Permit (117) CITY OF TIGARD MASTER PERMIT
71 :' '' COMMUNITY DEVELOPMENT Permit#: MST2017 00115
T[GAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/17/2017
Parcel: 2S106DB16300
Jurisdiction: Tigard
Site address: 13162 SW AUBERGINE TER
Subdivision: RIVER TERRACE NORTHWEST Lot: 163
Project: River Terrace Northwest, Lot 163
Project Description: New SFA. Building/unit 3.2
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
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 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 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: , c .l�%�2%FC/l�G�l�GK_ Permittee Signature: `li,1C�l,k-6G
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. !(fJ"
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.
4 t".07---
uilding Permit Application .,- ' F � � ' '�,}
b
Residential FOR OFFICE LSE O\Ll
City of Tigard r �s DateBy ,3 /7.,
4t:1----rt
`K// '. Permit Ny!�J_j j f/7_ O//S
0 13125 SW Hall Blvd,Tigard,OR 97223 Plan Review J Ipd,�p � �7,f 7 /
•Ph
Phone: 503.7182439 Fax: 503.598.1964 ;, DateBy. �'U
TIG A t D Inspection Line: 503.639.4175 Date ReadyBy. runs H See Page 2 for
Internet www.tigard-or.gov ,' potified/Method:u/////// Supplemental Information
®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 0 Other: equipment,materials,labor,overhead,and the profit for the
t _ �- y� 7- work indicated on this application..6 l
`'�,x� m '7--.:,1 E4'-f'� §) emits t E � g ,a 1
ii -_ _- . r _.7,z a..q.7:. ,. .._"e-r._ ._ .,--z. . . ._..; . .,s»} - Val $ /
1-and 2-family dwelling ❑Commercial/industrial uation)6Ii 7$0
❑Accessory building Multi-family Number of bedrooms: Z
0 Master builder 0 Other Number of bathrooms:
xt �� - Total3 1o1as1 / i a 19_
,��-"�'r "�, number of floors:
Lot p New dwelling area: ` square feet
Job site address: i� I U�Z 5\0 t ��'n Y�)� 1 t��� ' I 1 �
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 4 C13 ✓square feet S 6.1
Suite/bldg./apt no.: 3 7 Project name:River Terrace Northwest Covered porch area: 3(y'n "square feets 6 ca.
Cross street/directions to job site: Deck area: �� ,/ square feet C} 7
Vct
Other structure area: 7 a ✓ square feet
Subdivision:River Terrace Northwest Lot no.: 1_v3 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
materials,labor,overhead,and the profit for the
t: .., „x m ""`u �4. '- x- _� - :7 4 workindicatedon this application.
-*:f- s -'G. ak r- '_ ii ,.gg,>„a_�.�... _--.r+.x a-:,., ;tr-.
_ . - Valuation: $
Existing building area: square feet
New building area: square feet
.," 0 A!,.f. e, �.'�..:,,-.::,,,,,,T,,,,,...,..--
.,_- '° - " s'_1` iz� i,� 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:
'x SZ . .._ . ' ':""'r'�' t.. .+ T ...��... +.,s,� "�. "=?=:-.:— Tim" _ '
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:109 East 13th Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax:( )
t:CI- 't.,- .gym L g q taDi . -
E-mail:Angela.Grajewski®polygonhomes.com
Commercial and residential prescriptive installation of
,,t4N' ' ' w- ° 6? _ _ _"* _ 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/IP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
"'--me:(360)695-7700 I Fax(360)693-4442 State surcharge(12%of permit fee): $21.60
—B lic.:207247 Total fee due upon application: $201.60
Authorized signature: 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: '+i I i 4/ W IBJ/)l Fee methodology set by Tri-County Building Industry
0 1 Service Board.
I:\BuildinglPermits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
a
Mechanical Permit Applicat7ic1 E C E J yE D r OR OITIC1.(SL o\1.1
City of Tigard Received Permit No.:
I r 13125 SW Hall Blvd.,Tigard,OR 97223 A P R 1 7 2017 Paan Review
Phone: 503.718.2439 Fax: 503.598.I960 DateBy: Other Permit:
T I G A a D •inspection Line: 503.639.4175 CJTYOF-TI•GARD Date ReadyBy: "Bi See Page 2 for-
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Metbod: ® Supplemental Information...
aid �F a l P.A. ?1 :Se Q.1 ryL• , 6ibP ` ,; ,k 1 rs. f,,ern - �'r s)rd r,'"''".'' .£ , ./ ' :''t. , f'''
-.,;1,2'n:.'r_..�l .a417:it Z 'i '.uYi as '"�r.F ,,psi;.Ii�bS.,fie; =14;,• irc!...�aatz .. - work Mechanical permit fees*are based an the value of the work
®New construction 0 Addition/alteration/replaceaient performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit
.t Value
� : . ; ^ ri'G"' rfa ' \„
� r 9
•..;',: Gr , F,- 'y,1 t; `E�c ,:if',C A` Z!:.,-2:u t,l e)•0.,5.rs�,:- w>-4” S,X,,^ rx r t� sa �, � Ci tr ,i hi� ix l
❑ 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist
®Multi-family 0 Master builder 0 Other: Description I Qty. { Ea. I Total
4''''''` 's f ' tf af..G \ t4i i°1E y Yf .c F d�yi v41,0 Li..,.: Beating/cooling:
s,... >rc .l *T.szr = F. t. � 4 sr � 9 za.„;.4:477.f%,Ef'-,.;: Airconditioning
46.75
Job site address: 31(2_
S J4 ber 1 nL rraeL„ Furnace 100,000 BTU(duets/vents) 11 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(duets/vents) 54.91
Beat pump 61.06
Suite/bldg./apt,no.: -61 ( Project name.j2 ivc.-T blcG N I t— Duct work 2332
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: tiJ—� -r.ne cA fe, -(4'
1 M/,e.s #'t- Lot no.:11 97 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
h c -. 'r < � t 4s "Ur , ti- Gas fireplace/insert l
ace/insert 1 3339: r. ,max. t i.%)ariul �i ,frLz2fi .s_ _� r 1r.,,,Lt uq: _
Flue vent for water heater or gas
new home construction fireplace 23.32
Log lighter(gas) 23.32
- _• _. — Waod/pellet'stove _ 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Z1 U+ .)5- 'tf3 4,,`-. C 4-�
' 'Iw ._ .4 r. «••'
2332
!..:::-..-"A:,...:-...,-.;:1f( y: ., 1=L_ _ wh CY -:,-1":,44.1-Z..:1,2-. :. v:ti.-- �:::2' .' Ed.3v.cf'•-,-
Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
Address:7600 E Doubletree Ranch Road equipment 33.39
Clothes dryer exhaust i 33.39
City/StateiZTP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, LA
toilet compartments,utility moms) 23.32
Phone:(602)694-4031 Fax:( ) Attichxawlspace fans 23.32
°Arer • ''1ei Edi `-.:'''..,:-•,7-:,,I,,..--!-_-_--„-...,:7:::.,173 ,
>lx#t , , } 2a, 4�ch Other 2332
L.
.acJ...x. » ...�..aGx4...+. ...., ......�,_.. .. �..
Business name:William Lyon homes,Inc. Fuel piping:
$14.15 for first four,$4.03 for ich additional
Contact name:Angela Grajewski Furnace.etc.
Address:109 East 13th Street Oras heat pump
Wall/suspended/unit heater
City/State/ZPP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace
1
Range
E-mail:Angela.Grajewski@polygonhomes.com Barbecue F
4 7.i.,. 1-1, fi q.�' t. s) c } _ i Clothes dryer(gas)
Business name:Andersen Mechanical,Inc. Other
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)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
a i , days after it has been accepted as complete. -
Authorized signature: 1, ., • Fee methodology set by Tri'Courtty Building Industry Service Board
Print name:Nichole Thorpe Date:4/17/2017
I/ uiidingecrmitAMEC PamitApp 040113.doc 44G-4617T(1uovcoM/wE8)
l
EC IVE
Electrical Permit ApplicApplicationLOR OFFICE USF.ONLY
City of Tigard APR 1 7 2017Received
. 1,11.., , 13125 SW Hall Blvd.,Tigard,OR 97223 Planut •
ev,ew
Phone: 503.7182439 Fax s03.59805W OF TIGARD Data/By: - ItaiitzPermit it:
.
T1GARD Page 2 for
menet n wwtigardne: .419 75 BUILDING DIVISION No.goyt dnil,,thud SSupppllementalInformation
_,. .r+"h., J;�,. '"."^e" ri:«'-=&- ^..":1:,1. .<' ';�' 'A+fS. -,:' ,W,,,.2 " ti' ,. ,.V M~ 1ih1,; :-t.,-,,,,,r1:;:.-W,',.•,:41-. sxP
®New construction ElAdditiou/alteration/replacement Please check all thatapply(submit 2 sets of plan whlems cixeked):
0 Service or feeder 400 amps or more 0 Building over Haw stories.
0 Demolition ❑Other'
where the available fault current 0 Marinas and boatyards.
."• s- 'Q" - '?' a},,. t.-6.30,1:41,:a-0:C aawVia,,r 4-4. ›5-4,-.:[:- .. exceeds 10,000 amps at I50 volts or Q Floating buildings.
1-and 2-family dwelling 0 Commercial/indiistrial 0 Accessory building less to ground,or exceeds 14,00° Q Commercial-use agricultural
N Multi-family 0 Master builder 0 OtherFires for all ones installations. I nta i atio
0 Fire pump. Q Installation of 150 TCVA or
'-4 a: ij 4 S+ 7o;.!.<.:-
!. , • b 0. q ii.'._....':''''•"-;•‘,1,01013,6
''•"- {�1 gr- 'cm3 QEmergencysystem• larger separaielyderived
Job#: Job site address:/37/4002_5 w et_'erre e Q Addition of new motor load of system.
1 s""`C� 100i31,or more. Q"A«,•,E•',"1-2","13••,
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy.
�( Q Health-we facilities. 0 Recreational vehicle parks.
Sui&bldgJapt#: 3.) Project naine,R %fry 1.errcAePoo'k'blv3vr}-- Qliazatdaes'masoos. QSupply voltage for more than
Q Service or Seeder 600 amps or more. 600 volts nominal
Cross street/directions to job site: t.".3. w�zv nLx £ d "tK .3.i bra --t,^
rresesiatloa Qty. Each Tot711 *
New residential single-or multi-family dwelling unit
Subdivision:Q jev,'revrt„ rA f,„ 4�5 f•— J Lot#:ILIncludes attached garage.
Tax map/par
1c6i'# 9, I 1,000 sq.ft.or less t 168.54 4
add500 sq.ft.or 3392 1
,' _ii7~7 ; C 4 ialr :a 13- s "Ta,S�,;t .e ;3aau Limited energy.tesidcgizd
75.00 2
(with above aq.f.)
Limited energy.multi-family 7500 2
y residential(with above sq,ft.) ,
-;': rr'- `Rest µ:.i-3 i 7c-ivy' .,,_ '. 2�nrv.._i.`=, `'' --,_tw , '' -- Renewable Energy [l See Page
-- b`'q- -4.4-t'---' 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> ' since 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 y . I Fax:( ) - Over 1,000 amps or volts 552.26 2.
-` Temporary services or feeders installation,alteration;and/or ---•
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 59.36 1 1
intended far sale,lease,rent,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
-.::.,,,;-=''..,---'--= �Ey;`dn-n 'e'”' ria .40. `"ay e ,,,,iia A e ,, Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with i
Business name:William Lyon Flames,Inc. above service or feeder fee, 742 2
eContact name:Angela Gra'ewski Peeeal obr anch circuit
J B. fru'branch circuits without
Address:109 East 13th Street ba �oranch cirwit tire,first 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 Fax :(360)693-4442 Each manufactured or modular
dwelling,service and/or feeder 's 2
Email:Angela.Grajewsld@polygonholnes.com Reconnect y 67.E 2
_.�..._r�.._s� _ 2..22_n_ f,_ „,.� ,,.,e�_.FX�,.__�.;,.::�`�'�>.t,�;`,,`,5';, Pump orirrigation circle 67.84 2
Business name:Garner Electric Washington,LLC ' Sign or outline lighting 67.84 2
't.,•,:. Signal cironit(s)or liroited-energy
Address:6101 NE St Johns RdQ See Page 2 2
trattd,alteration,m extension.
City/State/ZIP:Vancouver WA 98661 Each additional Inspection over allowable hi any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(253)320-1657 Fax:( ) investigation(1 hr min) 40.00/Iv
Email:bdaniels@gweusa.com Industrial plant(1 hr min) • 78.181 hr
Inspections for which no fee is 90.00/ .
CCB Lic.: C115S Electrical Lic.: 208174 S�upprv..Lie.; s , s listed %hrmm
u
lc�l i a'l�� #. e" c ji.:-.ansa 1 eitt
Suprv.Electrician signature,required: L` tag _l! Subtotal: .
`•'' Print name: Joan P Albert Date: 4/26/2016 Cl Plan Review Required(25%of permit fee):
l - ----27_---...=...._---4.....„ State surcharge(12%of permit fee):
Authorized signature: 7- TOTAL PERMIT
L'i`�`;. Ly This permit application expires ifs permit is not obtslned within 180
• Print name: Bill Daniels Date: 4/26/2916 days after It has been accepted as complete.
* Number ofinspectioosallowedperpermit,f`y k t%zi8aUduJWaaits FermltApp
EU ERE.dos Rev 06/17/2015 440 l6I5ltll.05/CDt tIWEa
Plumbing Permit APPlieniIOfE�CEIVE r
Building Fixtures ioR (,l l l( t I ',:,1 0\12,,
City of Tigard: APR 1 7 2017 Revel xl
Date/.B}. kcrmit No.:
1.4 13125 SW Hall Blvd.,Tigard,OIL 97223 Plan Rcviery
u Phone: 503.718.2439 Fax: 503.598.19QITY 0�TIGARD DatelBy.. aherPerrttitNo.:
Inspection tine: 503.639.4175 BUILDING DIVISIO p.m Ready/By: suds. l3 Set Purge 2far
t 1 r'\1"i' Internet: www.tigard-or.gov Notified/me hod: SappIesnental loforraideo 1
' •. "�'' r K•4. ., .xr M~;*_ �, t . btt- !F 4.µ ° 5cy « , y,.Af i �� . . ...... ..
• 1tk x � 7 � 1 �4X• ra ...- K7. k•':,,,,,,•• .ls. ,vi
AL1,.. i Y ..L.at i~ e .."" Ci t -Y•.-0,., .i . . 1. :.. For special formaionusechecklit®New construction 0 Demolition
Descriptio i Qty. 'I Ea. I Total
D Addition/rdteration/replacerrnent 0 Other: New I.2-family dwellings(includes 11101 for Bch utility cortnecteon)
'''y"'t v< .f'Y'''`f A•„:;,,,,,,.?-,..;.2,,t
* 1 t ,z.t+.Y uN!,.x .,... '',,,:::Tx.
.1 a si`' _..i � ;_11.• n, as SFR(1)bath 312.70
1-and 2-family dwelling 0 Commercial/industria1 SFR(2)bath 439.78
SFR(3)bath ' 500.32
nAttessoryiunding 0 Multi:family Estith addrtidnai badt/kitclten 25.02
aster builder D Odtcr: • Fire sprinkler( sq.ft.) Page 2 : I
„. .,.- ' - Se s s•s c,. : l,.r°le , ;;F M..r G` , `,15 17 Site utilities;
• Job sere a-4c s: /30697 S V 4 Catch basin or area drain 18.76
""'rQ�l t�idGe Drywci[,leach line,or ttsnnch drain 18.76
CitylState Z1P:Tigard,OR 97724
+ Footing drain(no.linear ft.:____) I Page 2 l
Suite/bldg./apt.no.: 3.7, 1 Project came:4 �((iy t.(„hriA4G 1\1~4-Manufactured home utilities 50.03
Cross'sfietl/directions tojob site: Manholes18.76
Rain drain connector 18.76
- Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear IL:_) l • Page 2
Water service(no.linear ft.:_••_,_) Page 2
Subdivision 144- Tyr- T�n'ac�i. W�yf'd- rof no.: f 1,0✓
Fixture.or item:
•
i 31.27 rap/parcel no : " Backflow
Valveeer 1 12.51
;r..�1Y*i ,`w ` +. rA f E.yw Trmi3 Syb"�7." S5.'x? 4 ,• + R•�,-?.., r4'° Clotheswasherv
25.02
• Dishwasher. 25.02
.._ Drinicitig;fountain • 25.02
Ejectors/s(?mp 25.02
}} '- 1,t r# , .. ,- TT F `ale«`. ,- 4. I' �y,.s.:' it E 7.1 p t Ei a's ` T1. Expansion tsink. 12.51 t
'Namt;:ADVL'LLand'Hoadings;LLCFiX• '.:ower cap 25.02
• • Fleet.draiin/floorsink/hub 25.02
Address:7600 E Doubletree Ranch Road
Garbage disposal 25.02
City/Siate/ZIP:Scottsdale;AZ 85258 !rose bib 25.02 � 1
: ... .._,. )6 ( ) 1
Phoma(602 94-403) Fax iPe maker 12.51 ,
•
2 . ...,. .�`{•' A€ E ,,, .,. lnterceptorlgte trap 2502N r € �c }'r .., 3F1t*.c� , '7.:?a:,,.' 9 R4.�. r
Business rtetnei Willinat Lyon Homes,Inc
Medical gas{value:$ ) Page 2 , W i
_ _... Pitcher 12.51 , 1
•
Contact name_Angels'Craje»siti Roof drain(commercial) 1151
Address:.109'East 130 Street Siriklbgsin/tavatory 25,02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Pholie;{360)`695-7700' Fax::(3.60)693.4442 Tub/shower/show• crpen •
12.51 li
UiinaF 25.02
&rnlygonh
aili Aage1a.Grajewski@poomes.cem
4 _
�' ; . xs ? ' o f c t. ;. x1, aft. J[: yen '
Water• cIn�9L't _�
, . .- - Water heater 37.52
Business!tette:Ath ia:`t 1'lurnbiag LLCM `
Waterpiping(DWV 36.24
A4dre s 146'W Historic Columbia River Hwy atter: _ 25.02
City/State/ZIP:Troutdale,OR 97860 Subtoiirt•
Phone:(503)492-3490 Fax (503).912.6438 ..• Minimum permit fie: $72,50
CCB Lica 184601! Plumbing Lic.no.:PB732 Plan review(2r.
1o:afpermit€ee)
State surcharge(12%of permit fee)
Authorized signature; . TOTAL PERMIT FEE
Pitntrtalue Rtitiert Dislttnan Dale;523/2016 This permit apptke_iton expires if a'perntit is not obtained ri'itbih 180 days
... atter nine been accepted as eaa,plete.
*Fee methodology set by Tri.Couoty Bnildtag Industry Service Board _
1:0uadiri Perni ent4U4eottApp.doe 1001/09 440-4616T(IOM)ICOr.V EB)
lor
li
4
11111 City of Tigard
r COMMUNITY DEVELOPMENT DEPARTMENT
II
T 1 c A R D Building Permit Review — Residential
LX/a9 aA;;e,.c _.'fin....:: k_.,eLfK le-a u_a.?..yg.BS, +r5ittgt .M_F'.N2.54..a?"thiP*N4a:tf?w .'3:'CS�42.ss�Q&'s...S.h,-tx
.. �sf 3TV.�_*.s':sYSA:b_'.bafiJY31M5.{✓i°y3v. ter'Mid
Building Permit #: /‘-/-5. 77,---)C6/ 7 — G o/As—
Site Address: /32 .e Q -,1 :7th t, rgc
Project Name: Elver- '7�o9r or4 Lot #: _/4Q 3
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: / .✓
��60 --Clic /"— • Ii Ge / 2A �( me;)
erify site address/suite#exists and active in permitystem.
River Terrace Neighborhood: CI No -Yes,See River Terrace Review Addendum Attached
Silan Elements:
ree(3)copies of site plan ,1A
g structures on site
to plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
yawn to scale(standard architect or engineer scale) oor elevations
rth arrow tility 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) 0 z:sting trees to be retained with drip line,and tree
16`'( t dimensions and building setback dimensions s rotection measures
Lot area,building coverage area,percentage of coverage and Yi treet tree size,type and location
.ervious area(applicable if R-7,R-12,R-25&R-40) Street names
F.1 roperty corner elevations(2 foot contour lines if more than
4 foot differential)
1l dean Water Services—Service Provider Lett r(lot platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified No Received:
PP ❑ Yes ❑ No
Public Faciliti•s Improvement(PFI) Permit:
equired: Yes,applicant was notified ❑ No Applied For: yJ Yes ❑ No,stop intake
//and Use Case#: /6 ,e '7
366:0,c; (,, aig- C,45--cZe2-)e3
igyoning:
0 Required Setbacks: Front _65Rear ,S--- Side O Street Side /01.+Garage c20
andscape Requirement: 2(0
Lot Coverage Maximum: 0
uilding Height: Maximum Height A./fr Actual Height
ilg k isual Clearance
U asements
gi P'ensitive Lands: ❑ Yes No Type
►T/ Urban Forestry Plan
❑ Conditions `�'prier to issuance o b�jdint permit
Notes: 1?C1/712024i' // cN- r9 t71-- 1Sccter24
Approved By Planning: "°" ;:. " Date: ,16/1' .
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building1Forms\BldgPermitRvw REs 091216.docx
•'
w
Building Permit Submittal
Original Submittal Date: 1e: /
Site Plans: # `S
Building Plans: # ...3
Building Permit#: Er-Enter building permit#above.
Workflow Routing: Planning [8 Engineering ❑ Permit Coordinator C L Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: 2—Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: r
By Permit Technician: ` Date: -"V---/S// 2
Engineering Review
Slope at building pad: /"
Conditions "Met" rior to issuance of buildingpermit -- ��f/' f
p
❑ Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: El Yes ❑ No
Assess Water Quantity Fee in-lieu: El Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: '14 Li Date: J3 /7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved El Not Approved
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
PP
2(1
roved NOT Released: Date: ' /.2-'11 -Ps-.Notes:
4
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:
M„sDC Fees Entered: Wash Co Trans Dev Tax: 'lilies Cl N/A
Tigard Trans SDC: Olees ❑ N/A
Parks SDC: 'es El N/A
rOK to Issue Permit
pproved by Permit Coordinator: Date: 4/2-/
I:\Building\Forms\BldgPemutRvw_RES 091216.docx
City of Tigard
1 COMMUNITY DEVELOPMENT DEPARTMENT
c �
T I G A R D River Terrace Building Permit Review Addendum
EF,
Building Permit #: /YS% 0/7— 00//
Site Address: / JleQ c jj /jo s„ -iii ce
Project Name: , fv r 110 C / ;-Aitk. '• Lot #: 4,67 S
(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. deepBalcony w/access 2 Window Projection Vertical Wall Offset a
ft. deep min. 2ft.,5 ft.wide min. 2 ft.,6'.wide Gabled dormer
❑ ❑ ❑ i ❑
2. Eyes on the street: a minimu of 12%of e ch street facing fa ade must include windows or entrance doors.
Percentage Shown: ��� S7 i't'-`47C.: Ai
3. ntrances:At least one entrance must meet both of the follo ' g standards:
Max. 8 ft. setback from lon st street- facing wall Parallel to street,angle no more than 45° from street,
or o n onto porch
En nce opens to a porch: Yes ❑ No
I e all the following apply: sq.ft.min.
ne street facing entry ft. max.roof above floor of porch
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
Roof eave min. 12 inch projectioi '"�i ❑ ormer min. 4 ft.wide
. oof offset min. of 2 ft.'C...--
❑ Roof shingles either tile or wood u able,hip or gambrel roof design
(A❑ oof pitch oriented south min. 500 sq. ft. V orizontal lap siding min. 3-7 inches wide ()'
ccent siding min. 40%of street facade Window trim min. 2'/2"wide by 5/8"deepf✓(1F�"
❑ Window recess mm. 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 c oser 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
above the garage that faces the street with a min. area of 12 sq.ft.
Wi : (Check one)
12-foot-wide garage door ❑ 40%max. of street façade
❑ 50%max. of street façade with 7 detailed design elements
Notes:
Approved By Planning: - Date: - }
I:\Building\Fonns\B1dgPermitRvw_RES_RT_062216.docx
Plumbing Permit Application
Site Utilities �'§� vk ix FOR OFFICE USE ONLI
„ t , �y a --: Received
City of Tigard /
ll �� Permit No.: f) --6304/5--
ill 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
`
■ Phone: 503.718.2439 Fax: 503.598.1960 JUL 2017Pl444
Other Permit No.:
DateanBReview 7/ _�
Y:
Inspection Line: 503.639.4175 Date Read /B /�//7
T I G A R D r Ti, o Ready/By: ]uns ® See Page 2 for
Internet: www tigard or gov / t tNotified/Method: Supplemental Information
®New construction 0 Demolition For special information use checklist
Description Qty. Ea. Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
yis � �`: ° xpr ��` i SFR(1)bath
..• �� ... �� ..3� . � 312.70
1-and 2-famil dweSFR(2)bath 437.78
1:1y llin g ❑Commercial/industrial
❑Accessory building ®Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler(1,221 sq.ft.)014,p. Page 2
,11: 011 A'11t,0t i, , ' t ASite utilities:
Job site address:13162 SW Aubergine Terrace Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear 11.: ) 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.:163 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
.a Backwater valve 12.51
Clothes washer 25.02
Multipurpose Fire Sprinkler System Dishwasher 25.02
Permit#MST2017-00115 Drinking fountain 25.02
Ejectors/sump 25.02
e7 § 4 Expansion tank 12.51
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
,, , ,• x ,� , v Interceptor/grease trap 25.02
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
Water closet 25.02
„ it'i ,,,z •• .,. ::' 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
Plan review (25%of permit fee)
CCB Lic.:184601 Plumbing Lic.no.:P13732
�� State surcharge fee)
Authorized signature: / �' TOTAL
PEERMITMIT 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:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su s ression Systems:
Footing drain Pt 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
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
O* a each additional$100.00 or fraction thereof,to
'„ a, � �,.,.. \ '' \. ...; , 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*.
Quantity by re Type. "\ }
� ata €
Fixture Type for �' RegtN� Vii.£, �b)C � w; a . 1 tit?!
a�
td l c Plan review is required for any of the following.
Work Performed: `' •4 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 ❑ 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.doe
Mechanical Permit Application FOR OfFICF.l SE O\L�a
City of Tigard 7' p ax ,Z_. 2 �.J Permit No.: ),40 —, /
IN • 13125 SW Hall Blvd.,Tigard,OR 9723' plan Review /
• Phone: 503.718.2439 Fax: 503.598.1960 c -n r, r T7 Date/By:
Other Permit'
�. r1:, Inspection Line: 503.639.4175 �-+ "2 `�'' Date Ready/By: Imo: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
•
' i 'r ,. :� f s -''''I''''''1-''''''''1'
J� 1 V) t a'{i•i ' 1 ) ,I 1 ti y �' x .*.•,:,5,1',i,',4.-�d�.,i • - 5.',°-,-- �--c �.•.� h a tz_°'--,-,.c ---=.,e
..1:',:‘,,-.. :.._'r:,..N 5;r� �k t �. �. ..r I�r='»=1 . -4-'-s''''° ''.,-,.._--'"'-' ' ws Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit
0 Demolition ❑Other.
Value:
e e-f,Il ,'*� ry t2�.t IpiL:: Z *a ,: ,n�E 1' ik fr,:tt`1, t35i� s4� ki.-,
! i< 61 7 _
❑ 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For spedal Information use checklist
®Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
r `I ' - ' iutY ' a (C
l . , . Heating/cooling:
z�: � } a. y4 tl < ,< lx_ �:. aa v , : _ Auconditioning
1 46.75 46.75
Job site address: 3 �L3W �,_, ,117e,"ph �t
Furnace 100,000 BTU(ducts/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.:. s7, 1 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
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
Other: j 23.32
Subdivision:River Terrace Northwest �� Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
i
t . ,. F t _u 7 ,3-:,7--,:i, < t,,:4777:,..f::1,:-.!;;,::•'-'..:7,7-,:,-,=,,-,,,,. � Gas fireplace/insert 1 3339
i:.__w ._� L... a.. 1. ,u w ,.._t z 1,......_�. „, ..1.MLe�..,... ..._� ,r_
Fine vent for water heater or gas
Contractor Change
'�'� /`�1 e1 `y fireplace 23.32
r�S l IZ I I D V 1% Log d/pelllightet sto 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chinmley/liner/flue/vent 23.32
t � ' - ,.._„7,,,,, Other23.32
t f' 9 ) 'L'; r : ` i I rtlitr` �I _ y
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/crawispace fans 23.32
Qr 1< a 1-:''..:----1—.I '''i-,,.;; r`7,-'; �.- i { ' ',` ' - • 2332
Business name:William Lyon Homes,Iee, $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
Phone:(360)695-7700 _ Fax::(360)693-4442 Tireplaoe _ 1—
Range 1
E-mail:Nlebole.Thorpe®polygonbomes.com Barbecue
7.t.,-;., , 4. < c i y',, r -v I k k ."„ `.'.7' , Clothes drye (gas)
Business name:Pro Heating and`nCooling,INC Other { r, 3 ti r
Address:2095 NW Aloclek DR Suite#1103 Subtotal
City/State/ZIP:Hillsboro,OR 97124 Minimum permit fee($90.00)
l
Plan review(25%of permit fee)
Phone:(503)4435692 Fax:(503)9415075 State surcharge(12%of permit fee)
CCB Hc.:209001 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
��7
days after has been accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board
Print name:Nichole Thorpe Date:9/19/2017
L1BuildingTermits\MSC_PtamitApp_040113.doc 440-46172(I I/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13162 SW AUBERGINE TER, SHERWOOD, December 1 , 2017 at
OR, 97140 9:48:38 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00115
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
No A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13162 SW AUBERGINE TER, SHERWOOD, December 14, 2017 at
OR, 97140 3:12:21 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00115
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Provide stamped approval for street tree change from approved site plan.
All else appears ok.
No ac installed at this time.
Violation Summary:
Inspector Contractor