Permit CITY OF TIGARD MASTER PERMIT
> ' COMMUNITY DEVELOPMENT Permit#: MST2017-00380
T E ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/31/2017
Parcel: 2S106AD09900
Jurisdiction: Tigard
Site address: 16818 SW LEMONGRASS LN
Subdivision: RIVER TERRACE EAST Lot: 206
Project: River Terrace East, Lot 206
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 809 of Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 1858 sf Value: $230,949.73 Rear: 3
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
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
asin Y
Other: N Other Description: Ecom P 9
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 1858
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 Fire Rated Eaves-Both
STE 1 Sides
SCOTTSDALE,AZ 85258
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $31,271.90
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: /d t_ �/ Permittee Signature: 6cr4_ -/ 4 ea ii 0i4
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 7 / 0
VII ..ii F y' #E I FOR OFFICE 1 SF.O"LI
City of Tigard R&Ze '
13125 S W Hall Blvd.,Tigard,OR 97223 147 7 Permit No �/ ` 7S 91j �; i - J I! Pw // / % /�7iQ d// -(v3,40
Phone: 503.7182439 Fax: 503.598.1960 J
't< ;,,R i? Inspection Line. 503.639.4175 Date/BY: J0-1-1 C• i-7 Other Permit: ee /7-003/6
AR® Date Ready/By. Juns: H See Page 2 for
Internet: www.tigard-or.gov Notifed/Method:�6/-57/7 Supplemental Information
B L�„„u �tvis1on
N New construction 0 Demolition Permit fees*are based on the value of the work performed.
0 Addition/alteration/replacement Other: equipment,
the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
,, - -'1.-7,3 � ' � 7. ” work indica on this application.
® 1-and 2-family dwelling 0 Commercialfmdustrial Valuation. t 3 1 Q 7
J 9 f, i
0 Accessory building 0 Multi-family Number of bedrooms: (—tdl
❑Master builder 0 Other. Number of bathrooms: 3
.R °,:-jf: Total number of floors. z.aiy
Job site address: iJ t . � ,Y„ yASS Lane.,
New dwelling area: j fssil square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 4,4 51 square feet
Suite/bldgJapt.no.: Project name: g Vt r Ten-ace, CE'.,1 Covered porch area:$0 ✓ square feet 1 t7 l q
Cross street/directions to job site: �7 1
` v.x._ square feet SO 9
Other structure area: square feet
Subdivision Riv{,r Terrace,E is — Lot no.: /11/ 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
ax �� r � equipment,materials,labor,overhead,and the profit for the
,, work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
•ti _ .. �. ... C X , , TeTNumber of stories:
Name:ADVL Land Holdings,LLC Type of construction:
Address:7600 E Doubletree Ranch Road
Occupancy p y groups:
City/State/ZIP:Scottsdale,AZ 85258
Existing:
Phone:(602)694-4031 Fax:( )
� New:
�,� :�-.�, a � fiTi7 P ,:-. a77. 3
Business name:Polygon WLH,LLC .
Contact name: alk0 I r, Structural plan review fee(or deposit):
Address:109 East 13th Street t r, FLS plan review fee(if applicable):
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(360)695-7700 I Fax::( ) Amount received:
E marl
a � �� � Commercial and residential prescriptive installation of
'' roof-top mounted Photovoltaic 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
and administrative fees): $180.00
Phone:(360)695-7700 Fax:(360)693-4442
State surcharge(12%of permit fee): $21.60
CCB lie.:207247
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: JI ch ak
444, Date:��7 /� *Fee methodology set by Tri-County Building Industry
/�' �Tr 1 Service Board.
I:\Building\Permits\BUP-RESPermit&pp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
_.. . .- __• .. _ ....._,,
Mechapieal.reitiit ADDIkiittoii:'—'' ' ' ' '' FOlt OFFICE I SE ONE 1
•
114 bitY.oftigard N 0 'n i'7 • .;cciV..
Thuedlly: Pam#14417j2-320.1 2--0e), () .' '
--' ' *PPS aN Milt RIY4-,TigarkOR 9/2,7ij C,,T
Phan= $03,718.2439'Fast 503.59S.1960 . , , Dategiv:-
•
TI G A r u •InVel.466n1-111e:•lq,1.639:1!75 r'7'-----i ..::.s-.' -,. : :• ' , tuteR;i4ymy: . .
.1...,„. Et See eve 2 far.
Internet:•Wwii.tigtircl-orviv - - .; ,_ .,.,•,-- -•• •''-',.i Notified/Method;' Stippleinesiat intuiviition'
. .
.:,:,.Z.,:::f.::4400•1450lia.'.701:43.*:•044k1.04.Hi&SISOVIMftn* •".';::'5".**14W"-'1;:fr *4';71W4:**°:**:77:
• ,...,„ Mr:chanted permit fees*are based on the value of the work
I,4/slew etnistraction U AdditionialtetationirepinCentent performed,Indicate the value(rounded le'the nearest dollar)of an
0 ciegiolidov. [7.1 atilq: Mechanical materials.equipment.labor.overhead.and ruonl-
Value:$
•-••••is
1:,.,:.;•:: 4"1
.*aiiii#,,m_.-z.tre... ,...4•;gi,.z.",..4",,;-,,ii-b- 46', lik.„•2;,i,z22. ;-..&•;•::-ks.;,..!..t.:••, ,,,a,,.1,-.4
[,-,• ..---f-!..• - r',,,. '-• "•: ;"54A44
Y----.•‘2-'-'•tt ''''''''.."
71 1-and 24th4 diroliiiig. 0 ConatterciatiinduStrial. 0 Accessory bantling "For spade/krfornurti on use check fist.
Muiti-tilOy. El MagtP"b9110 er• 0 t4let:' - Deming* Oty. I EL • Total.
411,..41k.00441-47.010)C-001.**.A).*014.M4VP;I:"I.Y;45.-V.•`, "411dielmianAt - )
Ak Conditioning 46.7$
10 s4•addrPss; .1B/ti Sky) 1-tfivyNyass l_tx,me Furnace 100.000 13113(dueisk:erito 1 46.7.$. .
OYISlidea/P:linard„*OR 01224' Putaiici 100,000+BIO Edam/vernal $4.91. '
-
Meat pump 61.06
-Sitittibldgiapt.in. ': Plik*f iitlini:Pi Ver TE-rrn te— Eel + bueionrh _... ... ...
21.32
Cross street/directions tom,site lydreitio hot water mann 23.32
- . Residential boiler(radiator or
Itvdronic) . 23.32
Veit heaters(fuel-type,not electrie).
. . . . . .
ln-Wall in-duct.saga:tided.eic: 46.75
•
• Flaiivent.for*of*above. 1 23.32 . .
• •
--- • - - • Other . . 2332.
Subdivision: 1 ki•A , A A, .. _• Lot no:: • #
Other Mei anutiaiteis;
Tax rnapipareel no.:.
' Water heater .. _- • _ I 23.32
4:enki.4'S'Og..44.V):'ilIA:'% *.if.41.04*-AY.fOi.4aNi-sag.4,40:t-4-. W. i • 085 nrerlfaqilinsed 1 33)9
Flue vent for water heater or gas
ms-run - 6D30 AMA= . 7332
Log Etidder(104) 23.32
• Woodipetict stove 33.39 •
. . .
Wood fireadaeolasert 23.32
Chhnuevitinerfhtetvens .. 2332 •
23.32
frit..,.''..5!;r,f 1:Piiisliitif,-;j4,4 a
••'-a•-'':A. lter
Environment:id exhaust mod ventilatiere
Nathe: V L.-174.ekd-thAclinq 5 LIL : Row Wild/Aar khoite4.
i • " etadorneal I 33..19
Addre13:'711(100.. 6 DDLuilte.-0,_. gam c.14 jZADA.c1 Clothes diver exhaust t .33.39
C /State/Z1P:
• - II #da k,__Ii AL, 7__% . Single-duct exhaten(lattloomos,
toilet compartments.utility moms) 7 23.32
.Ph°.. .nqi i 01- (p64 Li63 j . Fax:( ) Attletcrawls. cc fans • 2332
,,•;....:":•.:" ..f.•,,:;•,:...0.40.14.0.:0=g::..i.., ... .._:•.•*. ,..C.:.f.,.:S. :... .?-44.i;jitidt.4**.-63#00.1.*.t4*-•:::•:':P:•••:
Other 23.32
Fuel oloieC.
Busjllef name litO t limy) VA4Dy-> thlves iLAC— • . . In ant fiat;54.03 tar swab additional i -
Contact name': mirktde.A-34)(4(...., Furoar4.etc.
. I
% *at
Address: 1 ‘ . do-4 kiOno . — Ir 1
wantsusigndratunittft*
-City.iStatetZIP:Vancouver,WA 90660 Oavim Water heater.
Pheue(360)695-7700. Fax::(360)693-4442 Fireplace
E'll"ii:Mi Op k- 1110
_ . •
A-11*.:64:•:14.Zi*:.;:i'A.C. ::fiAfi;•144:. :::tiiii.#01P.r.::. ...4:'.4',... J.J-•.%,.f.T.Ii.:!::-:N.q:.„. .• Clothes, '- •',, .
•
. .
BuSinestinartm Apex Air LI,C Other .
—
Ave
. ,, :7:7".: Ifq.f.***40e. ft4.10#*-4,44:',..:;4,)r',.q:''.-
Adchesi 18004 NE 72"
Subtotal
dty/State.+ZIP;Vancouver,WA 986114 Minimum permit fee($90.00)
' Plan review(25%of penult fee)
Phone:060)3424109 Fax:(360)326-1769
State surcharge(12%of permit feC)
C .CB lie.:.203034 • TOTAL FERMIT FEE
This permit appricatioa expos*If a permit it not obtained within 30
days niter II bat been accepted as onnipicte.
AillhOrided •i 1 -•4,-
* Fee nindeidolov wit by TnaZinuntyBudding lodualci Staninalionid
•
Print
name Lek ,• Date 4.14-A.
I VidnidtroPoirsiuMIEC nanackpp(40113 dug 446-4417 0 iiA...VCONVATZt
•
Electrical Permit Application -rj S" FOR OFFICE USE ONLY
City of Tigard I b a9 Received. Permit#71
Dah✓B , tJi'7_00.31,1a 13125 SW Hall Blvd.,Tigard,OR 9722a Plan Review
I Phone: 503.718.2439 Fax: 503:5.98./960 " Data : Related Permit a:
TIGAItD Inspection Line: 503.639.4175 ReadyDateBy 0 SeePage2for
Internet: wwww.tigard-OLgoV Noti&ed/ ethod; Supplemental Information
<R i: *-1 f-£. V;'tet `_-( ° is -- '� --:` `'—&-' ,.,,-*q:..' ti ' S � t—W . .' ,1-x ;,:
...� ° � l' a fi ",..'.t'J$
®New construction 0 Addition/8lteration/replacelnent Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition ❑Other ❑Service or feeder 400 amps or more ❑Building over three stades.
where the available fault currant 0 Ivfatinas and boatyards.
-ws''' ` '_,w -' 'atrxt vi '. .t 9. ivtc t^J .V4:fid-As �- ,vi t. `x+ exceeds 10000 amps at 150 volts or J�Floating buildings.
®1-and 2-family dwelling 0 Commerciai/itidlistrial 0 Accessory building less to ground,or exceeds 14,000 0 Commttetal-use agricultural
amps❑Multi-family - Q Master builderOther for all outer installations. I buildings..
0 ❑Fire pump. ❑Installation of 150 KVA or
c - • l,sa .`.. �'"i-t6`Cyr i;iso.v '-:Yl l r a'';;'''''''-0 Ast .; .', '.1 O Emergency system. larger separately derived
Job#: Job site address:!(A 511 SU)1J mocJ'oo Luxe- ❑100P Addition of new motor Load of system.
� ,C 100i•>P or more.
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
1:]Health-caefacilities. ❑Recreational vehicle parks.
Hazardous locations, El Supply voltage for more than
SuitelbldgJapt,#: Project name: ��►�+h,-T"��1(?tC-e cocci_
Q Hazardousce or feeder 600 amps or more, wits nominal.
Cross street/directions to job site: * S t•,sA ,is 3+ L :E Jai f s ak4, 7
Description J Qty. I Each Tote]
New residential single-or multi-family dwelling unit
Subdivision:Subdivision: r—i"- kter TQhrare- 'E +-
Lot#:21)140
Includes attached garage.
Tax map/parcel#:
1,000 sq.ft.or less I 168.54 4
Ea,add'1500 sq.S.or portion 33.92 1
ak
y- c y -e"..,$`,e, 1 ^S G'i ifi7or0d-6='s r;0 `,r-•.-.`-Z. 'a" _
Limited energy,residential 75.00 2
/14 ill 1 03e n (with above sq.ft.)
/V d 1 [�J Limited energy,multifamily 7500 2
,r-, residential(with above sq.ft,)
'w} v «...,,lo Lr:''r�3 :isles ov-osi6,yG v-'°,' ,-,,,, ^.''3a E^r., ,l.�,.-i- a--„. .�� ,:- S vices or feeders
❑ Set Fateand/or or feeders installatloazalteration,and/or refocatlon
Name:ADVL Land Holdings,LLC 200 amps or less 10030 2
Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2
Ci /State :
401 amps to 600 amps200.34 2
�` /ZIPScottsdale,AZ 85258 601 amps to 1,000 amps 301.04 2
Phone:(602)694-4031 1 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 -
Ye syn ti:o l-c1lc 3 r f' ` �,� T 1 o..-s rktF - y:- Branch circuw,alteration,or extension,per panel
A.Fex for branchits—netdrenits wilt
Business name:William Lyon Homes,Inc. above service or feeder fee,
Ni ch oke,Tyj 0r Peee�brbranc 7.42 2
Contact na^m1e: (�],.,n�n, �a�� c Soak
� 1 B. for branch circuits without
ee,first
Address: f 03 kJ] lR i.awa ! sit C`, S l0 service chh ciircuit f 56.18 2
City/State/ZIP:Vancouver,WA 98660 J Each add'1 branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 ' Fax::(360)693-4442 Each manufachrred or modular 67.84 2
I e h ole i .• p 0 ,r Reconnect
dwelling,serviceand/or feeder
Email:' ;� � 4�7t'1'1PS 1 At Reconnect only 67.84 2
_.5 7 . . ._. *).2 P-T- :>_ ;;. �, 2,-J,•+ Pump or irrigation circle _ 67.84 2
Business name:Garner Electric Washington,LLC Signor outline lighting 67.84 2
Address:"4 07 J a��.� �kS,t ` S - 11J
n Signal iter lt(s)or limited-energy ❑ See Page 2 2
J � 3” �1V `.,�(J lel,eltuatio�or extension.
City/Stare/ZIP:'p (� ?J� Each additional inspection over allowable hi any of the above
(A'j��'-4 ! w L Additional inspection(I hr min) 6625/hr
Phone:(253)320-1657 `I Fax:( ) Investigation(1 hrniin) 90.00/hr
Email:bdanielsQa gwensa.com Industrial plant(I hr min} • 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: C1158 Electrical Lic.: 208174 Suprv.Lic: 44968 specifically listed(4hrmin
Suprv.Electrician signature,r equirc -
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's 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
":•- .ABu0dinjgetmksllELC PermitApp_BLA ERE.doc Rev 06117/2015 440,1615T(11/05/COM/VYEB
Plumbing Permit Application.
Building Fixtare4 ,„, .,- , ,,,2 7n1-!
clty rif Trd pv2 •
PermitNo.:rifre.,./0/7,-aue,
IN- iga
112.1'Slii/X.*Ii Olvd;,Tigard,OR 23: ' ' . • " Date/B. y: ,
g Phone: 503.718.2439. Fax 503.598:19613 '. • " Plaititeltiewtata' r OtierPcmsitblo.:.
r%-. ,c,„,,,it..„
TI GA RD InSPectirra'41.112:' "'''''47.' .i 4- Pate ReillYnaY;. inric: lid See rage 2 rof
oblirMiattatifilv:0,10c7:434-441-274.104-.404 PrOtigtigISM-4414-P-WPA-rf-ZZIRK
'Iliteni• -,et-1 .9/WV1,--,:tlgard, :3i*„. 8.7. 1436ifedlgethatil Information
Ei New constmction... 1:--1 Demolition For special Information use chickrtat
Description I Qty. I Ea.. i Total
0.A.dditiOn/altenttion/Mplacennsot. . 0 Offer: New 1-2-family dliellings(includes 100 ft.for each utility connection)
'g2:r'-14*;*l:g-VPL:4 .*VtrYfafi?.;aliV4fiif-eGig-TieieitoifKAINztO4t•fg;tiliWS4.-,l SPR(1)bath 312.70
,e., ••;....,07-..,,,ML4, •-:. , 2:s.."....,.....,-t!;,,,, -„,..,,,--,A,:.:,-....47zizAz-ak.omPii -,•
SFR(2)bath 437.78
.0 leand 2-fatoily dwelling • CI Commesciairmdustrial
r-1 SFR(3)bath 1 50032:-
0.4.0.essbyyjraikfing Li Multi.7fs .
thily •
Each additional bath/kftchen 25.02
.
O Master builder: 0 Other: . Fire ccinkier( .sq.ft.) Page 2-
MaSttatT914-iiiii#01.0141WfWiffOX:WRAW47X9 Site'filth=
-Job site addreasi 1 19 e le SW .Lee trA Or\61.M.SS L-Cal6 Catch basin or wea chain 1 18.76
... :,
. line,Drywell,kph ot trench*Mu 18:76
City/State/Z1P:Tigard,0107224 , .
, . Footing&Ma(no.linear it: ) Page 2
Sult!kidgiaPt‘110.; Project game; gkr2,yrace. Manufactured home utilities.
. Ect,s4 tom
Cross street/direr:dims to job site: Manholes 18.76
,--
Rain drain connector• ' 18.76
. .
Sanitary sewer(no.fintar Pc.: _) Page 2
Storm sewer(no.linear IL:____) ' Page 2
Water service(no.linear ft,: ) Page 2
S•ubdivis59P: Neff Tasrate,-E0s4-- I Lotno.: 114 Fixture or item:
Tax.reap/parcel no.: Backilow prevent& ---S.
31.27•
Backwater l'alve 1151
s's.- ,!..'..::/11,4/5;7:.,,S.:-.. ......,..-y.i.11 .-_,-..,...1,,,.,.._„..„.--..;... - ..,.t•_.,,,_,0;:..,....._...,„...1,-_,,,c,..1 Ati.,... .,-.,:,.5 males.wailer
25.02
/44cT2.1)n -0036 0 Dishwasher 25.02
Drinking fountain 25.02
Bjeatom/sump 25.02
aglillgreRer:1,.. 'c'_5''...030C,A4,14:41E*14461.1.:14'10:::"'''.:C•ii7,14A47Z0-;- %:' Expansion
tank 12.51
Fkturelsewer cap 25.02
Name:ADft Land Holdings,LLC,
Floor drain' /floor sink/hub 25.02
Address t 7600 E Doublenve Ranch Road.
Garbage disposal 25.02
. City/State/ZIP:Scottsdale,AZ 85258 . Hose bib• 25.02. .
Phone:(602)694-4031 Far;( ): Ice maker 12.51
.,•i..:0:41,.3.1.".--1'-'44--,,,., 2:.-....f igy:F.,=:•;i-cg-f.:4•Wit:,Iii,:•,,4,-;,%.*;;.•tit,f;,65:,f4iti:17,1,t:.;.zivt, il.tta,14,0,;,., interceptor/yew trap 2502:
•kr*g•ii*:Nestlej€7.1i,:..._... .7:-,:,'21-k..;:::......:-44.'2..74:25;;4riti.r .s ..V.A.A.2-fr.k,,
Medical:gas(value:$ )• , Page 2
Business name:William Lyon Homes,Inc
Primer .
NIh .
Contact name D te,Th pry&
i t Roof drain(commercial) .
12-51
Addl'esg; 103. grvaciwal s-t- Rui,i7c- 1,Di Sink/basin/lavatory 25.02• •
City/State/ZIP:Vancouver,WA'98660 Solar units(potable water) 62.54
Phone:(360)695-7700 I Fax.::(360)693-4442 rtd,/showerishower pan 12.51
IDrkal 25.02
E-mail: C,i 0 , A i a , "I izay.9)11...4Onle.S.tiOrn ,
t!-;• aterVir closed 25.02
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AddresspOt 2542
.
City/State/ZIP: Sr. f4,4 Oft, -Ci F1131 Subtotal'
PlMne:(345"‘*$(4:". 14L1 Fax:(tiv,..--70....1?JD /vrinimumpermit fee: 572.50
Plan review(25%repeals:If:a)
-CCB Lic.: 1,64#M Phimbing u.....pt, kat/ .
State surcharge(12%of permit fee)
Autborked signature: lA )t lrit,v,e.‘"*..-.... L _ TOTAL PERMIT FEB
?tint IlaMM S÷fdift, PAP w ke, Date-s-36"'1 b This peradt application eqdres its permit Is apt obtained within 1110,days
atter ft km beee accepted as complete. .
iSce•melbodoloweetby Tri-County Building Judo/dry Service Board.
1:113elermaItoromintett-Purailapp.dec/Olio" 4411461410[0/02/C0wiYEB)
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
III
Transmittal Letter
T i CiA R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DAT �i'.r ,:EIV El)
DEPT: BUILDING DIVISION
OCT 26 2.017
FROM: Angela Grajewski CITY OF TIGA
RD
COMPANY: Polygon Northwest BUILDING DR/SIO
PHONE: 971-212-2144 ii-Ct--'. '
RE: 16818 SW Lemongrass Lane MST2017-00380
(Site Address) (Permit Number)
River Terrace East Lot 206
(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: Bulletin for Fireplace move
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.
Please see that attached for new plot plans and bulletins for fireplace to be moved in so we can vent to the
outside
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: ) O . a,6 - j-7 Initials: -ri
Fees Due: Igj Yes ❑No Fee Description: Amount Due:
-- -- H r se .' ef.
$
Special $
Instructions:
Reprint Permit (per PE): ❑ Yes jSINo ❑ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
FOR OFFICE USE ONLY-SITE ADDRESS:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
City of Tigard
V COMMUNITY DEVELOPMENT DEPARTMENT
g
r1cARD Building Permit Review — Residential
0
Building Permit #: „4-t 57.--).6/2- 6?
Site Address: j6g 1 € SW Lemon5rc,ss Ln
Project Name: 12 vw Te r-r-c,c¢.. Los i-- Lot #: 2010
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review ,p` ,/i 7
Proposal: S c(- /2--alis-r.,- P( ( C_'-'moo
0 Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: ❑ No X Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
,Three(3)copies of site plan ❑Existing structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper WiFootprint of new structure(including decks)with finished
f 71Drawn to scale(standard architect or engineer scale) floor elevations
North arrow ,Utility locations&easements(required for new and additions)
Site address,project or subdivision name and lot number Ll Sidewalk/driveway approach
Applicant information(name and phone number) Location of wells/septic systems
ZLot dimensions and building setback dimensions ❑EAb-arrg frees to be retained with drip line,and tree
Square footage of buildings to be demolished protection measures
CLot 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) ZiStreet names PI) 2
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? C-des-Q34o
4 foot differential) If yes,is a storm water quality facility shown? ElYcs ❑No
gi Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ,fi No Received: ❑ Yes ❑ No
,I Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake
Z Land Use Case#: ppa.2Oiko- 00001 ,. SuB2.0“b -040ay
7 Zoning: iL 1
Required Setbacks: Front i 2 Rear 3 Side 7 Street Side 0 Garage 3 _ (P
g Landscape Requirement: Zo %
g Lot Coverage Maximum: e 0 % //ryry
Building Height: Maximum Height N /1'1 Actual Height Z7
❑---isnai-Clearance
.D rrsitive Lands: El Yes ❑ No Type
g—Y1 an Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: ,Nj Date: t'O/c / 11
Revisions (after Building Submittal only) Reviewer Date
Revision 1: >1 Approved ❑ Not Approved Akf. 012-4(1.7
Revision 2: ElApproved ❑ Not Approved
Revision 3: El Approved El Not Approved
EBuilding\Forms\BldgPermitRvw RES 061417.docx
Building Permit Submittal n
Original Submittal Date: / /
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: Planning [ Tigineering ??.-Permit Coordinator SCJ 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.
.l Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: ,�j
By Permit Technician: /4 ✓1�;�i�Gtiy'"�`� � Date: lc)/,l/2
Engineering Review
Slope at building pad: U 70
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
,2 Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes A No
Assess Water Quantity Fee in-lieu: ❑ Yes .Ef No
LIDA Facility on lot: ❑ Yes ,®'No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: M. j V U-' , Date: / 1 y /7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: Er-Approved ❑ Not Approved Ai I, (711,1_ IA i'
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved 0 Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
• ,/�3AZ
►��"'' pproved,NOT Released: 'I ate: iv ff
i otes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: .' es 0 N/A
Tigard Trans SDC: 11 Yes ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes /A
*i K to Issue Permit
Approved by Permit Coordinator: liiDate: 1`31 13-
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
iiiN
City of Tigard
lj COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: i (o8 18 S vv Con()on rrAc3 Ln
Project Name: Il - -Pe_rr La E-q S
(New dwelling=subdivision name;Addition or Alteration=last name of owner) Lot #: Z�
Planning Review of River Terrace Plan District Design Standards (18.660.070.L);
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 ft. 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
71 ❑ ❑ ❑
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:
zr/1
Max. 8 ft. setback from longest street facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: ,Yes ❑ No
If yes,all the following apply:
e1:23'25 sq.ft. min.
One street facing entry
0.12 ft.max. roof above floor of porch
Jai 5 ft. depth min. W30%min.porch roof coverage
4.Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
C Covered porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft. deep
/0 Wall offset min. 16 inches
XI Dormer min. 4 ft.wide
)2I—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. ❑ Horizontal lap siding min. 3-7 inches wide
Accent siding min. 40%of street facade ,Window trim min. 2 1/2't 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:
AlfNo closer to front or side lot line, than longest street-facing wall. 0 Yes 0 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.
\0� 0 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) (r / A-
❑ 12-foot-wide garage door 0 40%max. of street facade
0 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning:
Date:
I:\Building\Forms\BldgPermitRvw_RFS_RT_062216.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16818 SW LEMONGRASS LN, BEAVERTON, March 9, 2018 at 10:38:18 AM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00380
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
No A/C installed.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16818 SW LEMONGRASS LN, BEAVERTON, March 21 , 2018 at 1 :07:06 PM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00380
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed.
No A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16818 SW LEMONGRASS LN, BEAVERTON,
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00380
Inspection Type: Inspector:
399 Plumbing final Allyson Armstrong
Result:
PASS
Comments:
Water pressure =38#
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16818 SW LEMONGRASS LN, BEAVERTON, April 4, 2018 at 9:37:59 AM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00380
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