Permit (41) 1114CITY OF TIGARD MASTER PERMIT
° 2., COMMUNITY DEVELOPMENT Permit#: MST2017-00183
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 09/21/2017
TtAkt.L� 9
Parcel: 2S106DB07500
Jurisdiction: Tigard
Site address: 17450 SW CLEMENTINE ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 75
Project: River Terrace Northwest, Lot 75
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 1254 sf Basement: 735 sf Left: 3 Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 1655 sf Garage: 464 sf Front: 12 Smoke
DwellingUnits: 1 Detectors: Yes
Third: 0 sf Right: 3
Total: 3644 sf Value: $438,503.56 Rear: 10
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
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: 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: 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
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 3644
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
STE 1
SCOTTSDALE,AZ 85258
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $35,774.59
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: /64- I ` - Permittee Signature: l e/�ILCGt21
�%�:
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 ,, A '`. S�
Regdettial
FOR OFFICE 1 SE ONLY '
City of Tigard `: 42 i `016 Received �Z.Z l7
C III ■ 13125 SW Hall Blvd.,Tigard,OR 97223 h. A y , P view _ Permit No
],,� / 57 .x]-60/n
Phone: 503.718.2439 Fax: 503 598 19M `.- k ',,,,,,t,.
, 7
Date/By: 6-027 -1 Other Permit: 4i)4 Cor Oet 6,
t c,:s P p Inspection Line: 503.639.4175 t.“; F Date Ready/By: Juris: ads
Internet: www.tigard-or.gov ',s�;'� '., . • Notified method:flCi//7 I H See Pagel for
/6w/A el- pp meatal Information
Su le
®New construction 0 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 ❑Other:
equipment,materials,labor,overhead,and the profit for the
"-. ,t £ ^z lit .µms work indicated on this application.
® 1-and 2-family dwelling
_.. Valuation: �9ttl�
,.
0 Commercial/industrial (i `7
❑Accessory building0 Multi-familyNumber of bedrooms:
cD 0 Master builder ❑Other: Number of bathrooms: 3
ii_ r rt , p+ � v *V. Total number of floors:
iv
Job site address: 7 ..�� New dwelling area: z, _� (' quare feet
City/State/ZIP:Tigard,OR 97224 7 Garage/carport area: 1V/t square feet
—1+J q
Suite/bldg./apt.no.: Project name:Ri _,p ,---e, - NvO Covered porch area:1 i n ;quare feet ,S
Cross street/directions to job site:
Deck area: )6 0square feet las 4
Other structure area: square feet 73
61k, ® tzN tS .Ha' r
Subdivision:� � - ', ` -� ._._ ,.r�_,s�.�-5 �� .�� �. �- ::- .__.
k 3 Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
- L., �� �� equipment,materials,labor,overhead,and the profit for the
t , t �.� '" � y h � work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
- � _ . -'- . .? .m',4 �-` - _ w.. Wi i.!• '...M'-*
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:
- ' r< .. ._ .a....,.....:..-._rs'.- v„-- + 4,- �`. tis 4 € 6 1%--
Business name:Polygon WLH,LLC €
Contact name:Angela Grajewski Structural plan review fee(or deposit):
Address:109 East 13th Street FLS plan review fee(if applicable):
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(360)695-7700 Fax::( ) Amount received:
E-mail:Angela.Grajewski@polygonhomes.com _4a �t � s �� t,t ,;
-� ¢:- c' - Commercial and residential prescriptive installation of -k.
roof-top mounted Photo Voltaic Solar Panel System.
Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details
Address: 109 East 13th Street and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review
Phone:(360)695-7700 Fax:(360)693-4442 and administrative fees):
State surcharge(12%of permit fee):
CCB lie.:207247
Total fee due upon application:
Authorized signature: R I - j 1' This permit application expires if a permit is not obtained
VI 1 ! ((kola
l Y l P/� within 180 days after it has been accepted as complete.
[ Print name: — - I Date: I *Fee methodology set by Tri-County Building Industry
Service Board. '
I:1Building1PermitslBUP-RESPeimitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application` 1 {01.()1tli I { ,( s).1 1
g: Rees T'er+nilNn.
City of Tigard ,'\ g
aste/Br
13123 SW Hall Blvd..Tigard.OR 97223 ,. Plan R6r4CW briar Penne;Phone: 503.7181439 Fax: 503.598.1940 n"'`B`: � H See pace 2 far
Inspection Line: 503.639.4175 - Date Rea'h 0y: l Supplemental Page
1 Information
'Internet: wrsw.tigard.orgov , r:, Ncxifiedibiethod
��
,et._�,..:...Fa tet g .: _ ..
'r5�:: k.� rya ���' ....: .rY^, ...
.fir'
- .... e.r -, .,_F: 1,,s -c F e5< y • . ,-- yam. ., - Mechanical perrnrt fees*are fraud on the value of the work
`3 ._ onned.Indicate the value(rounded to the nearest dollar)of all
®Demolitionetioconstruction 0 Other
Addition/alteration/replacement meehanicai materiels.wuiorric .labor,overhead.and profit. ,
❑-•, 4 o
��s '�'�'�- Forsprr3clhrfornrallonxsackeckli>fi
-I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building Description Qty. Ea. j Total
dull-tamil 0 Master builder ❑Other: ea Description
. . ,;
ta4 - ,:s.tea ., -!� --.-7 •• f-;a.tstr•�t t•,••,; i,r-c. - T>1�,3 j._'wt' ' ' Heating/cooling:
I 46.75
�-,z 4•,---1�,.< �.t.�p� }�. D Air conditioning
Joh site address:
/7(4S- ) t/\LI 11vn i 1ne Furnace 700.000 BTU(duas'vtats) 46.75
Furnac4:100.000+BTU(dtads't'eNsl 54.91
CityPState,2iP:Tigard,OR 97224 floatp 61.06
�,{
Suitrlbldgiapt.no.: I Pmject name:R:.\VC-Terrace,N Of k`nv i--Dlidwed 23.33
!lydtanic hot water s��sttm 23.32
Cross street/directions to job site: Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,pot electric), 46.75
in-wall,in-duct,suspended.etc.
Flueivent for any of above 1 2332
�,�ivt„f, tOther 23.32
(?���lir1- rol(P, o ys1 1 Lot n0.:c Otherfociappliance=
Subdivision: IV iNt� 2---23.32
Water hotter
Tax,, ,4„:map/parcel no.: _. 1 a K Gas fircpiaecnsM 33.39
r - - �'•,--7,.•=1.,•1 ?.rte i-15 ter 't•9 c�`7 .Y:: r.:,
r-_-- .,,-..--,4-,,,t1.-..-%,--_,.. - , :+:, ak , '.. ... *`x ',, %-3Flue vent for water heater or cos
firee4acc 23.32
Log lighter(gas) 23.32
Woad/pellet stove 33.39
Wood 6rrgtislicfiaurt 23.32
Cbimaey/lincriflueh gni 23.32
•;t : ; Other: 2332
„, .'4 , s.�`tel .`F7 s A e i F ,, .,as ,.- r ,-1 ` 'f1 F,aviroamen1 l exhaust end ventilation:
�*._ ., Range hoodfothcr kitchen
Name:Polygon WL/1,i LC equipment 33.39
Address:lltH test 13<s street
Clouts dryer cahaust L. 33.39
Simile-duct r.htau,t(bathrooms,
toilet WA 98660 toiletcompartmcnts,utility rooms) 23.32
Attic/crmwlspacc fans 23.32
Phone(360)69S-7700 Fax ( ) 23.32
p tTk.< j re 4i•'t, r iY�max': Other.
Fuel piping:
Business name:Polygon WLH,LIC 04.15 for tusk four.$4.03 for each Additiceal
`' �t 1,�w ,s Thorpe, Furnace.etc.
Contact Hemp:Ali Gas heat pump
Address:109 East 13th Street ,
WaiUsospatded/Unit heater
City/State/LT:Vancouver;WA 98660 Water heater I
Firetriact i
Phone,:(350)695-7700 / p�I Fax::(360)693-4442 1 Ranged
E-Mail:-. (,' i i !IA i► Oe F'�¢ '� r ' -/-n.- - t ,t ��. - Clotdn'cr(gas)
Apex Mr LLC .„,-..."-.=_-2.... _L`t _ �..__ Other e_ 1 r ;r„ s, ` '
Business name: Subtotal
Address:180041E 72"4 Avg !Minimum penult fee Subtotal
City/State/ZIP:Vancouver,WA 98686 plan review(25%of permit fee)
Phone:(360)342 8109 Fax:(35(1)325 i7b9 State surcharge(12%of pumil Re)
TOTAL PERMIT FEE
CCB lie 203034 This permit application apiece tra permit Isnot obtained within f e.0
days afterit bay been Accepted as complete.
+ Fee methodology se by Tri-County Building industry Semite Baird
Authorized signature:
Print name: t e' / I Date: 4.11.1C-- I
x41146171 r i irtmroM.'n'ral
I YtuildlultJ4mntsl�lt�_PermilAr?WGll�dae
1
Electrical Permit Application FOR OFFICE LSE ONL'-
City of Tigard v,`` , Received
Permit s`
13125 SW Hall Blvd.,Tigard,OR 97223, plan teeview Related Permit d:
Phone: 503.718.2439 Fax 503.598.196(5 ' Dau1B hila H Sea Paga2 for
Inspection Line: 503.639.4175 heady Dialer`
I1Gi RD ' Hedged/Method: Supplemental Information
Internetwww signed-or.gov
_ �_ _ � , .7 i�.ia Wit.�.a �a.�'�-��' � �:� .?'�?� .�v.�-•• i .,
_._.; i -alt Please check all that apply(submit 2 sets of plans whims checked):
®New Demolitiontnaction ❑Addition/81tei31ioniteplacelneIIt ❑S ceorfeeds400ampsormore ❑Building over three stdries.
. ❑ 0 Other where the available fault current 0 laminas and boatyards.
vl: nf4'j.is F-1d(0lq y=� 1' --tea exceeds 10,000 amps at 150 volts or CI Ploating buildings.
buildingless m ground,or exceeds 14,D00 O Commercial-use agricultural®1-and 2-family dwelling 0 Cotnmercisl/indtistriel 0 Accessory amps for all other installations. buildings.•
❑Mule family ❑Master builder ❑Other. ❑Fre pump. ❑1sWafalion of 150 KVA or
m t" ❑Emergency sys large separately derived
t o s t:,,rte.6.° i� �(a :-c , r _-`.� tem
' Addition anew motor load of
Job#:r `Job site address:, 0 vi 1c.me,N'�1 he.S-- 100HP or more. Cil-A..F",-1-2 -1.3",
0 Six or more residential units. occupancy.
City/State/ZIP:Tigard,OR 97224 ❑Health-oere faoilities. ❑Recreational vehicle parks.
� ❑Hamrdoua locations. ❑Supply voltage for more than
Suite/bldg./apt#: Project name: v{jr��GYY"Oi C,G ��'Yt1A1Cf 0 Service W iheder 600 amps or more. 600 wits nominal.
Cross street/directions to job site: " ." t P `.
Deaiption sty. 1 Each Tots) 1 •..
w-- New residential single-or multi-family dwelling unit.
Subdivision: r
�NWrye` .� ! Lot#:.--1S Includes attached garage 1
(�Lvit/�L.L I,000 sq.R or less V 168.54 4 I
Tax map/parcel#: Ea.add'l 500 sq.ft or portion I cp 3392 1 I
_-- i at,c i y q 1�;id1 ';. a� - �- � A,4 I3 Limited energy,resit 75.00 2
:, residential, ,- _ �
- (with above sq.R)
Limited energy,multi-family 75.00 2
residattiai(with above sq.ft)
Renewable Energy ❑ See Page 2
z :- s- •a t'it - , s}a11:=Ti."' .� -7=7"-'� - =" r Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
Name:ARYL Land Holdings,LLC 201 amps to 400 amps 133.56 2 •
Address:7600E Doubletree Ranch Road -
401 amps to 600 amps 200.34 2
City/State/DP:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 55226 2
Phone:(602)694-4031 + Fax:( ) vTemporary services or feeders installation,alteration,and/or
Email: relocation
1
Owner •
installation:This installation is being made on property that I own 59.36 which is not 200 amps or less 155 36 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 ampst
401 amps to 599 amps 16854 2
Owner signature: Date: Branch circuits-new,alteration,or extension,Der panel
z » 6 1��_-,,t.� S.x ` -- ..- .,._€- cl o7,..2-,,r,"&y �N-aDk --•.,,,,...:-.4.-„,•...,,,,
z - ' A.Fee for branch circuits with i
- - above service or feeder fee, 7.42 2
Business name:William Lyon Homes,Inc. _ each branch circuit .
) B.Fee for branch circuits without '
Contact name: /� Q(� 0 service or feeder fee.first 56.18 2
Address:109 East 13th Street branch circuit
Each add')branch circuit 7.42 2
City/State/ZIP:Vancouver,WA 98660 Each
(service or feeder not included)
Phone:(360)695-7700 I Fax::(360)693-4442 • Each manufactured or modular 6784 2
j dwelling,service and/or feeds
e-. II , 46 Ail Reconnect only 67.84 2
Vic,•1 e: c r) '� a � Pump or irrigation circle 67.84 2
_.. �--'''r,[1":7, ;rs_ �� � 67.84 2
---E.7.•._.--, Sign or outline lighting
Business name:Garner Electric Washington,LLC Signal (s)or lighting
energy 0 See Page 2 2 ,
yrs ,
Address:6101 NE St Johns Rd panel,altuation,or extension
Each additional Inspection over allowable In any of the above
City/State/ZIP:Vancouver WA 98661 Additional inspection(I hr min) 6625/1v
' Fax:( ) Investigation(1 hr min) 90.0W hr
Pbone:(253)320-1657 Industrial plant(I hr min) • 78.18/hr
Email:hdaniels@gweusa.com Inspections for which no fee is 90.00/hr
s tficelh'listed PA hr mm)
CCB Lic.: C1I58 Electrical LiC.: 208117l74 j ]Suprv.Lie:: 4496S zs y3 1=, a -c (e.svt-;F i r`t1 o-j . -k ?'
Suprv.Electrician signature,required:^V L , Subtotal:
Print name: Joan P Albert •- Date: 4126/2016 O Plan Review Required(2594,of permit fee):
State surcharge(12%ofper mit fee): 1
- = -- TOTAL PSRMIf FEE:
.' ' Authorized signature: - This permit application expires If a permit is not obtained within 180
:1 : ` days after It has been accepted as complete
;:r•Va. Date: 4/26/2016
i:;?�•':;:.) Print name: Bill Daniels • Number ofiaspections allowed parps:rink
>tic"1t,::Ilanldir,B.petmee117.C_PaadtApp HCR BREAK Env 061)712015 44046IS(1)ISS/t'OMAVE6
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i
Plumbing Permit Application
Building Fixtures
,,r
Reed Permit No.:
PhCity of Tigard _ .13125 SW Hall Blvd.,Tigard,OR 4743 , = 1 v. pian lleview other Permit No.:
I. Phone: 503.918.2439 Fax 503,19.8.1960 Dale/0 . rye I H See Page 2 for
Inspection Linc 503 639.4175 c� Dee lteadyigy' Ef See Page
2 Information
t! Internet NonSed/Meffiod
Cwww.tiprd-or.gov goo � - a�.3 =�€�.r'a .�=' -._„_;---'=:74-4 .1',..',.'"'. �. � t ,,t,.._!„,,,..;,,,.. .,..._,-,,,I'��3'`�-?.._ -.
t s% y ° l':::-.4074 t c 33 .„..tFor wecull in ormatum use checidist
CI New construction ■Demolition Description I Qty. I Ba. I Total
❑Addidonlaltererionheplecement 0 Other. New 1-2-family dwellings(includes 100 ft.for each utility connection)
r _ � SFR(1)bath 312.70
�' "- -�:e�c _n7c. � .'-tri a`�t}c mill ._13i 5 .=:_ a:.a _ 437.78
SFR(2)bath
❑Commermal industrial 500.32
►•I 1-and 2-family dwelling SFR(3)bath
❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02
O Master builder 0 Other. Fire sprinkler(_ ,_sq.ft.) Page 2
sjiF-14s v i,is e nli rrt tea`4:•Ei (6 `.yi j'psc��uS off`-`rV: Stte utilities
,^� _Catch basin or area drain 18.76
Job site address:
`i, W S Y v C Ft trpQ,v1 t iw.S Drywall,leach Fine or trench drain 18 76
City/StatePZIP:Tigard,OR.97224Fooling drain(no.Iinear ft.: ) Page 2 I
Suite/bldg./apt no.: I Project name12.11& taro* . N W e-At Manufactured home utilities 50.03
.. Manholes 18.76
Cross street/directions to job site: Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_,J Page 2 ,
Storm sewer(no.linear f ) Page 2,
�1 Water service(no.linear ft.:,_._•) Page 2
Subdivision: ! rx"t trt.WSS* I Lotno.: '" Furtureorlamb: 3127
a no.: �pxrr1r N Beef:flowpreventer
Fax snap/parcel - Backwater naive t 12.51
_� 1 t rte'c 1� ?�+t -� '; Clothes washer 25.02
Dishy/ether 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
F` - ,Sa .ti . mon tank 12.51
v . ' cl '`.1 _r _t.n> _ ,r ,C trx ,r.- ..3.1 __y:<,;. I, Fixture/sewer cap 25.02
Natne:ADVL Laud 13o'[diugs,LLC Floor drain/floor sink/hub 25.02
Address:7600 E lDopbletiee Ranch Road
Garbage disperser! 25.02
Hose bib
Cit'/Statc/Z1P:Scottsdale,AZ 85258 25.025.0I
Fax ( ) Ice maker
Phone (602)699-4031 25.02
- .4+? r 3. ,7-7F.1"-----"-6,-`,",e ac .�a�5:1Y - -let teeptor/grease trap
�! ,,..,:.,11,T,:•,1:1022 :�_ Medical gas(value:S ) Page 2
Business-aame:Willlam:Lyon Routes,Inc ppm 12.51
Contact name:
s G�0 le � Roof drain(commercial) Pt 12.51
� (Ij/�/j�
f vh, y_ Sink/basin/lavatory t,.iti t J r 25.02
Address:109 East 13th Street 62 54
Solar traits(potable water)
City/State/VP:Vancouver,WA 98660 �(ytb/shower/showtxpea 1231
Phone {360)054706 I Fax :{360)693=4442. 25.02
Urinal
25.02
B�rail,, - / I . _- J !/a (,, a ►t1 r ,�-.44- .a Water closet 37.52
i� e 11 , ,. c.-- --:-.1.A.......,„..,..4_,,,,,..,,...._ _-r-=s% water beaux
Business mace G.4-3 ki,FJD k ,r- rs, 4 Watex pip'ng/DWV 56.29
Other:
25.02
gddresx; P•a! ,�{;�^^�'''a,�� /� Subtotal
City/State%L1P: 51-, a�^+.1y ext. '7 �� ldinimuta permit fee: 57250
Pltcna:(SAY:''a - 1411 1 Fax'(11 V"'104''1�`� Plan review(25%of permit fee)
CCB Lie.. Q l Plumbing Lie.no.P q State surcharge(12%of permit fere)
�'•' `�� TOTAL PERMI;f LSE
Authorized signalur= ;;� _This pa m{t application aspires(f a permit b riot abt IT F within 1>�days
1- u . +w 1�i I Dam -,38-1 b oafter gy set has been mitt'Baccepted a,complete,
I Print naauo. *5cc methodology set by Tri-County B ding Industry Service Board
lzwesuesn'eurimpusttpennaApp.doe 1No1109 44o.46tsumen1oomrWes)
Plumbing'Permit ApplicatiRECEIVE r, iiiimaimmill111111111111111111
..,.."
Building Fixtures
Cityof Tigard MAY 1 7 2017 R...ived PenrthrNat'. •
N...< •• 1314 SWEall Blvd.,Tigard,OR 97'43 -.. .: •
. a * Phone: 503.718.2439 Fax: 563.59g40... TN OF TPkddieview
IGARD , . Other?emir 14o4 .
a , Inspection Line: 503.639.4175 BUILDING DIVISION Dee ReelYat: brit: 1 I.!et Nip I trr, a
hairnet iiww.tigard-or.gov *Nottfied/metboa:
..'- '-•.:g'•'.'fl•l'ifi.':..-*g•*,.:.14g,7:1; ',i,Af;',..•.;:InVi.a4''.-K•f*:.4---ii11.4i:•••'*- 1'-.0-.( ---A*:';:':;ri'*i%,,M5:41,4
FOr Week,'infornisfion like dieddist.
e Npwocinsiruction . 111 Demolition Deemiteice I CP. I Ba. 1 Total
111 4.ddition/altetatinn/replece1nent El Other:' New 1.2-family divaings(includes 100 ft breach utility connection)
-;:,:;,--.f.*---*-::Ts--,*,*..-•:-...i'',-.:,7'''...7-..::::-',.:*:.1:.`2.!f*•-',' •;:*':::-.-;,•c'.:f.f... lL.!--=:**-.''',: '; -':-;;'''''- 'SFR.(I)*all 312.70
SFR(2)bath 437.78
It'*I,staid.2-family dwelling 1111 Commembalfindirstrial SFR(3)bath 500.32
El A.criestany bnikring 0 Migti-lagnity Each additional 661/kitchen 25.02
El Masiesbufider . 0 Other: . *Fire aminlder ,___sq.it) Page 2
7.,,•.-.-,.,:c..1..7- .,7,,-)F...-....,..,:-.,:.),,, ,,,, ,...;..,,!..,._,„L.,_.,,....,,,;,.,....y13,{e.2,,....1.-,,,,cy.0_,L,,,,,,.1_e 1_,:-_,L1,,!,!,..i...-,,..:,,..."--f,:::-.,:':.,--7,,,,,!`;..P':::.;:. -,-!;:, tate O'Neil:
Comb basin or area do& 18.76
Job site address: P Nhj 11"-
C.Ar‘eiNtil •
lc. ""ir Drywall,leach lint,or wench drain 18.76
City/SO*21P:ligerd,OR 97224 Footing drain no.linear ftL:_____) Page 2
Sui:p*Adgdept.no:: • Pmject name'g i Ve r 7firrafe thetl4Wert Menefactmed home utnitbts , 50.03
Crossstreet/directi ous to job site . .PT..011301es18.76
•
Ran drain connector 18.76
. . . ...•_.. .
, Sanita' ry Seam(no.linear it.:'_____) Page 2
Storm sewer(no:linear it:____,) Page 2
Water service(no.linear ft.: ) Page 2
Subbrisiq 24\ter I _rat . NOrrktkm-f+- 1 Let no1Citem..._,-;
Tait'inqqpretel no.: . . Rackflow preypaw4 31.27
- - - - -• •. - Backwater valve. 1251
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Ar(a 1. 4 . . OWN,1 ate r ffea VY- . . .Dishwasher . 25.02
Prink*fountain 25:02
'Ejectore/SPP 25.02
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Fixture/sewer cap
*Nana'ADVL Lend lialdiuge,LLC Floor drithinloor sink/hub 25.02
Address:7600 E Dpoutrie Expo Road Garbage disposal. 25.02
City/Siam/70:Scottsdale,AZ 85258 Hose bib 25.02
-• •' -
*De:(04)04401. Fax:( )
Ice maker, 12.51
7; ': ...7.-:;:1•,!:= - Z.,,, •POree09FigrOe 11-aP 25%04
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144*gas(value S.._) Page 2
:Business name:William Lyon Homes,Inc PO4er 1251
Coi4004,04Me: Nil c,IA(1 tellrItyrpe,
ot411114(Commercial) 12.51
•
Address:too East 13th Street Siektbadin/bivatory 25.02
Citi).-/Stere/22i1):*Vancouver,*A 98660 Soler units(potable won) 62.54
Phone:(360)695-7700 Fax :(360)693-4442 Thblebower/slower pan 12.51
Urinal 25.02
E-mail: AA . . iti4L. file.
- - . ''- ----------------------/ i 1(4, OnleS• , ----..-- Wald clout 25.02
, ., . - . - . ,.....,e37.52
Water licatcr
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.Business midi**
-' . • .3 - tti. . Ci vrstwir-7414_ *rater PiPinFAYWV 56.29
Address:: P.6!, 1.,,tx O _Other: ' 25.02
;Oi4y/Siale/PP:
T. e44411 131t, q1131,
Acinel(3.63.-•Sist-' I'-U1 I
Fax vtif-.191-f - Methuen permit fee; S72.50
Plan review.(25%of perrait fee)
Ca.Lie.: 18131a._ .. Plum*rtic.rati.ft ..63t1 State surcharge(12%prifenzth fee)
K•1111/Olimed
I.-. . signture: 0r4)1Ct0t4.A- )4 *•
S0I - m. ' - it- • 'TOTAL
nrg.Oar4r FEE
I ' '- I1Thep .°P& °4etbtind th
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Print AftiI Da0 ' ke0== tl16il
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earieldiaeieciiisinAiu.ateaitAppnoo Mum 44a.4.516r(tatobtoNITSV60)
City of Tigard
IIICOMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: M STA0/7— (F_
Site Address: 17LISC s c- VA- 5C
Project Name: V,NR:( .may- c c )J C.0 Lot #: 75
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review 9//1//7 /2. 't iS /o ALS
Proposal: neo S F 2 St i" ,44-"/ c)/E-z-2 V -774,Ais
dVerify site address/suite# exists and active in permityrstem.
ErRiver Terrace Neighborhood: ❑ No lid Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
I
free(3)copies of site plan 1';', xisting structures on site
VSite plan must be on 8-1/2"x 11"or 11 x 17"paper C Footprint of new structure(including decks)with finished
L Drawn to scale(standard architect or engineer scale) fl or elevations
Rf>orth arrow tility locations&easements(required for new and additions)
In Site address,project or subdivision name and lot number Sidewalk/driveway approach
pplicant information(name and phone number) PP,ocation of wells/septic systems
NIA of dimensions and building setback dimensions xisting trees to be retained with drip line,and tree
'1!'.uare footage of buildings to be demolished protection measures
J Lot area,building coverage area,percentage of coverage and treet 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 attorm water quality facility required if>1,000 sf of
4 foot differential) impervious area is created or replaced. _
1Z Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified la No Received: ❑ Yes E No
ii Public Facilities Improvement(PFI) Permit:' t5-,a0k12
Required: ❑ Yes,applicant was notified ❑ No Applied For: ?f Yes ❑ No,stop intake
V Land Use Case#: p 1D1-1 c 5 —COCCI)
d,/Zoning: 7 «)
LJ Required Setbacks: Front Rear 4, 10 Side 4.i Street Side gg f3 Garage 7O
,, /�Landscape Requirement: 20 %
LI Lot Coverage Maximum: 00 % ii uu
Building Height: Maximum Height '<do N/A-
Actual Actual Height
7Visual Clearance ��
V ensitive Lands: I Yes ❑ No Type 1-04)C.:{ "M\ e kieAj, k
iv Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: 110Cill ,/
- Date: 5/22/ 7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: , Approved ElNot Approved 11 1J'" `. 1"\"--1.-, q1 Fl 11 1
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_051617.docx
Building Permit Submittal
Original Submittal Date: f•Zlj'C�j//7
Site Plans: #
Building Plans: # _1
Building Permit#: VEnter building permit#above.
Workflow Routing: Planning Engineering M Permit Coordinator — Building
Workflow Sign-off: P Sign-off for Planning(include notes from planning review)
Route Application Documents: rEf 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: j
By Permit Technician: / /" 4:4'
Date: 7._7,Z
Engineering Review
--� a51ope at building pad: al.
' �1'Conditions "Met"prior to issuance of building permit ,r:r- 7 ,.°' .,.,-'"
❑ Easements (encroachments) per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: E Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes E No ,
.01 NOT Approved by F ngineeri g: 74/ f/ Date: ; Z,r �'
Notes °c-K-6. _.,-- i Z ,---/ e /( 7`:1 -7- g _'�1,4--z 2,'').4:--%- ''
__:,--
-----
Approved
Approved by Engineering: Date:
Revisions (after uilding Submittal only) Review r Date
Revision 1: pproved ❑ Not Approved L,1) 9--J - f
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
s
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit pp /
> Approved,NOT Released: .eh vcc-S74 Date: $�7�5-/ ------
Notes: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:
7
SDC Fees Entered: Wash Co Trans Dev Tax: NAP es CI N/A
Tigard Trans SDC: %' Yes ❑ N/A
Parks SDC: r Yes ❑ N/A
LIDA ❑ Yes N/A
/1(44:114//q---
K to Issue Permit
Approved by Permit Coordinator: ///e7-Da-te: "T 47---
I:\Building\Forms\BldgPermitRvw_RES_051617.docx
City of Tigard
I " COMMUNITY DEVELOPMENT DEPARTMENT
r 1 c A lz o River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: 11'150 SW CE-614EWTTRL
Project Name: Rive '1 ce, Lot #: '7S
(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? ❑ 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.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 ft. deep Gabled dormer
f ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: le • �c
3. Entrances:At least one entrance must meet both of the follog standards:
1"_!#_(Max. 8 ft. setback from longest street- facingwall
[ "Parallel to street,angle no more than 45° from street,
�g or open onto porch
IJ
Entrance opens to a porch: Yes ❑ No �/
If yes, all the following apply: [125 sq.ft.min.
EiOne street facing entry 2"12 ft.max. roof above floor of porch
[,7l5 ft. depth min. V0%min.porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of ie following elements on all street-facing facades:
[ overed porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft. deep
,,/Wall offset min. 16 inches ❑ ormer min.4 ft.wide
L�Roof eave min. 12 inch projection LJ Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood ,,__,,//Gable,hip or gambrel roof design
CI Roof pitch oriented south min. 500 sq. ft. �G orizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40%of street facade ir Window trim min. 2 1/2"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. L 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 2440%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: Date: _612247_
I:\Building\Fomes\BldgPermitRvw_RES_RT_062216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17450 SW CLEMENTINE ST, BEAVERTON, March 21 , 2018 at
OR, 97007 10:21 :49 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00183
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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17450 SW CLEMENTINE ST, BEAVERTON, March 21 , 2018 at
OR, 97007 10:14:21 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00183
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed. Water pressure = 70 psi
Violation Summary:
Inspector Contractor