Permit (130) CITY OF TIGARD BUILDING PERMIT
Permit#: BUP2017-00303
COMMUNITY DEVELOPMENT Date Issued: 12/06/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2816/20/7 100
Jurisdiction: Tigard
Site address: 15445 SW 150TH AVE
Project: River Terrace Crossing Subdivision: None Lot: None
Project Description: Demolition of 3,722 sf residence and 1,175 sf accessory structure on septic. UPON FINAL INSPECTION,DEMO
CREDITS FOR SDC FEES MAY APPLY.
Contractor: NORTHWEST EARTHMOVERS INC Owner: ALBERTSON, BARRY D&
PO BOX 1609 LESLIE, ROBIN R
SHERWOOD, OR 97140 15445 SW 150TH AVE
TIGARD, OR 97224
PHONE: 503-625-3100 PHONE:
FAX: 503-625-3108
FEES
Specifics: Date Amount
Description
Type of Use: SF Permit Fee-Additions,Alterations, 12/06/2017 $520.07
Class of Work: DEM Type of Const: Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 12/06/2017 $0.50
Dwelling Units: 0 11x17)
Stories: 0 Height: 0 ft Erosion Control w/Development 12/06/2017 $107.60
Bedrooms: 0 Bathrooms: 0
Value: $30,800
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $628.17
Required Items and Reports(Conditions)
Required:
1 Ersn Cntrl 503-639-4175
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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: Permittee Signature: /117 /9749/6 -/e
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
Residential FOR OFFICE USG ONE1
Received ,p
CityaPii of Tigard Date/B 1/ /7 /j Permit No/3 /7 0"',
C. 13125 SW Hall Blvd.,Tigard,OR 972.2„a,.,:- Plan Review `' ^
• Phone: 503.718.2439 Fax: 503.5 o e p ', Other Permit:
Inspection Line: 503.639.4175 s 1 I Date/Re
! 1 i ',!,17 p Date Ready/By: /s� Anis 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method� /7 < ic-i-I Supplemental Information
N 0 V 1 4 1017 s7'`7 -ii. %✓t Cfle c-
TYPE OF ow(j 1. , AM)f REQUIRED DATA:1- 2-FAMILY DWELLING
��ss1� � r �aI�"
❑New construction 3tql
pijttirC° ;S;C."1."
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
CATEGORY OF CONSTRUCTION work indicated on this application.
❑1-and 2-famil Y dwellin Valuation: $30,800
g ❑Commercialindustrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:15445 SW 150th Ave New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:River Terrace Crossing r/ Covered porch area: square feet
Cross street/directions to job site:East of SW Roy Rogers Road,South of SW Deck area: square feet
Bull Mountain Road Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Demo existing structures,fence,and gravel Valuation: $
Existing building area: square feet
New building area: square feet
121 PROPERTY OWNER 0 TENANT Number of stories:
Name:CDCG 4 WLH 2 LP Type of construction:
Address:703 Broadway St Suite 510 Occupancy groups:
City/State/ZIP:Vancouver,WA 98660
Existing:
Phone:(360)695-7700 Fax:(360)693-4442 New:
0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH LLC (Please refer to fee
Structural plan review fee(or deposit):
Contact name:Angela Grajewski
FLS plan review fee(if applicable):
Address:703 Broadway St Suite 510
City/State/ZIP:Vancouver,WA 98660 Total fees due upon application:
Phone:(360)695-7700 Fax::(360)693-4442 Amount received:
E-mail; PHOTOVOLTAIC SOLAR PANEL SYSTEMFEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:NW Earthmovers Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:13600 SW Galbreath Dr Solar Installation Specialty Code checklist.
City/State/ZIP:Sherwood OR,97140 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)625-3100 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:62761
A _ Total fee due upon application: $201.60
Authorized signature: 1 i This permit application expires if a permit is not obtained
lll..•///\\\"' 180 days after it has been accepted as complete.
Print name: A .C7ra'e u)Cir/ i Date: i( I 10111(iwithin
*Fee methodology set by Tri-County Building Industry
F^^ Service Board.
I:lBuilding\Pennits\BUP-RESPermi�pp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
T l c A u o Building Permit Review — Residential
Building Permit #: , ‘,//32o/7 -Co 303
Site Address: / /-1L-/j S
Project Name: �; � C,./etc e Cf,S5, Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review /
Proposal: Po ,y�n1.�sti A.5'1%''� S Fi
2t Verify site address/suite#exists and active in permit system.
ge-R.iver Terrace Neighborhood: ❑ No 'Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
ies of site plan 1717mistrg-structures on site
aSite-platrrrrust be on 8-1/2"x 11"or 11 x 17"paper - -Fvetprirrtaf-new structure(including decks)with finished
ale(standard architect or engineer scale) floor elevations
drraw— s&easements(required for new and additions)
mess, oject or subdivision name and lot number atidevratritlriveway approach
I-I a..pliea. -i ormation(name and phone number) (4;14=eratiun of wells/septic systems
,, nt et-dimer is and building setback dimensions PFY;s„ng trees to be retained with drip line,and tree
C�Squaw footageof buildings to be demolished protection measures
of MT-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) ❑street names
nn..,,pe..ty corner elevations(2 foot contour lines if more than ...11660 sf of impervious area created or replaced? ❑Yes El No
4 foot differential)til) 4f yLN is a 3r water quality facility shown? ❑Yes ❑No
Clean-Water Services-Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
u c s Improvement (PFI)Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
and Use Case#: 5--0t3 _C.)QO/3 PPeaD/6 - Q / ivv
°ring: R-Q(P17)
a-Required-Setbacks: Front Rear Side Street Side Garage
E Landscape Requirement:
o Coverage Maximum:
$-Btriltiitrg�Ieight: Maximum Height Actual Height
n Vicnal Clparane
la_Se. •_ - Later ❑ Yes ❑ No Type
,n Fores Plan
"Met"prior to issuance of building permit
Notes:
Approved By Planning: "��` Date: i tA1 j/7
Revisions (after Building Submittal on y Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\B1dgPermitRvw_RES_061417.docx
Building Permit Submittal
Original Submittal Date: 4// 11//7
Site Plans: #
Building Plans: # /1/ e
Building Permit#: Enter building permit#above.
Workflow Routing: Tanning engineering e'Permit Coordinator ❑ Building
Workflow Sign-off: U-Sign-off for Planning(include notes from planning review)
Route Application Documents: D-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
lJ 1 Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: 1,I'
By Permit Technician: "/__ ___i Date: ////7,//,
Engineering Review
❑ Slope at building pad:
❑ Conditions "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: 11A I GG A Date: 113io 17
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
IN-Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes: cketrY10 °Nil
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: ❑ Yes 1 ► /A
Tigard Trans SDC: ❑ Yes n N/A
Parks SDC: ❑ Yes • N/A
LIDA ❑ Yes ❑ ' /A
> OK to Issue Permit
Approved by Permit Coordinator: Date: (?i1, r
I:\Building\Forms\B1dgPermitRvw_RES 061417.docx
Pacific
Community
Design
Transmittal
DATE: November 14, 2017
TO:
City of Tigard
RE: River Terrace Crossing Demo Permits
PROJECT NO: PDR2016-00016
Via:
® Messenger: 0 Mail ❑ Overnight ❑ Pick-up ❑ Electronic
Rush / Route
❑ Fax pages (including this page) Fax No.
Transmitted:
❑ FOR APPROVAL ❑ FOR REVIEW AND COMMENT
® FOR YOUR USE ❑ AS REQUESTED
❑ MYLARS TO BE FILED
Attached:
COPIES DATE DESCRIPTION
2 11/10/17 Building Permit Applications for two separate demo permits
4 Demo site plans
REMARKS:
SIGNED:
Eric Ha son
Mail: 12564 SW Main Street, Tigard, OR 97223 Phone: (503) 941-9484
Website: www.pacific-communitv.com Fax: (503)941-9485
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15445 SW 150TH AVE, TIGARD, OR, 97224 December 27, 2018 at
12:05:44 PM
Record Type: Record ID:
Residential - Building BUP2017-00303
Inspection Type: Inspector:
299 Final inspection Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor