Permit (76) lipi CITY OF TIGARD MASTER PERMIT
li
COMMUNITY DEVELOPMENT Permit#: MST2017-00029
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/10/2017
Parcel: 2S 106DB 14800
Jurisdiction: Tigard
Site address: 17327 SW FOREST HOLLOW ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 148
Project: River Terrace Northwest, Lot 148
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 978 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1251 sf Garage: 380 sf Front: 8 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2229 sf Value: $273,680.89 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add]500 sf: 3 201-400 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 SF VB R-3 2229
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 2 Fire Rated Eaves-Both
STE 1 Sides
SCOTTSDALE,AZ 85258
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $32,242.24
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. r -1�--- - Permittee Signature: �° ',/,/of r?
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.
4
t
Building Permit Application
RECEIVE . /„.07.--- /Lig
t tFOR OFFICE 1 SE O\Ll
DEC 2 0 2016 r .!4 "T
.fr/iPermtNX42 /7OaIII Sd.,T93 qq /960 -YrI ^ --7 Other Permit: / ,_gyp,
Inspection Line: 503.639.4175 ]T � "' a ReadYBY: ` �7 /uric El See Page 2 for
T 1 C r; I I� rl F 1 � etho± f f �/ Supplemental Information
Internet: www.tigard-or.gov
eit., C re--:
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®New construction ❑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
' work indicated on this application. I F
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i t, •». -- Valuation:
0 1-and 2-family dwelling ❑Commercial/industrial
Multi-famil Number of bedrooms: 4 a'1 3t 6 $ Q ii
❑Accessory building 0 Y
Number of bathrooms:
0 Master builder ❑Other'
W Total number of floors:Z
� ; � � �,47_�� �4,�`��� 'k�.��, .��� ���3 art � �6 0
_�.._.�_ . x�
Job site address: ym�],\ II-An ta` _ New dwelling area:177 square feet
S'',. City/State/ZIP:Tigard,OR 97224 Garage/carport area:( G1 square feet
Suite/bldgJapt no.: Project name:lizi t,r--' ov0 Covered porch ared•"4`quare feet j as i
Cross street/directions to job site: Deck area: la g square feet 97 S
Other structure area: , square feet
--' sl'i ;'' 5`a0a' ~1 ',1;-,:i.-',;i-4: ID,. r
Subdivision: / U y J Lot no.:, 1111111 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
€ £ ; �t 7` ` '.7` � work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
� ' �
'°�,�" �� 'r� �e � + ����'�'s���° � � � 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=.7-7."' f; , el 7 �s�:iar z� , ` ��,:� �-�ra � �� �ri"z�� s��°� :?� 7 7�� � � .t'a fie
Business name:Polygon WLH,LLC Structural plan review fee(or deposit):
Contact name:Angela Grajewski FLS plan review fee(if applicable):
r Address:109 East 13'h Street
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax::( ) W
E-mail:Angela.Gralewski a@polygonhomes.com "" ".
- Commercial and residential prescriptive installation of
! v 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
Address: 109 East 13th Street Solar Installation Specialty Code checklist.
Permit Fee(includes plan review
City/State/ZIP:Vancouver WA 98660 and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee):
1
CCB lic.:207247 Total fee due upon application:
Authorized signature: This permit application expires if a permit is not obtained
cAl n;5 1 y►�
within.180 days after it has been accepted as complete.
l *Fee methodology set by Tri-County Building Industry
Print name: Date: Service Board.
'1Building\Permits\BUP-RESPemmitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Apptica+ut '
ttlf'�t)}t�l( i. 1 .-1 t}tl.\
City of Tigard +
STi PermitNo.;r
gard.OR 97223 rimdil>: �%�G'�'/�/1�a�� +
...-1,"2.5., 701474111133:411,i-fiot .1`a' 50 ,39;.1940 IIA)" b 201 C Pica It vscw 1�_
'inspection Line: 503.639.417SDate Reah/8y.[IatalHp;,.. C?Ure;Nennic
Internet: www'.tigard-or.gov CITY OF` AGAR t,,..„,,,,,...a: h"" set Pape 2 for
'i 1 LING DIV!S1Ot
Supplemental information -
. .. ;-� .:: � :.. ' st v a :; '4. E t_ e•A t_.a.r
oi- , r . ,,: „- '4 .r'- C1_ r a514. ' y 4Meerafl l permit ies*arc based on ate value ofthc woodis]New construction 0 Additionfahetationfreplacement performed Indicate the value(rounded in the nearest dollar)or all Demolition �Ober:
mechanical materials.equiprment,labor.overhead.and profit.
. 4k a.n _;. watte' *9C `vv,-:k� < z�° 'ire: f A � „ttF}'- Cl isai i 'tz.„ ,, t•e'.±�t .i,, µr; rgzj. 1y. e
1 ,1,,11-.4 yJ4 ,.., ,fit:'`tt x., `'u
941-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For spedal fnformariem necked-fist
I Multi-family 0 Master builder 0 Other: Description
y l �� I �. { rel
-.2.1s..r.,._ ,"1....-..' :s 3_, l2A tE.t,f}zs.',11, �* d t+"`E ..:-5^`t ys'jl.mak' �. .� ,idi.� Hir co ditimin�:
'"� � _/wn�.,`faR_. ;mow }: AitcaunditlottinR 46.75
Sob site address: / I SW e ' 1 f welt/,,c'- Furnace 100.000 BTU(ductthentst 46.75
City/State/ZIP:Turd,OR 97224 Furnace 100.000+BTU tdnric'vaaral 54.91
Suite/bldg./sot no.: 1 Project name: 11Gr ienra G 06r - ,Drat torn 61.06
r_t Dud wort 23.33
Cross strcet,'direc lions to job site: Ilydronic hot water sysicm 23.32
Residential boiler(radiator or
hYdronic) 2332
Unit heaters(fuel-type.nol electric),
in-wall in-drat,=trended.etc. 46.75
�{ '` V� y r� Flue/vent for any.of above j• 2332 ,
Subdivision:..K.1Y re,�i Q-C'�i N 1 11,otnoltia Other; 23.32
v Other files aPANaneex:
Pax ntap!parcel no.:
Water heater 23.32
�: —._11.axr s ?at.3.1,, eltyiy�- w. ,:gs+§:�,?i clio os ilreplafocrr3fwnascterrt heater or gas
I 33.39
/14.S/ 0 fat
2332
Log lighter(gas) 23.32
...._. Woadrp eller stoves
—
Y. - - ....-.�.. rood(iri reuse<tscrt -�� 23.32 .
Chimnevr/lmctltludvent 23.32
2332ta c± t fl_E) � >aa3r 7.6 _-- Y ae - ; cfig„ i Y Environmental exhaust and ventilatioaName:Polygon WIN,LLC
Range hood/other kitchen i
Address:109 East 131h Street eq
41pmInt 33.39
Clothes timer exhaust 1 33,39 f
City/State/ZIP:Vancouver,WA 911660 Sinelerductexhaust(bathrooms,
toilet compartments,utility moms) Li' 23.32 i
Phone (360)695.7700
Fax ( ) AtticJerawlspace.fans
23.32
-3:4.1°;:;'1f-',,-;,:. c....)E.a�(1-xr`1�4�:..s a i k.S.�g�,...4y 1c:t'�sai1.t-4,Sa KF4 .a�,_Es,i�-�.f:,.a."_$.";:: pi ,,`'4 Ot+eG
-
2332
Business name:Polygon'WL11,LLC plplmt=:
f�
31435 tor first four,$4.03 for each` additional
Contact rtffinc:N 1 lA t i)�. Furnace,ere. ` 1
Address:109 East 13th StreetGas.hrat pomp
Wa11fstispended/unit heater
CitytStateiZ1P:Vancouver,WA 98660 termer heater
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace i ,
E-mail Range . i
1 i 11 I, 1, it
<A F i i iii Barbee
r�. .`•+.. sl,., :--'t'''....fE...,,, ..,j S k� E l,r.... -c q;�.,1�.4^++„r� 51< r. -,,,r V.V.,
r. r. r. ;: Clottws dryer(gas)
Business name:Apex Air LLC (?thee:
Address:1.800411E 72"t Ave
Subtotal ~
City/Stale/DP;Vancouver,WA 986155 Minimum permit tee(590.00)
Phone; 350 3d 8109 Plan review(25%.ofpermitfee)
( } Fax:(360)326.1769 State surcharge(12%of
permit fee) ,
CCB lie.:203034 TO7'AL PERMIT FEE
This permit application expires if a penal!.is nor obtained within I ae
diva**erit lies beta aecaptett as eumplarae.
Authorized signature: ` gere methodology act by Tti-Cventy ttnilding Industry Service Omni —
Prim name. t n ' `l Date: e •h7•It-
1;nutii aj.t' x'ttUte.C_t'et, thpp own 13.doc 44Q-76171 r1 th032C014AVral1
. t ,
Electrical Permit Application FOR OFFICI.I,SE ONLY
City of Tigard MAY .. 2ill% /vI i/�— 200
13125 S$'Hall Blvd.,Tigard bR.. . �* Peimir 6
- ' Phnom 503.7182439 Fax 503.548"OFT G,At� Re`'s*" . i
bsilecttonLin
e
:
503.669.4175 BUILDING UI ISIO.: edynatasr See Page 2Tor
T I GA 1.1) Internet www.tlgerd-or.gov blotified/Method: Sapplea¢enta1 Information
-Z:' _ z? r1".� `�h n4o�:' m ate.. "''`iti`� lt'�1< S ,k41::r� ,71. ..�' 57 fix 'tA ''�--1"',..
-.., . � s.._, _., - mss._ ,r^=� � .�:
®New construction ❑Addition/alteration/replacement cplacement Please'ebeck all that apply(subunits sem of plans wfuems checked);
❑Demolition 0 Other: QS or feeder 400 amps or more ❑Buhiding over flute stthie&
where the evadable Fault current Q Marinas and boatyards.
d - ,' -..r.<�'"_,:n_i 1.n ..e, '-5K41•'S_-0:33f 1(is�'r._t';4A1„ rt_ryhr ;+i - exceeds 10,000 amps at 150 volts or ❑floating buildings.
IS 1-end 2-family dwelling 0 Commercial/indtistrial ❑Accessory building iris to ground,a=Mods 14,000 ❑Commercial-use agricultural
amps for 1 other iostalladoos. buildings.•
❑Multi-family 0 Master builder ❑Other: ❑ pump. Q dation of 150 KVA or
..°q..'7 -% . e'l .sa t „?,v .4.(a ~%nt .a. 1. ''''.d-•' -'=2,,,1 v'°W; 0 BroortiflooYsYslem. brgerseparately derived
Job#: Job site address/ 32:1 S��]r" th1 J ' -- C ro i iann ofnaw motor load of system.
�'", �`" lt>OFtPamore.
City/State/ZIP.Tigard,OR97224 0 Six or more residential oldie occupancy.
� Dxealth-care facilities. ❑Recreational vehicle parks.
Suitrlbldgiapt#: ( Project name:R.IVI(Tt rrace AK*WC S.}•- ❑Hazardous locatioffi. ❑supply vol,aga for mom thea
Q SmvJce or Tsetse b00 amps or amore. 600 volm tmiaal.
Cross street/directions to job site: {> '`1 .,..r,'"'"" T•i,-lltigr f ra:•-- ;;r ' ,'1"s^.
Ventilrtba Qq. Eaeb Tata{ •
New residential single-or multi-fancily dwelling unit.
subdivision:aikar1 ed r I W+(�-r Lot#14?) Includes attached garage.
Tax map/parcel# 1,000 sq.ft.or less 168.54 4
Ea add'1500 sq.R or portion 0 3392 1
s t�°,-. -r_ �= ;ai� 0.,mal sr�l") �7 5,1,, z-
,- �i� , Limited energy,Toidatisi
75.00 2 r JrLn , !I 9 (with above sq.R)
Limited
energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy Q See Page 2
''-.5'"='''''-'-'2''''-'�! '' [� _1 s. u�-I_i< .*: ' " 5K?-rice 4 ''I•k, 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
..493A:,_(.69)694-4.031. ,• _. .1 Fa`-( __D...< -.. Over 1;000 maps or.volts . , 552.26 2 . -__
Email: Temporary Services of feeders installation,alteration,and/or
•. relocation
Owner installation:This i itdallation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. ' 201 amps to 400 amps 125.08 2
Owns'signature: Date: • 401 amps to 599 amps 16854 2
t» :i c n y -p--.',":, - -. ", -$.3., ..i.1,-4, ,'y - Branch crib tS—new,alteration,or extension, panel
_��i.r . :�<t;�-�'�',"�.�a��'�v -� �s a?��k�pa����c��';�'i A.Fee for branch circuits with �
Business name:Witham Lyon Homes,Inc. above service or feeder fee,
each branch circuit 7.42 2
Contact name.k l I(iA lVf)f B.Pee for branch circuits withmd
Address.109 E1a'st 13th+ Street 3/� �'' service or feeder Ibe,first 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Each add'l 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 67.84 2
Finailh ; ! Ii t,U S, ,,i „LA ilk T kli A Reconnect only 67.84 2
.__x �.r 2- ��.��, �7 :Cr?r z� !.- Pump or irrigation circle 67.84 2 1
Business name:Garner Electric Washington,LW Sign or outline lighting 67,84 2
!»., Signal circuit(s)or limited-energy
Address:6101 NE St Johns Rd alteration,or ardensiaa ❑ See Page 2 2
City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:hdaniels@gweusa.com
lndustrial plant(1 hr ruin) • 78.181br
Inspections for whirl no f• is 90 OOlbr
CCB Lie.: C1158 Electrical Lie.: 208174 1 Suprv.Lie.: 44965 1 listed humin
j^�-��,,..1 ,�y ";.-Cht::' 'F .�;lG:t(i..:--t'..- -;15,17.-.,l. "}_t, ,."rt, ��z—r
Suprv.Electrician signature,required:jla tL I' (-K . Subtotal:
Print name: Joan P Albert_ ,Date: 4!26/2016 0 Plan Review Required(25%of permit foe):
—� - —= - state surcharge(12%of permit fie):
Authorized signatote: -- =� TOTAL PERMIT FEE:
".;.; This permit application expires ata permit is not obtained within 180
5fr::, Print name: Bill Daniels Date: 4/26/2016 days after it hasbeen accepted as complete. _
..^t:::t,l' • Number of inspections allowed per pearit
kisic i;,,V
��'�. ,: •aumaagisma'tAmt.!'ermitAPP Fl.R KRKdoc Rev Dbl{JRnlS 440.4615T(1]!05/COAtlwf9
Plumbine Permit Apulica i -' .
. Build_ing,Fixtures IOR 011 1( 1 I ,I i)\i ,
:. City of Tigard MAY• r 2017 1tecaved - .. - PettedNo: 4
13125 SW Hall Blvd..Tigard,011 9 Dated3y: , /.S% �7 ()C)0.??
Phone: 503.718.2439 Fax: 503 �'IRw Other Permit No.:
I 1,I Inspection Litre 503.639.417BUILDING It»e Ready/BY: heir ®See Page 2 for
Internet www.ugard-or.gov Notified/Method:od: - Supplemental tatormation
ft's•y;.;.a:=fy^ ... It•,1*(...i.. _... ..._ .'...-..L... .. ` . T;F:ti. ; ?.M::,?'y2Y. •::.:4L
Y
0 New construction - o Demolition For special Worms:ion nae ekec**st
Description I Qty. I Es. I Total
❑Addition/alteration/replacement 0 Other New I-2-family dwellings(includes 100 ft for each utility connection)
•' • . CATEGORY OF CONSTRUCTION' • - SFR(1)bath 312.70
®1-and 2-family dwelling 0 Commercial/mdustrial SFR(2)bath 437.78 •
D Accessory building 0 Multi-family SFR(3)bath ` 50032 _
Each additiceal bath/kitchen 25.02
❑Master builder , 0 Other: Fire sprinkler(-,,_sq.ft.) Page 2
• ',EOB SITE INFORMATION'AND'LOCATION Site nodes: -
Job site add essl 732,1 SW Forte Ho/I( St-- Catch basin or area drain 18.76
Drywall,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
�
Footing drain(no.linear ft.:_,•J Page 2
Suhe/bidgJapt.no.: I Project name: i'ICr Te rrni.Lt, N(Y" let I* 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 It: 1 Page 2 _
_ Water service(no.linear ft: 1 Page 2
Subdivision:P\J y Cifl- l in y--' LLot no.:i 1 Fixture or item:
Tax map/panoel no.: Backfowprevventer $ 3L27
. - DESCRIPTION OF•WORK• Backwater valve $ 12.51
: Clothes washer 25.02
.. _
.114.
. il- .C.12.3' MM
Drinking fountain 25.02
Ejectors/slurp 25-02
® .oipars 1 0 UAW Expansion tank 12.51
Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:7600 E Doubletree Ranch Road Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02
Phone:(602)694-4031 I Fax:( ) lee maker 12.51
0 CO?TACT PERSON Interceptor/grease trap . 25.02
Business name:William Lyon Homes,Inc Medical gas(value:S ) Page 2
Primer 12.51
Contact name* f�tryt f o/,,. Roof drain(commercial) ` I2.5I 1
Address:109—East
�13t'h`'Street 1`+v� $` Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 T»blshowerlshower pan 12.51
E-mail: Urinal 25.02
{ � - / ( /: ,h / 1;1/ 1J I Water closet 25.02
Water heater 37.52
Business name:Malmedal Enterprises int. Waterr WV 5629
p!> Sro _
Address:PO Box 207 Other: 25.02
City/State/ZIP:Banks,OR 97106 Subtotal
Phone:(503)324-0759 Fax:(503-)324-0580 Minimum permit fee: 572.50
CCB Lie.:102535 Plumbing Lie.no.:34-276PB Plan review(25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: C„...--------- TOTAL PERMIT FEE
Print name:Carolina Maimedal Date:04/25/2016 This permit appriearioa expires it a permit is not obtetned within 150 days
atter it has beau accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board,
11ButdireWermitctPLMO-PenehAppdm 1O0IA9 440-4616T(101t2,COINWEa)
lh
City of Tigard
11111 a COMMUNITY DEVELOPMENT DEPARTMENT
■
•
T I G A R D Building Permit Review — Residential
Building Permit #: 7/45 ,0/7~-a/.a2 5
Site Address: 11- 21 S N foY.eSt i*Ol\av\I ,c-Teref
Project Name: IQ-WC t -TCrra.Ce No tnvdc + Lot #: t-kb
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: NeVJ ST'i(z 7L. AO) /",fir'-. -e6---4--, a7410 Cokft-el
jk Verify site address/suite# exists and active in permit system. /
River Terrace Neighborhood: ❑ No jg,Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
1-three(3)copies of site plan *.Existing structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
Drawn to scale(standard architect or engineer scale) floor elevations
,North arrow .Utility locations(required for new,may apply for additions)
Site address,project or subdivision name and lot number location of wells/septic systems
Applicant information(name and phone number) *Existing�, JExisting trees to be retained with drip line,and tree
i.2 .t dimensions and building setback dimensions protection measures
►=q of area,building coverage area,percentage of coverage and Street tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) , Street names
Property corner elevations(2 foot contour lines if more than
4 foot differential)
1 Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified Xi No Received: ❑ Yes ❑ No
S( Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified tel No Applied For: ❑ Yes ❑ No,stop intake
Rr Land Use Case#: PD12-2015 Co`c5
. r Zoning: (2-(2- LPD)
Required Setbacks: Front ej Rear 0 Side 3 Street Side Garage 2D
Landscape Requirement: 2X) % CPIr1vGltG TY�( f�-
Lot Coverage Maximum: %
a;Building Height: Maximum Height OA-- Actual Height2�
0 Visual Clearance
Izt Easements
Igi Sensitive Lands: ❑ Yes tg. No Type
Urban Forestry Plan
Conditionsly "Met"prior to issuance of building permit
T
Notes: 1 U C idivvtS snail 1Z I YLQ� (7 Y I l5r -h) usGec.X1CP .
Approved By Planning: I' a i A ik 0 y Date: I (2- 11
Revisions (after B ilding Submi l' only) Reviewer at CI 1: Approved Not Approved ---- --------
1
*--.. Arloi-
Revision 2: Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw REs 091216.docx
w
Building Permit Submittal
Original Submittal Date: ON 70//7
Site Plans: # 3
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: Planning Engineering ? I' 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.
Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ,1 i../ ,Lrj,Adj`;,��i Date: //,,2.' ?/17
�. � �. •,,. r r:.r.
En6gineering Review
Slope at building pad: .. A
Conditions "Met"prior to issuance of building permit y07 /f7 `
_______________
El 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 ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: ,* p Date: Age.„6'_/?'
Revisions (after Building Submittal only) Rex, ate
Revision 1: %Approved CINot Approved OW
Revision 2: Approved 0 Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
Xpproved,NOT Released: ate: / 4)
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:
DC Fees Entered: Wash Co Trans Dev Tax: 'es 1:] N/A
Tigard Trans SDC: Yes ElN/A
Parks SDC: `�Yes 111 N/A
K to
:;::ornator:
Date: 4)'
?-
I:\Building\Forms\BldgPermitRvw_RES_091216.docx
,
r
City of Tigard
II
IN 111
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
(,
Building Permit #:
Site Address: n321 SW ye + olwv,i S'`Yee4-
Project Name: '(2.\,v-'( T-e'(race NJ pr4NJQsf Lot #: l4B
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.660.070.1.):
Is the project subject to the plan district design standards?i (Yes ❑ No
1.Articulation: a minimum of 1 element per each street-facing façade that has 30-60 ft. of frontage.An additional
element required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 ft. deep ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide Gabled dormer
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing façade must include windows or entrance doors.
Percentage Shown: `4°(o
3. Entrances:At least one entrance must meet both of the following standards:
Max. 8 ft. setback from longest street- facing wall T'arallel to street,angle no more than 45° from street,
*Iaor open onto porch
Entrance opens to a porch: AT Yes ❑ No
If yes,all the following apply: A 25 sq.ft. min.
One street facing entry isi 12 ft.max. roof above floor of porch
►' ft. depth min. 430%min.porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
fRece.�' overed porch min. 5 ft.wide x 5 ft. deep
ssed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches El Dormer min. 4 ft.wide
Roof eave min. 12 inch projection , [Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood kGable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min.40%of street façade ErWindow trim min. 2'/2"wide by 5/8" deep
❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35%or less of street facade
5. Garages and Carports:May face the front or side lot line on a corner lot.
Setbacks:
No closer to front or side lot line,than longest street-facing wall.-Yes ❑ No. If No (Check one):
❑ May 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.
Width: (Check one)
❑ 12-foot-wide garage door ❑ 40%max. of street facade
'50%max. of street façade with 7 detailed design elements
otes:
Approved By Planning: A1u,/) Yeal Date: \ 1 12 (-1
I:\Building\Forms\BldgPermitRvw_RES_RT_062216.docx
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
NI i..,
, r Transmittal Letter
,;A P.t 1 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov
TO: Tom H. DATE RECE
IN:,/PD
DEPT: BUILDING DIVISION FIEGh
APR 3 ,_ 2017
CIN OF TIGARD
FROM: Angela Grajewski BUILDING DIVISION
COMPANY: Polygon Northwest
By:
PHONE: 971-212-2144
RE: 17327 SW Forest Hollow St MST2017-00029
(Site Address) (Permit Number)
River Terrace Northwest Lot 148
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS
0 Additional set(s)of plans. 3 Revisions: deelt //f,` j p &Air:-
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.
addideci, ue to terrain
rah-0 eeivr. r 1 1 1+ li&k
fikaliA"" ifil "" OMO mss,
Routed to Permit Technician: Date: (4. " aLt , i"7 Initials: 4'
Fees Due: X Yes ❑No Fee Description: Amount Due:
" �� --45,,,-,i,.:r - ) 1 J r 1 1�+h I e-v 1c V
4
0 s g $
Special
Instructions:
Reprint Permit(per PE): ,Yes ❑No Done
Applicant Notified: Date: I tials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
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
III Ill
= Transmittal Letter
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DAT ,,,1.,•,
a � ilt
DEPT: BUILDING DIVISION
FROM: Angela Grajewski
CITY OF T1CAliD
COMPANY: Polygon Northwest 3UII,D1NG DIV1SIOtk-
PHONE: 971-212-2144 By:
RE: !Sss)s w Fores+ �n)J4)w sl--- brim r �°OZ9I
?,\\i-.r Te_rcckcg, N orianw�s-� LDA- I`18
Project name or su ivision name anlot numDer)
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 Technici • Date: Initials:
Fees Due: ❑ Yes No Fee Description: Amount Due:
$
$
$
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes ❑No ❑ Done
Applicant Notified: p/- Date: (0/(6-(77 Initials:',,
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Residential
TIGARD
Building Permit #: dic7aj/2- 72 9
Site Address: 112"1 SW .€5-1.- }W1\0x grCei.
Project Name: PAVE t `der race No( nvvt,+ Lot #: 1'kS ,
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: N c 71- /Lao l"-Pu-- -10 facie) etAftki
igt Verify site address/suite#exists and active in permit system.
5S River Terrace Neighborhood: 0 No Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
three(3)copies of site plan All4xisting structures on site
.4 Site plan mg he on 8-1/2"x 11"or 11 x 17"paper XFootprint of new structure(mduding decks)with finished
'1;7Drawn to scale(standard architect or engineer scale) floor elevations
,North arrow •.Utility locations(required for new,may apply for additions)
.htSite address,project or subdivision name and lot number 14t.ocation of wells/septic systems
gApplicant information(name and phone number) N 1Existing trees to be retained with drip line,and tree
►: •t dimensions and building setback dimensions protection measures
=m st area,building coverage area,percentage of coverage and X,Street tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) ArStreet names
Property corner elevations(2 foot contour lines if more than
4 foot differential)
Igf Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified al No Received: 0 Yes 0 No
Sf Public Facilities Improvement(PFI)Permit
Required: 0 Yes,applicant was notified tf3 No Applied For: 0 Yes ❑ No,stop intake
IgiLand Use Case#: PD2.2 15 00X)5
IR Zoning. Q-12- CPI))
Required Setbacks: Front 8 Rear 1 O Side 3 Street Side 3' Garage W
Landscape Requirement. 20 % CprWc i 1G 'CY LfS
Lot Coverage Maximum: 2-
Building Height Maximum Height OA- Actual Height -1'
lir Visual Clearance
AEasements
Sensitive Lands: 0 Yes ta. No Type
Urban Forestry Plan
MI Conditions`i et"prior to issuance of building permit
Notes: C' t'UvS f r1Gt1,1 1Z fl1 prior -to ISSL.LOorIL.o.
Approved By Planning: ii�J di, _I v. I y Date: I 1'2-1("7
Revisions(after B 'ding Submi only) Reviewer t
Revision 1: Approved ❑ Not Approved j
Revision 2: Approved 0 Not Approve A/ i A V iy ; A i ;
Revision 3: 0 Approved 0 Not Approv i
1:\Building\Fomts\BldgPennitRvw RES_091216.docx
1
Building Permit Submittal
Original Submittal Date: 1)1)0/17
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing. Planning ''Engineering ?EI' Permit Coordinator uilding
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
I
original plan review routing form.
L 7Building. original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: A.,. , ,♦ i.. .‘,:�I•
Date: j/.? 7
Engineering Review
6Slope at building pad: ..2:4
Conditions"Met"prior to issuance of building permit 7 o'
r- ,
❑ Easements(encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 0 No
Assess Water Quantity Fee in-lieu: ❑ Yes 0 No
LIDA Facility on lot 0 Yes 0 No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 4 I,' Date: /...,4,6-._/7,
Revisions(after Building Submittal only) Re*rei ate
Revision 1: Approved 0 Not Approved i/ r
Revision 2: Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
/ 61A
pproved,NOT Released: ate: 1
Notes:
I
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
DC Fees Entered: Wash Co Trans Dev Tax: '[ries 0 N/A
Tigard Trans SDC: XYes ❑ N/A
Parks SDC: p Yes 0 N/A
K to Issue Permit
(APPby
Approved Permit Coordinator: Date:4 0)i
I:\Building\Fomu\BldgPermitRvw_RES_091216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17327 SW FOREST HOLLOW ST, BEAVERTON, November 29, 2017 at
OR, 97007 1 :36:03 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00029
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17327 SW FOREST HOLLOW ST, BEAVERTON, December 11 , 2017 at
OR, 97007 10:48:37 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00029
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - CofO
Comments:
Final erosion control passed
Street tree certificate received
Moisture content form received
Moisture barrier acknowledgement form received
High efficiency lighting form received
Insulation certification verified
Blower door and/or duct seal test certificate received
C of 0 left on counter.
Violation Summary:
Inspector Contractor