Permit (93) CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2017-00194
-F[G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/05/2017
Parcel: 2S 106D B03000
Jurisdiction: Tigard
Site address: 13390 SW AUBERGINE TER
Subdivision: RIVER TERRACE NORTHWEST Lot: 30
Project: River Terrace Northwest, Lot 30
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 978 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1251 sf Garage: 380 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right 3 Detectors: Yes
Total: 2229 sf Value: $271,047.13 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 Rain Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 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
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: 4 201-400 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 2229
Owner: Contractor:
ADLV LAND HOLDINGS LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY FORSUM,MICHAEL 703 BROADWAY STREET,SUITE 510 1 Fire Rated Eave
7600 E DOUBLETREE RANCH RD VANCOUVER,WA 98660 2 Ersn Cntrl 503-639-4175
STE 1
SCOTTSDALE,AZ 85258
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $32,134.44
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 OA 52-001-0090. 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: 7C�C,� Permittee Signature: 5, - 6E_,L GG"�/LGL,
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
. / 30
lmE1=1=10101
City of Tigard RECEIVE D re 51.2 `1/p / Permit No//451 /?-00///
13125 SW Hall BlvdTigard,OR 97223 2017 Plan Review
s Phone: 5.03.7182439 Fax: 503.598.1960 MAR 2 8 6.1 • ' Other Permit:<94
Date/By:
t I( a I`i> Inspection Line: 503.639.4175 Date Ready/By: JunH s: See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notifed/Method: /Q/�7 Supplemental Information
BUILDING DIVISION .0 d,L A// 6—
'1E)
w w �
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
13 Addition/alteration/replacement ❑Other. Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
® 1-and 2-family dwelling ❑CornmerciaUmdustrial Valuation:all 0( 167578406., �)
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other. Number of bathrooms:
, > Total number of floors: agog
Job site address: ! el t l SVtJ T J IJLI. tar9i T-eXY .— New dwelling area:721.:RISI square feet
Ict City/State/ZIP: Garage/carport area: 360 square feet
e0 Suite/bldg./apt.no.: Project name:River Terrace Northwest Covered porch area:`14L4plisquare feet j aas--•
Cross street/directions to job site: Deck area: square feet q 7 S
Other structure area: square feet
Subdivision:River Terrace Northwest Lot no.:9)0 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
=p�� �' ��� ` ` work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
Y°'" , 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:
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Nichole Thorpe
FLSplan review fee(if applicable):
Address:109 East 13th Street pp )'
City/State/Z1P:Vancouver WA 98660
Total fees due upon application:
Phone:(360)695-7700 1 Fax::( ) Amount received:
E-mail:Nichole.Thorpe@polygonhomes.com ee , ti
j � y � Commercial and residential prescriptive installation of
o � � "- • t ,, `� ga �s roof-top mounted Photovoltaic Solar Panel System.
Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 109 East 13th Street 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.:207247
Total fee due upon application: $201.60
Authorized s'gnature!/ /, , This permit application expires if a permit is not obtained
/// within 180 days after it his been accepted as complete.
Print name:Nichole Thorpe Date:3/14/2017 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit ApplicatiollECEIVE • 1 (11,1 ,,1 ii,. I i ,,, (0,1 \
City of Tigard
13125 SW Hall Blvd.,Tigard,OR 97223
gi MAR 28 2017 N
Phone: 503310.2439 Fax: 5033981960 D.9
y,
Inspection Line: 503.639,4175 CITY OF TIGARD
Internet www.tig.ard-or.gov an krises.
Date BUILDING DIVISION
DIVISION
ThHeRc'ca,TavedyPmnit':'W,57--A00—CrY,f
ad.ftnnii
PO'. la See Page 2 for
Sapplantatal-Information
, , , „, ,, .. •
'''1-1T.e''->-•-•',"'"4"It:',i;"it--", . ,'":.A24:41,4111#0:.-5;:ri`:::';'$;7:.ifr'7 i,-:';',,,ie-:i.,,I;:,,,-,.„,A,,,,A,;,,,-4m:"44,,'-:;;;ide:;.:;;`,4
4.'.;i6t01‘..4.66.,A,47',F4, 2451.2714i4Z,43240;4,•:&.:4664, 0444,mii.la4c4i,u,x,',.. .,-a°- --...-4.4 ,--,., 0.. mechanical permit fees.are based on the value of the work
121 New construction 0 Addition/alteration/replacement , performed.indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanirn1 materials.equipment,labor.es ahead,and profit.
value-,$
Ii' L qT.S,::-.1.4t'4igl.'° ' ''.,4.t'4 4**_": l'.,..,*"..---‘4:1-1."1'44.—:-.116":..i,----,r2-44.:Y- '''''''''67'.,:;:..7-''':VA'''.:t'''';.:1.:tr',,:4 iii,''' $,l''''.4.'.4.,'''''4--s4„1.4-'''=":,`,',f4k', .".."',.,v,',A.',',j`'•
-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For apotdat&formation use chetifist.
P Aulti-family 0 Master builder 0 Other: Description I Oty, I Ea. Total
,- ,,.„„.., • - -.1- st+-,-;-+*, **-.-,.**-- ..‘- ,,,,-,,,.--,,,,,, • ,„e-*,:v, t-s' *,'4,!'„.-",'-.44..'.;--''',,...14. 4s;=';'''.,ft4i,*e iltittiallt°C4ilikt:
,.,', t-Z10:014.24illiitii, -;;;C:4itatii[114 .044:14:1414:44'.444$•46.4iant44WikkiaC•106;tY-* Air.emditie„ino I 46,75
A
Job site address:/ 9D s 19e4(91(le.. I elefiCALc_. Furnace 100.000 BTU Own/vents) 1 46,75
City/StateIZIP:Tigard,OR 97224 Furnace 100.000+BTU iductitiverust 54.91
Heat pump 61,06
Suite/bldg./apt,no.: I Project°tette 2fer1-f,Difacie iQi_‘iftkAkmest Duct work 23.32
Cross street/directions to job site: Hydronic hot neater system 23.32
Residential boiler(radiator or
hydronic) , 2132
Unit heaters(fuel-type.not electric),
in-wall,in-duct,suspended.etc. 46.75
Flue/vent for any of above 1 23.32
Other 2332
Subdtvist°°:P-X\itrreTrac4. Nal iArlkPt. --t- Lot no.(34C) ,
Other fuel appliances;
Tax map/parcel no.: _Water heater 23.32
;„•+.+, .1,1-;:on‘c74,4.4.-- -.-71).:,e,,,,4 t:,,,,,,,,, :Z.w,';tial.:Z2ifti4.441 :,:1,45;i:43ttVi Gas fireplaceijowt 33.39
ati?...1-1:4:!:•:,i.'4:1>,'r;,-,Kttki'54:,,,IT,„:-., ,,xt;twe%;',-,LtaiIte,t,ltItem-Ii4S-tX:.Taif...1,tx.xlta*»,4*, Vitixerstr1 Fi.reel for water heater or ga$
fireplace 23,32
Log lighter(gas) 23.32
' I . Wood/pellet stove 33.39
Wood Fireplace/insert 23.32
Chironevlineriflueivern 23.32
Other
Environmen2332
. ...**+*,.."*U.,:-,t&xel:t1.1..7,4Wras:;'.1.7.,-;,4"..a ...,;,''"'...., '40''.,, ',*....,...4.:, •.':;:0:" ,,,,,,I;t4lio, .,-,,,.-, -.ftheMa,:i4/0„, bi ttbaust and ventilatiGE,
Name:Polygon NV1,11,LLC Range hood/other kitchen
equiffnem 33 39
Address: 109 East 13I4 Street Clothes diver exhaust I 33.39
CiirStateiZIP:Vancouver,WA 98660 Single-duct exhaust(bathmorris,
toilet compartments.,utility rooms) Lt 23.32
Phone:(360)695-7700 Fax:( ) Attickrawlspacc farts 23.32
Oilier,
.7 k:i..+*-,-44/,,,,,,V,;:...J4."ts'-,-.0,,,-,,id,,...;v-,,:.i-0.0•::,..,- -,;-,I,':--4ti-:;:.-,--:.:re.4.,".".,,c".7.,.: t,,,• ofi',4es ''''""'^- 23.32
Fuel Piping:.
Business name:Polygon Wt,H,LW S14.15 for first four;$4.03 for each additional
•
Contact name: WI cif)0 e,7\novve_ , Furnace.etc. I
Address:109 East 13th Street Gas heat pump
Wall/suspended/unit heater
City/StaterLIP:Vaneouver,WA 98660 Wmer heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace 1 ,,
Range t
E-mail:A 4 , . id ji, a! ,4,1110 le A
Barbecue
'4'''''''' ' 'W•Mtri4W.,'t ,0'4' • -4K: 02
rif„4,34y7y,t74,„§„:.,(711-K67,,n1.47..$:04.,;„..,,,:4,...,14',,,ryr*,.:t;.^7,1),,.4&0•546,•,,, •,,,,A.--4-4., ,..<4, 11,,,-,„:-..-,4:::-.,--4. 1..,0A14646 un'et 4 gas,
Eik-41X1'ta?.4:=A-1...z,,,;°,2.61?ff'..itft-s',4qa:114:4..-zutzi4",V,.. .-.114-2V,Alltifiamig-,—Zikt.,,,,..nr;.,,t A•«..4,:-::*.Zz ,
Business name:Apea Air LLC , Other
-,.;•t!,•:',;;I:=1.!;;;;;;'.,*$:'' ';'1:,:''‘',::'t,',.ri:1,41'et.:-... "t71 is'to„:70.:..?i,.t.,"24.i*',StIttwt't
Address:18004 NE 72-Ave Subtotal
CityiStateiZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee) 1
1
CCB lie.:203034 0a//
. .„. TOTAL PERMIT FEE J
Ibis permit implication expires ifs permit is not obtained within LIM
, days after it him been ateepteil as complete
., . ,
Authorized signature; . fee methmisdoo set by To-County Budding Industry Semite Board
Print name: I^ Nt , Date: 4-il-ft...
I,Bas141144tntAtOrIEC_PaYstaApp 04#3113(lac 440-46 tn.(I VOliCt:)M1W113)
* Electrical Permit Application RECEIVES FOR OFFICE USE ONLY
City of Tigard Received
MAR 2 8 2017 Datc/13 : IZZLIWINEFEMAn.
'I 13125 SW Hall Blvd.,Tigard,OR 97223
5111 Plan Review
"' Phone: 5017182439 Fax: 501598.1960Related Permit II:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD DathiB .
Ready Date/By: kris: El See Page 2 for
Internet www.tigard-or.gov BUILDING DIVISIO Noti6ed/Method: Supplemental Information
:"-:371.7.-4;tie-, :-•&,-;04,g-:Wia,.,„.4. 7,7 :157-'2;r64;i.l.':01.7: -..,„;: tI,S.: : -.P AtErAntratigl 10,A l'''''. -ZIWVYAMitnte,
El New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/iterns checked):
0 Service or feeder 400 amps or more 0 Building over three striries.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
t.:,-,-,511:W.:::'-'7'.-- -4:.;:5:_--4"',--,' -1CgaYtr .WigiO.W':".11•ff g.Fri-R..':;•_;-W4-- ..,:-17: :-:-,:j exceeds 10,000 amps at 150 volts or 0 Floating buildings.
El 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less toground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family -.• 0 Master builder 0 Other 0Fire pump. 0 Installation of 150 KVA or
;g4731-faaPtit4MSAPINOMPligriglOANO.7.04170.8.'410.regnigtk o EmergencY sYstem' larger separately derived
Job#: I Job site address:%913
0&Al MA, n Addition of new motor load of
100I4P or more. sYstem
0Six or more residential units. occupancy.
City/State/Z1P:Tigard,OR 97224
['Health-care facilities. 0 Recreational vehicle parks.
n,
Suite/bldg./apt.#: Project name:pve r Te,nract, NI omewjes+ 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: mumnimikceltttMr.4-•21:1*
Description I Qty. I Each I Total 1 .
New residential single-or multi-family dwelling unit.
Subdivision ibt\kAr Twace. Nix t‘ew je 4.4_ 1 Lot#: '0 Includes attached garage.
1.000 sq.ft.or less .. 168.54 4
Tax map/parcel#:
Ea.add'1500 sq.ft.or portion 33.92 1
NEMS": Limited energy,residential
75.00 ')
(with above sq.ft.)
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
_,...... Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2
Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 2
Phone:(602)694-4031 . " I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
•
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 i
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
r-----v----.- -•, -,,z1,,,,s-,5-1,.i.moirrzz,twa-ecio.4-0,3,4, 2;I:ff=pr a----7,--,.-4744-wogwkt.:,.aitg: Branch circuits-new,alteration,or extension,per panel
_•'.,-,-,2-..',.,,,-.-:,-.;.-..---,,''..s---7,1.”--vt-,r1- -,•c'''t.-+.-,,, t--,-1--al-,-,,-i-----?''---'-','-' ,-----'-'------ --------414- - """'''''. A.Fee for branch circurts with
Business name:William Lyon Homes,Inc. above service or feeder fee,
7.42 2
each branch circuit
Contact nameN i cAn 0 It Thole., B.Fee for branch circuits without
service or feeder fee,fast
Address:109 East 13th Street branch circuit 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each add'l 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 2
dwelling,service andfor feeder
EMI NI ich01-e -11(1 it, e -Du , • haws.,c,Onn Reconnect only 67.84 2
4ckif-4J';-4-;:,
Pump or irrigation circle 67.84 2
_
Business name:Garner Electric Washington,LLC • Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy S„Page 2 2
Address:6101 NE St Johns Rd panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:Vancouver WA 98661 Additional inspection(1 hr min) 66.25/hr
Phone:(253)320-1657 . Fax:( ) Investigation(I hr min) 90.00/hr
Industrial plant(I hr min) ' 78.18/hr
Email:bdaniels@gweusa.cotn Inspections for which no fee is
90.00/hr
CCB Lic.: C1158 Electrical Lic.: 208174 I Suprv.Lic:: 4496Sspecifically listed(%hr min)
MitiMg40,:;. i: i Of•-02-: 1 7SW,',., -..-,7747.412
Suprv.Electrician signature,required: ' '"mic A . . Subtotal:
_
Print name: Joan P Albert • Date: 4/26/2016 0 Plan Review Required(25%of permit fee):
----- -- .. -- —__ State surcharge(12%of permit fee):
Authorized signature: r. ---.___----'----------'--:— • TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Bill Daniels Date: 4/26/2016 days after it has been accepted as complete.
* Number of inspections allowed per permit
IABuilding‘Permits\ELC PermitApp ELR ERE.doc Rev 06/17/2015 440-4615711/05/COMMEB
::: :
•
Plumbing Permit Applicatio ECEIVE
D
Building Fixtures ± 011 OI1 1( I I �l (,\l.1
City of Tigard MAR 2 8 2017 n Received Permit No.:/Lj TAop,-�t9i/
14 • 13125 SW Hall Blvd.,Tigard,OR 97223 Y -4 5
Phone: 503.718.2439 Fax: 503.598.1 TPlan Re
Y OF TIGARD DatelBy:view --other Permit No.:
I , , r n Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: runs: ® See Page 2 for
Internet: www.tigard-or.gov Notifted/Metbod: Supplemental Information
TYI'E OF•WORIF - T itL>g.
®New construction - fl Demolition For special information ase checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other
New 1-2-family dwellings(includes 100 ft,for each utility connection)
CATEGORY OF CONSTRUCTION" SFR(1)bath 312.70
0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler(-sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:1310 SW /91/bei-9)01Zp . J.e�/^M Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldgiapt.no.: Project name:RUQ/I/[ f CQ. N�wat Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear IL: ) Page 2
Storm sewer(no.linear ft: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:RA 4ij/ Itipaltct NI O f J ---- Lot no.:--3O Fixture or item:
Tax map/parcel no.: v Backflow preventer I, 31.27
DESCRIPTION OF.WORK Backwater valve 12.51
• Clothes washer 25.02
�___ Dishwasher 25.02
Drinking fountain -- 25.02
Ejectors/sunup 25.02
®.:PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:ADVL Laud Holdings,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:7600 E Doubletree Ranch Road
Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02
Phone:(602)694-4031 I Fax:( ) Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2
'` Primer 12.51
Contact name: c Vuk 11/14 t, Roof drain(commercial) I2.51
Address:109 East 13th Street Sink/basin/lavatory 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
E-mail: `,,I,, Urinal 25.02
N IU ch ole . I FW e q,pti,440Aymmts.c ()iy, Water closet 25.02
CONTR1CTORI
Water heater 37.52
Business name:Malmedal Enterprises Inc Water piping/DWV 56,29,
Address:PO Box 207 Other 25.02
City/State/ZIP:Banks,OR 97106 Subtotal
Phone:(503)324-0759 Fax:(503-)324-0580 Minimum permit fee: $72.50
CCB Lic.:102535 Plumbing Lic.no.:34-276PB Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Carolina Malmedal Date:04/25/2016 This permit application-expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Pee methodology set by Tri-County Building Industry Service Board.
I:1Building1Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
.111 ■ COMMUNITY DEVELOPMENT DEPARTMENT
II
T I G n K D Building Permit Review — Residential
Building Permit #: M 57-7 0/7— 0Jd/711
Site Address: ('YtC) "AZ MAE E-TLC 1 L 1 E 1Z
Project Name:
`(Z'`v-ir ��nYctc_gi )i`Lk) Lot #: '2,G
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: nelZ 5\
si Verify site address/suite# exists and active in permit,�system.
River Terrace Neighborhood: ❑ No 4y Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
ree(3)copies of siteplan
MiteP i� sting structures on site
L> ite plan must be on 8-1/2"x 11"or 11 x 17"paper F ootprint of new structure(including decks)with finished
[rawn to scale(standard architect or engineer scale) floor elevations
[1--//forth arrow [�/6tility locations&easements (required for new and additions)
Ritite address,project or subdivision name and lot number L�7Sidewalk/driveway approach
'Applicant information(name and phone number) Air` ocation of wells/septic systems
[ Lot dimensions and building setback dimensions 1'TA xisting trees to be retained with drip line,and tree
VIt§quare footage of buildings to be demolished protection measures
UlLof area,building coverage area,percentage of coverage and Bl S)reet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) Mtreet names
[Property corner elevations(2 foot contour lines if more than 44Storm water quality facility required if>1,000 sf of
4 foot differential) impervious area is created or replaced.
14 Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit:i) )S.00 I )2_,
Required: ❑ Yes,applicant was notified ❑ No Applied For: Eckes ❑ No,stop intake
["Land Use Case#: ?Dv...2.Cj 5 - C Oc2O C)
Zoning: j- \ 7- (?
'Required Setbacks: Front 17 Rear IC) Side " Street Side 8 Garage Z0
I Landscape Requirement: -az %
Lot Coverage Maximum:
t uilding Height: Maximum Height Actual Height
''11 Visual Clearance
N Sensitive Lands: ❑ Yes ❑ No Type
Urban Forestry Plan
oCti Conditions "Met"prior to issuance of building permit
Notes: ri<i*K-cc`KC11Cfv 5 ‘' - V 1pi1Z i `-oct, ce-e- 5-4-:1 1 Q 45 t1 11"
Approved By Planning: ". , , ' 41 %t 7
Date :`1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES 051617.docx
Building Permit Submittal
Original Submittal Date: 3�,1 7/7 •
Site Plans: #
Building Plans: # 7
Building Permit#: ;ii'Enter building permit#above.
Workflow Routing: Planning 0.9-11 Engineeringermit Coordinator 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.
"Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: /
By Permit Technician: Date: 1
Engineering Review
5 Slope at building pad: 4MP japf
400 onditions "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: k--ai7 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
pproved,NOT Released: Date: S 3eA q
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:
ylir SDC Fees Entered: Wash Co Trans Dev Tax: 7 es ❑ N/A
Tigard Trans SDC: 'i Yes ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes ,eq/A
VA OK to Issue Permit
Approved by Permit Coordinator: Date: elfrd' i
I:\Building\Fonns\B1dgPermitRvw_RES_051617.docx
City of Tigard
W COMMUNITY DEVELOPMENT DEPARTMENT
1011 ■
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: I-33q ) $ aUc), 22
Project Name: 'RN-M.' `` sfl pz MI,) Lot #: '770
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Dist 'ct Design Standards (18.660.070.1.):
Is the project subject to the plan district design standards? [Yes El 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 deep Balcony w/ access 2 Window Projection Vertical Wall Offset a
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide Gabled dormer
El El ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: ,-2.°/0
3. Entrances:At least one entrance must meet both of the following standards:
3/Max. 8 ft. setback from longest street- facing wall
WE'Parallel Arallel to street,angle no more than 45° from street,
���-,(' or open onto porch
Entrance opens to a porch:cZ Yes ❑ No ��
If yes,all the following apply: L2"25 sq.ft. min.
2r9ne street facing entry I2 ft.max.roof above floor of porch
lam'5 ft. depth min. '30%min. orch roof coverage
p
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
®/Covered porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft. deep
gr//Wall offset min. 16 inches El Dormer min.4 ft.wide
[ "Roof eave min. 12 inch projection 1134Zoof offset min. of 2 ft.
❑ Roof shingles either tile or wood C /Gable,hip or gambrel roof design
El Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40%of street facade Lam'Window trim min. 2 1/2"wide by 5/8"deep
El 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 jz No. If No (Check one):
CP/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)
,❑�12-foot-wide garage door El 40%max. of street facade
Ef 50%max. of street façade with 7 detailed design elements VG/0
Notes:
Approved By Planning: 7���, %t ( J9'-/f Date: 5/2771(7
I:\Building\Forms\BldgPermitRvw_RES_RT_062216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13390 SW AUBERGINE TER, SHERWOOD, February 28, 2018 at
OR, 97140 12:46:53 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00194
Inspection Type: Inspector:
199 Electrical final Chip Barnett
Result:
PASS
Comments:
No A/C installed at this time
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13390 SW AUBERGINE TER, SHERWOOD, March 5, 2018 at 4:29:09 PM
OR, 97140
Record Type: Record ID:
Residential - Master Permit MST2017-00194
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Interior stairs exceed allowed variance per code with no finished floor installed.
Provide slope away from structure 6" in 10' or approved drainage swale at gravel walk off
rear porch to code. R401 .6 ( both sides of rear porch.
Fix loose handrail at top of stairs.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13390 SW AUBERGINE TER, SHERWOOD, March 22, 2018 at
OR, 97140 11 :01 :35 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00194
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - CofO
Comments:
Corrections completed.
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