Permit (199) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2017-00155
13125 SW Hall Blvd.,Ti Date Issued: 07/13/2017
Tf 1 ;E�.C and OR 97223 503.718.2439 9
Parcel: 2S108DC01400
Jurisdiction: Tigard
Site address: 15685 SW 150TH AVE
Project: River Terrace Crossing Subdivision: None Lot: None
Project Description: Demo(1)1,603 sf dwelling on septic and(12)accessory buildings. UPON FINAL INSPECTION,SDC CREDITS
MAY APPLY.
Contractor: NORTHWEST EARTHMOVERS INC Owner: NEIDERS, REGINE I &GUNARS K
PO BOX 1609 14517 SE 178TH PL
SHERWOOD, OR 97140 RENTON,WA 98058
PHONE: 503-625-3100 PHONE:
FAX: 503-625-3108
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 07/13/2017 $564.15
Occu Demolition
anc Gr
p Y P Occupancy Load: Info Process/Archiving-Sm$0.50(up to 07/13/2017 $0.50
Dwelling Units: 1 11x17)
Stories: Height: ft Erosion Control w/Development 07/13/2017 $107.60
Bedrooms: Bathrooms:
Value: $34,700
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $672.25
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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: 4/` Permittee Signature:
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.
14
Building Permit ApplicatioRF , 1 �. -
Si a 4.£1,,.. FOR Of'FI(;ELSI'011.1
CitINIy of Tigard j 201-7Received 67/:-?//7 ' Pen hrra.C!/ /7'die/S
• 13125 SW Hall Blvd.,Tigard,OR `7E z3".i i,.-,(+ ,1 tit-- t , Plan,Review Other Permit.
la Phone: 503.718.2439 Fax: 503.5 140 to i,,; s k.,x• Date/By:
Inspection Line: 503.639.4175 / r e w u e Date Ready/By: Juris: El See Page 2 for
TTGARD p 1 lI fi t'
Internet: www.tigard-or.gov � �z,tA�i:`t k5.�y=�.ip'��iC N. ed/Method: �� t Supplemental Information
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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
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
t 7; , ",` ' "�,�.�.r'"T"�,ig§ ''✓ ,.1714.j";'4
71 - ,T i .' ``- ,�. sg'."� '''' 4 uZ work indicated on this application.
®I-and 2-family dwelling Valuation: $ 314700❑Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
. '-z: 1 a.1 r."_r -,..a'6'. r c6 - J. 1 VnQ '� .x Pt
Total number of floors:
.:. q,-.'1:-,,t--`• �,,e:.',, c '''''13-',, ,....,:A.A.;. t �--an,- -a � c ..,',,wua. --.:�..4: .,
Job site address:15685 SW 150141 Ave New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bidg./apt no.: Project name:River Terrace Crossing Covered porch area: square feet
Cross street/directions to job site:East of SW Roy Rogers Road,South of SW Deck area: square feet
Bull Mountain Road Other structure area: square feet
� r r rr rw ,�wr vs.4s ..
:acv tSt awi'x5T 1,,,i ��. 61:MAi�ti ,,.7
Subdivision: Lot no.: 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.:2S108DC01400 _ equipment,materials,labor,overhead,and the profit for the
- .....2 1 + '�' F 1_`` �` - ri:::r-T .0 �-nx- ,3,„ y-,.moi. work indicated on this application. ,
���sa.�,,tt��.,>'k v,.:a::t=+-.i `'_ c ��''Mt�,..: .c.i€:��..y «.�« •;A.tr;�,>u'za�; —. ��`,`,ntk.r_.:�„t--,.4.-.:0,
Demo existing structures,fence,and gravel Valuation: $
Existing building area: square feet
New building area: square feet
,✓5 r <".y. z is .t','.:'.---v-4. . zr FC ,ic,; -Ty'. . w ::4 :.�".y" Number of stores:
.:,Lw � � �.�-, S-.' ;0.' sc:", acx„� ' x . r �,� .:dL-i_N" . _,�1.� �'; -...,"-.,
Name:Alan Hasuike and Susan Hasuike Type of construction:
Address:15685 SW 150th Avenue Occupancy groups:
City/State/ZIP:Tigard,OR 97224 Existing:
Phone:( ) Fax:( ) New:
-1737,-5''
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Business name:Polygon WLR LLC
Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:109 E 13th Street
[ Total fees due upon application:
City/State/ZIP:Vancouver,WA 98660
Phone:(360)695-7700 I Fax::(360)693-4442 Amount received:
. ��� ti 61 'gAv: 7,- � �2q' '-
E
s-mail angela.grajewski@polygonhomes.com
Clfial and residential prescriptive installation o
''' -:': �,? r aa - 2c711„ uY;E :::: roomcmounted
PhotoVoltaic Solar Panel System.
Business name: 1)IA Sev(.J.(1- I tie.YS Submit two(2)sets of roof plan with connection details
/ and fire department access,along with the 2010 Oregon
Address: 15600 ('w l(i 1As' i ,'L , Solar Installation Specialty Code checklist.
City/State/ZIP: ^, e / •/��`L f b Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(50 ) / U i Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: V Q7 lP/ Total fee due upon application: $201.60
Authorized signature: l/dr14 ( This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: �� �� jtwski Date: f�. '1 ' SlBdollogy set by Tr-t ounty Building IndustryI:1BuildmgWeimits\BUP-I SPermitApp.doc02/24/2011 440-46113T(1I/02/COM/WEB)
Albert Shields
From: Albert Shields
Sent: Monday,June 19, 2017 3:06 PM
To: Angela Grajewski (Angela.Grajewski@polygonhomes.com)
Cc: Monica Bilodeau
Subject: River Terrace Crossing, demo permits
Angela, in reviewing the application for four demo permits for River Terrace Crossing, BUP2017-00154, -00155, -00156,
&-00157, we noted that we do not have on record an arborist's certification that required tree protection is in
place. Accordingly, I will code these applications"Approved but Not Released." Plan review will continue but the
permits will be held until we receive an arborist's report.
Albert Shields
1
City of Tigard
1,1 ■
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review - Residential
Building Permit #: f-.o`7 - O O i55
Site Address: )6 COs SW 16071-1 A\E
Project Name: RICKY Te.rfrcce Cfo 5s r h Lot #: ' IA_
(New dwelling=subdivision name;Addition or Al e ation=last name of owner)
Planning Review '
Proposal: Ve 1oMI!Ai QXt ,15-11Yt3 CIc c4(4 0 aeSS'ON/ 54►Y&C414
C Verify site address/suite#exists and active in permiitt/ystem.
Ll River Terrace Neighborhood: 0 No 1 Yes, -_ .• '...' -- '=-- - ' _ -
Siitt.Plan Elements:
[ -/
Three(3)copies of site plan- Z' ter a frtC1il axisting structures on site
ite plan must be on 8-1/2"x 11"or 11 x 17"paper �I�Footprint of new structure(including decks)with finished
--//Drawn to scale(standard architect or engineer scale) floor elevations
[�,�Torth arrow tility locations&easements(required for new and additions)
[Vite address,project or subdivision name and lot number idewalk/driveway approach
applicant information(name and phone number) Otocation of wells/septic systems
III' •t dimensions and building setback dimensions ErExisting trees to be retained with drip line,and tree
Square footage of buildings to be demolished protection measures
'lt .t area,building coverage area,percentage of coverage and V/treet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) EiStreet names
titPkir
operty corner elevations(2 foot contour lines if more than Worm water quality facility required if>1,000 sf of
4 foot differential) impervious area is created or replaced.
*let Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
/Required: CI Yes,applicant was notified VI No Received: CI Yes ❑ No
LTJ Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: @/Yes ❑ No,stop intake
Land Use Case#: 12Vazdi 0(XI' ,Ej ) S U `2.916-600 13
Zoning: 11-'1
Required Setbacks: Front Rear Side Street Side Garage
ttiN Landscape Requirement: %
!1/ Lot Coverage Maximum:
I' Building Height: Maximum Height Actual Height
( 'l. /Visual Clearance VYes Lands: LW Yes ❑ No Type 51 y1j•NL0g4 hAP-`lck rept
d .rban Forestry Plan
01 -21-1) onditions "Met"prior to issuance of .uilding permit
otes: C) .,�,u • • �?✓l�• 1� • L -- .,:.�U (# • c 0 h .- �•
SIM T
arWM
Approved ByPlanning: �y�,�� ate: 11
PP i ."'NIa-�::'
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES 051617.docx
Building Permit Submittal
Original Submittal Date: 6A7//7
Site Plans: #
Building Plans: # AJ/,$-
Building Permit#: 'Enter building permit#above.
Workflow Routing: ,Planning W Engineering @'Permit Coordinator ❑ Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: I 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.......)401.- r Date: .4,A//7
Engineering Review
❑ Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes ❑ No
Assess Water Quantity Fee in-lieu: 0 Yes b No
LIDA Facility on lot: 0 Yes b No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 9 Date: (,c ho//7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
;1,::Approved,NOT Released: J �,,/ ,/ �-1 I/ i ate: jv1)9/
otes:
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:
,F SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes 0 N/A
( Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
LIDA ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: /77,k-Date: 9/1111 7?'
I:\Building\Forms\BldgPermitRvwRES 051617.docx