Permit (121) ti,
CITY OF TIGARD MASTER PERMIT
IICOMMUNITY DEVELOPMENT Permit#: MST2017-00116
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/17/2017
[ ° ' 9 Parcel: 2S 106D B 16400
Jurisdiction: Tigard
Site address: 13174 SW AUBERGINE TER
Subdivision: RIVER TERRACE NORTHWEST Lot: 164
Project: River Terrace Northwest, Lot 164
Project Description: New SFA. Building/unit 3.3
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 97 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 32 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: $161,780.64 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 Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw 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: 3 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Fu rn>=100 K: 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 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: $22,693.63
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 2-001-0090. You may obtain copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ,b
Issued By: ! • o��'l�i-e/�G��%t'�ri Permittee Signature: 4(L- �,/y�.2i C -l/--{,
i,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. �f7
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= l & 1/
giiidential
FOR OFFICE t SE ONLY
City of Tigard u' k, ' ' Da eisy '77.2.0 /7 r-- Permit Nc (fs��`/ liL�/��,
71 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Other Perr, tG�,°2GI/7 /Q
_ Phone: 503.7182439 Fax 503.598.1960 DateBy. i+' j j 7 �
Inspection Line: 503.639.4175 Date ReadyBy. 7 ocz rum H See Page 2 for
T 1 G i;R D Internet www.tigard-or.gov s Notified/Method: f '7�/ Supplemental Information
_ �3 . _,...... � �
� �� ` #.. r r Si �k @ " :� (iE 10- i � �
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®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
a
workon application.
1-and 2-family dwelling V L ❑nCommercial/industrial Valuation!6) g�� lr� .�
Number of b
DI Accessory building [0,Multi-family
ooms: Z
o Master builder /❑Other: Number of bathroomsQ,
:w- .2.7M
-tom- t ",;�:: i- 740 1?:-4:c .;='!- ' '- Total number of floors: a. ,
_ i New dwelling area: square feet
Job site address: 19j 4I LI SW fiu bf yl(}e 1-1'TaCQ� ✓
City/State/ZIP:Tigard,OR 97224 _3f Garage/carport area: L1.c�� square feet s'6a.
Suite/bldg./apt no.: 3,% Project name:River Terrace Northwest Covered porch area: 311/ f square feet S 6a '
Cross street/directions to job site: Deck area: 7a ✓ square feet q'7
co vc./
Other structure area: 74a. /square feet
T~I
_ � �._— .mss.- --'=�— r _�--�.,..r
Subdivision:River Terrace Northwest Lot no.:(tpl- 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
;,axn- - ''''''''-:'•--- ---'-'''-' -'7--'''" -9".''''''''''''''''''7•7•::'.-- — work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
`} a� .tra m P f 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
7_F. _.. __ __ :.ss-zM. :-..7-1,-�-�-ice"-=t :4: .i 4'-=-'I'4.7,��.... -.... ... ..:x,,,.c.= $I - r-r.-:
I
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:109 East 13"'Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax:( ) 7 „_` k
E-mail:Angela.Grajewski@polygonhomes.com
It I s "1 , 'V FFF fi ii
Commercialand residential prescriptive installation of
,.a --4, z,.:1.'.1---__ .-p` _ "`,. roof-top mounted PhotoVoltaic Solar Panel System.
Business name:William Lyon Homes,Inc 4Submit 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):
' '-,ine:(360)695-7700 Fax(360)6934442 State surcharge(12%of permit fee): $21.60
_�B lic:207247 Total fee due upon application: $201.60
Authorized signature: c...„„Pcteif •
• This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Angela Grajewsld Date: 'ill/W/01(1)-1, 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 Application FOR OFFICE t SE ONL\
City of Tigard 1 EC E IV E D refry- CEMOI
13125 SW Ha1113Ivd.,Tigard,OR 9 Plan Review
C Phone: 503.7182439 Fax: 503.598.1960 1 Date/By: Other Permit.
T i G A R D Inspection Line: 503.639.4175• APR 7 2017 Date Ready/By: ® e See Page 2 for
Internet: www.tigard-or.gov .Notified/Method: Supplemental Information
CITY OF TIGARD
� '.g ,T°--— 7i eo.1,: ii*='1 .4 if.:F.6e
e: uZ L 1,. � a0.21 :al't i'42;�l cfkr4grCfF)�o-C. 9l:. ° { { , , i.
Mechanical permit fees*are based on the value of the work
►1 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.
i»�.r 374 Hi fi .rr4,�.,� ,7). ` x"e- IW..;; 4t 44 e Y� 7.34 l c-Ti 5 v.,r " ,».'^•'••;z7. aloe $ : ,lf- r r,, 1: ,
71,i�. �'asr wK^x ,F ,. "`2:nd tl C'�0 ;,5,. y,.'.^ g,l� ,,;4t�ui (foe ,.:k^s'� +$ pis 1 -(7';;.';�1 d "1,t,I. .YfiV4 ,"t�'. I4f e�' .,Z.tAl:,::4a 1. ,-+-',;)za'
❑ 1-and 2-family dwelling 0 CommerciaVindustrial 0 Accessory building For special information use checklist
®Multi-family 0 Master builder 0 Other: Description I QtY. I Ea. I Total
«,^L%..M.,. wsff .,1• - .E '� 1;. . i .gv �� ;;:. . Ay r,, t "if, ,
Heating/cooling:
.. .3,„•7-•z.„, - r«, . Lk``:• ° .Yr . a ,; ..."..r.er.aa JAirconditioniug
46.75
Job site address: 1 sV
f'D„brg,(N , r(`cl Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 f Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: ,; I Project name,.`U n T,CA"�� Ni l Olen 4.-- Duct work 23.32
Cross street/directions to job site: t ' Hydronic hot water system 2332
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 I 23.32
Subdivision: �,4tc 1 4CG 0 a /es- - Lot no.:i Y Other 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 2332
s-1:,">;,5-7•••.--•••- -« ' ,"t ,�i,F 77;1`; r; Gas fireplace/insert j 33.39
Fr-- -.,------ ----,4,,.-c,1 k.,-tfr,4 - --- {i:I� ,..,{ ,ttt..',,,,,..,`,.,,,,:re"..-1,":g,"' „ L}...�W,,. ,.r c'l.c-•
w -�•.-,� Flue vent for water heater or gas
new borne construction fireplace 23.32
Log lighter(gas) 23.32
— Wood/pellet stove _ 3339
Wood fireplace/insert 2332
Chimney/liner/flue/vent 2332
y Other: 23.32
s:,;:;1___st`I.-`,1. Z `5,` .x t._..>:_,,'L 1__.. ,C..6' Lalf $lt :..._ ,1 11 ::: 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 t 33.39
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) LA 23.32
Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans 2332
� Other: 2332
flz,,;' ` ,,o tit 31'�v S+. t'I tai<+ W _< ` ` �a >i5n`r �. �yw.� ...�.��. r.
� x �... �L�_.._ �_.,. .w_4 ..._r __.x Fuel Pining:
Business name:William Lyon Homes,Inc
$14.15 for first four,$4.03 for etch additional
Contact name:Angela Grajewski Furnace,etc. .
Address:109 East 13th Street heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 1 Fax::(360)693-4442 Fireplace t
Range t
E-mail:Angela.Grajewski®polygonhomes.eom • _ Barbecue
,z ., ,c''''./,,Lf-!--S',1,e ± a , Clothes dryer(gas)
Business name:Andersen Mechanical,Inc OlderxrI :{6 cr ,
r w,. ,.,1,_z ._�,:I 1'l(.'� !i:. -... -..-_ ..��._. .,...a,
Address:16285 SW 85th Ave Subtotal
City/State/ZIP:Tigard,OR 97224 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)992-6664 Fax:(503)5364615 State surcharge(12%of permit fee)
CCB Iia: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: CA1 * Fee methodology set by Tri-County Building Industry Service Board
Print name:Nichole Thorpe Date:4/17/2017
LlBuiidingPermtsIMEC,.PermitApp 04ott3.doc 440-4617T(IiN2/CCOM VEB)
•
Electrical Permit APPlica FOR orrICL USE ONLY
City of Tigard Received
IN
112/1111111/1 s 13125 SW Hall Blvd.,Tigard,OR 97?j R 1 7 2017 ` ;iew
Phone:
503.7182439 Fax_ 503.598196v Daten3: Related permit/t; '-
Inspection Line: 503.639.4175 Rea Date/B
TIGARD. CITY OF TIGARD `b o 1� plemene2!cr
3nteoaet, www.tigard-or.gov Notified/Method, Supplemental!cremation
P1► P ig IIN P to
'' . ,,4 ,. 'M.. -•cos 'm-.' *. • 2 as'F y .4.6,...M—Z-74 ^.4,...,-1,-1:' y t.. ,Y �a^
�.L f :,...�-�a�-Q��:�..�..�S',�„� H � w...'-. =i .. :.i'�',ry,�'t--.s�'"��_.'_?'+.i. 7:.'�s� �„#- '>;'Y��=
®New construction 0 Addition/alteration/replacement Please check all thatapply(submit 2 sets of plans was checked):
0• Demolition Q Other: D Service or feeder 400 amps or more 0 Building over three stories.
where the availehly fault current 0 Marinas and boatyards.
'1.:As.' s° =-tss �- arMi .3k ''...' 11Z1::'t• if ai1:"0.:'7_,,?T**`k ?`` , exceeds 10,000 amps at 150 volts or 0 Floating buildings,
I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground.or exceeds 14,000 D Commercial-use agricultural
amps for all other installations. beadier .�i Multi-family 0 Master builder 0 Other: Dfire pump. 0 installation
of ISO KVA
VA or
,a �.3 *1, %," a ..D ��' �?M �� �„�� r•:� i � CI EmtrgancY em' larger separately derived
) •, D Addition of new motor load of system.
Job#: Job site address13f 7 U _�! - c,..,e , 10014P or more
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units, occupancy,
0Health-Date facilities. Q Recreational vehicle parks.
Suite/bldg./apt.#: 24, Pmject nameRl vitt,TecC'dr .N+ 1+iw D Hazardous locations. D Supply voltage for more ffiau
Cross street/directions to job site: DServiee or feeder 600 amps or mom. 600 volts aomtaal
24F--..Z..','`:-:"AY ;a ,r Al tlfTi5ff-i'di*s.3 .,'
Desalt:dos I Qty. Rath 2tmi1 7
New residential single-or multi-family dwelling unit.
Subdivision:gwey T r(&C , r! • 5 t - 1 Lot#: ,�' Includes attached garage.
Tax naap/parcel#: 1" / / Eadl•> less
IIII 16834
0i . ., IT'` +fx Z- ;.i ?+a. t _#s:S,,,, s 4 ',4A "',4P. . W: r t'',- -•,',1-:_(;'1,,...... Limited energy,residentiaor l
33.92on ��
(with above sq.R) 75.00
Limited energy,multi-family 75.00111
residential(with above sq.tk)
'' �f s.,n a cc i � F f s t y w n Renewable ED, 4 D See P . 2
-1 •°' 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 20034 2
City/State/2P: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
Email:
Temporary services or feeders installation,alteration,and/or
- relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 1 I 125.08 I 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
°`, aE':20 t'e�'4 e f,,, j< , r s+ s 4,07-41 o j• a; .•"s BraDeb elreuits-new,alteration,or extension er.noel
�"s- �",., y�` g ��.���� '� �'�� ��' A.Pee for branch circuits xdth
Business name:William Lyon homes,Inc. above service or feeder fee,
7.42 2
Contact Warne:A Dgela Grajewald each branch circuit
B.Fee for branch circuits withotd
Address:109 East 13th Street service or#1 oder The,fust 56.18 2 •
branch circuit
City/State/ZIP:Vancouver,WA 98660 Each add')branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 - ' ' I Fax::(360)693-4442 Each manufactured or modular 57.84 2
Email Angela.Grajewskt®.polygonhomes.com
dwelling,service and/or feeder
..: . ,f..�.�.:. s Reconnect only 67.84 2
rs _c ✓:f- . _, ..:i,. -y C�$1i � B w,.' ,�. .]i1. _ .
Pump orungatior circle 67.84 2
Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2
Address:6101INE St Johns Rd panel, l eatiion or extension. D See P e 2 2
panel,alteration,or extension. �
City/State/ZIP Vancouver WA 98661 Each additional inspection over allowable In any of the above
Additional Inspection(1 br min) 66.25/hr
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr
Email bdanieis@gweusa.com Industrial plant(1 hr min) • 78.18/ht.
Inspections for which no fee is 90.00/1v
• ;\, "�``
CCS Lic.: C1158 Electrical Lie.: 208174% Suyprv.Lint: 44965 s' I listed Arain
Suprv.Electrician signature,required: ' / !' t.•� ., ..-. + 1, •-• ' '`', e.:',O
•
3 L-0'f Ltt3 t .t_. - fie'g
AdD. Subtotal: all
Print name: Joan P Albert Date: 4/26/2016 ❑Plan Review Required(25%of permit fee):
<•' —w State surcharge(32%of permit fee):
Authorized signature: ; --s` TOTAL PERMIT 1 r
4, • This permit application expires ifs permit is not obtat ted within 180
,:g..';,,,''‘, Print name: Bill Daniels Date: 4/26/2016 days after it has been accepted an complete. 1
,r;,, `x, * Number of inspeatio s elbowed per permit
I:6BuIdonaVrnaltrAE,C_PmrehApp_EZa ERE.dse Rev 06/11/2015 440461ST(l1/e51COM/WES
iftea*?z::::i'...„
Plumbing Permit Apulicat CE I V E
Building Fixtures APR 1 7 2017 KHz"(>1'i if I 1 ,l 19'+1';
City.of Tigard Received•
Permit No.: ... .
TY OF TIGARD Date-8Y:
13125 SW Hat!Blvd:,Tigard,OR:eftsplan
Phones 503.718.2439 Fax ! .;n ING DIVISION Pate/B new �y. 'p ""°:
1 i \1,ainspection•!tine: 503.639.4175 tate Ready$y awn. El See Page 2 for i
Internet: www.tigard-or.gov Notil edrmethod Supplemental!reformed/4a 1
c�;. r ,.x ^.;W,. m n III ,q '7 4:i. s i< ,rr ti a rt p.-4- i". $tt> 3' s. �� n
�"s4- �m' rs�ar.-.K. �nv...., Demolition� 'd�s��-0*�;Rt � <�„+ h'4�... Ott'.. ;.�(� ��. ... .. .,.. ....
®New consuruction ❑ r ornrafien use.c/recktiat
• Discxiption ( Qty- 9 Ea. I Total {
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
Wift .,, ?0,,. I. a SFR(1)bath 312.70 1
! and 2-family dwelling 0 Cornmcrcial industciai SFR f2)bath
SFR(3)bath 500.32
0 Accessory building. igMulti-family
Each additianal bath/kitchen t
taster builder
. ..� 0 Other:
e..r: .. ,. Fire*inkier(.. sq,R.)
;•-1(.43;411:i2 e7r" :7";su - ;x'1, F eSe ,43 �(a ,r? u c.k ` 'a-" t ra site utilities:
1
,ob s►te ads: 13 1 114 c tr ro�‘ne.Tf rraCtl
, C basin or arca drain l8.76
1,leach brie,a trench drain I
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.:_ 1
Suite/bldg./apt.no.: Project name:. p 4' r' vttt• Manufactured horn utilities 50.03 ri
Crossstteet/directions to job site: Manholes _ 18.76 1
Rain drain•connector 18,76 1
Sanitary sewer(no.linear ft.:, ___) . Page 2 ri
Stonn sewer(no.linear H.: ,) • Page 2 •`
' Water service(ho.iit>ear ft.:) Page 2
Subdivision;Tyr t I _ .• - id.cf t--- Lot Mx: 1 Fixtureor item:
Tax map/pmeel.no.:. Backflow pieventer .. 1 31.27
f ",IT-7"',) t £`.-'3.777?�`"""S+ .<4�.�"j-`s. r,P'�, «,,,f5@,E ', 'F:tE"�"a".i'o-t ""k-- '7 y ack.. tetervalve t 12.51
y„,zke. y^y xr ...z a:.P �.4p. 4. ...tst •. ',..4. x.'+5.,+'1' '`-• =.'r";-4,;(.1•1:•'•fT. ,+y- 42 (4.*:F4
'1Clothes.washer 25.02
. .•. Dishwasher 25.02
• - __., . prinking fountain • 25.02
Ejectors/sump ... 25:02
s,. 4 •-r°- t<t< y; n"° ,1x'-,-„. s. ti a E atision lank. 12.51
<•E, 4 R 1 f t aft:-. - W c„z, �,:s,,s 7a k 9.,".. .4.r �'. XP,
Narne'_•ADYL`Lfud holdings;LLC Fixtturdscwtr cap 1 25.02
Floor draiir/floot sink hub 25.02 •
Address:7600E Doubletree Ranch Road
Garbage disposal 25.02
City/State/Z1P:Scottsdale;AZ 85258 Hose bib 25.02
Phone:(M)2)694-4031 Fax ( ) • Ice maker 12.51 �
;;,x ' t `.� :4..i`! vsa?'`�44F�4r:.= aat- r.,"� t r1 Y,."effl•S� •_:fiwkF 3;kZ IntlCctorcase p , 25.02
• Business cl(in)e;iVillitili t Lyon Homes,Inc Medical gas(value:$ ) Page 2 ,
t?nmer
12.51
Coiilactname:Ane6i'Grajetvski Roof drain(commercial) 12.51
Andress:I09 I3a11t Street Sink/basinflavatory 25.02 1
City/State/ZIP:Va teouver,WA 98660 Solar units(potable water) 6154 .
. Phone:060)4954700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
Urinal 25,02 . `
E-rnatl Angela.GrajewskiimppoIygonhomes.co
. a
+ Water close( 25.02
4� aG., - > f ' ' ' L�mi4 c "1� 4 y � :+roC
Wald heater37.52
,Banat mettle:A)Iiaidee 'ltarnbiag LLC ,• . Weterpiping/DWV 56.29
Address:146.W Historic Columbia River Hwy Other25.02
•City/StatelZlP:T.rostdalt,OR 47060 Subtotal ,
Phone:(503)49$-3490Fax:(503)912-6438 - .Minimum permit.fee: $72.50 t
CCB Lie.:184603 Plumbing Lie.no.:PB732 Plan review(25%a.ofpermit feej '
State surcharge(12%of permit fee)
Authorized..signatu e: TOTAL PERMIT FEE I
Print name:Robed-Mittman Dislaman Date:5/7312016 This permit application empires If t permit is net abtsbmtd within 180 dais
• .. _ .... .. thee`ii hes been'tempted as complete.
'"Fee methodology set by Tri-County Building Industry Service Board
i;tBui diieg Pom n\Pt t tU,PesmkAppdoc MAIM 440.4616T(30/eWMAFYES)
It
City of Tigard
r COMMUNITY DEVELOPMENT DEPARTMENT
11111111C
T 1 c �D Building Permit Review — Residential
►s._,,,.^r _ moi.a'-,�<,: . •_ ..- ,....- ...t.:-1, : .3..iso-..b Fa' .3... .3i..- i-gii a 4..s.,,,,,..r._.,„y, ar ., -.A. e.°.
Building Permit #: /-S 77,26/j 2 e-9 ///
Site Address: / „ck) a 1Yt.(/ •-�- ac
e _
Project Name: Elve- °^7 -rIoc.e o 7t Lot #: _ /ee 1/
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review ___-)
Proposal: L.49.e. (irpiolteel
it erm
I/erify site address/suite#exists and active in P Y
stem.
River Terrace Neighborhood:
El No Yes,See River Terrace Review Addendum Attached
Si - Ian Elements:
vA,
El ree(3)copies of site plan ±fisting structures on site
!A it
e plan must be on 8-1/2"x 11"or 11 x 17"paper rFootprint of new structure(including decks)with finished
raven to scale(standard architect or engineer scale) oor elevations
rth arrow tility locations(required for new,may apply for additions)
ite address,project or subdivision name and lot number o► ation of wells/septic systems
pplicant information(name and phone number) 0'.&:sting trees to be retained with drip line,and tree
Lot dimensions and building setback dimensions protection measures
t area,building coverage area,percentage of coverage and ,tA treet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street names
ni 'roperty corner elevations(2 foot contour lines if more than
4 foot differential)
Olean Water Services—Service Provider Lett r(lot platted prior to 9/10/1995):
equired: El Yes,applicant was notified V No Received:
❑ Yes ❑ No
Public Facile Improvement(PFI) Permit:
Iequired: Yes,applicant was notified ❑ No Applied For: VJ Yes ❑ No,stop intake
/and Use Case#:°nmg: ie—/Q (PZ ,) y
0 Required Setbacks: Front8 Rear Side Street SideP Gara e
andscape Requirement: 7(7 %
Lot Coverage Maximum:
wilding Height: Maximum Height A)49-- Actual Height
' isual Clearance
y asements
U1 �'ensitive Lands: El Yes No Type
ill Urban Forestry Plan
❑ Conditions "lam"pri9r to issuance o f b4ding permit
Notes: (_- j?� ei/1'76;44' // fin A
Approved By Planning: --- �
Date: ---,...
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES 091216.docx
1
Building Permit Submittal
Original Submittal Date: ,�/-2Cy/
Site Plans: # ,3
Building Plans: # j
Building Permit#: ❑'Enter building permit#above.
Workflow Routing: Planning C Engineering Permit Coordinator L -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.
'uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician:
DateZe//
a
En_ineering Review
%�;we at building pad:' 'j��
411/ Conditions "Met"prior to issuance of building permit O/
elefees-/
❑ 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: El Yes El No
LIDA Facility on lot: El Yes El No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: M' 2 2 Date: 07,g/,/ 7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved El Not Approved
Revision 3: ❑ Approved El Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
pproved,NOT Released: Date: 3/) /
/i-?---
�: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: Yes El N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: ' Yes ❑ N/A
K to Issue Permit
vA roved by Permit Coordinator: Date: 1
PP � / '
I:\Building\Forms\BldgPermitRvw_RES 091216.docx
v4
IIII II City of Tigard
iii
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: /`(--(7:-.2- / —7 — C)?//(
Site Address: /5/?"171 ,,c1/10 A -- Y -re,'
Project Name: , .e...- ,;''a _ l - iz,,C.,S Lot #: /(P
(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.
Balcony w/ access 2 Window Projection Vertical Wa ffset a
Porch min. 5 ft. deep Gabled dormer
ft. deep min. 2ft., 5 ft.wide min. 2 ft., t.wide
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum o 12% of each street facin-�facade must include windows or entrance doors.
y
Percentage Shown: ,, -, S/;t
3. trances:At least one entrance must meet both of the foll *ng standards:
Max. 8 ft. setback from Ion t street- facing wall Parallel to street,angle no more than 45° from street,
or op onto porch
Entrance opens to a porch: Yes ❑ No
If es .ll the following apply: 5 q.ft.mi .
ane street facing entry ft.max.roof above floor of porch
LAI 5 ft. depth min. 30%min.porch roof coverage
4. etailed Design:All buildings shall include a min. of five of the 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
all offset min. 16 inches ❑ t.ormer min.4 ft.wide
Roof eave min. 12 inch projection f Voof offset min. of 2 ft. ..
❑ Roof shingles either tile or wood able,hip or gambrel roof design f
❑ oof pitch oriented south min. 500 sq. ft. G orizontal lap siding min. 3-7 inches wide
Accent siding min. 40%of street facade' Window trim min. 2 1/2"wide by 5/8" deep` -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 closer to front or side lot line,than longest street-facing wall. ❑ Yes No. If No (Check one):e❑ 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
a ove he garage that faces the street with a min. area of 12 sq.ft.
Wi the (Check one)
12-foot-wide garage door ❑ 40%max. of street facade
0
❑ 50%max. of street facade with 7 detailed design elements
Notes:
, ./.7 e.
Approved ByPlanning:PP ... ` '� Date:
I:\Building\Forms\BldgPermitRvw_RES_RT_062216.docx
Plumbing Permit Application
e Site Utilities FO/R 0FFICG t SE ONE\
City of Tigard 1-I fi =^� RDate/B a 77:47/7 y//�/ Permit Ng p s7 /, /6„
13125 SW Hall Blvd.,Tigard,OR 97 2 i y (/ ,v ' ,v
Plan Review
Phone: 503.718.2439 Fax: 503.598.1964Q, L
2UI 5 Other Permit No.:
J01q 7 Date/Sy: 7_,S'-/7 '4L
T 1 c,A R D Inspection Line: 503 639 4175 Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
SSS
a.�`�s'?`Cii��cx ., r .A.4 ,. ...l .4 .£..� s .• �.�.e H,c ....,�a.�.y g. 4r` �y��-i. .... Sb'm .. � �51 `cl`,a�7 • .c.,n 't_, 1
®New construction 0 Demolition For special information use checklist
Description I Qty. Ea. Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
ft I. <" ✓s.01 SFR(I)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory buildingSFR(3)bath 500.32
ZMulti-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other
y ,• Fire sprinkler(12sq.ft.) Page
2
. ol!SIT
;IM ORM T14i1 ..,t i Site utilities:
Job site address:13174 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.: 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: 1 Lot no.:164 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
••• • I ;i of I Backwater valve 12.51
Clothes washer 25.02
Multipurpose Fire Sprinkler System Dishwasher 25.02
Permit#MST2017-00116 Drinking fountain 25.02
Ejectors/sump 25.02
\ / j /
� ' Expansion tank 12.51 1 ' ` � 4 �
Name:Polygon Northwest Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
` 1"4' ' r ❑ tA P Interceptor/grease trap25.02
Business name:Alliance Plumbing,LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Robert Dishman
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
� ® y v,yi a Water closet 25.02
��..... �::.,, ., 4 Waterheater
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
Plan review (25%of permit fee)
CCB Lic.:184601 Plumbing Lic.no.:PB732
/�/ 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.
I:\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 S stems
w' iii y ��� �
Footing drain-1"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 S stems:
Water Service-each additional 100' 37.52 ‘e 1 At
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
Ot eY" a ' B,43C ' j. .>, 2 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
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
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*
iliiitotto by Fixtu Type t�°�rlw le s ` ,' �#€ ,,'4410410 0,1• .
WType iter Plan review is required for any of the following.
== ? ,, j Please check all that apply.
Baptistry/Font
Bath Tub/Shower
0 Any new commercial building with water service 2"and
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.
-3"
Car Wash Drain
Garbage Domestic-non-food
0 Isometric or riser diagram is required for new buildings
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-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:
\\up-dc2\home\gavin\My Documents\Fire Sprinklers\RT\City of Tigard Pgmit.doc
Mechanical Permit Appliccti[ni 1 012 011l(f. t SC ON )
City Of Tigard Received
Date/BY: _ a k21 4/2R
:1,1, • 13125 SW Hall Blvd.,Tigard,OR 97223r.:o 2M. CI .,7i Plan Review per permit
Phone: 503.718.2439 Fax: 503.598.196b Date/By:
1 1 u A F, Inspection line: 503.639.4175 Date Ready/By: Ilial
i3 See Page 2 for
Internet www.tigard-or.gov Notified/Method, Supplemental Information
•
T x i ;:',4/'',.-e":':•';.i,4.1.::!.....".".):;:n- ,r I,u) J I'�' 4� ::%4'1 E hi i' iris ,1ts 4T Pint , �,
V:'
x f
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.
e ,�y r' _.: -; 3`' .-.., y t,..
Value:Y$ yt
rl�F ,, XCj' ..: 2iExe} f[ :1 r._ ...LC',.. 2.., t"it[7,4 ` w.� ,jrt,4 4 i , ti aq � >:r
❑ 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist
®Multi-family 0 Master builder 0 Other: Description 1 Qty. I Ea. 1 Total
Head,• coolin
__._ Air txrrdiHonin 1 46.75 46.75
Job site address: 13 11 SvJ fililllenj
I t 1-fivya O Furnace 100,000 BTU(duets/vents) 1 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: J;I) I Project name:River Terrace Northwest Duct work 23.32
Cross street/directions to job site: Rydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-du.. suspended etc. 46.75
Flue/vent for any of above 1 23.32
I 1 WL1 Other
Subdivision River Terrace Northwest Lot no.: Other fuel appliances: 23.32
Tax map/parcel no.: Water heater 23.32
k 4� d I Wr � !u k ; ?
Gas fi .lace/insert 1 3339
..2. � - ,_ _ :.. ._ -:- ".---': .. .-. ` -:.�' ...''': - � �--'---amu`-. *.
Flue vent for water heater or gas 1111
Contractor Change fireplace 2332
Jn -DO t,V L1i: 23.32
Wood/pellet,:Ill stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 2332
., .
Other2332
iM -, 5� ,"- . 3 f M1..`7 1 d ; t7ef 5t I 4 :
I > rY i _.I1_t rf -_ . -_-,,,',',1,•2,,,11
>-:...<_„_-7__._. ,.—,,,---1- •.. 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/Z1P:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 4 23.32
Phone:(602)694-4031 Fax:( ) Attic/crawispace fans 23.32
` rx z-r-'- .� , p o •ther
2332
r F -`,.:!5,..,1-i 3 r V C{ 1 1 t,t �C fr . [.�5 f t,, ,, : O
� '4........:.... .. ...... . •
. . . , ...7 •
Fuel ping:
Business name:William Lyon Homes,Inc. $14.15 for first four;$4.03 for each additional
Contact name:Nichole Thorpe Furnace,etc. 1
Gas heat pump
Address:703 Broadway ST Suite 510 Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
re la 1
Phone:(360)695-7700 Fax::(360)693-4442 rtrcp1
Range
E-mail:Nlcbole.Thorpet polygonhorrtes.eom Barbecue
. Clothes dryer(gas)
Other
Business name:Pro Heating and Cooling,INC •
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
�� days after it has been accepted as complete.
Authorized signature:6;� "1 A.4 • Fee methodology tel by Tri County Building Industry Service Board
Print name:Nichole Thorpe V� Date:9/19/2017
t:1HuildineerrakalBC PernitApp_040113.doc 440.4617T(I1/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13174 SW AUBERGINE TER, SHERWOOD, December 7, 2017 at
OR, 97140 11 :05:16 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00116
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Plumbing final inspection passed prior inspection. See inspection 12/5/17
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13174 SW AUBERGINE TER, SHERWOOD, December 14, 2017 at
OR, 97140 3:28:26 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00116
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Provide approved street tree modification for missing street trees.
Ac whip not installed, final electrical and mechanical inspections complete.
Provide separate electrical permit and inspection for ac connect prior to building final
inspection.
Not ready for final inspection, work not complete.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13174 SW AUBERGINE TER, SHERWOOD, December 18, 2017 at
OR, 97140 3:33:42 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00116
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - CofO
Comments:
Note: separate mechanical and electrical permit for ac partially installed to be obtained
by 12/19/17.
Final erosion control approved.
Street tree certification received. New tree location verified.
Moisture content form received.
High efficiency lighting form received.
Insulation certification checked.
C of 0 left on site with contractor.
Violation Summary:
Inspector Contractor