Permit (144) CITY OF TIGARD SITE WORK PERMIT
COMMUNITY DEVELOPMENT Permit#: SIT2018-00004
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/26/2018
T TGA,P.T Parcel: 2S106AD08900
Jurisdiction: Tigard
Site address: 16952 SW LEMONGRASS LN
Project: River Terrace East Subdivision: RIVER TERRACE EAST Lot: 196
Project Description: Retaining wall in front of lots 196-207.
Contractor: WILLIAM LYON HOMES INC Owner: WILLIAM LYON HOMES INC
703 BROADWAY STREET, SUITE 510 BY POLYGON WLH LLC
VANCOUVER,WA 98660 ATTN GAST, FRED
109 E 13TH ST
VANCOUVER,WA 98660
PHONE: 360-695-7700 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 03/26/2018 $674.92
Plan Review 03/26/2018 $438.70
Type of Use: COM 12%State Surcharge-Building 03/26/2018 $80.99
Class of Work: ALT Erosion Control w/Development 03/26/2018 $161.40
Info Process/Archiving-Sm$0.50(up to 03/26/2018 $18.00
Project Valuation: $75,000.00 11x17)
Site Specifics:
Excavation Volume: cu.yd.
Fill Volume: cu.yd.
Impervious Surface: sq.ft.
Engineered Fill: Soil Report Required:
Paving: Grading:
Landscaping: Site Prep:
Storn Drains: Retaining Wall: Yes
Fire Underground: Accessible Parking:
Fence:
Total $1,374.01
Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
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 folioz rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. ...may obtain a copy of the rules
or direct questions t• •UNC by caving 503. or .2344.
Issued By: ermittee Signature:
/ir/;,L '
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
rS ? ct�b
- ;'°.. FOR OFFICE t'SE ONLY
City of Tigard 1 Received
II 4 gab% �� DateBy: t) I -- Permit No.: , � })1 8-,� ui
13125 SW Hall Blvd.,Tigard,OR 97223* ii e )PI Review O
Phone: 503.718.2439 Fax: 503.598.1960 ‘1\1.\\N
. 6- i
M� 9 � y.
Other Permit:
T I G n R D Inspection Line: 503.639.4175 ;�� ate Read B
V�6 �1��. y y: kris: El See Page 2 for
Internet: www.tigard-or.gov ,�'� - Notified/Methocc
(,' ��' / (� Supplemental Information
ii Su le
❑New construction ❑ mol
Demolition Permit fees*are based on the value of the work performed. ry
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ®Other:retain wall equipment,materials,labor,overhead,and the profit for the
/
"� ti t e' work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
0 Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
�O t ° i i t 1 r t". Total number of floors:
Job site address: t; el c- .-L J 1 nh. .,� - _ New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Polygon at East River Ter Covered porch area: square feet
Cross street/directions to job site: Deck area:
square feet
Other structure area: square feet
�' i s i,oAte! 1 d d 1
`>;zbdivision:Polygon at East River Terrace t ' r.. ' r
Lot no.: Permit fees*are based on the value of the work performed.
I Tax map/parcel no.: fq(P-.2-0 7 Indicate the value(rounded to the nearest dollar)of all
equiP ment,materials,labor,overhead,and the profit for the
ke . O,t:. w,,•' A# , ' % work indicated on this application.
ETA1w,d/6 teAu, Air f�rtrr OF (/TS r0OF ro Valuation: $75000
ToPo640444f OF (j % - / //:/ 7-71-&---76-44.7— Existing building area: square f et
New building area:
square feet
Number of stories d®0i4 # T �. �
Name:ADVL Land Holdings,LLC
Type of construction.
Address:7600 E Doubletree Ranch Road,Suite 700
Occupancy P Y groups:
City/State/ZIP:Scottsdale,AZ 85258
Existing:
gone (602)694 4031 Fax ( )
I �� 4"--)4i.:::'4'031 . ., �.. ,,, ��i New:
.. / /� - mac.. / \�;:' ` k� '�''. �`
Business name:Polygon WLH,LLC .� t � ,•, ,� „ ;.� ;,
Contact name:Tom Dicianno
Structural plan review fee(or deposit):
Address:109 East 13th Street FLS plan review fee(if applicable):
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(503)577-4160 Fax::( ) Amount received:
E-mail:tom.dicianno@polygonhomes.com
B \ 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 $180.00
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: $201.60
Authorized signature: This permit application expires if a permit is not obtained
.---- --.... °
� within 180 days after it has been accepted as complete.
Print name:Tom Dicianno Date: 3 \yg`$ *Fee methodology set by Tri-County Building Industry
)c,10 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard: Site Work Permit Checklist
•
Page 2-Supplemental Information
Commercial,Multi-Family and One-and Two-Family Dwellings:
No permit is required if fill is less than 50 yards(5 dump truck loads), or less than 3 feet deep and will
not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If
fill is in a flood plain,drainage way, or wetland,the applicant must apply for a sensitive lands review
(SLR).
Please complete all items below,unless otherwise noted.
Excavation Volume: cu.yds.
Grading Volume:
(Soils report required for>5,000 cu.yds.) cu.yds.
Fill Volume:
(Fill exceeding 12"in depth shall be compacted to
90%of maximum density) cu.yds.
Retaining structure? (Check one) ZrRock
CMU
❑ Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks, and .avin::
s•. ft.
Site Utilities Plumbing Work:
Complete the Plumbing Permit Application for site utilities plumbing work.
Plans Required: See"Site Work Permit Application-Plan Submittal Requirements"attached.
The following must accompany this application:
❑ Site Plan with Vicinity Map showing ADA ❑ *Parking(including ADA)and Lighting
compliance Plan
❑ Grading Plan and details ❑ *Landscaping Plan
❑ Erosion Control Plan and details ❑ Soils Report(if required)
❑ Retaining Structures
*Does not apply to One-and Two-family dwellings.
Plan Submittal: Permit Fee:
F,t4 ,,,i 8[t5 ",, �A
.:4411��yidV '° s �' ?.7-EJ 1 te ik. __ o T a
$.00 to$500.00 $51.09 minimum omit fee
At- $500.01 to$2,000.00 $51.09 for thefirst$500.00 and
$2.69 for each additional$100 or fraction
Commercial 3 thereof,to and includin• $2,000.00.
$2,000.01 to$25,000.00 $91.44 for the first$2,000.00 and
$10.76 for each additional$1,000 or
Multi-Family R-1 Occupancy 3
fraction thereof,to and including
One-&Two-FamilDwellin 3 $25,000.00.
y g $25,000.01 to$50,000.00 $338.92 for the first$25,000.00 and
$8.06 for each additional$1,000.00 or
fraction thereof,to and including
$50,000.00.
$50,001.00 to$100,000.00 $540.42 for the first$50,000.00 and
$5.38 for each additional$1,000.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and over $809.42 for the first$100,000.00 and
$4.49 for each additional$1,000.00 or
fraction thereof.
I:\Building\Permits\SIT-PermitApp.doe 08/02/2016 2
ilkCity of Tigard
• p COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G a R D Building Permit Review — Residential
Building Permit #: gr-j--,9.4..)i -ill ,
Site Address: //q52 din) i'..,-,",,Yvr s S 1.41
Project Name: V : -r rrctcc t -t Lot #: 19(P-207
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: PC-17,11Y111(1 Wall IS
14 Verify site address/suite# exists and active in permit system.
21. 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
ite plan must be on 8-1/2"x 11"or 11 x 17"paper 493-Footprint of new structure(including decks)with finished
'1 Drawn to scale(standard architect or engineer scale) floor elevations
Pl• orth 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) `,"ocation of wells/septic systems
j,Rot dimensions and building setback dimensions +."xtsting trees to be retained with drip line,and tree
r
•uare footage of buildings to be demolished protection measures
M of area,building coverage area,percentage of coverage andtreet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40)
treet names
dein-E.-petty corner elevations (2 foot contour lines if more than >1,000 sf of impervious area created or replaced? [ ��e No
4 foot differential) If yes,is a storm water quality facility shown? ❑Y'ea No
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified X No Received: ❑ Yes ❑ No
A Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified CNo Applied For: ❑ Yes ❑ No,stop intake
.Land Use Case#: p7122011D -OOCX) k
,zoning: 12-2 St P 1))
1—f equired Setbacks: Front Rear Side Street Side Garage
N/ Landscape Requirement:
1 ` ' lLot Coverage Maximum:
(#716.-Building Height: Maximum Height Actual Height
'Visual Clearance
Sensitive Lands: ❑ YesNo Type
14*Jrban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes:
❑ Approved Byquirement: 7) -� Q Date: '3 121.0116
Revisions (after Building Submittal oniy)'
Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES 061417.docx
Building Permit Submittal
Original Submittal Date: 3/fir }�'
Site Plans: # ///
Building Plans: #
Building Permit#: er building permit#above.
Workflow Routing: ��iiiPlanning CrLLngineering ermit Coordinator E _ceding
[
Workflow Sign-off: ign-off for Planning(include notes from planning review)
Route Application Documents: [engineering: (1) copy of permit application, (1) site plan, (1) building plan and
aoral plan review routing form.
LYBuilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
,•- Date: o �l
By Permit Technician: li- — —
Engineering Review4—
❑ Slope at building pad:
Cl Conditions "Met"prior to iss ance 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 VNo
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: /17 L`' k. Date: /2. (2/1 8
Revisions (after Building Submittal only) Reviewer
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved El Not Approved
Permit Coordinator Review
(Nfpi-Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
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:
-SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC:
CI -N/A
Parks SDC: ❑ Yes 2<N1N/A
LIDA ❑ Yes A
XOK to Issue Permit kAC
Approved by Permit Coordinator: VO ` iV) � Date: 212 %,,I
i kg
I:\Building\Forms\B1dgPermitRvw_RES_010118.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16952 SW LEMONGRASS LN, BEAVERTON,
OR, 97007
Record Type: Record ID:
Commercial - Site Work SIT2018-00004
Inspection Type: Inspector:
499 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor