Permit CITY OF TIGARD MASTER PERMIT
f° ' - COMMUNITY DEVELOPMENT It��l�. -" Permit#: MST2017-00322
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2017
Parcel: 2S108DB01500
Jurisdiction: Tigard
Site address: 15307 SW PEACE AVE
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 13
Project: Polygon at Bull Mountain, Lot 13
Project Description: New SF. Transfer SDC fees from voided permit MST2017-00209. 12/20/2017: REPRINT permit
to add 4th bathroom.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1571 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 4 Second: 2167 sf Garage: 735 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3738 sf Value: $465,364.70 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 2 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: 5 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: 7 201-400 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 3738
Owner: Contractor:
POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions)
109 E 13TH ST,STE 200 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX: 360-693-4442
Total Fees: $37,305.72
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: -0-' Permittee Signature: rif '9�e�7eik,
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.
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
•
Transmittal Letter
Tic-LARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATE s t; D,1`: 7
DEPT: BUILDING DIVISION
DEC 1 3 2017
FROM: Nichole Thorpe CITY OF'fIGARD
COMPANY: Polygon Northwest BUILDING
PHONE: 360-989-4204 ByY
RE: 15307 SW Peace Ave 44S-T-28-1-,14102(19_",
(Site Address) (Permit Number)
Polygon at Bull Mountian Lot 13
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
0 Additional set(s) of plans. 3 Revisions: Plan Sets- 4th Bathroom add
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 Technician: Date: Z- )9 - )'2 Initials:
7 114
Fees Due: ®,Yes ❑No Fee Description: Amount Due:
1 )-fir r�v; $ qd
$
$
Special
$
Instructions:
Reprint Permit(per PE): -t] Yes ❑No ��� one
Applicant Notified:,/>C/ % - Date: / / 7 nitials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
CITY OF TIGARD MASTER PERMIT
III 114
COMMUNITY DEVELOPMENT Permit#: MST2017-00322
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2017
TIGARD 7 Parcel: 2S108DB01500
Jurisdiction: Tigard
Site address: 15307 SW PEACE AVE
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 13
Project: Polygon at Bull Mountain, Lot 13
Project Description: New SF. Transfer SDC fees from voided permit MST2017-00209.
BUILDING
Floor Areas Required Setbacks Required .
Stories: 2 Bedrooms: 4 First: 1571 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 2167 sf Garage: 735 sf Front: 20 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors:
Total: 3738 sf Value: $465,364.70 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Tvpes 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'I 500 sf: 7 201-400 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 3738
Owner: Contractor:
POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions)
109 E 13TH ST,STE 200 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX: 360-693-4442
Total Fees: $37,161.57
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: Yf ,G�L!Y '" Permittee Signature: . " `% I '^
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.
Building Permit Application
..
I, ntzal . � FOR OFFICE FSE ONE\
City of Tigard ( y n t Received 5/1 7 ��j _ Permit No. S7` /7'-eo 3 a
g fiU6 1 4 201! Plan Re:
Ill 13125 SW Hall Blvd.,Tigard,OR 9722 f� Plan Review ���
■ w Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Qf(S f, 4'P Other Permits ) / 9
Inspection Line: 503.639.4175 +dry/ a I Date Ready/By-
CITY
eady/By: Tuns. 8 See Page 2 for
T 3 G r�h l7 1 1 l.f t✓ Notified/Method: /7 Supplemental Information
Internet: www ttgard or gov
1 DI ION ,1
°t t :sl � / - ll
, �, .,
®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
q i work indicated on this application. I i/ ��, e
„ . _. .. .. Valuation:
-14 KIP
® 1-and 2-family dwelling 0 Commercial/industrial
Number of bedrooms: 4
0 Accessory building 0 Multi-family
Number of bathrooms:
0 Master builder ❑Other:
'� ,.j Total number of floors.
Job site address: 15307 eace Ave New dwelling area: 1-17;?)
square feet 151ik �'City/State/ZIP:Tigard,OR 9`7224 Garage/carport area: square feet 2,!(..g, '1'
Suite/bldg./apt.no.: Project name:Polygon at Bull Mountain Covergd porch arquare feet //
v
Cross street/directions to job site: . 191 square feet
Other structure area: square feet
Subdivision:Polygon at Bull Mountain I Lot no.:13 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
j work indicated on this application.application p.
f � � Valuation: $
/ Ns S,Ld �„ a11 trr 'i7-,®0 7A Existing building area: square feet
4 ,sail ge/7 —eO/� r/cry oYs New building area: square feet
�1 4 ct ,� • `AT; Number of stories:
Name:Polygon WLH,LLC Type of construction:
Address:703 Broadway ST Suite 510 Occupancy groups:
City/State/ZIP:Vancouver WA 98660 Existing:
Phone:(360)695-7700 Fax:( ) New:
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Nichole Thorpe
FLS plan review fee(if applicable):
Address:703 Broadway ST Suite 510
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 I Fax::( ) C'
' t , t
E-mail:Nichole.Thorpe@polygonhomes.com
Commercial and residential prescriptive installation of
'f F roof-top mounted PhotoVoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name:Polygon WLH,LLC
and fire department access,along with the 2010 Oregon
Address:703 Broadway ST Suite 510 Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:204238 Total fee due upon application: $201.60
d This permit application expires if a permit is not obtained
Authorized signature:, //le.,4,041
within 180 days after it has been accepted as complete.
Date:8/8/2017 *Fee methodology set by Tri-County Building Industry
Print name:Nichole Thorpe Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
RECEIVE!)
Mechanical Permit Application FOR OFFI( I. I SF OyI,v•
AUG1 1. 4 2017 R,.�ei,cd _
11P1City of Tigard I� Pcnnii t4 5/�j/7 )0.3 ,,2
• 13125 SW Nall Ift,d 1 te:ud.OR 97223 Plan ly.
Phone: 503 7161,24 i9 Fax: 5t),t,.9fi y i lin ih:
T I G A ii f) Inspection Line: 503 639.41750TV Date Read)Aty. JIM, 0 See Pae 2 for
Internet: www,ignrd-or.ga, INC SION Nctir"Istcthod: F•upplrmrntal Information
' ` 'TYPE OF WORK ' COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
Mechanical permit fees'are based on the value of the wort.
®New construction 0 Additionlalteratioi'replacement periiimted.indicate the value(rounded to the nearest dollar)of all
❑i)etnolilion ❑other: mechanical materials.equipment,labor.overhead.and profit.
1'nlue:$
CATEGORY OF CONSTRUCTION - RESIDENTIAL EQUIPMENT/Sf'STENIS FEES*
❑ I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For specialInfirmanun usecheaIiaL
0 Multi-family 0 Master builder 0 Other: Description 1 (,qty, ( Fa. I Total
11 CM iftriC001i(M:
. JOB SITE INFORMATION AND LOCATION
1531)7 StJ peaceAir iC1conditioning.0 ( 1 46.75
Job site address: tFurnace 100.000 wry tductoems) 46.;5
City/State/ZIP:Tigard,OR 97224 furnace 100.000i (tTt)(dunshetttsi 54.91
Beat pump 61.06
Suiie'hldg./apt.no.: Project name:Polygon at Bull 1lounfain Duct t,ork 23.32
Cross strcctidireclions to job site: i lydronie hot water s1•slcrn 23.32
Residential boiler(radiator or
li'drenic) 23.32
Unit heaters(fuel-type,not electric).
in-,cult.in-duct,suspended,etc, 46.75
Flue/vent for:OW of above 1 23,32
Other: 23.32
Subdivision:Polygon at Bull Mountain l.ot no,: /3 Other furl>lppliaures:
Tax map/parcel no.: Water healer 1 23.32
•DESCRIPTION OF WORK . (ias fireplace/insert I 33.39
Flue vent for water healer or gas
fireplace - 23.32
Lug lighter(gas) 23.32
Wood/pellet slow 33.39
Wood fireplace/insert 23.32
Chiumes/linerflluchent 23.32
Other; 23.32 1
0 PROPERTY OWNER J . ❑ TENANT '-•
Environmental exhaust and ventitation:
Name:Polygon Wl.lL,l.LC Range hood/other kitchen fj
_cyui nucnt � 33.39
AAdd" >r
1.1)3E 'I�n,..l I,(�(,�'�' 5/0 Ckoihe., t er cshaust _,_--r33.39 ----~
(StyiSliuei711':Vancouver,WA 9866(1 Single-duct exhaust(bathrooms,
toilet compartments.utility rooms) L4 23.32
Phone:(360)695-7700 Pax:( ) Atncicrrnvlspacc fans 23.32
0 APPLICANT, ' Q CONTACT pERsOi1' Other: 23.32
Business name:Polygon W1,11,1.1.C. Furl piping
S14.15 for first four,S•i.A3 fur each additional
^ �^
Contact name: f'\J i li ate_ 'C I p
P Furnace.etc,
Address 1 D3 12ivlYai u) C t- &_ f t.�t 0 Gak heat pump .
�] 11'aliisuspendediunit heater
City/State/ZIP:Vancouver, 'A 98660 Water heater ^
Phone.(360)69S-7700 Frts::(360)693-4442 Fireplace
Range
F-mail: A-./(n11it.,, -'O' i i ___L
-701 jmhom c-Win8nrbecuc
C A Clothes dryer(gas) —
Business name:Apes Air LI.0 Other:
MECHANICAL PERMIT FEES4
Address: 18004 NE 72"Ave Subtotal
City/State.7..II':Vancouver,WA 98686 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)326-17(19 _ — — State surcharge(12".�of permit fee) __,
CCU lie.:203034 'I'OTAI.PERMIT FEE
""'— ------- – — This permit application expiry if u permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature:_, ' Fee methodology ket by Tri-Coruny Building Industry Stoke Timid
Print name: 1 Ir, ,y Date: y•Pt•/4•
1,ngii.I,.cpe,mitrtifT.remit A1p-ri4ol114- 4wU-40171'11h ITAIWEB>
. i ♦ •RECEIVEP
Electl l'erniit Application I tm 011 I( 1, I tie.(1N1.1
City of Tigard Al1G 14 20 i r Receival Permit ri/LtSC 017-do j a)e„.2_
13125 SW Ifall Blvd,Tigard,OR 97223 A Plan Raieu
Phone; 503 718,2439 Fax: 503.5"J T. �1, + l Related PCrmn M
!9 il' I)ata8y:
Inspection Line: 503.639.4175 (� )?cad;[hta7ly: Jun. 8 See Page 2 for '�
Internet. www.tigard-or.gov'y� /fit, l�f`f I1\t , !t j aified'Method: Supplemental information
i. =`r 1't ,r d, $`? .�FN`T.OF 4O'.. ,1,-1,# m•a..iv'+kt 'd '•a ,.1 yr ,; i"'W- :,`a •„a f t r;i i / dt`er 44 ., ";„a
DA New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/iteins checked)
❑Demolition ❑Other'
0 Service or feeder 400 amps or more 0 Building ova three stories
where the available Paull current 0 Marinas and boatyards
Jr.',- ” ' resR1'41 R)CT101 r -,.', .,;.‘7.--:•:;:-:•;_:.:".. exceeds 10,000 amps at 150 volts or 0 Floating buildings
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps fa all other installations buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation or Iso RVA or
tr r�' iN ❑Lmer en s stem larger separately derived
ori .-"• ::-- �28 . �.. R)�ffi'I'�l��i'`,i1Np1:0(:�1' 1�N._.�. � � ,ar_t` s cY 1' ase
Job#: Job site address: S' Pe.� f� e. ❑10Ad0Hp armee motor load or system
53�� 1 'fir IOOHPormore, ❑•,A„•:E,•.,•1.2...,.i,3•,,
cy
Cit)'/StaiefZ IP:Tigard,OR 97224 ❑his nr more residential units 0 Recreational occust
vehicle parks.
❑Hearth-care facilities
Suite/bldg./apt.#: Project name:Polygon at ❑Hemrdous locations. ❑Supply voltage for more than
�' ' `" 'w'i� ❑Service or feeds 600 amps or more. 600 volts nominal.
Cross street/directions to job site: t `' _ F0 -fip1 : ,
Description I QR'. I Each I Total I •'
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at- pv ti Mo.rtc1.x.n Lot 8: t 3 Includes attached garage.
Tax map/parcel 8 1,000 sq.R.or less ( 168.54 4
is #, r ' 4.qr Ax 5'='tvi:AtfESCRIPTtON..OLWORK :,.. ,_`a* , 1"; i-`_ `. + Ea.add'I 500 sq.R.or portion Le 33.92 1
Limited energy,residential 7500 2
(with above sq.R.)
._�* ® .Q •R �d R''" >-�.e ,.-- "' jy�r�-
Limitedrsidential ith above sq.R.) 75.00 2
Name:ADVL Land Holdings,LLC Renewable Energy 0 See Page 2
Address:7600 E Doubletree Ranch Road Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
City/State/ZIP:Scottsdale,AZ 85258
201 amps to 400 amps 133.56 2
Phone:(602)694-4031 Fax:( )
Email: 401 amps to 600 amps 200.34 2
Owner installation:This installation is being made on property that I own which is not 601 amps to 1,000 amps 301.04 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. '
Over 1,000 amps or volts 552,26 2
Owner signature: Date:
Temporary services or feeders Installation,alteration,and/or
'2w,r, ®! 0Plet iii ' ;. %-, * ;,`;',. t�' Gr014J'At;`J:40.10)Y ▪ relocation
Business name:William Lyon Homes,Inc. 200 amps or less 5936 1
Contact name: \ (I C hi)
201 amps to 400 amps 125.08 2
Address: f"�3--1�-JJQ m - • (-. t I 401 amps to 599 amps 168.54 2
City/State/ZIP:Vancouver,WA 98660 Branch circuits—new,alteration,or extension,per panel
Phone:(360)695-7700 Fax::(360)693-4442 A.Fee for branch circuits with
above service or feeder fee, 1
Email i g I 11 l Al t ,IZg,1,,� A AA. t ht each branch circuit 7.4_ 2
„ ,� c 4.,wx T"t‘'s,, aaR�+�� ''a# t c B.Fee for branch circuits without
-e • service or feeder fee,first
Business name:alameda electric branch circuli s6.ls 2
Address 3415 ne 44th Each add'I branch circuit 7.42 2
- Miscellaneous(service or feeder not included)
City/State/ZIP:OM R7,-9/1 /VIZ /'' 2 13 Each manufactured or modular 67.84 2
Phone:(503)3192192 Fes.( ) dwelling service end%or feeder
Reconnect only 67.84 2
Email:solarpdx@me.com I
Pump or irrigation circle 67.84 • 2
CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: y f 7/,$
Sign or online lighting 67.842 -
Suprv.Electrician signature,required:
Signal circuit(s)or limited-energy ❑See Pa e 2 -'
Print name: ,L,it /200 1 Date: 5-7Z,V7,/ panel,alteration,or extension. g
Each additional inspection over allowable in any of the above
t
Authorized signature .•
Additional inspection(I hr min) 66.25'hr
1 Print mune; ,, ..A....,...-- -------- Date �Z,3��� investigation(I hr min) 90.001 hr
1 WuitainaV'amintEt-C HrmtApp_kiJt fAE.dec Rev ewii 2415 ii0.06157(ii/atKOM'WEB
i.
Plumbing Permit ApplicatiaLki . -
Building Fixturest� { .., Foil OFhicE, ( SE ONL1
NU r11 4 ?It Received ,
City Of Tigard Uaa Received
- - Permit No/S� ,2,,60 3,42_
A 13125 SW I full Blvd.,Tigard,OR 9 rki y I Plan Rcwie„
C - n 4-r: Other Permit No.:
Phone: 503.718.2439 Fax: 503.5 ,4.1 �$ U d,.By:
Inspection Line: 503.639.4175 T l vi silt 0 Viate Readoty taus HI See rage 2 for
TIGARD btternet: w w.tigard-or.goV 1,kailied(Method: _Supplemental Information
TYPE OF WORK FEE*-SCHEDULE
Demolition Forspecial irrjrrrnreuort rrse checklist.
®New construction 0Description *v. Ea. Total
Q.
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 fl.for each utility connection)
• CATEGORY,OP cOi0RUQ40('( SFR(I)hath 312.70
SFR(2)bath 437.78
® 1-and 2-family dwelling 0 Commercial/industrial _ + 5003278
SFR(3)bath
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler(^sq.0.) Page 2
JOB S3TF`IINFORMATIONi AND.LOCATION Site utilities:
Catch basin or area drain 18.76
lob site address: 5 01 S-\.Q P en. e Drywelt,leach line.or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no,linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:Polygon at Bull Mountain Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear Ii ) Page 2
Storm sewer(no.linear II.:_) a Page 2
_ Water service(no.linear Il.: ) l Page 2
Subdivision:Polygon t(t Bull Mountain l..ot no.: 1---S Fixture or item:
Backflow preventer I 31.27
Tax map/parcel no.: ' 12.51
Backwater valve
>IIE5CR1T30PN;OF 1YOttlfi 25.02
_ .- _ - - - • Clothes washer
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
- I
!: PROPI;RTl.OWNER � r� ❑` 'TE)VAN')<`-
Expansion tank 12.51
Fixture/sewer cap 25.02
Name:Polygon WLH,LLC Floor drain/floor sink/hub 25.02
Address:10 ` ...e. �._s _, _ t Garbage disposal
5 25.02
City/State/ZIP:Vancouver,WA 98660 Nose bib
25.02
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
.�Ppato11 �.: z ;, '[r:C0(VTACTTElp 11!+x; Interceptor/grease ora p 25.02-
Medical gas(value:S ) Page 2
Business name:Polygon WLH,LLC
Printer 12.51
Contact name:
Ai''r4/10IL. Roof drain(commercial) 12.51
Address.-03 Qv Lk c U4 S' u,t-k S 1.�1 Sink/basin/lavatory 4Air> y r 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) / 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: N+rho o I e o ��� (��V�+�t�e�eS,C,�en Water closet 25.02
f
` 9 -� ' CO'TI A '1 Ok 7 ,,- y Waver heater ir37.52
Business name:BDL Plumbing LLe Water pipinglDWV 56.29
Address:PO Box 85 Other: 25.02
Subtotal
City/State/ZIP:Corbett OR 97019
Minimum permit fee: $72.50
Phone:(503)351-3903 Fax:( ) Plan review (25%of permit fee)
CCB Lie.: 180345 Plumbing Lie.no.:P131582 State surcharge(12%of permit fee)
Authorized signature: ,-• ,.. TOTAL.PERMIT FEE
Date: This permit application expires If a permit is not obtained within 180 days
Print name:Brandon Lanter after it has been accepted as complete.
"Fee methodology set by Tri-Couniy Building industry Service Board.
t:UtuildinrPenniis5PLa11U-PefmitApp.doe 1010099 -461611do1(,vCO\LA4'L-a)
r
Ph1City of Tigard
*1 COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 c A R o Building Permit Review — Residential
Building Permit #: /TS 2";20/ 7 -QQ 3 2--
Site Address: IS jyj SW �C3tCC ACV ei
Project Name: PO(labra a f 1 NINvtivi l,/ Lot #: I3
(New d g=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: New si �,...,_ .101 7. -env Z c7=7
*Verify site address/suite#exists and active in permit system.
k River Terrace Neighborhood: ❑ No :Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
J'hree(3)copies of site plan existing structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
io,Drawn to scale(standard architect or engineer scale) oor elevations
forth arrow XUtility locations&easements(required for new and additions)
INtite address,project or subdivision name and lot number idewalk/driveway approach
pplicant information(name and phone number) L ocation of wells/septic systems
'4 it dimensions and building setback dimensions NI Existing trees to be retained with drip line,and tree
.quare footage of buildings to be demolished NI Existing
measures
r= et 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) 7gtreet names
,Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced?- 'es ❑No
4 foot differential) If yes,is a storm water quality facility shown? El Yes $NcOhos
'Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified it<No Received: ❑ Yes ❑ No
.S, Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified X°No Applied For: ❑ Yes ❑ No,stop intake
0 Land Use Case#: SU?j2 O t -00002-
Zoning: lz 4.5
1 Required Setbacks: Front 20 Rear 'lj' Side CJ Street Side 10( Garage 2.0
.Landscape Requirement: VJ/R
,t Lot Coverage Maximum: I'>PC
0/0
Building Height: Maximum Height Actual Height t2,531Visual Clearance14
A.
38(Sensitive Lands: / ❑ Yes N'No Type
Urban Forestry Plan
Conditions "Met"prior to issuance of buildingpermit
Notes: ',(11 / ( w►�-�pIW lisI.an.0 •
Approved By Planning: I,AIk-.4 7AL/At. Date:0/14/17
Revisions (after Building Submittal o ) Reviewer l Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\B1dgPermitRvw REs 061417.docx
or
Building Permit Submittal
Original Submittal Date: ee/.�///'7
Site Plans: # 3
Building Plans: # 3
Building Permit#: L9'Enter building permit#above.
Workflow Routing: a-Planning [Engineering Permit Coordinator E3-'Building
Workflow Sign-off: ®-Sign-off for Planning(include notes from planning review)
Route Application Documents: Et-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Er-Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: eee 4-74,....-- Date: /-s`/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: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
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: --Yes ❑ N/A
Tigard Trans SDC: es ❑ N/A
Parks SDC: es ❑ N/A
LIDA ❑ Yes N/A
L'-'0K to Issue Permit //��% / d/1 l,i7--- --
l
(Approved by Permit Coordinator: /Date: 0
I:\Building\Forms\B1dgPerniitRvw_RES_061417.docx
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
111
T 1 cA RD River Terrace Building Permit Review Addendum
Building Permit #: .- i c2O/7 CO3
Site Address: (Sv'1 "Patc e
Project Name: 17b1 (dBtAii M vrt- i h Lot #: I 3
(New divouing=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? ❑ Yes BNo
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. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dormer
ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide
❑ ❑ El El El
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown:
3. Entrances:At least one entrance must meet both of the following standards:
facing wall
I=1 Parallel to street,angle no more than 45° from street,
CI Max. 8 ft. setback from longest street-
or open onto porch
Entrance opens to a porch: El Yes El No
If yes,all the following apply: El 25 sq.ft.min.
El One street facing entry El 12 ft.max. roof above floor of porch
El 5 ft. depth min. El 30%min. porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing façades:
❑ Covered porch min. 5 ft.wide x 5 ft. deep El Recessed entry area min. 5 ft.wide x 2 ft. deep
El Wall offset min. 16 inches El Dormer min. 4 ft.wide
E l Roof eave min. 12 inch projection ❑ Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood El Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. El Horizontal lap siding min. 3-7 inches wide
Cl Accent siding min.40%of street facade El Window trim min. 2'/2"wide by 5/8"deep
❑ Window recess min. 3 inches for all street facing El Bay window min. 5 ft.wide by 2 ft. deep
El 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 El No. If No (Check one):
El May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
El 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)
El 12-foot-wide garage door El 40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes: 0a 1,0.
Approved By Planning: P`'„`S I Date: g I'{ 117
I:\Building\Forms\B1dgPermitRvw_RES_RT_o62216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15307 SW PEACE AVE, TIGARD, OR, 97224 May 3, 2018 at 10:57:42 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00322
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed
A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15307 SW PEACE AVE, TIGARD, OR, 97224 May 3, 2018 at 10:56:29 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00322
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed
A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15307 SW PEACE AVE, TIGARD, OR, 97224 May 8, 2018 at 11 :15:43 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00322
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - CofO
Comments:
Final erosion control passed
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