Permit (174) CITY OF TIGARD MASTER PERMIT
!pi P ✓•
f ST2
Permit#: M017-00392
COMMUNITY DEVELOPMENT Date Issued: ST22017
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S106DA05600
Jurisdiction: Tigard
Site address: 16805 SW LARKSPRING LN
Subdivision: RIVER TERRACE EAST Lot: 56
Project: River Terrace East, Lot 56
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 948 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1130 sf Garage: 380 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2078 sf Value: $253,947.70 Rear: 15
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
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel 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: 3 201-400 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 2078
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: $31,748.38
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 95 001-0090. You y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
' ' t
Issued By: Permittee Signature: G�:p/�(�
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.
r ' 0
Building Permit ApplicIation RECEIVED S
„,,,..:11!....,1,114.1
' -.tir t zi
z FOR OFFICE 1 SE O\Ll
City of Tigard JUN 2 `• .4 DeatteBy /6//2,/f �iJ Permit NI5 7-�17(.6 372.
III ■ 13125 SW Hall Blvd.,Tigard,OR 97223 ' Plan Review �/
■ Other Permit: I/ ,C/7--02?.2 L
Phone: 503.718.2439 Fax: 503.598.1960E .. ', rid Date/By: f 0- ) 2” ) ��%! /'�►
Inspection Line: 503.639.4175 1 , r Date Ready y: Jugs: H See Page 2 for
i it.,%RD BUILDl r DIVISION
Notified/Method/444,p 7 Supplemental Information
Internet: www.tigard-or.gov
42-IL- /vie 4.6
irtV?Zw 4R-Vet ' fi t '+ 60:1
®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
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
'''as`c v s* a' 'e ', 5 0 work indicated on this application.2-51-zit E ,.. n,,mai z. ,t , ,�._ .mA, �, F -s' �_._ .' •
Valuation: $
® 1-and 2-family dwelling ❑Commercialfmdustrial
❑Accessory building 0 Multi-family Number of bedrooms: 3 .-,-3j q Lj 7
❑Master builder 0
Other: Number of bathrooms: 3
‘fit-, -- �,, 7 :- ,:s �- Total number of floors: 2., 6
Job site address:l kb Sw Lar New dwelling area:201 6 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: D square feet
Suite/bldg./apt no.: I Project name:River Terrace East Covered porch area:(3b square feet 1 , 3 O
Cross street/directions to job site: Deck area: square feet LI l
Other structure area: square feet
:0Ti' �-
s ,_esf. ` Sx t l bt man � 4 ,i,
$1'_
Subdivision:River Terrace East 1 Lot no.: /) 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
- ,«-', , ' work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
,ka �` trs esI . a, i, , 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:
`:--" i-.H rz< �° *a.. _. a ._.•, ,. K , ` 41f dmt t a m> .. ,..
Business name:Polygon WLH,LLC Structural plan review fee(or deposit):
Contact name:Nichole Thorpe
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)695-7700 I Fax::( )
�t � 4.,%. .', t,s v' 1� 1. r
E-mail:Nichole Thorpe 4,:-: ,:`-:;':e‘',.
.:.
� � ,, Commercial and residential prescriptive installation of
_ ,2 a a F.1 �s , .r.
�� �� �,..,. �� �� ����� ,_���� � ���� ate;:;:i,:::,71 _ pQ 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 $180.00
City/State/ZIP:Vancouver WA 98660 and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lie.:207247 Total fee due upon application: $201.60
Authorized signature:- ` / This permit application expires if a permit is not obtained
0/ 17 ---- within 180 days after it has been accepted as complete.
*
Date:06/16/2017 Fee methodology set by Tri-County Building Industry
Print name:Nichole Thorpe Service Board.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 4404613T(11/02/COM/WEB)
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Mechanical Permit Aimal.maticl‘- FOR OIL IC t.SE°NIA
.. ..
y of-tigard iVi. 't 6 2017 ..=a; Pm"''447.57P0/7--a03 .-1-.-•- .
II
-$ 1P-5 w HIITBIri,,TIgardcOR 51M..
' cint 50174.2439'FXO :Set.59Ltraq-,,-r c,1,7'f'n 1;it:2-::j. MiRle1!1?
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Pbon
See rs
A,, .4rispactitut thus; 503.6394175 "-:,...i. k ,,, '--" '-'.: . ,.,: Dte Robley: • moo 0 ete2ST
1 1 4-1 • -, itlibiliet;i's4.tigifiti-nr;g0ir ,1••••:!; :',';'-:,I- :1' 1.i ::-::'':)'iNintifiedlidethect' Supplemental Interinattan
. . . ..
Ter:Miiil.f n-73--1. '-:***..-.-fi.' .iiiariileZAFX:XigattlJp0.04.90' 4K4010-Tti.g.SO-Ail-Wtsruli- .11,_it-..,..r4.Itts_.*:,:titt_-_.t#CLAte.--..I.
Mechanical permit fees*are based on the value of the work
121.Niw eoristiuction 0 Addiliontalterationfreplaceindit. perforated.indicate the value(rounded tolhe nearest dollar)daft
CI Dtmlolittoit 13 cittcr: filiteltaliCal materiek equipment labor.overhead,and profit.
• Value:S .
Ylit2§ *t IVOMOW,41:05fiftifidOltite-fslti.,-ve',a5m;$7 .4i.t***0-04,w-opiiiitorito-:-.:TolltiM2y&ei .
Iigl=and 2-fain4 dvinlliiig. 0 CotuuerCiatruiclustial Ei Aczesstuy building For special brformation me c.keckft.g.
_
_ gy. I Ea. I Total.
Multi-601y. 0 Masti4"*Or- 0 Other' Dem/farm
••• - - • - • - -- • --- -• •-- -.: -• ---,•;,.•,:z.i.TT;t.4..ik.•:....1:4:#7,..lta. lielitpfenatr,
',-;:'alg;•'''X'ti:'4:5,,V51;..I'.;(i**:t1kt$..filt*A;gr*0:_ii:R:',-fo:q%llcf :&-.4.::k%F-sr:-t.-.-L -A3Air iio„ditioning - 1 •
46.75
.
k.t?stt9 addr.ess.:Ili eos- so.) Lairt45?ticyl 1...0„fte.d Ftenace 109.000 ETU(ductsevento 46.75 .
:City/Statoriie::Tigarkoll 97724. Furnace.1.00,090441711(doessMais) .
fleatiiiiiip 61.06
tit_±./b_Idgittpt iiPfe,icet ittitti: i Vey- Net.wort 2332
Cross slicatfilireetiorts to Job slle.; 6.)-lydrearie hot isthmian. 23.32_
• • lesidential boiler tradiatot:or
hydronic) 23.32 _
. .
Unit heaters(fuel-tme,not electric),
. . . . lii:wall,in-Oncl.sostendat fie: 46.75
• Flurivent.ftir any of aliove• 1 23.32 . .
Other 23.52. ,
SubdiVisi°TliIi!jVC.=....eCd2S...L..---,...----t""-...aU.: . ' OttuitIttel allOTeike-r .. .. _
Taurnapiparecl no.: .
• Water healer . . 2332
...
1•046-ilg';:-.3"-V, Ii',-L:A;V:4; 5.7.*~itto.02:.**iertlft7::.4y.,,z.--V:i.;::-,,,-7:,: -:,i,:?;:.7 1 - .gass,rfri4aLLe.fileitheatti,--or gas ' I .33.39
/14 S T2.01-.7 - 0 0 L fireplace- - 23.32 , 1
Log fighter(Psi . 2332
'
Wood/Pellet stove 33.39
-
Wood.fireplaecruisert 2332
" - •
ChltnneyilitterIllueNeat 23.32 •
,, 2332
"L.':':-"'.,.' 1011.6iiiiiti4.0t1V;P::::-I:j;'•':-F4:4;A.A"*tilliOtiff4:t4iKX •
°tiler nd miaow
Nathe:'ii-D V L .tAilri fi-Dicti nei 5 I L.LC.. . • : Range hoedfother kitchen.
equipment 1 33,39
Additsc.:Itoo.. e oculote:t .e (2,Ln c,14 (2-0Ce.q Clothes dryer exhaust 1 1_1 33.39
Ci ty 6 ±
11._ _. -is: da. ickl. Q5-2...% . Single-duct exhaust 4sithrootris,
toget compartments.utility rooms) 1.1
Pheute* i el/.., 4,2 .. 11' Per( ) _ Aoiricrewlsoace rani 23.32
..::--.:.', ":4-'.,:.;:•:,:rogt40.:0041t.,.i.,. .:ci:',..,,: -.:, :•-y-. 4-1.,rotrActil.!_., ,.....,, ,-;.... . Furl opineOther . 23.32 .
Busines Mime IVO i i MAI ,k.IDte t-tONVS !LAC- •
surs for fiat filar;14.03 for each additional.
Contact iuun . i‘,\i chle:IV ogx Furnace.ett •. I
A
Ad....2.L...ess:_aiallcbfci .• II e fill II Gas beat ut.uas
WalltsricPendedfanil healer .
City.StateZIP:Vsocouver,WA 98660 Water hailer'
Phone:(360)693-7700. Roc:060)693-4442 Fireplace I'
, - - --
•
E`m11111M 1(4t1)k. jborpq po 1:Lilip41 _ ..,,.,... B.,beci!. .
. :
Bus
Oa=inesinainc Apex Air ILC
W*1 t4.0E14.4**#044 -':i-,'Vf.'.4.-•:.
Address:18004 NE 72 Ave -. •
eityiSinte/ZIP:.Vancouver,WA 98686 ... blinernuu permit fee(S90.00)
. Mao review(25%of permit feel _
Phone:OW 3424109 Fox:(360)326-1769 State=Mane(12%of permit fee) • '
,
CCS lir:203034
.....r4,_____
_ Dam 4,Pt.gr. TOTAL PERMIT FEE
This permit applicatioa expires not it a permit is obtained within tan
days Oar it b*t been accepted as complete.
•
.Authoriaed sipanur • . Fee methedology art by Building lathe*SamieelloaSd
Print name: tek.
•ia...taffigiperoaxict-Potonapp_0401 LI dao 44046177 t l uoic•Owietaii
Electrical Permit Application FOR orricE USE ONLY
City of Tigard Received
III 41 13125 SW Hall Blvd.,Tigard,OR 97223 ,
I: Phone: 503.7182439 Fax 503.1941960 ,µ t - ` item e"' Related Permit a.
InspectionLine: 503.639.4175 ' '' Ready Date/By: Jnrir. 0 See Page 2 for
TIGARD '
Internet www.tigard-or.goV '' NotiSed/Method: Supplemental Information
s w.'-it ., -S.3 ',W_c•';t 17zy,;j" PFK0.. sc ak.a t.lc;i -,r � `-,' ', : .>;r qtr- 4+5.-s.,4r+' ' . o pan 4a ,":'r.54-44
®New construction ❑Addition/alteration/replacement Please check all that apply(submit z sets of plans writeme checked):
0 Demolition 0 Other: ❑Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current El lvfarinas and boatyards.
1 SS ?� r��? ;;Ca k.".'3;,`9 Etl 0_' , .z .,_ exceeds 10,000 amps at 150 volts or O Floating buildings.
®1-and 2-family dwelling ❑Cornmercialii ditstrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
0 Multi-family ❑Masker builderamps for ell other installations. . buildings.•
0 Other: ❑Fin pump. ❑lnstailation of I50 KVAor
•t,3` 6;10-040\-i. ®a-(a"'' i''j',01 o:', -,f A t`__ ,;•`- ❑Emergency system. larger separately derived
1 i V, SW��r s r ❑meAddition ofnew motor toad of "Atem.
,"
Job#: Job site address: ' `v ] lOD£1P or more. Q"A",'S","1-2","1-3",
City/Stgte/Z1P:Tigard,OR 97224 0 Six or more residential units. ceup�oY•
❑Health-care facilities. 0 Recreational vehicle parks.
Suite./bldg./apt,#: i Project name: Ive ' rciAni`e �'��-L ❑fiaztndons locations. ,:,,up„,,,Svoltage for more than
�-+�^� ❑Sernce or feeder 600 amps or more 00 volts nominal.
Cross street/directions to job site: -, }+ Al —
Description I Qtr Each Tota] I
New residential single-or multi-family dwelling unit.
Subdivision: ri4' I o f#; Includes attached garage.
�� T�%1'IrGt C�_ T f- 1,000 sq. or less n i 168.54 4
Tax map/parcel#:
add'I
Ea 500 sq.ft.or portion '� 33.92_ 1
', - ,-_ r,-.-1: /t-7,::ct 1.,0 e) +;il `i. , +00:01 -;;`k-! -w .. -:. Limited energy,residential
A a MAO O ii 'O(�,(w) (with above sq.ft.)_ 75.00 2
/t/1 J 1 (�(J �Jl,L� Limited energy,multi-family
residential(with above sq,It) 75.00 2
, . _> Renewable Energy ❑ See Page 2
zp , 9r )' t rF V �iFol - -, , ..x _ 1i / -- i, „ N-
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 20034 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 I 5936 1 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 1 2
Owner signature: Date: . 401 amps to 599 amps 16854 2
a 5 pro.4' � ,t hit 8...0,00,€ ,;5 •'„`azy, ;4 Branch -new,aration,or extension,per panel
-' A.Pec for brancircuitsch cucuits withlte
Business name:William Lyon Homes,Inc. above service or feeder fee,
Ni chOk, y))rte eehorancomc 7.42 2
Contact name: B.Pee for branch circuits without
k7 n ja St f•, S vt) serviceorfender fee,fust
Address: U0�7 1 J1A./� 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 • ' ' Fax::(360)693-4442 Each manufactured or modular 67.84 2
Ddwelling,service and/or feeder
Email,,
-
j)'� 0 _�j,,, 0 pa j 4 �,,.. me A ii,, Reconnect only 67.84 2
W
S.< :,- x','`€"cl i.li i;r [C S: c ,. sx r It &"P- Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC Signor outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:k 4 DZ \ �v`.k p ,. \ S �Q, ('[y �1 panel,alteration,or extension. ❑ See Page 2 2
`� V �V !Up 0 Each additional Inspection over allowable in any of the above
City/State/ZIP:'pu vo Lf t4 pi v3-11, cies-) I Additional inspection(I hr min) 6625/hr
Phone:(253)320-1657 1 L Fax:( ) Investigation(1 hr min) 90.0W hr
Email:bdaniels@gweusa-cum Industrial plant(1 hrmin) 78.IS/hr -
Inspections for which no fee is 90.00/hr
CCB Lie.: C1.158 Electrical Lic.: 208174 Suprv.Lica: 4496S s .. luted A In rain
Suprv.Electrician signature,required: . of
.. Subtotal:
Print name: Joan P Albert 1. I Date: 4/26/2016 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: _,.+ _ - --- ---` TOTAL PERMIT FEE:
This permit application expires if a permltis not obtained within x$0
Print name: Bill Daniels Date: 4/26/2016 days after It has been accepted as complete.
`'; ,:1auWti 1Pamirsifi[C * Number of inspections allowedperpennit
Ii.
nos _Permk.App_ LIt.ERE-doc Rev 06/17/2015 440-4615T(11/05/COM/WEE
• •
•
1 M
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Plumbing Permit Application "°' ' �j
Building Fixtures );' I f, 2017 FOR 01 1 1( i- t Si 0v1_1
City of Tigard r .5. <'. may. Permit No _5 t 7-003 9
1111 a 13125 SW Hall Blvd.,Tigard,OR 9'2" „
� ` P1anRcview
Phone: 503.718.2439 Fax 503.59/(4,96Q., Date/By: Other Permit No.:
I If.,n R D Inspection Line: 503.639.4175 fi 1 !:, , _ Date Ready/By:
it'd:: I id See Paye 2 for
Internet: www.tigard-or.gov Notified/Metbod: Supplemental lnformstiots
i2 New construction • '0 Demolition For special informed- on use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 It.for each utility connection)
•,.:',:•:•:: ••CATEGORY OF CONSTEWC1'ION'• .. . . SFR(1)bath 312.70
®1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 '
12 Accessory buildingSFR(3)bath i 500.32
❑Multi-family
Each additional bath/iatchen 25.02
❑Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2
•. SOB.SITE INFO1 MA PION`,' AID•LOCATION ' • Site utilities:
Job site address: l 4?)U J J LOX Vr�(��v(\ ( �^t a(�e, Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224
"J `_- "`""'Lail
Drywell,leach cine or trench drain 18.76
Footing drain(no.linear ft.: Page 2
Suite/bldg./apt.no.: Project name: Ii Ver Terrace,-E Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: Page 2
Storm sewer(no.linear it: ) Page 2
Water service(no.linear It: ) Page 2 •
Subdivision: I-t V er -reA G.Ge. fgS.4-- I Lot no.:SO/) Fixture or item:
Tax map/parcel no.: `Y Backflow preventer 1 31.27
. . . DESCRIPTION OF.WORK_ • Backwater valve 1231
Clothes washer 25.02
i" , t"L 0039 L Dishwasher 25.02
•
Drinking fountain 25.02
Ejectors/sump 25.02
®.'PROPERTY OWNER • , I. • 0 TENANT Expansion tank 12.51
Name:ADVL Land 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/LIP:Scottsdale,AZ 85258 Hose bib 25.02
Phone:(602)694-4031 Fax:( ) Ice maker 12.51
:.• ( .APPLICANT .• . . 0 CONTACT PERSON: Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:William Lyon Homes,Inc
PrContact name:01 C t 0 le,-Th t v Roof 12.51
drain drain(commercial) 12.51
Address: 1 O' Ct--9 Si- Sup 0 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
% 1w Urinal • 25.02
E-mail: Cr\0 k---01100Pe e povifjorNy omvvS- `��n • Water closet 25.02
`.� +`C"O'CNTRA- vGTO `r`" T 1 Water heater 37.52
Business name:Mahnedal 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 'PlumbingLic.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:0425/2016 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
L•1BuilrrwgWamits\PLMU•PenoitApp.doe 10/01/09 440.4616T(10102/COM/WEB)
T
t City of Tigard
IIW COMMUNITY DEVELOPMENT DEPARTMENT
T GARD Building Permit Review — Residential
e Eve- ..-,—.2-,. .���� aex��:.x��,s��.sl Il/ �' ! ) ru...;�� ,:c�.-t' 3�u._:va�l�r t»..�de�.��.e,a,`+acs: .,.
Building Permit #: I L-
Site Address: I 660 _ Svd L 6r let. S Pnv?5 L n ,
Project Name: i 1V' r Y rr Le- &G1 S+ Lot #: .S9
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review �^
Proposal: NJ e/W JF-R-
Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: ❑ No le Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
ree(3)copies of site plan ng structures on site
/Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
Drawn 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 Sidewalk/driveway approach
,Applicant information(name and phone number) gT oc- on ^Lwans/septic systems
I Lot dimensions and building setback dimensions Existing r4ies.to be retained with drip line,and tree
X'Square footage of buildings to be demolished protection measures
, `Lot area,building coverage area ercentage of coverage and /Street tree size,type and location
impervious area(applicable iR-12,R-25&R-40) treet names
f Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? ❑ es Nci i'F/�
4 foot differential) If yes,is a storm water quality facility shown? eNo
geClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): !VA'
/ Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
,z Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake
Land Use Case#: 4) [)R2AJlto —0000 i g V6 z-o 16 _.tjoo 9
Zoning: It1
/2T Required Setbacks: Front 12_ Rear 1'5 Side a Street Side Garage 2,0
Landscape Requirement: IX
Lot Coverage Maximum: Qa 0 % p
7'Building Height: Maximum Height IV/ Actual Height 2-41
Visual Clearance
f Sensitive Lands: ❑ Yes /-No Type
XUrban Forestry Plan
Conditions "Met"prior to issuance of building permit
otes:
Approved By Planning: /V) 0/1.."-V--.., Date: t 0 / ) I / 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_061417.docx
Building Permit Submittal
Y
Original Submittal Date: _
Site Plans: #
Building Plans: #
Building Permit#: 'Enter building fr
ermit#above. C
Workflow Routing: Planning Engineering i'ermitCoordinator `�-.Building
Workflow Sign-off: p- 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.
2 Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes: /
By Permit Technician: , / '�1 i ,'9'� Date: !U//24j
/Engineering Review 1'
;❑ Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
E1 Water Quality/Quantity Facility: �{
Assess Water Quality Fee in-lieu: 1: Yes LI No
Assess Water Quantity Fee in-lieu: ❑ Yes c2i No
LIDA Facility on lot: ❑ Yes [7 No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: ( /AJ ( Date: /a / / 7/ / 7
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
,*ilp
1 Approved,NOT Released: ; ' Date: /0 2.; ) 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:
DC Fees Entered: Wash Co Trans Dev Tax: eyes ❑ N/A
Tigard Trans SDC: G Yes ❑ N/A
Parks SDC: < Yes ❑ N/A
LIDA ❑ Yes 7N/A
OK to Issue Permit
Approved by Permit Coordinator: AievkA441c1 p,a1A.. Date: 1,11141(-7
1:\Building\Forms\BldgPermitRvw RES_061417.docx
' City of Tigard
in
11111 COMMUNITY DEVELOPMENT DEPARTMENT
■
I l CARD River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: I ( b 0 S .S w r k pry el e2 Lo.
Project Name: 14 ive r Te rant-Z. CIS 4—' Lot #: 5-‘0
(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?grYes ❑ 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 Gabled dormer
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
❑ ❑ / ❑
2. Eyes on the street: a minimum 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: I
3. Entrances:At least one entrance must meet both of the following standards:
7
ax. 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: /2:125 sq.ft. min.
AOne street facing entry 4 12 ft.max.roof above floor of porch
5 ft. depth min. ,Z30%min. porch roof coverage
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 Al Recessed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide
/Roof eave min. 12 inch projection r2f Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood 71 Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. Z Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40%of street façade /Window trim min. 2'/z"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. ❑ Yes eNo. 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 ❑ 40%max. of street façade
50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: Date: 10/ Ili I 1
I:\Building\Forms\BldgPermitRvw_RES_RT_062216.docx
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ticirmsctwtfun ImOilrfl. s ,.,. -,_ Pape 2 ___.
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TAN maparmino_ ll,tcilln..plc vetitcrIIII 3177
UI'SCRtl'11ON OF WORK lia,_Fnl!cnalsc 12 Si
t'lot hes na+lirt 25 02
7— .__�
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In iiii:mg bunions25 02
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1)a,ls r ;ump 7.5 02
® PROl'®t11`OWNl2t 0 '11TAN�`I' I apaa i.siitis Il.11
Name:AD1'L Land Holdings.LIC I it wl es:rc 25'02 ___
lb.;draulill=.ia sad )soh 2502
Address. 7600 E Doubletree Ranch Road _____. __..___ _.__.-__ _.
I iothni e dt.p-.sI 21 02
,
Cllv;StateZIP:Scottsdale.A7,852,X
[lose 25 0: f
1
I'Iwne(602)694-4031 I as i ) Ks-maker 12 51
®
APPLICANT 0 CONTACT PERSON. lid vl.•c!1t'o1 case trap 25 02
Rosiness name:William I.5-on Homes,inc Medical pas is saw,S_, Page
Primer 12.51
Contact name:Angela Gra jrnsl,i i
Root sb ain i czmimeiciul 1 12.5.1
Address: 109 Ells) 13th Steve1 Sin kasiwula•ltik” 25 02
City/State/ZIP:1'st n eau ve r,W'A 986611 Solar win sIpot able sssatui 62,54
Phone:(360)695.77pp las 13601693-4442 1 ii isissetisIsos spats 12 51
F.-mail.Angrla.Crajrgcki apull;(mho n(cs.rum —�- l lrninl 25.1,2
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r/ Winer hraia 37 52.
E3usiness uame: �.(1 �IIr t.j r/r t—� I C 11'invt pipint+'i)N`1` 311:29
Address: Li �j,. ii;{ s:Jiher 25 02
City/St atcell Ps 7 C J <', 7 Subtotal
s minimum Phone 15-1:�f�� � S �rs�l 1•ax:t !
CCB Lie.' )C/ 3 S &7 Plumbing Lie ns, f`by,,,C'C Plasirrvicu ( .'oafpirrnit(cc)
State,slucliate i 12%ofpeimit fee)
Authorized signal arr' '•\ •I'DI AL PERMIT LEE
Ibis pre mit a mil kali uneepiresitMpermitltnot°hiaxedwithinIXOdays
Print name: C 1�Y y/--c-r-—rs,t,a t/0 Da ,is d`yj'j$�} atter it list Leto omitted as Complete.
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City of Tigard
1„, , COMMUNITY DEVELOPMENT DEPARTMENT
2
Building Permit Review — Residential
TIGARD
6
Etaa.i- ,:, F i„�;7,2;1:, ,r 5-75,27401)
^wr3��,w,,:w,�+cif;5wi�a'Xx�.��.�r5r:«enl; .;i' - - -
Building Permit #: � /V/_/✓y//' �!!// �-
Site Address: I (4 6 0SW Lark. S PnV7 S Lam ,
Project Name: (1V t TT-rre1Le. &G►s 4- Lot #: 50
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review � /� � ��b /6)e9-770
eO��� �/..2‘,Proposal: �em/ J^E-(L '��'/'� f ia
Verify site address/suite#exists and active in pertm ystem.
River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached
S' Plan Elements:
ree(3) copies of site plan g structures on site
Site plan must he on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
Drawn to scale(standard architect or engineer scale) floor elevations
North arrowi . %' tility locations&easements(required for new and additions)
Site address,project or subdivision name and lot number ''a Sidewalk/driveway approach
Applicant information(name and phone number) =- -- /septic systems
/Lot dimensions and building setback dimensions14Exishing-t +es-to be retained with drip line,and tree
Square footage of buildings to be demolished rotection measures
0Lot area,building coverage area ercentage of coverage and Street tree size,type and location
f
impervious area(applicable i R-12,R-25&R-40) ,Street names
JWI-
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? 0 es Nc/j/y1
4 foot differential) If yes,is a storm water quality facility shown? e No /'t
AjADPI 'Clean Water Services-Service Provider Lett (lot platted prior to 9/10/1995): N`A L 4pprs / Flk
Required: El Yes,applicant was notified ANo Received: ❑ Yes 0 No gg
Public Facilities Improvement(PFI)Permit:
Required: ❑ Yes,applicant was notified 0 No Applied For: Yes 0 No,stop intake
Land Use Case#: n p 12 2 to -0000 , `S V LC coo v
Zoning: 1`i
Required Setbacks: Front j�„ Rear y5 Side Street Side Garage '2A)
Landscape Requirement: f..00 % i
s Lot Coverage Maximum: 0 0 %
*Building Height: Maximum Height ►"/�� Actual Height 2-61Visual Clearance
Sensitive Lands: 0 Yes /OPNo Type
Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
otes:
Approved By Planning: 7 ) + 0-,1/1.-� 1/1''�`� Date: loin l i i
Revisions (after B} ding Submittal only) ).f,✓o Reviewer Date
Revision 1: L� Approved 0 Not Approved S-S- S Y
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
1.1n-.11.1:-.�\C..�..-1D7.1..D......:4D..... DCC (14.1 A1'7.1nnv
Building Permit Submittal
Original Submittal Date:
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: Planning Engineering cPPermit Coordinator ;;;—Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: I 'Engineering: (1) copy of permit application,(1) site plan, (1) building plan and
original plan review routing form.
i Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes: /
By Permit Technician: -e 4 % 1 Date: (0//2-,ll7
Engineering Review '/'
7 ;'
iii Slope at building pad: .) / v
❑ Conditions"Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
.Z1 Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes i ' No
Assess Water Quantity Fee in-lieu: 0 Yes Vi No
LIDA Facility on lot: ❑ Yes V No
❑ NOT Approved by Engineering: Date:
Notes: /
Approved by Engineering: � ;
' City of Tigard
"
1111‘ COMMUNITY DEVELOPMENT DEPARTMENT
■
•
TI G A R D River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: I ( B 0 S S n r kJ r)h (2 Lei.
Project Name: R Nei- Te Canc.e. e C i 4— Lot #: 5-(,
(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
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
7 ❑ ❑ / ❑
2. Eyes on the street: a minimup.412%of each street facing façade must include windows or entrance doors.
Percentage Shown:
3. Entrances:At least one entrance must meet both of the following standards:
ax. 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: )2125 sq.ft. min.
ig,1One street facing entry 4 12 ft.max.roof above floor of porch
5 ft. depth min. ,"30%min. porch roof coverage
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 oirf Recessed entry area min. 5 ft.wide x 2 ft. deep
/Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide
)32Roof eave min. 12 inch projection c2i Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood fr Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. ,li Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40%of street façade /5 Window trim min. 2'/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: �p
No closer to front or side lot line,than longest street-facing wall. ❑ Yes YJ 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 ❑ 40%max. of street facade
50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: _ ( — ....- Date: i 0/ 1 1 / 11
I:\Building\Forms\BldgPermit Rvw_RES_RT_062216.docx
!O
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
i 1 Transmittal Letter
F,, 14 n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Dianna DAT ' E l
DEPT: BUILDING DIVISION
FEB 2 i 2018
FROM: Tom Dicianno CITY Of11(;A.Ra)
COMPANY: Polygon Northwest BUILDING DIVISION r
PHONE: 503-577-4160 B
-} g7
RE: 16805 SW Larkspring Ln. MST2017-00392
(Site Address) (Permit Number)
East River Terrace Lot 56
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies:.:. Description:
0 Additional set(s) of plans. Revisions: plet-plair-
0 Cross section(s) and details. 0 Wall bracing and/or lateral analysis.
3 Floor/roof framing. 0 Basement and retaining walls.
0 Beam calculations. 0 Engineer's calculations.
0 Other(explain):
REMARKS: Covered rear patio. Please pay fees owed with Trust Account.
I V49 0
T
OFFICEE'`ONLY ' ,,_ x,
Routed to Per it Techni.•. : Date: Initials:
Fees Due: FA Yes WI k o Fee Description: Amount Due:
$ �v
I1 ,.7.— s 11,c-------
ur 2 ) ilZiAn $
4, 't tt, °' tig t' .; e?fr,0 41 4F11 I $
Special
Instructions:
Reprint Permit(per PE): ❑ Yes No ❑ Done
Applicant Notified: '- 7 t-1 Date: /..5'// (CS' Initials:- ig
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16805 SW LARKSPRING LN, BEAVERTON, May 4, 2018 at 9:36:52 AM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00392
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:
16805 SW LARKSPRING LN, BEAVERTON, May 9, 2018 at 12:52:10 PM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00392
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:
16805 SW LARKSPRING LN, BEAVERTON, May 9, 2018 at 12:48:30 PM
OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00392
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed.
Water pressure = 45
Violation Summary:
Inspector Contractor