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Permit (85) CITY OF TIGARD MASTER PERMIT IN ' COMMUNITY DEVELOPMENT Permit#: MST2017 00118 T t ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/17/2017 Parcel: 2S106DB16600 Jurisdiction: Tigard Site address: 13182 SW AUBERGINE TER Subdivision: RIVER TERRACE NORTHWEST Lot: 166 Project: River Terrace Northwest, Lot 166 Project Description: New SFR. Building/unit 4.1 BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 103 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 646 sf Garage: 499 sf Front: 12 Smoke Dwelling Units: 1 Third: 633 sf Right: 0 Detectors: Yes Total: 1382 sf Value: $182,461.31 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 Drains: 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckfiw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 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: 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 1382 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: 602-694-4031 PHONE: 360-695-7700 FAX: Total Fees: $23,359.32 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 2-001-0090. Yo may obtaintaina copy of the rules or direct questions to OUNC by calling 503.232.198719or 1.800.332.2344.4. b Issued By: , r�� bl %wti� Permittee Signature: J'r GG////�/i CC1 1'7 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. Buildintg Permit Application . , `,� s,` 1 Residential FOR OFFICE ISE O\'L1 City of Tigard � ,1'{ rat Re eeeiverd A(�/) / , PermitNo%�G [/ -00yO - 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Reviews��-1/ - j 7 Other Permir �l�Zr��O� ' Phone: 503.7182439 Fax 503.598.1960 Date/By: J Inspection Line: 503.639.4175 �,l DateReady/By: Juria: H See Page 2 for T 1 C 4 D Ins p Li , , Date Ready 74 T.,'« 4 - a .Ik klotifed/Method. 7�y�7 ,,I ��" Supplemental Information Internet www.tigard-or.gov ',' ,:c. i y ---7V,1 �� ,-•»�;: �' '�'s�—�3� ��Q, -,�- �.`ti � ��"�� - �: ��./,.-•i�.;��� .._. E.:.:..a,.. ®New construction ❑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 workindicated on this application. _ Valuation: $ _� ag�_J 1-and 2-family dwelling ❑Commercial/mdustrial Number of bedrooms: ❑Accessory building Multi-family -41 ❑Master builder ❑Other Number of bathrooms: 9.2 �r .r, _ ,, �, �- -.��,.- ilr, xiil a Total number of floors: I L1 tD 1 ✓ Job site address: 1'3143Q 5\0 fiu,tYGo.k, 1 UcT&& New dwelling area: ✓square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: qO�Cl ✓square feet 43 3 Suite/bldg./apt no.: 4, i Project name:River Terrace Northwest Covered porch area: t 0 V square feetL 4.6 , Cross street/directions to job site: Deck area: q 6 ✓ square feet) ca COVGr Other structure area: 9 4,c ✓ square feet 5. a r sin--rte= + '`--s, -4•.iiiirtii Subdivision:River Terrace Northwest Lot no.: i TQ Permit fees*are based on the value of the work performed. `�tl Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the �- w= ' - + r 4$. r ,4- work indicated on this application. 7. Valuation: $ Existing building area: square feet New building area: square feet `y amI -=-=,'r. 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: - � t 'VFW ri � sd. tl� A� p.i .' - ® .7'+ �-` i s .. ', ,-.,ate �Jf . 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/ZIPP:Vancouver WA 98660 Amount received: Phone:(360)695-7700 Fax::( ) r :" i �'a E-mail:Angela.Grajewsld@polygonhomes.com - - , .,_,-.__, >.g Commercial and residentialrescriptive installation of �` { '�QE t` ..4, 7o.m roof-top mounted PhotoVoltaic Solar Panel System. Submit two(2)sets of roof plan with connection details Business name:William Lyon Homes,Inc and fire department access,along with the 2010 Oregon 1 Address: 109 East 13th Street Solar Installation Specialty Code checklist Permit Fee(includes plan review $180.00 City/State/Z1P:Vancouver WA 98660 and administrative fees): "-me:(360)695-7700 Fax(360)693-4442 Stat.surcharge(12%of permit fee): $21.60 _..B lie.:207247 Total fee due upon application: $201.60 + This permit application expires if a permit is not obtained Authorized signature: within 180 days after it has been accepted as complete. Fee methodology set by Tri-County Building Industry Print name:Angela Grajewski Date: "-/I'V � )//l� � Service Board \ I:Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(111'/02/CO `•M/WEB) • • Mechanical Permit Application RECEIV i t312 of FI(E US 0 r City of Tigard EEIIIIIIIIIIIIIIIIII Permit No.' 14 ■ 13125 SW Hall Blvd.,Tigard,OR 97223 APR 1 7 20 plan - ' . ' Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: 7" ins ion Line: 503.639:4175 , .. :-.. . CITY OF TIGA'ill to Ready/By: lugs: .M See Page 2.for ' • i iGnlir� l Internetwww.tigard-or.gov BUILDING DIVI.Ii ed/vethod: Supplemental Information . 4,...` i ,c, `.pi`" o ,9 ,, `q 1 ? yY P,W,r-i1L;l4 : ', "e.1 1 It i3:" 'r ,x=$ i' ' 7rti` ' t`,' rh " `' s, rx. k •`m r:ti.( . - = , ," . i ''" ' Mechanical permit fees*are based on the value of the work ®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. ,,a ., j W "„ + .,�a"�Y.. �C 1..;;x:3; �.sc- :----v•-.-,..r...-1.1lqa i .r r- Ri -Np...v'tr.,,- gx. Value $ r 6 �+, ?:^ice.: 1.�1 �'*,'s..,,,l-.Jr'j,� :5:: .;.t , .� ,"fa,,t,,,,,,,- "qt�x, c-r r.» k . . .,�w 's�•- ut§ >t'"r.;t;. k1j,}'N.e if t , ,,,ggeJ it f_h,,ld £`.i.,41,k�,,,,g,`a '�yhs r.,q,t,'L 0 i-and 2-family dwelling S 0 Commercial/industrial 0 Accessory building For special information use checIdist ®Multi-family 0 Master builder 0 Other: Description ( Qty. ( Ea. 1 Total a•'i: x'a'- r=4'•:,01f^it, t,-1'e' �ytr(c;,, ` 6 Sr €t7"-,.'7.\d'':2-,"'`t: C "`4t-!R HeatinR/cooling: ,A .+t� 41,i',�i.:� M ,. Ms. alv , x .,. w� ,..u- s , c., �.......,. Air conditioning 46.75 Job site address: I 16L SW A LLber >I r yret Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+13TU(ducts/vents) 54.91 Suite/bldg./apt no.; j Project name. T a 4,v N�S,t Heat pump 61.06 .4 � �,{vfJ� t�t/i r�� N Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) , 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 1 23.32 Subdivision: �i j fi Vii!G 1 J t7V.('�l� ct' Lot no.: t tp Other: r: 23.32 Other fire#appliances: Tax map/parcel no.: Water heater 23.32 �- r1 ,,,,,,,,+,:!-:.,,,, 'z ? : Gas fireplace/insert 1 33.39 _�.. +�r r it a + �€ fob`4 a�t.,., �� ' ° . . � `; . ? �'�'„'Y �k .:.,. ..>�..-s. .: �zFBF , �'^ -0'� Flue vent for water heater or gas new home construction fireplace 23.32 Log lighter(gas) 23.32 . __ Wood/. let stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 r € �` ti rglr < if +ia��s a -',43:::�� Other 23.32 . F � .° ..ir r.4 ., .. ... _ ,- :-k 1, Environmental exhaust and ventilation: Name:ADVL Land Holdings,LLC Range hood/other kitchen ( equipment 33.39 Address:7600 E Doubletree Ranch Road Clothes dryer exhaust 1 33.39 City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) LA 23.32 Phone:(602)694-4031 Fax:( ) Attichaawlspace fans 23.32 i Other. 2332 -•, I r �'.3?'ueEr c�+*F. � C�i31� 1*�r ��� S,'��ty Business name:William Lyon Homes,Inc. Fuel piping: $14.15 for first four;84,03 for Tab additional Contact name:Angela Grajewski Furnace,etc. Address:109 East 13th Street Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace l Range { E-mail:AngelaGrajewski@polygonhomes.com • Barbecue + 'r t mFC iE E -( + Clothes dryer O Business name:Andersen Mechanical,Inc. Other: tin 3 k TMP1:5, rth j..i4 + f 4;L, ,.. Address:16285 SW 85th Ave Subtotal City/State/ZIP:Tigard,OR 97224 Minimum permit fee(890.00) Plan review(25%of permit fee) Phone:(503)992-6664 Fax:(503)536-6615 State surcharge(12%of permit fee) CCB lie.:168214 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 ',/,, / -. days after it has been accepted as complete. Authorized signature: . ,, * Fee methodology set by Tri-County Building Industry Service Board // Print name:Nichole Thorpe Date:4/17/2017 I:tBuiiding\Por itslbg.C_l'etmitApp 040113.doc 440.461n(11/02/COM/WEB) r Electrical Permit Applica Lion RECEIVED FOR OFFICE USE ONLY City of'Tigard APR 1 7 2017 Received - Ill Date/ 13125 SW Rail Blvd.,Tigard,OR 97223 B . Illi -Is Phone. 503.7182439 Fax 503.5 34Ig>�OOF TIGARD Raters new •Inspection Line: 503.639.4175 Ready Date/By: Avis: Sea Page 2 for TIGARDinternee wsvwtigard-orgov BUILDING DIVISION Notified/Method: SapplemeotalInformation _.1 ...Z�.I r_;,&- V3 T g5.., `Q .n- "f'' i ,;: 24;-_c --*. yix"1T.*,-!- s4.•.•'.A Mitt i 1::.t"--s - ` - :4;,1:'".`, ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wTdems checked): ID D=00111100Other. 0 Service or feeder 400 amps or more 0 Building over three shines. where the available fault current 0 Marinas and boatyards. �;G'-','-4b '.' _cdCEi Eta h';KCCn 3'NG1(ilt,W1 �,.,3'`, ' 'f:' exceeds 10,000 amps at 150 volts or ❑Floating buildings. I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground or exceeds 14,000 ❑Cwnmere al-use agricultural amps Ii1 Multifamily D Master builder 0 Other: far all other installations. Installation o Firs pump. D Lutallation of 150 ICVA a 7.7'' .-4:Y ",; UAL; --01.'"f...2..- fy _ .. ,:-•l 0 '.•c . 'c7 ,_?a" -,1=47-1.04C-PRN D Emergency system. larger separately derived 1 Jam S Vs) n,- �UG T e 0 Addition of nay motor load of system r Job#: Job site address: i"� � '1 i. IOOtiP or mom. ❑"n",.'Ts.."1.2^,�l-3r, City/State/ZIP: ,Tigard,OR 97224 0 Six or more residential units. occupaney. ❑13oalttimae faei€ities. ©Recreational vehicle parks. Suite/bldg./apt.#: q, Protect name.R,;ktv-errate 3c*-k D Hazardous locations. El Supply voltage al.more than El Service or feeder 600 amps or more' Cross street/directions to job site: 2"" t 5; 3':'r3 ol;T U tz, - ` Description I Qtr. 1 Each Total I New residential single-or multi-family dwelling unit. Subdivision:faNese T�ery-&-, o etkweS f— I Lot#: t/} Includes attachedgara:e. 1 V� 1,000 sq.ft.or Jess 1" 168.54 4 Tax map/parcel# Ea.add'I 500 sq.it.or portion 33.92 I s : 4'V `�3—14arr-_ �-sIN r t •�tit?v- As ."''".F1\.ck�a..��,:.tiZj.,-Nz �: j:-,:�s-=w. Limited energy,residctltia} 75.00 11111 (with above sq.ft.) Limited energy,multi-family 75.00 (�';;� }}�� -?� t� residential(with above sq.It) E-.0.2fiV.liba�''1 y`'=1:c:XPihe rd-'j,` F:a.-.�•PF`" ` -F..i Y"rf9 2;71t`.ir`i•c '''',` ReneilYsbt:fin C# ❑ S2CP Let �r`GA 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 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 2 Phone:(602)694.4031 (Fax:( ) Over 1,000 amps or volts , 55226 2 Temporary services or feeders installation,altEt'ation,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 5936 I I 1 intended for sale,lease,react,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: • 401 amps to 599 amps 168.54 2 „cif: ..5 ,; .w 2" a ?yyi Z z, ,,,, ii y :se,?4- } s:I o,.!4. r : e .1 .,: Branch circuits-new,alteration or extension i er,anei : �»c�� A.Fee for brencir circuits with Business Dame:William Lyon Homes,Inc above service or feeder fee, 7.42 2 Contact name:A.n ela Gr 'ewski Feeeeh branch circuit g aJ B. for branch circuits without Address:109 East 13th Streetservice,branw or feeder res,first 56.18 2 City/State/ZIP:Vancouver,WA 98660 Each sdd'i branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 • . Fax::(360)693-4442 Each manufactured or Modular 84 2 dwelling,service and/or feeder Email:Angela.Grajewsiti@polygonhomes.com Remy 67.84 2 1:-:, 5 _!1. �, 7 F+0 " Sh p .��.. ..-5 `„r't ?5„` t _, •r,� . , -^�'�i_�, _�. ) „�, e_.t::,< � �;.� .., `:, Pomp ar irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC Signor outline lighting 67.84 2 Address:6101 NE St Johns Rd Signal eirctut(s)or limited-mangy D See Page 2 2 panel,alteration,or mdeasion. City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(I hr rain) 6625/hr Phone:(7,53)320-1657 I Fax:( ) Investigation(1 In min) 90.00/hr Email:bdanieis@gweusa.com Indusbialplant(1 hr min) 78.18/hr inspections for which no fee is90.OO/Lr CCB Lic.: C1158 I Electrical Lic.: 208174 Suprv.Lia: 44965 ' " listed h irmin) Snprv.I'slecEriciansignaizirc,required:_- - i- Let- "1-\• =' '( i•�s ,skr,j -,-L•,- ---,•-•=i-_ ,11,. ^,� _ i •'.._„. Subtotal. " Print mune: Joan P Albert Date: 4/26/2016 D Plan Review Required(25%of permit fee): '' State surcharge(12%of permit fee): i; Authorized signature: ,_r,��_.----- TOTAL PERMIT FEE: ry', I This permit application expires if a peradtis not obtained within 180 f:-.0:;;1`..I Print name: Bill Daniels Date: 4/26/2016 days after it has been accepted ne complete. . * Number ofnsPectionsallowed per`.t,. ;;,1.�•c;: Saa�V7ermitAELCPermitApp EU.ERE.doe Ray 05117/20I5 44046I5T(11/05/C)WWEg • i'iutnbine Permit Appiicati 1 E t.,a F I V E : Building Fixtures 1{)1; ()1,1 ( 1 t ';l. O ti i a _ City of Tigard APR 1 7 2017 Received Pe• retti:Np. . 13125 SW Hall Blvd.,Tigard,OR 97223 Plat By. • „' Plan Revicw Cabe.Permit No.: `� " Phone: 5011182439 FU: 5°3391ffreYOF TIGARD patuey. Inspection-Line: 503439.4175 para Rexdy/By: saris. 13 See Page 2 tar '1 ,f;n BUILDING DIVISION Internet www,tigatd-ocgov NoufierUMethod Sapplem na(fa fGrn YYrt ,jea :&k'i5a"°3" r 0,4�M«' rw w.s c ms itiMt�ii '�� ti.� _ 10 .�u �.. G .. {New oonxtion ©Demo€ttton For special in�ormationusechecklist .. Description I Qty. 'I Ea. I 7'olal CI Additiotdaiterationfreplacement 0 Other New 1-2-family dwellings(includes 10011.format utility connection) q M._, 3i m' -:. '''''''''''''A-•114,* „ fi ' 01.1 SFRf1 bath 'C''' 1 312.70 _ «Bran.t:i;.v_�.> i-affil 2-family dwelling 0 Commercial/industrial SFR• )bath 437.78. SFR(3)bath • 1 50032 , ©At eessar}tiiiilding Multi=family Each additional bat/kitchen 25.02 [aster builder fir. Fire sjtri ice sq ) Page 2 • 1'. w .w ri 2 b• 1e 2 kFs . '�i„-` n' �is?'a ` s t+�a,,,,,,,,-1-, c st�y,f•�'�'g ��"� a���'�"�'.,."�` `x �" •�^ Site utilities: drain lob site address: 31g� �V rlvlr 1{ -TrifV A.C� - Caleb basin or area I8.?6 Dryv/el€,leach line,or trench drain 18.76 City/State/ZIP:ILl P:Tigard,OR 97224 Footing drain(no.linear ff.: _) Page 2 , ____ Suite/bldg./apt.no.:q rf 1 Project name:,4 ),'f i i hroz Nt} '(„,,,6 T-1vlanufactuted home utilities 50.03 Cross sttcet/di ructions to job site: Manholes 18.76 Rain drain connector 18.76 .Sanitary sewer(no.linear ft.: ) . Page 2 . . , Storm sewer(no.linear ft.: TI ' Page 2 , Water service(no.linear ft.: ) _ Page 2 Subdivision)12,4kffir` t,neAct est ono-:I V , Fixture or Item: Tax tnapipetsei no.: Backflow preventer i 31.27 am. 1-''‘, • 'Backwater va• lvem s Y"i > Rv gamc ,�:i ' dv ' r:55,1:-"'.= . , 12.51 ,'k � .G -,Y,- . .c , .,a_;. .. .1' . ,tti ,. - clothes.waste 25.02 .. - . ... Dishwasher 25.02 • _ . , • -- Drinking fountain " . 25.02 Ejtxtorstsump 25:02 pE 'r --'-, if.i titti ." r ;;.; i ` 'i 44 Expansion tankti 12.51 s;1?„,,,t fk' 4,,,,,r„,,,,..41•,•,,,, , ... tr` k ..i1 » ..,,V,-.•.. '`£; Natiie::ADVI,-aibdHoldings;LLCFi>ayrrlseweroap 25-02 Floor.drain/floor sink/hub 25,02 AddmeSs:7600 E I}oublctree Ranch Road Garbage disposal 25.02 City/State/ZIP;Scottsdale,AZ 85258 Hose bib. 25.02 Phone:1602)69440 Fax:( ) Ice maker • 12.51 r 4 r �� 'i'-' n--�,v2+f'vi7r. }� �°�,��t " x' : ,w.4 €nlCtvCpYOr/$reasetrep 25.02 Business name.Wiiliaitn Lyon Homes,Inc Medical gas(valuer.$, ) Page 2• *brier12.51 Coi►ta6t,name::Angela Gttikleti silt Roof drain(commercial) 12.51 Address:.i69"pot I th Street Sink/basinilavatoty • 25.02 C ity/,State/ZtP:Vancouver,WA 913660 Solar units(potable water) ' 62.54 . . Pho)ietr(360)'695-7'700 Fax:;(360)693.4442 - Ttdrtshowertshower.pan 12.51 E-mail:Angela.Grajewsld mm ®polygonkoes.coUrinal 25,02 MMS Watea closet 25.02 .;' : } ,tt 4 C^ati �." FltW {x4^...r ,x. t:X ..,.:.,e.'�` .at-�_ . W.. ::a.c�. ....z,ui. _ v.=:2.. . :.� ,... _N �s:..,rY :,, z:. cz::`a....:....k�:v. Water fleeter 3 .52 Bftsiaess ktatne:Atitilifee t'lumWog ULC - Water piping/DWV 56.29 • Address:=146 W Hitttorlc Columbia River Hwy Other: 25• .02 • City/State/ZIP:T.r'ot!td'ak,OR 97060 Subtotal . Photic (503}492-34911 Fax:(503)912-6438 Minimum permit fee:e: $72 50iiidii„:„..... . CCB Pc.:'184601 PlumbingLic.no.:P0732 Plan review (25%of it fee) State surcharge(12%of pe init fee) AUthorized,signature: . TOTAL PERMIT FEE .Print name:Riobet t DIsittnan Date:5/23/2016 This permitspplicition expires if a permit is not e'btalned within 180 days . atter it hits been accepted as complete. ""Fee methodology en by Trl.County Building industry Service Bostd 1:lauadfrigt.PermiuU't.Mu e,mhhAppdoe 10181/09 440-46167(t09071CDM/WEB) City of Tigard p COMMUNITY DEVELOPMENT DEPARTMENT 114i r 1 G A R n Building Permit Review — Residential Building Permit #: 1A5Tiv/7-00/4"-- Site Address: /'�/ ls>V 0 - � �'l�L�? f 7 r 'ct _ Project Name: elver- '7arcyre /jo Lot #: /i_te,Le (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: ��2sj boe ( u4 ) 7„,,) Xpermit Y erify site address/suite# exists and active in it stem. River Terrace Neighborhood: ❑ No (Z1 Yes,See River Terrace Review Addendum Attached Si lan Elements: ree(3)copies of site plan .: is g structures on site to plan must be on 8 1/2"x 11"or 11 x 17"paper ip Footprint of new structure(including decks)with finished yawn to scale(standard architect or engineer scale) oor elevations rth arrow 11 pity locations (required for new,may apply for additions) tte address,project or subdivision name and lot number !. ation of wells/septic systems Applicant information(name and phone number) ` :sting trees to be retained with drip line,and tree t dimensions and building setback dimensions .rotection measures Lot area,building coverage area,percentage of coverage and n treet tree size,type and location .ervious area(applicable if R-7,R-12,R-25&R-40) Street names 1 roperty corner elevations(2 foot contour lines if more than r 4 foot differential) 14lean Water Services—Service Provider Lett r(lot platted prior to 9/10/1995): equired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No Public Facili ' s Improvement(PFI) Permit: equired: Yes,applicant was notified ❑ Novt Applied For: yJ Yes ❑ No,stop intake /AandUseCase#: / r JO/Zoning: R-/c' J 6) Required Setbacks: Front /� RearSide /, Street Side Garage e� C.7 g �t, eandscape Requirement: ,Q(.7ot Coverage Maximum: L wilding Height: Maximum Height A)49— Actual Height E isual Clearance nasements ii �'ensitive Lands: ❑ Yes No Type kvi Urban Forestry Plan ❑ Conditions ` "pri9r to issuance o b dine permit Notes: ( ,jam/17Oa�1&' / Aoc...),-- 4 p7L /Accit,(-04 € Approved By Planning: ' Date: , -)//Xe/117-- Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\BuildingTorms\BldgPernvtRvw RES 091216.docx T.,, Building Permit Submittal Original Submittal Date: 34/A 1 l/7 Site Plans: # Building Plans: # 3 Building Permit#: "Enter building permit#above. Workflow Routing: 7 Planning Engineering p-Permit Coordinator - Building Workflow Sign-off: re Sign-off for Planning(include notes from planning review) Route Application Documents: fii Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. lit Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: .. Date: 312///z Engineering Review Slope at building pad: , Slope "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 Engineering: Date: Notes: Approved by Engineering: ,L _12Date: 1—.Z21-0/ Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 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 pproved,NOT Released: Date:,/n(L__ ____ t 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 Dev Taxes El N/A Tigard Trans SDC: (�—Yes 0 N/A Parks SDC: -es ❑ N/A •K to Issue Permit / ,/ Approved by Permit Coordinator: Date: 4 1 i I:\Building\Forms\B1dgPermitRvw_RES 091216.docx City of Tigard e COMMUNITY DEVELOPMENT DEPARTMENT ill 0 T l cA RD River Terrace Building Permit Review Addendum Building Permit #: Site Address: /��%9c ,,S24) ,ie„7 j) 'W -.2ne Project Name: - , A�'��- -E?-err °_ 'mu � '" 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. 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 Gabled do r ft. deep min. 2ft., 5 ft.wide min. 2 ft.,ao wide ❑ ❑ ❑ (2-09-12- )vn--- 2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance oors. Percentage Shown: �T.: /7-9%,, r t..9/0 3. trances:At least one entrance must meet both of the foll 'ng standards: Max. 8 ft. setback from longest stree 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: ❑ 25 sq.ft.min. ❑ One street facing entry ❑ 12 ft.max.roof above floor of porch ❑ 5 ft. depth min. ❑ 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: overed porch min. 5 ft.wide x 5 ft. deep 0 ecessed entry area min. 5 ft.wide x 2 ft. deep all offset min. 16 inches Dormer min. 4 ft.wide'. Roof eave min. 12 inch projection' 0/Roof offset min. of 2 ft. ❑ Roof shingles either tile or wood able,hip or gambrel roof design` 1_ ❑ oof pitch oriented south min. 500 sq. ft. horizontal lap siding min. 3-7 inches wide12 - Accent siding min. 40%of street facade' indow trim min. 2'/z"wide by 5/8"dee 1 ❑ 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 loser 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. 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 abov the garage that faces the street with a min. area of 12 sq.ft. W. the (Check one) 12-foot-wide garage door ❑ 40%max. of street facade ❑ 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: c — _ Date: c_71/4,43._. I:\Building\Forms\BldgPermitRvw_RES_RT_°62216.docx SitePlumbingUtilities Permit ApplicaticR ���� City of Tigard JULED h 2017 Received •� 6'//7pc- DateBy: (! PermitNolill II 13125 SW Hall Blvd.,Tigard,OR 9 �/ �� UU�`� _ Phone: 503.718.2439 Fax: 503.5TIG OF Plan Review ARD Date/By: 7"!$-J7 444, Other Permit No.: TIGARD Inspection Line: 503.639.4175 BUILDINGDIVISION Date Ready/By: Juris:s See Page 2 for www.tigard-or.gov Notified/Method:fied/Method ?Ad/7 Supplemental Info rmation7 ' Ze ONOttair For special information use checklist ®New construction 0 Demolition Description Qty. J Ea. Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) Ai7 ` ; 1 `# ti 1 a 1, SFR(1)bath 312.70 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ®Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler(1,382 sq.ft.) Gk_ 99� Page 2 4 ' l;Y l l 'i t ,: ,,,4„,,.,,,,,„:„„,,.„,,,,, Site utilities: �V Job site address:13182 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.:166 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 l tp Backwater valve 12.51 Clothes washer 25.02 Multipurpose Fire Sprinkler System Dishwasher 25.02 Permit#MST2017-00118 Drinking fountain 25.02 Ejectors/sump 25.02 1.:40-41,:$� 11' .. �&�' 1 � f� -- � Expansion tank sr; 12.51 Name:Polygon Northwest Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone: ( ) Fax ( ) Ice maker ��, 12.51 # j \ Itritt t i;, Interceptor/grease trap 25.02 Business name:Alliance Plumbing,LLC Medical gas(value:$ ) 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 f gl y� ti t ?"6a ,,, 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.:113732Plan review (25%of permit fee) � / State surcharge(12%of permit fee) Authorized signature: L ) TOTAL PERMIT FEE Print name:Gavin Thomes Date:7/3/2017 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. 1:1Building\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 Sup s �. ression stems 3 ii1 � � \ ' #te = %v �" €€ = . 'u -,, . Footing drain-I"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' ➢ ' - ,, tom€ # € ,., ° �.x ,,; Storm&Rain Drain-1st 100' �.$1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain each additional 100' $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 l € a w.., 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 # €# €«t� 110 tn*by FixlI e � +1xtrx %m ' a „ Fix:: py for - e ^' x- f .. ', • Plan review is required for any of the following. Work POtcmed, ... - '- "Cel d Ft Please check all that apply. PP y Baptistry/Font Bath -Tub/Shower ❑ Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool 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. Car Wash Drain 0 rIsometric 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 Washer-Clothesincrease 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-del\home\gavin\My Documents\Fire Sprinklers\RT\City of Tigard Peltmit.doe Mechanical Permit Applicati tu. ., - -- 1OR ot-rmc'r. 4:1, Ci of Ti and Received 0 tY Date/ar /I li / A13125 SW Hall Blvd.,Tigard,OR 97223 _ � F,, rx y,-,' plan Review / , Phone: 503.7182439 Fax: 503.598.1960 ,�;��, !.- .2i..., .: Date/By: Other Permit: T f G..A D Inspection Line: 503.639.4175 Date Ready/By; SI See Page 2 for Internetwww.tigard-or,gov Notified/Method: ® Supplemental Information z T' .v i . ,* -e �S. r '5- " f E x. i:.7' C)�I e.Nilfi ae rt,ar'}. @x1Pr (ritr , _ tn.^f 8 4J'i4 4 }..i. - -- - � ��rva Mechanical pe it fees are ased on the valve of the work ®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. ... .. :..C .-.' .... ..., _... VI✓alue drT - Tt aR � r € c �! .. i .,..._ xu.l _..._ _ _ r_'s„... . : ___ }.v.. .},,..G,_uc .t_. r�.z.,_.. . ., ' _��_.n .c,: ':,:i ti ; l r a! E? s :fs �,s,_ 2iA,:"1,T 1.t..__,. ❑ I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special Infonnation use checklist ®Multi-family 0 Master builder 0 Other: Description E Qty. I Ea. 1 Total a a: 7, ..,3P t > ' r Heating/cooiing: r .> n. _,.� .��. .a'' H ,:, ,!' t ,,,I, ,---7,;,..7i-,:;;-::„.:-.:,xF Ci- '. ',.',4::::.--::1 ..r . Air conditioning 1 46.75 46.75 Job site address: a S . im I. 1•. 4 / 'Id,[.. . Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(duets/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:River Terrace Northwest Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydropic)c) 23.32 Unit heaters(fuel-type,not electric), is-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 1 23.32 Other: 23.32 Subdivision:River Terrace Northwest Lot no.: / Other fuel appliances: Tax map/parcel no,: Water heater 23.32 3 Gas fir lace/insert 1 3339 P , „1'r ..F,'6 Ei Sita e' r. r ky Flue vent for water heater or gas Contractor Change fireplace 23.32 Log lighter(gas) 23.32 L1 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/tlue/vent , 23.32 6 Other: 23.32 ....1.. —_,:,-.7: 1. __a-'1,'--.Z.' t .. ' _� -4 -_4:. c,:, =r�._...w, �� .pz ..-�.-.. - .- —r Environmental exhaust and ventilation: Name:ADVL Land Holdings,LLC Range hood/other kitchen equipment 1 33.39 Address:7600 E Doubletree Ranch Road Clothes dryer exhaust 1 33.39 City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 4 23.32 Phone:(602)694-4031 Fax:( ) Attic/crawls-pace fans 23.32 23.32 s-:'t � k<i k t is :'----7-7`7;-.47,:77:':',.,;•5 ��� t 1 7 k t Other: , .�. ........ .. ........�.. Fuel ping: Business name:William Lyon Homes,Inc. 514.15 for first four;$4.03 for each additional Contact name:Nichole Thorpe Furnace,etc. 1 Address:703 Broadway ST Suite 510 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater . Phone:(360)695-7700 Fax::(360)693-4442 I,;replace —1 Range 1 , E-mail:Nichole.Thorpe@polygonbomes.com Barbecue F.',-'1.'''''''''',' r7 t k ,,,, '� ,:::-..,;_-_,,,7 = clothes dryer(gas) Oth Business name:Pro Heating and Cooling INCAS -j'7: s iA�i t s P t I ...''., x ..,._ ar.,...,.,_ uG Address:2095 NW Aloclek DR Suite#1103 Subtotal City/State/ZIP:Hillsboro,OR 97124 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)4435692 Fax:(503)9415075 State surcharge(12%of permit fee) CCB tic.:209001 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 . /t � • Fee days after it bas been accepted as complete. Authorized signature:6 "� '` methodology set by Tri-County Building Industry Service Board Print name:Nichole Thorpe Date:9/19/2017 I10uilding\PermitAMEC PermitApp o40113.doc 440.4617T(I ,2/cOM!IVEB) City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13182 SW AUBERGINE TER, SHERWOOD, December 1 , 2017 at OR, 97140 10:18:54 AM Record Type: Record ID: Residential - Master Permit MST2017-00118 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS Comments: No A/C installed Violation Summary: Inspector Contractor 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 4 111 _ Transmittal Letter , ,,,,,RD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tom H. DATE RECEIVED: DEPT: BUILDING DIVISION E I " w`� DEC 1 8 2017 FROM: Nichole Thorpe CITY O i IGM E) BUILDING DI\/ S; _.,. COMPANY: Polygon Northwest I PHONE: 360-989-4204 Byji ; RE: 13182 SW Aubergine Terrace MST2017-00118 (Site Address) (Permit Number) River Terrace Northwest Lot 166 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 0 Additional set(s) of plans. 3 Revisions: plot plan- Tree update 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. FOR OFFICE USE ONLY Routed to Permit Technician: Date: Initials: Fees Due: ❑ Yes ❑No Fee Description: Amount Due: $ $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes ❑No ❑ Done Applicant Notified: Date: Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT 11 ci1 u) Building Permit Review — Residential k.,,,,3t::iMe ?,oka�:, . ' iccSsiYi::.ss:....,,a,"rY....'.isi til'k inti yf ilk.lJ+ ...t..+,....„.3 ..g. .. ,•. Building Permit #: S7' /7-00//T Site Address: // �J/ ,c/J , , ie / �e1'Qzc,L _ ' Project Name: Ek.,- '7Pira�..P ,44 'W Lot #: _/1 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review /�"" /f . ...) Proposal: Ot)eft) S'1 L!— '�-1fNi . ..7C l Kivt,,/'LCnki j erify site address/suite#exists and active in permit tem. i River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached Si lan Elements: I ee(3)copies of site plan t.,+' ir.;•: structures on site tte plan mug bsi on 8-1/2"x 11"or 11 x 17"paper !I Footprint of new structure(including decks)with finished yawn to scale(standard architect or engineer scale) •oor elevations rth arrow VI ty locations(required for new,may apply for additions) tte address,project or subdivision name and lot number m �, lion of wells/septic systems plicant information(name and phone number) 9 rting trees to be retained with drip line,and tree oVt dimensions and building setback dimensions •rotection measures f area,building coverage area,percentage of coverage and 'I treet tree size,type and location _., • rvious area(applicable if R-7,R-12,R-25&R-40) Street names i I • •perty corner elevations(2 foot contour lines if more than r 4 foot differen Si ', can Water Services—Service Provider Lett• (lot platted prior to 9/10/1995): ' quired: ❑ Yes,applicant was notified v! No Received: 0 Yes 0 No FA Public Facile Improvement(PFI)Permit: equaled: Yes, Yes,applicant was notified 0 No Applied For: Yes 0 No,stop intake a,�d Use Case#: /,(�e2Q (' iii =deb jRte: R-/Q equired Setbacks: Front j Rear ,c---- Side 0 Street Side Garage O , 0 dscape Requirement: 7O °" •t/ .t Coverage Maximum: 00 uilding Height: Maximum Height NM— Actual Height ''isual Clearance rat ements • ri I'ensitive Lands: 0 Yes No Type Urban Forestry Plan 0 Conditions Nor prier to issuance of b4dirw permit . Notes: J7ci/A i k' / )O - 'A i f /nll7'L i 4:=14cf Approved By Planning: ✓ Date: __s �e — ` �-=.��_ Revisions(after Building Submittal only) Reviewer Date Revision 1: %Approved 0 Not Approved Ai,--t r', ,71,1,-, , A0 12i\11 ti Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved I:1Building\Fonns\BldgPermitRvw_RES 091216.docx Building Permit Submittal Original Submittal Date: .) },,l/7 Site Plans: # Building Plans: # 3 Building Permit#: p'Enter building permit#above. Workflow Routing. 17r Planning .p Engineering ts^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. fit Building original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: / tZ. Date: 3/A 1/17 Engineering Review cSlope at building pad 7, onditions"Met"prior to issuance of building permit Cl Easements(encroachments)per engineering conditions of approval and plat Cl Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: Cl Yes 0 No Assess Water Quantity Fee in-lieu: Cl Yes 0 No LIDA Facility on lot 0 Yes 0 No 0 NOT Approved by Engineering: Date: Notes: Approved by Engineering: 4S Date: - �` Revisions(after Building Submittal only) Reviewer Date Revision 1: 0 Approved Cl Not Approved Revision 2: 0 Approved ❑ Not Approved Revision 3: Cl Approved 0 Not Approved Permit Coordinator Review 0 Conditions"Met"prior to issuance of building permit proved,NOT Released: if' Date:3 t 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•. ?i+111DC Fees Entered: Wash Co Trans Dev Tax: es 0 N/A Tigard Trans SDC: (p-Yes Cl N/A Parks SDC: es 0 N/A . i ►` K to Issue Permit Approved by Permit Coordinator. //f/ :-ate: 4� ! I:\Buildmg\Forms\BldgPermitRvw RES_091216.docx