan Review Other Permit No.:
Phone:SI
503.718.2439 Fax 503. OF TIGARD �d
Inspection Line: 503 639 4175 DIVISIOint Ncti Rd/Mcth ms's
BUILDING 1 1 1 B See Page 2 for
Ndl6atrMetlad Supplemental Information
Internet: www ugard-or goy ,
Demolition For special information use checklistNew construction Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 R for each utility connection)
r
SFR(1)bath t 312.70
. I1F� ,., �„ ,., .,,. ,T.. SFR(2)bath i 437.78
I-and 2-family dwellingommerciaUindtstriai
SFR(3)bath 50032
Accessory buildingMulti-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other Fire sprinkler( sq.ft.) Page2
... ,... ;; .m., _. .,. ,... . s.., i
: v- )4 y *i c at,:,1/:f6,!,;:,,, � yrSite utilities:
18.76
-terraced,, Catch basin or area drain
lob site address: 171/0 5� �Ya� 1 Gr(QC� , Dryweli,leach line,or trench drain 18.76
✓�' i V
City/5tate/Z1P:Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no:5iL Project •name: rV-ey T iltt 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 1
Scorn sewer(no.linear it: ) Page 2
A �^t /^� Water service(no.linear R: ) Page 2
Subdivision:It%�/ /e "ai e I% v t Lot n6.•J /i Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.:
Backwater valve
- <)--e---,t Q �5 ,o s - ,. j 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
EJectors/sump 25.02
bz,. ' f. fit ` _( Expansial tank 12.51
rte' >) � .. = F 25.02
ixttirdsewtr cap
Name: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
Phone:(602)694-4031 Fax ( ) Ice maker
12.51 ___-,
. r .x ;1*--'$i t''' Interceptor/grease trap 25.02
3N
Medical gas(value:S Page
Business name:William Lyon Homes,Inc
Prima12.51
Contact name:Angela Grajewski Roof drain,(comnlercial) 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 Fax::(360)693-4442 Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:Angela.Grsjewski®polygonhomes.com
g, ,_
Water
closet
25 0
Water heater 37:52 r
Business name:Alliance Ploughing LLC Water piping/DWV 56.29
Address:146 W Historic Columbia River Hwy Other: 25.02
City/5tate/ZiP:Troutdale,
dale,OR 97060'
Fax:(503)912.5438 Minimum permit fee: 57230 ,
Phone:(503)492-3490 Plan.review (25%of permit fee)
CCB Lie:184601 Plumbing Lic.no.:PB732 State surcharge(12%of permit fee)
Authorized signature: i.4fiticvTOTAL PERMIT FEE i
Date:5123/2016 T lin appNcauon expuss if a permit is net obtained within ISO days
Print name:Robert Dishman after it has been accepted as complete:
`Fee methodology set by Tri-County Building industry Service Board
I:\Bulldirtg4PErmiiii'LTM-PermitAppdoe 18/01109 440-4416Y(10102rco /WEs)
w,
City of Tigard
I/ 11/ COMMUNITY DEVELOPMENT DEPARTMENT
S
T l c lzn Building Permit Review — Residential
4=' 't . l,'e,,s kY,,,,A , .... sE:. oes; ._".: -4 .. _.. . ;axs swot..t ge
Building Permit #: rfS 7'12-a/6 - 't?'/rf -
Site Address: 15 , 7l0 ,',e h,? 72r
,
Project Name: jVrr rr0a /AA:-)Mi c--- Lot #: /•
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: (AJ sSFAI
rz( erify site address/suite# exists and active in permits tem.
River Terrace Neighborhood: ❑ No L Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
xee(3)copies of site plan 0 'sting structures on site
Vi' e plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
Z. P rawn to scale(standard architect or engineer scale) ;•or elevations
Vorth arrow 1i Utility locations(required for new,may apply for additions)
� te address,project or subdivision name and lot number a •cation of wells/septic systems
Vpplicant information(name and phone number) ►\;', sting trees to be retained with drip line,and tree
Lot dimensions and building setback dimensions otection measures
t area,building coverage area,percentage of coverage and eet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street VProperty corner elevations(2 foot contour lines if more than
4 foot differential)
0 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(PH) Permit:
Required: ig Yes,applicant was notified LINo Applied For: IV Yes ❑ No,stop intake
All—and Use Case#: P,�< ,_ QC ,3166a01-c-: � E3
fes' Zoning: iC—/" P1
Required Setbacks: Fron 0 Rear 3— Side O Street Sidej9Garage 7O
IZ(Landscape Requirement: c,..,90 %
MaLot Coverage Maximum: % •
wilding Height: Maximum Height A.)44 Actual Height _ 3?7
IA isual Clearance
v .
Easements
10ensitive Lands: ❑ Yes No Type
rc
Urban Forestry Plan
❑ Conditions "Met"pj.or to issuanceofbuilding permit /
Notes: aeciv Jsc)d7? ,`�f 2�I be ni /JIJr A /L19// ii°SZe,10ce
_ft/leillte
Approved By Planning: `'— f,6' Date:
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\BldgPennitRvw_RES_091216.docx
r
Building Permit Submittal
Original Submittal Date: l'e,/////0 ,I
Site Plans: # "._3
Building Plans: #
Building Permit#: -Enter building permit#above. �,
Workflow Routing: Kr-Planning Engineering [ ermit Coordinator `E Building
Workflow Sign-off: ,I2'Sign-off for Planning(include notes from planning review)
Route Application Documents: p—Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
yriginal plan review routing form.
ai Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: ///f,
Engineering Review
Slope at building pad: cl,
LC/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 by E eering: Date:
Notes: j,, / 4.e. poei°
z---7
Approved by Engineering: 44 Date: (j' /-4
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: El Approved ❑ Not Approved
KIIMMESEEMINSIMENIKSEESZOWEr
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:
7.„
DC Fees Entered: Wash Co Trans Dev Tax: Yes CI N/A
Tigard Trans SDC: 0-Yes ❑ N/A
Parks SDC: Yes ❑ N/A
Oft•K telssue Permit
proved by Permit Coordinator: , Date: 1C 2
I:\Building\Forms\BldgPermitRvw_RES 091216.docx
4
City of Tigard
Ill COMMUNITY DEVELOPMENT DEPARTMENT
C
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: /7..5'7 /6 pp 4/6471--
Site Address: / Q 2 & ) /9u $t �. -
Project Name: f?jve,,- -7� ro 4,2e) "veg."- Lot #: /a -
(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? 9d 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. deepBalcony w/access 2 Window Projection Vertical Wall Offset a
/ Gabled dormer
,1,�,I{ ft. deep min. 2ft., 5 ft.wide min. 2 ft., Eft.wide
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: /4 6 /
3. i ntrances:At least one entrance must meet both of the follo g standards:
QI/Max. 8 ft. setback from lon st street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: Yes ❑ No
If1/es,all the following apply: (2/t5 sq.ft. min.
t�l�'( ne street facing entryft.max. roof above floor of porch
5 ft. depth min. 30%min.porch roof coverage
4.petailed Design:All buildings shall include a min. of five of�he following elements on all street-facing facades:
/Covered porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide
pna Roof eave min. 12 inch projection Vi/Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood `dable,hip or gambrel roof design
oof pitch oriented south min. 500 sq. ft. ❑ Iorizontal lap siding min. 3-7 inches wide
Vli Accent siding min. 40%of street facadeIV Window trim min. 2 1/2tt 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:
N closer to front or side lot line, than longest street-facing wall. El Yes No. If No (Check one):
Vay extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
SCJ 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
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
Vr 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: —y ..... Date: 7 F3 /
,,
I:\Building\Forms'\BldgPermitRvw_RES_RT_062216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13226 SW AUBERGINE TER, SHERWOOD, October 31 , 2017 at
OR, 97140 10:16:47 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00482
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:
13226 SW AUBERGINE TER, SHERWOOD, November 3, 2017 at
OR, 97140 10:58:02 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00482
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Water pressure = 55 psi
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13226 SW AUBERGINE TER, SHERWOOD, November 2, 2017 at
OR, 97140 9:46:02 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00482
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed.
A/C installed.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13226 SW AUBERGINE TER, SHERWOOD, November 6, 2017 at
OR, 97140 12:24:57 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00482
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
Plumbing Permit Application
Site Utilities RECEIVED FOR OFFICE, USE ONLY
City of Tigard MAR 15 2017 Received /
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: .5 &i f-1 f; Permit Npf/� n//�D(./�j l
Phone: 503.718.2439 Fax: 503.598.19 Plan Review f lb//7 46_67
(�t (O o L
TIGARD
Inspection Line: 503 639 4175
CITY OF TIGARD Date/13y: Other Permit No.:
Internet www tigard or gov BUILDING DIVISION Date Ready/By / Juris ® See Page 2 for
Notified/Method L�/��J�7
1 / Supplemental Information
Tii P at(WORK ,, _ ..
®New construction 0 Demolition For special information use checklist.
Description
❑Addition/alteration/replacement 0 Other: P Qty. Ea. Total
New 1-2-family dwellings(includes 100 ft.for eachutility 1 in f lily connection)
- OP OP iLLOTOT,7I0I , .. SFR(1)bath
..n, ,� 312.70
0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
ElAccessory building ®Multi-family SFR(3)bath 500.32
❑Master builder Each additional bath/kitchen 25.02
❑Other: Fire sprinkler(1,2D_sq.ft.) s`ry Page 2
.J0H ITS '� V i
01�i�,T�)�I=s1.t��ll ' ,T� �\ ���°' '"` „� :� Site utilities:
Job site address:13226 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
Suite/bldg./apt.no.: I 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.:171 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
,,, i, it +b 0 kk ;‘,,x: Backwater valve 12.51
Multipurpose Fire Sprinkler System Clothes washer 25.02
Dishwasher 25.02
Permit#MST2016-00482
Drinking fountain 25.02
Ejectors/sump 25.02
��� P .OPR ' NII' ,
�. �E.,..Y R . A>� � � °���g�.l� Y �� :i 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
i4 4i 1L 1t ,' l :'
� ��'�� P �O1 ;.m 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
Urinal 25.02
E-mail:robert.dishman@allianceplumbing.net
.. Water closet
C 1`lI TCR:
Plumbing
Page2 - SupplementaPermit AlpplicationInformation- City of Tigard
Residential Fire ��
suppression
Systems:
Fee Schedule
Site�d>ltl<e .._ ' "� to 'T°141 �Clt ,e
�sit-
Footing drain-1"100' 50.03 0 to 2,000 $121.90
2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 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' 37.52 a cj m1t
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
t e ) ital 4 each additional$100.00 or fraction thereof,to
� .� � 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*.
Quantity by J'ixture Type gOttlift*,0611rabbliblittlittittlititS.
Fixture Type for ReulaeelPlan review is required for any of the following.
Work Performed:. Capper. Addeo Relbeatc Please check all that apply.
Baptistry/Font 0 Any new commercial building with water service 2"and
Bath -Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash -EachDStall
0 New exterior plumbing site utilities for any complex structure
Dpi ra or as defined in OAR918-780-0040.
Cuspidor/Water DishwasherCoirator
-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.
*410* Ciai ` I+' g ntk'
Car Wash Drain 0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food that meet the qualifications above.
Disposal -Domestic-food related
-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
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
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