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Permit (37) CITY OF TIGARD MASTER PERMIT "1 COMMUNITY DEVELOPMENT Permit#: MST2017-00140 Date Issued: 09/21/2017 T-i r; r,R i„] 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DB07400 Jurisdiction: Tigard Site address: 17476 SW CLEMENTINE ST Subdivision: RIVER TERRACE NORTHWEST Lot: 74 Project: River Terrace Northwest, Lot 74 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 1108 sf Basement: 812 sf Left: 3 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 1396 sf Garage: 385 sf Front: 8 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 3316 sf Value: $397,470.59 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 RainStorm Sewer: 100 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 Drains: 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 Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum<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: 6 201-400 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 Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 3316 Owner: Contractor: ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) BY FORSUM,MICHAEL 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175 7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660 2 Geotechnical Inspection STE 1 Required before foundation SCOTTSDALE,AZ 85258 PHONE: 602-694-4031 PHONE: 360-695-7700 FAX: Total Fees: $34,829.02 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. Youmay obtainbta copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.234444 �,—' Issued By: /'4(.71.4,;- ?��,�'Y'"5��9iPermittee Signature: �c r 6��/!4�f� ,,a� 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 ` Lc R'esidential. R CEIV D FOR OFFICE ISE ONLY Received y PermitNo.: Wal City of Tigard APR 6 y 2017 Remy L ��� 17 577` 6q It 13125 SW Hall Blvd.,Tigard,OR 97223 .. Plan Review • y Other Permit- P ,0 —t 'i Ili ' Phone: 503.718.2439 Fax: 503.598.19 y: 6-aa ' %) Other H See agel or Inspection Line: 503.639.4175 ulTY OF TIGARD DateReadyBy: q� 7 �7 . . Supplemegeal Information TIGARn BUILDING DIVISION NotiSed/Method: Internet: www ttgard or gov QiL— Nr e, t �` f Permit fees*are based on the value of the work performed. 0 Demolitiondollar) ®New constructionIndicate the value(rounded to the nearest of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the " $ work indicated on this application. `� .�w� a,.. _ .�.. , ;i Valuation: . Commercial/mdustrial ® 1-and 2-family dwelling 35146-11.399 3971 4 70 Number of bedrooms: ❑Accessory building ❑Multi-family --tr -....1 0 Master builder 0 OtherNumber of bathrooms: 3 ,37O1 rr a ;Me if Total number of floors: 1 �� utt � , . =4 ' £ Ofit�W F 331 - `" °- '^�'°""� +n e %\--- New dwelling area: square feet Job site address: �7 y?� � �,��m.��1 LCA City/State/ZIP:Tigard,OR 97224 Garage/carport area: 3&S square feet j R1`/4,r,e, & R M Covered porch area:'I ;quare feet )3 9 G Suite/bldg./apt.no.: I Project name: `D 1 " 1 �0 Cross street/directions to job site: Deck area: 1 1 if square feet Other structure area: square feet 8 , Subdivision:1 .4'V.eo e. Va) l Lot no.n 4 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 ''. -‘ ' -' � � ` ,, ff work indicated on this application. �:�. � _ r� .... , . .,.� Valuation: $ Existing building area: square feet New building area: square feet ---.)::::‘,„,:,--,--"sr,-, r - 1 fi '., 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 ( ) � ��` i �". 5 FSB;4 {i .l x. 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)6954700 I Fax::( ) ms's I`i b ��' : `'', "z E-mail:Angela.Grajewski@polygonhomes.com Commercial and residential prescriptive installation of f . $ Pa, y , 1- 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 I Fax:(360)693-4442 State surcharge(12%of permit fee): I CCB lic.:207247 Total fee due upon application: This permit application expires if a permit is not obtained Authorized signature: ( V i�S n 1 Lina within 180 days after it has been accepted as complete. l/f U1 1 I *Fee methodology set by Tri-County Building Industry Print name: — I Date: Service Board. ' I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) • • Mechanical Permit Application [ UIti(II tl( I. ',itltill ' Received permit tn: City of Tigard lithadBy ; ` 13125 SW Hall Blvd..Tigard.OR 972`23` I9aa Rac+�' rl Permit:Permit:°°1STl e. ` Phone: 503.718.2439 Fax 503-598.4960 t - - 'OY OC)dtfor g Ste Pate 2 Inspection Line: 503.639.4175 , Date Rcady.By: ISI Steo+eae 2 fefarmatioa Internet: wlkw.tigard-or.gov . - Nonf�ed1Mehod f,-,,,,,---„,-_-:;.,,,,,,-,---, • s , °` .,-.s , ,,, -.. ...,4-s-....,- -,v, ', "% --u a t. vim'- ` K . r ' ,4 :-: ' ss _ ': '-.- a. r--•- ••, -, * ` Mechanical permt feesarc based on the Vatue of the work ®New construction 0•Additionlalterati0n-ht:placement performed.intricate the value(rounded to the nearest dollar)of all mechanical materials.equWmcN,labor,overhead.and profit. ❑Demolition 0 Uthcr.. . tialue:S -..";•:';f:' ..-" *I '- Pa•H; it � ,`,r:r1r,.p .,:-._4C. � w ,;.,-4 4F� d:w i x r _ T '': t Ct t," `til., t -.. For)i��JlJ,fOrrrratfdn AS[checklistV.,1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building Description + Qty. ] Ea. _l Total iultt-famil 0 Master builder 0 Other a k, Y ' c 3 x r. K t„ k r 21`( ;1% ` t-,,,' Air conditioning 46.75 SW 1 r efltsne, k" ( 46.75 Joh site Address: �(..,��/1 Furnace 7 tK1.1100 BTU iduc+s'��eatrl �r Furnace 100000+RTU idoetsivents;l 54.91 City/State/ZIP:fLt1' Tigard,OR 97224 Beat pump 61.06 { ,, Suite/bldg./apt.no.: ` Project mune:RNcr Te�rrctce.N\ .c-ytV 1V.fl0ua work 23.322 1lydranic hot water system 23.32 Cross sheet/directions ecVdircctions to job site: Residential boiler(radiator or hvdronic) 23.32 •. Unit heaters(fuel-type.not electric), 46.75 in-Hall,in-duct.suspended.etc. Flue/vent for any of above 1 , 23.32 Other. 23.32 Subdivision:(u'tY Terfa(r, t113YrriAviesi I Lot no.: 14 Other fret appliances ^� ' Water heater i 23.32 Tax map/parcel no.: 33.39 .,, i s ties fireplace inacrt f*�3 'r' 1 ms s, :r:%a a 1 % r'°l Z5.b c.17t- 2 -• '> Flue Veal for water heater or gas 23.32 { a fireplace Loe lighter feas3 23.32 Wood+pellet stove 33.39 Wood 6ir plecciinccrt 2332 Chimneyf inedt)wivent 23.32 Other 23.32 rµ` S F " f n 5''�:' ' -7c ' }.`:.* LS ---1�:'.,r tr. --rn* : u=, '� r. , r FY lj r ,, ''' - Environmental exhaust and ventilation: Range hood/other kitchen I 33.39 Name:Polygon WL/1,LLC equipment Address:109 Fast 13'h Street Clothes dryer ueltaost f 33.59 , Sinele-ductekhausi(b(bathrooms. CitytSlatelZlP:Vancouver,WA 98660 toilet e'oompartmcnts,utility rooms) 4, 23.32 Fax:( ) AnicicrawlspacC fans 23.32 Rhone {3b0)695 7700 •ic:l .4' n^ -1 ,ta � 1 ` = ?. Other 2332 cr �, ,.' .f , $: Ff. ,.r*. r n--- u.n ,'4 . Xi i" —. Fuel piping: Business name:Polygon WLH,LIC . 51415 for first four:54.03 for each additional ����Thome • Furnaoc.etc. 1 Contact tttune: Oars heat pump Address:109 East 13th Street WaIUstispendedlunit beater City/State/ZIP:Vancouver,WA 98660 Water heater -I Fax::(360)693-4442 Fireplace Phone:(360)6954700Range E-mail 0 0 (fi din i .4 I,. 4 Burbceuc I 1 ''''1:-M7=-7Z17-'-'717..77.'''' 1/ 7.' a (gas) t:.-•- _� Y L,,- 2:7-2,i::-.1 ;-'-''.'".�,.� eco(�,,.�. k..-ik=, '._.`��v_ -E Other -i Business name:Apex Air LLC Y ` _fit` cy rM`rc+_f tl,i"�''}:- <- Subtotal Address:18004 NE 7214AveMinimum permit fee(590.00)ta City/Statt fZIP;�!anrnnver,'1VA 98686Plan review(25%of permit fee) Phone:(360)3424109 l Fax:(360)3264769 State surcharge(12%of permit fee) TOTAL PERMIT FEE CCB lie.:203034 This permit application expires VA permit Is not obtained within 130 days afterit has beta accepted as complete_ Authorized signature: • Fee methodology ad by Tri-Courcy Banding Industry Ser'ice Board[ Prim nnme: 1 I Date: 4'Il.ft.-- I t Viufldia@'J4rmitsliif ,Pennmpp"Hitt LI doe er0-617T t 1102tt'otua'FJcl M , � r Electrical Permit Application FOR OFFICE ISE ON LA ii,ti , /, ! Received City of Tigard nais/B Permit h: 13125 SW Hall Blvd.,Tigard,OR 9722, ;,: lila Review Phone: 503.718.2439 Fax: 503.5981960 a •, pig , Related Permit it: Inspection Line: 503.639.4175tdD T ReadyDay: 65 Sea Fage2 for Ti G ART) Internet www.tigard-or.gov P ' No6GadThath d; ® Supplemental lnformadon s P.f ti-?4-i- 5: a A ahad ;:- fit- ' •P• .r .a ;,3 7,"a. c . A?'"` 0 New construction 0 Addition/alteration/replacement Please check all that apply(submit z sets of plans wrrtems checked): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition D Other where the available fault naomI 0 laminas and boatyards. 4,r c4' tilt-...0);_:;44_4(.6.17',i, A E 0) '-'' _=� exceeds 10,000 amps at 150 volts or ['Floating buildings. 01-and 2-family dwelling 0 Commercial/uidttstrial 0 Accessory building lets to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. bat7dings.• 0 Multifamily 0 Master builder 0 Other °Fire pump. ❑Installation of ISO KVA or r ;. s:.a =".h, .io{.;'.urn a*: i�1 4°...e.". a` C' ---1''',$,',/,:` D�ergencysystem. larger separately derived �7 y7�SVV le me, the D Mdmon of newmore.motor load of "A Job#: Job site address: 100HP or more. ❑"A".E';"1-2"."1-3". :Tigard,OR 97224 ❑Six or more residential trolls. eoccupancy. City/State/ZIP • ❑Haelth-Dere facilities. ❑Rcaamonal vehicle parks. SuitrJbldgiapt#: I Project name:?,,4\{/d'yT W iliU f ❑lSaaznicedouslocations, ❑Supply voltagefor more than orfeeder600amps ormore. 69°wiammival- Cross street/directions to job site: F.-- -.47'•• -•--::-..1.;!-,x•, 73=+"f:4a21..• ```3`i-- Description D4'. I Hath Total • 4— New residential single-or multi-family dwelling unit. Subdivision: 4i _ ►blit!! A. Lot#: includes attached garage. 1,000 sq.ft.or Jess 368.54 Tax map/parcel#: 1111 Ba.add'!500 sq.ft or portion 33.92 1--` ipl a 21 0 dt,err . z 4•u - '-- Limited energy,rrsidential 75.00 (with.above sq.R) Limited energy,multi-family 75.00 residential(with abovesq.ft) Renewable En a ❑See P :c 2 tai _--=is a l;{u.). Fa..;��}`,9,s • lr-. c t -_ac3v9�,11 -. ":- Services or feeders installation,alteration,and/or relocation Name:ADVL Land Holdings,LLC 200 amps or Jess 100.70 2 Address:7600 E Doubletree Ranch Road 201 dO to`00 133.56 2 401 amps en 600 amps 200.34 2 City/StBteIZIP:Scottsdale AZ 85258 60)amps to 1,000 amps 301.04 2 Phone:(602)694-4031 Fax:( ) Over 1,000 amps or volts 55226 2 Temporary services or feeders installation,alteration,and/or Emat7 . relocation Owner installation:This installation is being made on property that I own which is not 200 amps or Iess 59.36 I 1 intended for sale,lease,rent or exchange,according to ORS 447,449,670,and 701. • 201 amps to 400 amps I 1 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 .� _ s .-- �1�- �-, rt 4, o -`-�y -;• Branch electors-new alteration or extension ,er,and �^. � >� �1.��(� -a r "��'��c,,�.,s�-=y' X �.... �3.,,-!.` ' �3�"'�'-...� A.Fx for branch circuta with Business name:William Lyon Homes,Inc. above service or ti eller fee, . 7.42 11111 each branch circuit Contact name:ilk OI'► 1 QVf11 B.Pee for branch circuits wilhmd Y'� service or feeder fee,fust 56.]8 2 Address:109 East 13th Street branch circuit City/State/ZIP:Vancouver,WA 98660 Each add')branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 ' • I Fax::(360)693-4442 Each manufactured or modular 67.84. 2 dwellio: service and/or feeder Email. �/ e•-• /1 l 4 I I, a I ,(4( 1/ Beconnatonly 67.84 _© _ cr ;t r ',?` ' --: . � •'- Pump or irrigation curlc 67.84 2 Business name:Garner Electric Washington,LLC Signor outline lighting 67.84 2 jSignal circuit(s)or limited-energy 0 See Page 2 2 Address:6101 NE St Johns Rd panel,alteration,or extrusion. Vancouver WA 98661 Each additional Inspection over allowable in any of the above City/State/ZIP: Additional inspection(I hr min) 6625/hr ?bone:(253)320-1657 I Fax:( ) Investigation(I hr min) 90.0W hr Jndustjial plant(1 hr min) • 78.18/hr Email:bdaaielsaQgweusa.cor g Inspections for which no fee is 90.001 hr 9 CCB Lie.: C1158 Electrical Lic.: 208174 Suprv.Lia: 4496S s listed 14 hrmma) _ .__-• _ e--'."=4, rElk HrzfcZtCi* jeljro � , t. •cJ✓ ' X. a Snprv.Electrician signature,required; :4‘,Al . itt a ` - Subtotal: Print name: Joan P Albert •• Date: 4/26/2016 ID Plan Review Required(25%of permit fee): '' :. ----- State surcharge(12%of permit fee): c' _ _� -"�� TOTAL PERMIT FEE: Authorized signature: This permit application expires If a permit Is not obtained within 150 e't+•'�''- Print name: Bill Daniels Date: 4/26/2016 days after ft has been accepted as complete. • Number of inspections allowed per permit ''•.,••".-;; .,o;.• .18endingtoermitsUiLe PermlrApp urn Eitsdoe Rev 06.117/201S 44O4$1Sl hlMIIXlbcWE9 i Plumbing Permit ApplicatiOn ,;; . Building Fixtures ry 7 ,? ',,,,',\:" Received ® City of Tigard y: p` ''No.: N 13125 SW Hall Blvd.,Tigard,OR 97223 , - p)m Revaew Phone: 503.718.2439 Fac 503.59829M 'i- ,-Y---+ .` Dare/By: Other Pamir No.: Inspection Line: 503.639.4175 ,1 r r,, =Dale Ready/By: Joao: I H See Page 2 for 1 , 1 ✓ Notified/Met od; emenfal Iaform:don Internet www ngard or gov r . s- - - ...e Ser 1� �' � � "s Y1, lays-,F:- 4' 3i y�'^Yir l'!.'4,114. -;.•,':i:-, :.: c+�,-.- ..p..Li '_-�1,��4t:1 3 �'? £Y7',.;?- "�.v:,s='4 ..L4 Ys..�c`� �...c r "..zst..g-.- 166 For special infonramion use checkraL El New construction 0 Demolition Description I Qty. Ea. I Total ❑Ad ditionlaltetationhtplacement ❑Other: New 1-2-family dwellinp(includes 100 R for each utility comroaioaa) t--- -v - MF L lilt'n + .ra.`--,Kt,----u.i �E4- . ri� �,�: ;�'� .> FR(1)171111 g 312,70 '' _SFR(2)bath 437.78 ►�� 1-and 2-Ls�y dwelling+ Commercial/industrial SFR(3)bath i 500.32 0 Accessory building ❑Multi-family Each additi:old bathAatchen 25.02 D blaster builder 0 Other: Fire sprinkler(_sq.ft.) Page 2 --).-_,•-•-•,,-;.-,:` , .z ` ?1 is a .ra ,�•• etc y uta ,e.0-_,-4,1,.__0.4±----:,,,},t = ;} a Sheutilities: C /1 �V V t • ie,".1 tom_ 4 Catch basin or area drain 18.76 Job site address: Drywetl,leach line,or trench drain 18.76 City/State/TIP:Tigard,OR 97724Footing drain(no.linear ft: __) Page 1 Suite/bldg./apt no.: I Project namaRii(&fGrn*cc. 101yd/west- Manufactured home utilities 50.03 Cress 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 _Wafer service(no.linear ft.: ) Page 2 Subdivision:94`V r reA- te, N a 't Wed'-F I I.ot no.q i ....re or item: Backflowprcventer 1 31.27 Tax maplparcel/20.: Backwater eerie _...:;',',..1".. ? 1251 -Clothes washer 125.02 251 Disbviasher 25.02 Diinking fountain 25.02 Ejectors/sump 25.02 . c Fi tam1251 P a i f Kt „r . a - W s Fixture/sewer cap 25.02 Name.At/VI,Land Holdings,LI,C Floor drain/tloor sink/hub 25.02 Address:7600 E Doubletree Ranch Road Garbage disposal 25.02 City/Statr/ZIP;Scottsdale,AZ 85258 Hose bib 25.02 Phone:(602)694.4831 Fax ( ) Ice maker 12.51 12.52 x :,1 4( z - ;N w%?,r f t• r---;,�� i�=i r;;.-; , p Intetceptor/greasetcap -,._-'-.4--- • Medical gas(valve:B ) Page 2 Business name«William:Lyon Homes,Incpier 12.51 . Contact 11$1°:A tfr di U( ve- ovRoof drain(commercial) 12.51 Address:109 East1 ' 13th Street f I"- . . . Sink/basin/lavatory 25,02 Solar Units(potable water) 62-54 CilylStattlLIP:Vancouver,WA 98660 i F12.51 Fara: 150 4442. 'l shower/shower pan Plionr(368)b95-T7A0 1 (3 )693- _Urinal 25.02 8741311.0 .4 1 14 JAI f,. 1 r i . a IA -ell!4 _ - Water closet 25-02 ` � . : ' ' _ � - -r r -' A... ? e. r.,", e • s � • 111_;, , -.- Waer betelf 37.52 Business-natae., Gd�1 Q IAO)V1.1.4.-6014 water piping(DWV 56.29 Other: 25.02 Address:. Qfrac; O n f J' 1 i aJ� Subtotal ciiyr<stawz>P5T,� • �"'` art , •.y/. 1mrnum permit fee: 572.50 )'honer ,.,-a"us"' I U1 Far 11,p..'791-!'.f'!'o - Plan Mview(75%ofpermit foe) GCB LiC: lS`f3�- I Plumbing Tic.no. State surcharge(12%of permit fee) Authorited sigoatur : _ TOTAL PERMIT FEE I Print name:.6-1-f I1t W(li. Dater-38 I Gi€ / I expires application expiIf a permit is riot abtatned within 189 days I atter it has been adapted as complete. *Fac methodology set by Id-Comfy Building industry Service Board le aoc 1001/09 449-4616T(19102/ooir MEB) 1 I Plumbing'Permit Application Building Fixtures ,-... RECEV IE 1) City of of Tigord Itackived 9741 AY 1 7 2017 taft. Pennitl+Io.4 • wwvgard.or . • la _:. 12125 SW.Rall RN,Tigtott OR • •"11 •- " Phone: 501718.2439 Fax: 503.598My oF,,..1 G , DaosSY: Dila-Permit No.: • t.=11174n7.5°16"41„.41" BUILDIN iliViti7 114"46 ' Ione El Stel•age 2 fir . Boiplensanial Infornsatkon " ?-7AI':W!r4: -:" .-:: . .ZIP:Ae..4.W1,-:;r4tP3WrI -41 ,-W, 5467t CI New construed= . 111 Demolition Air world Inforsuarans sise cheated. Deserintion I Qty. I Ea. ' Total CI Additiontelteradoutaepbeetnent ID*hen' New 1.74amilY dwellings(ineliales 100 it.for each utility comieditm) -SFR(1)bidh I 312.70 It61.. 1-end 2-ibmfty'dwelling 111 Commereialfmtbstrial SFR(2)bath 437.78 SIF4(3)WA 508.32 0 Aceessorylenicrmg 0 Mubit-fandly Each additional hen/kin:hen 25.02 CI 1014ster.builder DOW= Firesprirddert___sq.ft.) Page 2 •‘-',•.:7-"f Site utilities' a_1 - . -Caleb basin or ania dran 18.76 Job suc address: f , .01Pnitill -_,. Dtywell,leach line,or want drain 18.76 City/State/4P:Tigard,OR 97229 Footing drain(no.linear ft.:___) Page 2 ,... _ _S•Ctte4.08Alit••.: I FrOjeCt Dame'giverltrrare tioetiacsi Multitalented hone utilities 50.03 Cross street/diatetions,to job site:, Manholes 1176 Rainehain nounixsor 18.76 . . .,.... Sanitary newer ' Storm sewer(no.,linear ft.:___,) NV 2 . . - Water service(no.linear ft.:____) Page 2 • Saulirgisior pier-arram_Nortiope,i÷- totoollt4 Fixture.or Item ' Backflowpreventer 31.27 Tat mapiporeel no:: 1251 ,i-17.if'ir-.:''' ''''..L.;.',--.--1--1.,-c-:',---''-''jj-•=".f.T.C.: [ 0,'„Y'rfk„t,;-..:1:"Ll•:`,-',.:::',±,::. • ''----"-,.'1'.,-,', • . .25.02 4 i 414 / . Mai Ater Heil/TX-. .... ,Distimsbee . rxieking- towilabi 25.02 Ejectorilaninp. 25.02 . . 1 .-:,-:,.7---..;;:','F'eL,,-,-,•-.-',....;-:".7 IX:77.7Z'1,7.':ir--i':..7-,:,,:::.• :.;,--.. .7=-`).-::ET-.r•CY2:177:::--ff-7E'f'g'.7;2: giiKirdiOzi tank' 1251 ,Lt. ,''- !-L ,,,1. s1. , -. Fixture/Sawer cap;:t?':) ,''jlY'&-,,,-" 7.: 25.02 Narne011iit Lend Holtibigst LIZ Mot draintfloor sink/hub 25.02 Addrew 7600 E Doubletran Ranch Road Garbagedisposal , 2,5,02 .. Mx/State/in':Seoirsliale,ii1152.58 Hose bib 25.02 PJIPPFt4004404/ Fax.( ) Ian molter, 12.51 • --7,::.-:-.--'-,••:.r.:!.---..-7 77:,..f5: ‘7::::';:- ..:----'-FT-7- .7,77,:-%'' 7:•-'v-2;:7--,'";.-7;7...7. ,.....71-'7217,::-7:7777: intetcwortrehse trap 25,02 -.• , - ----. .. . - - , . ..,, • .,. ...,... - ., ,.. ,. ......., , .... , . • ldedical gas(vane:S . ) , Fags 2 Oiliness=Me;Wilibma.14,en Humes,litie ,P404sr 12.51 C0.004.01.Me: 141410(.11161)e. ,Rootdraio(nommen:M) 1251 . Addre.ng Aoprlafpc Oda Street Stairlhaliellavatogy 25,02 dity/Stater13:0Natileouveri VitA 98660 Solar anis(potable water) 62.54• . . Phone'':(3c*695-770D Fax :(360)69 -4442 IbbishoWer/shower pan , , 12.51 Urinal 25.02 47.PAilf- 44 . • 14, 1 4 tr 174. 1 / ,J, ernes. _ . ...atk,„„_ ,„ Water closet 25.02 1 37.52 Oisi•ass 11tmc' 144 t .i,kerr- tra 44- *saner piPMg/DVIV 56.29 44404•:.- p, 1.. ti.3‘ 42iA Other: • 25.02 city/Side/0i ST, e 4.4 0.,... 41113-1 • . sa..... KO Finc oppf....79,1,4 ,r1 - KbrimUm permit rem, S72.50 Plan review(25%of permit fee) colic.: le#3-A., . PlUm,b1DtLic,.n4*) bog - Ithorized/4mpg= . . . oujbe----,sAVOt Ste sin?birge(12%ofPerreit tee) Au TOTAL PAtlar OS . .. , _pog iamei:6+ivt. p.,,w14...e._._ mdc&-si) if nu Ptrmit aPPlielltl.°1'afiaritttra if alerpdttairo,r,w1*MOW days *Fec roethadobil sat by TrI•toautyBuBding Industry Senrice Board. kadaltasodwainIPLidu4erndtAppece 10/01/09 446‘4616014+02/CONvotos) 3 f City of Tigard 1114 " COMMUNITY DEVELOPMENT DEPARTMENT N T l c A RD Building Permit Review — Residential Building Permit#: AS , # -o Site Address: /' -'4'97" Q{) C /re ilr w Project Name: iveA-- 7-?/7-47 a ', s Lot #: 7-272 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: k �7 /erify site address/suite# exists and active in permits stem. River Terrace Neighborhood: ❑ No Yes,See River Tefrace Review Addendum Attached Si Plan Elements: tee(3) copies of site plan ! '--^id sting structures on site I/:ite plan must be on 8-1/2"x 11"or 11 x 17"paper TA Footprint of new structure(including decks)with finished FI •rawn to scale(standard architect or engineer scale) 'oor elevations 0p':?FI orth arrow �I tility locations(required for new,may apply for additions) e address,project or subdivision name and lot number J''.iocation of wells/septic systems A plicant information(name and phone number) sting trees to be retained with drip line,and tree of dimensions and building setback dimensions .rotection measures 1 area,building coverage area,percentage of coverage and VA.treet tree size,type and location pervious area(applicable if R-7,R-12,R-25&R-40) Fl Street names Property corner elevations(2 foot contour lines if more than 4 foot differential) IIt an Water Services—Service Provider Lette of platted prior to 9/10/1995): equired: ❑ y ,applicant was notified No Received: ❑ Yes ❑ No Public Faciliti Improvement(PFI) Permit: /Lequired: Yes,applicant was notified CI No Applied For: Yes ❑ No,stop intake ,,and Use Case#: � 1„S'= '.Oa. .� ,e ' J/, = i,6008 "o�g: 4�`J'r gb) / equired Setbacks: FrontRear 0 Side _) Street Side 4 Garage Qc) andscape Requirement: 2C)of Coverage Maximum: eo Building Height: Maximum Height i/Actual Height & 6e isual Clearance IIIasements v(E ensitive Lands: Yes CI Type Q ) — c tom,• •J rill s' Urban Forestry Plan Te'+�' il ei),rrlc or— /'e-1 ' ❑ Conditions " t"prir to, issuance of b' gpf rmit Notes: ( /( /$&is 1' ��*// 2e iI' =-1pr7 O r /711/` I SS-1:- rC _ -- ,._ �,y/ Date: ` Approved By Planning: t 'Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: El Approved ❑ Not Approved Revision 3: ❑ Approved Cl Not Approved I:\Building\Forms\BldgPermitRvw_RES_091216.docx V N. Building Permit Submittal Original Submittal Date: (.f�(,//7 Site Plans: # Building Plans: # 3 Building Permit#: Enter building permit#above. Workflow Routing: Planning ,. Engineering Permit Coordinator 75p-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. r_ir Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: /1 / / Date: 1-//07 Engineering Review Slope at building pad: ./ 4" �.r--- /OConditions "Met"prior to issuance of building permit e9je�l ❑ 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: #11/1., ..73Date: 41`1-/7 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved O 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: C Fees Entered: Wash Co Trans Dev Tax: es CI N/A Tigard Trans SDC: Yes CI CI Parks SDC: Yes ❑ N/A (k) OK to Issue Permit Approved by Permit Coordinator: Date: . , : - I:\Building\Forms\B1dgPermitRvw_RES_091216.docx 01 I P City of'Tigard COMMUNITY DEVELOPMENT DEPARTMENT IIs TIGARD River Terrace Building Permit Review Addendum Building Permit #: Site Address: / 7,J9 c7i Cinr� \C24- Project Name: ver- ,7« 71--- Lot #: 171 (New dwelling=subdivision name;AdditionAlteration=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 t. dee Balcony w/ access 2 Window Projection Vertical Wall Offset a p ft. deep min. 2ft., 5 ft. wide min. 2 ft., 6ft.wide Gabled dormer ❑ ❑ ❑ ❑ 2. Eyes on the street: a minimum of 2%of ach street facing facade must include windows or entrance doors. Percentage Shown: '2i. 1y c 3. trances:At least one entrance must meet both of the folio ' g standards: Max. 8 ft. setback from longe t street- facing wall Parallel to street,angle no more than 45° from street, or o en onto porch Entrance opens to a porch: Yes ❑ No If es,all the following apply: i q.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 e following elements on all street-facing façades: overed porch min. 5 f.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft. deep cit all offset min. 16 inches El Dormer min. 4 ft.wide Roof eave min. 12 inch projection 0 oof offset min. of 2 ft. ❑ Roof shingles either tile or wood able,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. horizontal lap siding min. 3-7 inches wide El Accent siding min.40%of street façade Window trim min. 2 I/2"wide by 5/8"deep El 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. Set acks: N closer to front or side lot line,than longest street-facing wall. El Yes No. If No (Check one): yMay 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) E50-foot-wide garage door El 40%max. of street facade %max. of street façade with 7 detailed design elements Notes: y ts4 . Approved By Planning: -------:-.:-.-...,,,. .... ,_.........-----z - , Date: / • I:\Building\Forms\B1dgPermitRvw RES RT 062216.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17476 SW CLEMENTINE ST, BEAVERTON, OR, 97007 Record Type: Record ID: Residential - Master Permit MST2017-00140 Inspection Type: Inspector: 699 Mechanical 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: 17476 SW CLEMENTINE ST, BEAVERTON, OR, 97007 Record Type: Record ID: Residential - Master Permit MST2017-00140 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: 17476 SW CLEMENTINE ST, BEAVERTON, OR, 97007 Record Type: Record ID: Residential - Master Permit MST2017-00140 Inspection Type: Inspector: 399 Plumbing final Allyson Armstrong Result: PASS Comments: Water pressure =70psi Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17476 SW CLEMENTINE ST, BEAVERTON, OR, 97007 Record Type: Record ID: Residential - Master Permit MST2017-00140 Inspection Type: Inspector: 299 Final inspection Allyson Armstrong Result: PASS - CofO Comments: Collected ETO site inspection certification High efficiency lighting form Moisture content acknowledgement form Moisture barrier acknowledgement form Left C of 0 on the counter Violation Summary: Inspector Contractor