Permit (191) CITY OF TIGARD BUILDING PERMIT
14 .` COMMUNITY DEVELOPMENT Permit#: BUP2017-00154
-f [13A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/13/2017
Parcel: 2S108DC01401
Jurisdiction: Tigard
Site address: 15515 SW 150TH AVE
Project: River Terrace Crossing Subdivision: None Lot: None
Project Description: Demo(1)3,509 sf dwelling on septic. UPON FINAL INSPECTION,DEMO CREDITS FOR SDC FEES 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 $423.53
Occupancy Grp: Occupancy Load: Demolition
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 $80.70
Bedrooms: Bathrooms:
Value: $22,650
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $504.73
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090, You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: der gG0, Permittee Signature: ‘..c.„6 /GG��Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
I
RECEIVE!)
Building Permit Application
'tet"A JUN2 �'`�' FOR OFFR'E 1 SE o L1
V
0125 of Tigard g F k 4x R Received 67 PcrnatNo.'- t 2 //C5e7A5
g��� '�I 0'l DateBY: �.> �7 ��
N..._ • 13125 SW Ball Blvd„Tigard,OR 97 3 Plan Review Other Permit:
_ , Phone: 503.7182439 Fax: 503.5 I4;4 p�ya.�� DIVISION DateBy:
Inspection Line: 503.639.4175 11-4$.'Z:`i�tiDI �Si l DateReadyBy: // /, loris: HSeePage2for
l-i Cr A F;L7No'ied/Method: 7{/3//? / Supplemental information
Internet: www.tigard-or.gov _
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�C�^:�°�N1'1ne q ' 4� , s'''' ''''' '' -'-'. x'''' ,aiR , xPermit fees*
are based on the value of the work performed.
■ construction ►,t DemolitionIndicate the value(rounded to the nearest dollar)of all
■ ■ equipment,materials,labor,overhead,and the profit for the
•••-7-1--..V_., j -f,-.7d'''7 ,-. ..a.r,sEy a �. - -z-�aa ini::i`.,5 +.�},;.,'�"1,•;?, *3 :h y7° C ha work indicated on this application.
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- Valuation:(El 1-and 2-family dwelling 0 Commercial/industrial �
Number of bedrooms:
0 Accessory building 0 Multi-family
Number of bathrooms:
0 Master builder 0 Other:
EQr "' .rTotal number of floors:
Y i ,t— veo s � sM6 -4 i o ' ;' ,_b.
>
' 150'h
New dwelling area: square feet
site address:15515 SW
Ave
City/Stateat' Tigard,OR 97224 Garage/carport area: square feet
oname: verCovered porch area: square feet
.: Project
Cross street/directions to job site:East of SW Roy Rogers .. South of SW Deck area: square feet
Bull Mountain Road Other structure area: square feet
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
i: 1 i i equipment,materials,labor,overhead,and the profit for the
-+i
G'.f ' ' „ i,+ri:"k� , L; 3', �` work indicated on this application.
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$
Valuation:
Demo existing structures,utilities,fence,and gravel
Existing building area: square feet
New building area: square feet
z � r" `t' " ry :44
Number of stories:
yyb2t u wrM, sz
Type of construction:
Address:15515 SW 150 Occupancy groups:
City/State/ZIP:Vancouver,WA i Existing:
(360)695-7700 (360)693-4442+ New:
R.,. :,47-11.-ga«.':.., • . u.....r. : ..�„ - tI1 w -... .i,. , 6 irr,- r[ �
t
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Business name:Polygon WLH LLC Structural plan review fee(or deposit):
Contact name:Angela Grajewski FLS plan review fee(if applicable):
Address:109E 13th Street Total fees due upon application:
City/State/ZIP:Vancouver,WA 98660 Amount received:
Phone:(360)695-7700 I Fax::(360)6934442 ,,,_,,,E,,,_
...a;`l E3yc D1c,}-q-F,[{'1; 6 G.S 4t '�' a''• e '�-�L"'"d -,t
E-mail angels grajewski®polygonhomes corn + ' :�pr
a
r r ,� •.., .».,,,, I y y, Commercial and residential prescriptive installation of
- - C1 ' .r x x£ roof-top mounted PhotoVoltaic Solar Panel System
,�qq Submit two(2)sets of roof plan with connection details
Business name:
ftftki f dl.r4h ' and fire department access,along with the 2010 Oregon
Address: (' tQ0 (/E)�f,bi ea, -V�(r-- Solar Installation S,-cial Code checklist.
p� Permit Fee(includes plan review $180.00
City/State/ZIP: SNA W v�»... on tt4 b and administrative fees):
Phone:(503) (02,S _ 3 too Fax:( ) State surcharge(12%of permit fee): $21.60
CCB tic.: Lo'. ..--i LD\ Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
��t. within 180 days after it has been accepted as complete.
6 € _i_ (tt *Fee methodology set by Tri-County Building Industry
Print name: Date: 12 Service Board.
I:\Buildin \Permits\BB1iP- SPermitApp,docc 02/24/2011 440-4613T(11/02/COM/WEB)
g
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
City of Tigard
IIICOMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: 6et,.' / 7 -ea/.
Site Address: iS GIS 50 15c/114 AVC-
Project
iEProject Name: 1Rvc`f TexYCICe Cfo S sr Lot #: p I
(New dwelling=subdivision name;Addition or Al e tion=last name of owner)
Planning Review ( r
Proposal: "�ey io h4-1(911 (4'. b(15401 1 and c Ce ..S5o h./ .5÷(4524L11121,
Ci Verify site address/suite#exists and active in permi_t/ystem.
U River Terrace Neighborhood: ❑ No L!d'
Sit Plan Elements:
Sthree(3)copies of site plan *2 Iter ciew,d r ci12 i —/Existing structures on site
ite plan must be on 8-1/2"x 11"or 11 x 17"paper ;Jl Footprint of new structure(including decks)with finished
floor elevations
,��l!Drawn to scale(standard architect or engineer scale)LNNorth arrow ttlity locations&easements(required for new and additions)
N(ite address,project or subdivision name and lot number idewalk/driveway approach
applicant information(name and phone number) Ira •cation of wells/septic systems
IN' •t dimensions and building setback dimensions Ir Existing trees to be retained with drip line,and tree
J Square footage of buildings to be demolished `' protection measures
I'It •t area,building coverage area,percentage of coverage and 1''7a.treet tree size,type and location
tj`impervious area(applicable if R-7,R-12,R-25&R-40) Street names
operty corner elevations(2 foot contour lines if more than I/?.torm water quality facility required if>1,000 sf of
14 foot differential) impervious area is created or replaced.
att Clean Water Services–Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified Vi No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI)Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: LC 'Yes ❑ No,stop intake
Land Use Case#: � 01(O' O(�'j' ,6 1 5 u .o i6-600 13
Zoning: P-7- 7 /
Required Setbacks: Front Rear Side Street Side Garage
illiN Landscape Requirement:
Lot Coverage Maximum:
Building Height: Maximum Height Actual Height
N /Visual Clearance. ilYes
�1 ry
VSensitive Lands: @l Yes ❑ No Type 519y1 *Nt—c1 c hQ��' "Ol MCA
1 rban Forestry Plan V
gi a Conditions "Met"prior to issuance ofbuilding permit )71-foe,otes: d ndl # s 4 1�c �Q IL/ dls Aro Den tt4.- O YI itl
QY1 'may • ' ;:•I 4U.V'1 €*1 7
Approve By Planning: j ,® 1' /14• y Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved ❑ Not Approved
1:\Building\Fonns\BldgPermitRvw_RES_051617.docx
Building Permit Submittal
Original Submittal Date: �s,/c//7
Site Plans: #
Building Plans: # '✓
Building Permit#: $ Enter building permit#above.
Workflow Routing: lig Planning ,$Engineering $D Permit Coordinator 0 Building
Workflow Sign-off: pSign-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: ) J ' / - Date: 6/33//7
Engineering Review
O Slope at building pad:
l7 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 No
LIDA Facility on lot: ❑ Yes No
O NOT Approved by Engineering: Date:
Notes:
0
Approved Engineering: / /I Date: 0//41/7
PP owed by _.._....,�'
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved 0 Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
O Conditions "Met"prior to issuance of building permit
n/,_ ��,�r '
Approved,NOT Released: 4/11,./�I.y4 's"'" 4fro /�
*ate: ,/
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:
SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes N/A
Tigard Trans SDC: El Yes N/A
Parks SDC: El Yes N/A
LIDA El Yes N/A
K to Issue Permit
., 3.7-71 if/74--
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_RES_051617.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15515 SW 150TH AVE, TIGARD, OR, 97224 December 27, 2018 at
12:06:34 PM
Record Type: Record ID:
Residential - Building BUP2017-00154
Inspection Type: Inspector:
299 Final inspection Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor