Permit (101) tai
CITY OF TIGARD MASTER PERMIT
P 11. ' COMMUNITY DEVELOPMENT Permit#: MST2017-00463
T) ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/19/2017
Parcel: 2 S 106DA01300
Jurisdiction: Tigard
Site address: 13247 SW 169TH AVE
Subdivision: RIVER TERRACE EAST Lot: 13
Project: River Terrace East, Lot 13
Project Description: New SFA.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 115 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 646 sf Garage: 543 sf Front: 8 Smoke
Dwelling Units: 1 Third: 633 sf Right: 0
Detectors: Yes
Total: 1394 sf Value: $189,143.97 Rear: 5
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: 2 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
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'500 at: 2 201-400 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 SFA VB R-3 1394
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: $24,305.67
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�oobbttaina copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: .�iii' "�� Z�ZZs-hePermittee Signature: e5e2* Ili /!.l°2� --(
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 Z—O 7 /3
Residential -f--7.-` ' '' FOR OFFICE l SE O\Ll
City Of Tigard AU rr t Received /� PermitNo.'
IllR 13125 SW Hall Blvd.,Tigard,OR 972AU G 2 2 20 17 plan Revieti o2? /7 �� /'���
Q Phone: 503.718.2439 Fax: 503.598.1960 Date/By: J�--61.---*)-1 Other Permit. /7
T 1 c R D L'..,,,:'t Inspection Line: 503.639.4175 ,, Date Ready/By: / �j/ 2 4 Juris: El See Page 2 for
Internet: www.tigard-or.gov ;L Notified/Method:/�/�7 '! 4 Supplemental Information
e,1//.— /1/'el*1 E-
®New construction ❑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
/ '' t .,, r , 4` work indicated on this application.
1-and 2-family dwelling 0 Commercial/industrial Valuation: $ Ilt7t7/4/3 .-4/
❑Accessory building n Multi-family Number of bedrooms: "Z II 8 '1 9.1
❑Master builder ❑Other: Number of bathrooms: il. 3
k,- - `-'-. t d g"s t •`AET6 "tr" 1� A' Total number of floors: 2_ 19 3-7
Job site address: /-32/../7 SvJ 11p`"L V New dwelling area: /339 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 5/.43
square feet 6 33
Suite/bldg./apt.no.: Project name:River Terrace East 7rkCovered porch area:,( square feet 6'1 6
Cross street/directions to job site: Deck area: 9 square feet 1 1 —
6e%fis coy.,
—Other structure area: square feet
¢.":" r,, ,. « s¥,„:'^ b _9. 2%,-,4„..,,,,,4.4
Subdivision:River Terrace East Lot no.: (3 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
t C e ;e °Edo ` t t : work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
I ' r8 µ � .,,��' tR W ,4 ' r Number of stories:
4. „ a-, . F ,Siq,_ r. ®ate, x .,,�,s_.� <a 'A_ e,I?•, ,,. �.M
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
' FLS plan review fee(if applicable):
Address: 7 03 OaabilSk- 1SU ll . SID
Total fees due upon application:
City/State/ZIP:Vancouver WA 9866
Amount received:
Phone:(360)695-7700 Fax::( )
rii"E-mail:Nichole Thorpe t , ,;,y 1 r lor
4 Commercial and residential prescriptive installation of
P
t,.,11,4-r=1.4.4,- ' . ",, „ . , ", roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Poi im LH l Submit two(2)sets of roof plan with connection details
Address: 1C)3 g��w� Sfi I ��L1 kk. �, O and rfiInstallatione dtmenp Specialty
Calodeng checklist.wc the Oregon
Solar S ecial Code
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: $201.60
Authorized signature: / -/ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Nichole Thorpe Date:06/16/2017 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
.., -
Mechanical Permit Application ; , ; , ' '2 i 1,,; FOR OFFICE USE ONLY
City of Tigard
Permit No/t/S 7:72.ev 7-a,v.6 s
'11 13125 SW Hall Blvd.,Tigard,OR 97223 ! ' • , plan Review
III
I Phone: 503.718.2439 Fax 503.598.1960 ' Date/By: Other Permit
TI GARD
Inspection Line: 503.639.4175 : _
Date Ready/By: rune B SeePage 2 for
Internet www.tigard-or.gov Notified/lvIethod: Supplemental Information
'e:A4191AVESIVIVIt4- 4-RiWg::::4t10,71raatI731,41#'2',1,1?
Mechanical permit fees*are based on the value of the work
El New construction 0 Addition/alteration/replacementperformed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit
Value:$
voi.,...rmatv.rnvarkid-akifitleswloozvat-Nsvm .: .'7,41.;iiis•-iiiirijik-eiviitawsiglig.§-migi---Rir•-,,
• __., 1-and 2-family dwelling 0 Commercialimdustrial 0 Accessory building For special information use checklist
'Multi-family 0 Master builder 0 Other: Description Qty. Eu. Total
04%rre-Al.-'544-00#"..k-W144#71ePli It 40,--4.1.**#afeiggig.tV Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address: I3Li.n Sy kucith Nei Furnace 100,000 BTU(ducts/vents) 1 , 46.75
City/State/ZIP:Tigard,0R97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:River Terrace East
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 2332
Residential boiler(radiator or
hydronic) 23.32
Unit beaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 1 2332
Other 2332
Subdivision:River Terrace East Lot no.: i.3
Other fuel appliances:
Tax map/parcel no.: Water heater 2332
;-IPiikra-7:4%1:6'4Z;F:5N4:;Vise.—ruitOl4f tiii:,*,000,-,0-f,tt{:i.A7-1114,1?;%iikiiiiM Gas firePlseerieserL 1 3339
....1 '''''''''•7'''''•''• '' '''- 7'''. •'• ''' ' - ' ' ' ''''' ''''' 7'''' ' ' 7' — • Flue vent for water heater or gas
fireplace 23.32
_
Log lighter(gas) 2332
Wood/pellet stove 33.39
. Wood fireplace/insert 2332
Chimney/liner/flue/vent 2332
2332
:40**ttO -iti#P. -:. t.'''''$);;7.''''''":'"i1:17.1.FROTA4-::'-.1.:,?: :.; Environmental exhaust and ventilation.
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment 1 3339
Address:7600 E Doubletree Ranch Road Clothes dryer exhaust t 3339
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, i_
toilet compartments,utility rooms) '`'l 23.32
Phone:(602)694-4031 Fax( ) Attic/crawlspace fans 23.32
C: WAPigtlf*.4:02,0-1.. .: a . 1:1A-.6*.t.W7*X0414.,:i0<1; j. Other: 2332
Fuel piping
Business name:William Lyon Homes,Inc.
S14.15 for first four;$4.03 for each additional
C°11tlet name: 31 CA/D -e,IkA OIrct Furnace,etc. 1
Address:1p) MarAiVj al 1/4S-t- S\j‘k . Si 0 Gas heat pump
Wall/suspended/mit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax:(360)693-4442 Fireplace 1
Range
: 1
E-mall:PEU 1 CAM te... INV 0\09er.ine PlAkIsnrYAVOIYIeS •f Anti Barbecue .
14.-. ;-:+;-:4-; Clothes dryer(gas) _
Business name:Pn hfiaMo Otyy ,t)0\InI t f\ --ry\r, Other:
:44-''4.1211.:2.:7_ :-:—.L.—.1:::''lil 71. VE.:10,ctr-V::•::-:.-iT?i
I rr
Address: etnqs-- t \>,1 .1N\ c..\. oft SlkNk f. 11. 1 Subtotal _
City/State/ZIP: - \\SIOn k)X,L- Lc, 1 0,-)1 Mixaimuin permit fee($90.00)
Plan review(25%of permit fee)
Phcaae: ti"-)))4.6... clo41_, Fax:61-b) atL\1''' c0-17- State surcharge(12%of permit fee) _
CCB lic.:2.01 Doi TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
. , days after it has been accepted as complete.
..
Authorized signature: 444„, -(A, „0---- . Fee methodology set by Tri-County Building Industry Service Board
Print ntime:M t',/4 gji7l11 NW-- Date:
1
Electrical Permit.Applistation FOR OFFICE USE ONLY
Cityof Tiand Received
,D r't' To26►/7- l
Permit�`
13125 SW Hall Blvd.,Tigard,OR 97223° '; f . `Plea Review
Ilv/6`" Phone: 503.7182439 Pax: 503.598,1966 batem. Related Permit it:
Inspection Line: 503.6394175. El See Page 2 for
Read Date/By. 7nris
TIGARD lntemet:•wwwtigard-or.gov Notified/Method:Method: SapplemenfalI Information
__f -- fes r'rlAT: .. ':rdfL'.a oAg.fv,,,:o.. -'-g ..� - 3 ',A F 3 2'w
®New construction Q Addition/nitration/replacement Please check all that apply(submit z sets of plans wiitoms checked):
Q Demolition 0 Other: ❑Service or feeder 400 amps or more ❑Building over dare stades.
where the available fault current ❑Marinas and boatyards.
, " �='. =r C-=EV1I M.'`is As. r£°)'i-tLi7: ;' _ exceeds 10,000 amps at 150 volts or [ZI Floating buildings
-and 2-family dwelling Q Commercial/iridlistrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
Multi-family = 0 Master builderamps for all other installations. . buildings.•
v 0 Other: Te pump. Cl Installation of 150ICVA or
41:-
a b �...�.,' ,w — is :1-`,- _ f 0❑emergency system. larger separately derived
^� ❑Additionofnew motor Toad of system.
Job# Job site addre.�' 1 S J '1.p� pa e_., 1L:ormme. ❑"A",s',u1-2^,'1-3°,
City/State/ZIP:'ISgard,OR 97224 13 Six or more residential units occupancy.
❑ldeatth-eao faor'lities. ❑Recreational vehicle pads.
Suite/bldg./apt#: 1 Project name:g1veh°-Tern (..e £4f ❑Rsearnzarc1ie°::t1raadteOna
60.0 amps or more. 0 60Sppv`olvtsnotamore
tu
Cross street/directions to job site:
Derciprion I QtY. Bach Intel a
• New residential single-or multi-family dwelling unit
Subdivision f'j ;,/p r (f, •'� „ t.,►- Lot ii �21 Includes attached garage.
Tax map/pareel#: �1 .--/' 1.000 aq.R or less I 168.54 4
Ea add'I500 sq ft or portion I 33.92.
, .2,,f,;5.,::•,.. .'-:21.-.4i--.7-_, 4 I tit.Iir t-er :a a folia :` -x- r :51 Limited energy,residential 1_
(with above sq.It) 75.00 2
Limited energy;,multifamily 75.00
residential(with above sq.d•) 2
7-1
z,; ��41f3 3s)�f�s��r " �, _ �� ��a��^ 3aE . sa,.._ Renewable Energy El See Paget
Services or feeders installation,alteration,and/or relocation
Name:ADVL Land Holdings,LLC 200 amps or less 10020 2
Address:7600 R 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
Rrnat1; Temporary services or feeders installation,alteration,and/or
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 1 2
Owner signature: Date: . 401 amps to 599 amps 16854 2
-;'A ,.' 2,'?t t S tib z.s,,y't; "�,t '�.�„,,m T.c2 tki, E'r t- Branch eri moreui s—new,alteration,or extension,per panel
..,., 4 � -50L-,,,,,,,,,73,,,,,w.: A.Fee for lxarteh eircoits tui&
Business name:William Lyon Homes,Inc, above service or feeder fee, 7.42 2
L ''nn each branch circuit
Contact name: N'rho o ririm, B.Fee for branch circuits without
service or feeder
Address: 103 (3T-Oac Ja/ St S11UO1—+ \ U branch circuit fee,fust 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each add')branch circuit 7.42 2
Miscellaneous(service or�fexder not included)
Phone:(360)695-7700 ' • ' , Fax::(360)693-4442
Email;
1 dwelling,stxvice anchor feeder 67.84 2
m ; i► 14.P t1 L ,PQ #p 4 rnP Reconnect only 67.84 2
µ" r.�" ;.' ,� ;PSC c�,-I31‘:--'.T .:-:"V:.,17 --h,,:,:..-?-=t-V_•,'''''':---i-•:7-7i" `s3"s7 Pump or miggaton circle 67.84 2
Business name:Garner Rlect-ic Washington,LLC Sign or outline lighting 67.84 2
Signal Address:,C„I,07 v l)✓1,Q p- ri0„ `� S u:..),\47, t'�y/ tenet,alteration,or odensr'or on.ergy ❑ See Page 2 2
City/State/M: i.k t ! >'" Q gyp, !`••"� Each additional Inspection over allowable in any of the above
Phone:(253)320-1657 Q'!�t ' "V� ( Additional inspection(I hrm� 6625/hr
tit Fax:( ) Investigation(1 hr min) 90.00/hr
RmRil•bdaniels@gwensa.com Industrial plant(I heroin} 78.18/hr
Inspections forwMchno f=b 90.00/hr
CCB Lic.: C115'8 Electrical Lic.: 208174 Saprv.Lir,: 44965 s'-cificalty listed 44'- 40
= 1
Suprv.Electrician signature,required:7.-B.--11 117Pa - jt r ��Required(25%o�r z`lat 4 �,
Print name: Joan P Albert Date: 4/26/2016 0 Plan Review Subtotal::
<-
f permit ties);
C ®--'s, State:surcharge(12%of permit fie):
Authorized signatr'e: "" ---- - TOTAL PERMIT REE:
,`• Print name: Bill Daniels Date: 4/26/2016 This Pitt d aftaro u`ha;b If Spa l=not to obtained within 180
Y cceptedascomplete,
:ie * inspections perpermit
� Number allowed
ll..lBdldieaReoaualn.Cierink/gp EL8•Esdoe Rev 06(1712015 a4oa6rsT(irro51COlvUvl7as
.. •
Plumbing Permit Application ; ' ?`,2117
Building Fixtures ,
City of Tigard - ,` P.ec•mit N°•l.S y 7-Oe v63•
II,- • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.7182439 Fax: 503.598.1960 elgy.; OtherPermit No.:
TIGInspection Line: 503.639.4175 Dam R yiBy; Jude Si See Page 2 for
Internet: www.tigard-or.gov Notidedfidet ed: Supplemeatst Information
• 4-:1':.• .i •';TJ.. . •!` as.
. '1 .f8i•
4. ' .�'. f .
'i`1uifEEd•� LrCI
V :' .
EINew constructions .. � � 13i' 7►V❑Demolition For spec&&formafloa use checkist .
,Description I Qty. 1_ Ea. J Total
❑Addifion/aitetetion/mplacement 0 Other: New 1-2-family dweliings(includes 100 ft.for each utiii cormection)_
• t -- :. : ,. 5 kn(o ;dir biq - >:. .:=A ~ ' SFR(1)bath 3I2.70
_1-and 2-family dwelling 0 Cotnmerciali<mdustrial SFR(2)bath 437.78 ',
❑Accessory building XMulti-family SFR(3)hath 4 50032 .
. . Each adclitional bath/kitchen 25.02
❑Master builder.' ❑Other: Fire sprinkler(_____sq.R) Page 2
' =1
`F ' i)*V 11&11 ATO: f tidbC1i1.t'1 }"` Site utilities:
J
Job site address: I QU.i 1^ 5 J t`Q 00+), { '�.e, Catch basin or area drain 18.76 .
City/State/ZIP Tigard,OR 97224 I " Drywell,leach line,or trench h drain 18.76
Footing drain(no.linear IL:_j Page 2
,Suite/bldg./apt.no.: f Project name: Z Vi°it Tex f-e CDA- Manufactured home utilities 50.03
Cross street/directions tojob site: Manholes 18.76; I
Rain drain connector 18.76 ,
Sanitary sewer(no.linear ft.: ) . Page 2
Stoma sewer(no.linear IL:_) Page 2
-� .Water service(no.linear it.: ) Page 2 :
Subdivision: (v.eiY- �'e , frjAs+- Lot no:,13 I Fixtnre•or item:
Tax map/parcel no.: Backflow prevetttn . . . 1
3I27
• .- *.�:_.: ,.- ,P- . _- _.. Backwater valve I 12.51
Clothes washer 25.02
Dishwasher . : 25.02
1
Drinking fountain 25.02
EjeCxots/sump ' 25.02
`�' : : Kh. Expansion tank 12.51
Name:ADPL Land Holdings,LLC Firtutelsewer cap 25 02
Address:7600 E Doubletree Ranch Road Floor drain/floor sink/bob 25.02
Garbage disposal , 25.02
City/StatedZIP:Scottsdale,AZ 85258 Hose bib 25.02 _
Phone:(602)694-4031 Fax:( ) tee maker 12.51
' . .'`.m_:"L- ' '::: .c : .:''0• ' Y;: ! Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:$ ) 2
Contact name: \Gha2.1\- Primer 12 51
r^� ,,,p Roof drain(commercial) 12.51
Address: I b3 ( -rood ko ("e.. .0 in/lavatxxy 25.02
City/StatetZIP:Vancouver,WA 98660 Solar units(potable water) . 62.54
Phone:(360)695-7700 Fax::(360)6(93-4442 Tub/shower/showerpan 12.54
E-mail"L I 1 1 " IA 1 &• " 971 \or\kg\ PS •�(� urinal i 25.02
,�_ i ±.. •n r 1.::1 -•_r. . r Water closet 25.02
Water3eater •
3752
Business name:Alliance Numbing LLC Water.piping/DWV • 56.29
Address:146 W historic Columbia River Hwy Other; 25.02
City/State/ZIP:Troutdale,OR 97060 Subtotal
Phoae:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50
CCB Lie.184601I Ali Numbing Linc,no.:P13732 Plan review(25%ofpermit fee)
State surcharge(12%of permit fee) ,
Authorized signature: j A / TOTAL PERMIT FEE
Print name:Robert Dishiness Date 5/2b2016 rids permk'4Ppitsatton aspires fa perm-kis nut uiotained stititirt If*days
after It las bees accepted accomplete.
*Fee methodn1ogt set1y Tri-County Budding Industry Service Board
t.uBuitdinBvktmim PPennitApp.doe toms 4404516T(19/(12ICotewsu}
City of Tigard
N COMMUNITY DEVELOPMENT DEPARTMENT
I
T 1 c A a D Building Permit Review — Residential
Building Permit #: /j(` 11^e0 1-16.3
Site Address: )L / i11P SI iP
Project Name: !�-'VQr- '---77-61n2 Ce_ 4,qT Lot #: /_
ew dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review l�
Proposal: �)/�) �'/� 49 u / C t� /1 ti l
IS- Verify site address/suite# exists and active in perxntt stem.
M River Terrace Neighborhood: ❑ No 4d Yes,See River Terrace Review Addendum Attached
S. e Plan Elements:
ree(3)copies of site plan :
:sting structures on site
tte plan must be on 8-1/2"x 11"or 11 x 17"paper YA Footprint of new structure(including decks)with finished
raven to scale(standard architect or engineer scale) i'or elevations
1110).(orth arrow YA 'ty locations&easements(required for new and additions)
e address,project or subdivision name and lot number idewalk/driveway approach
plicant information(name and phone number) ation of wells/septic systems
��At dimensions and building setback dimensions 'P*sting trees to be retained with drip line,and tree
al 0•„are footage of buildings to be demolished otection measures
et Lot area,building coverage area,percentage of coverage and Lip S eet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street names
N 'roperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? !ld Yes ❑ o
4 foot differential) If yes,is a storm water quality facili shown?i ❑ es MN,
an Water Services—Service Provider Let (lot platted prior to 9/10/1995): T' r cotte A _
equired: ❑ Y ,applicant was notified `Ui No Received: ❑ Yes ❑ No
Public Faciliti Improvement(PFI) Permit:2Q PP�0/co C c
Required: Yes,applicant was notified ElVLJ No {{ Applied For: Yes ❑ No,stop intake
�nd Use Case#: P�� )// , 'p// .P.A'-s.2t)1Lo—( o P�,�'c (o Lc-oZ, (e
qd Zoning:
Required Setbacks: Front 0 Rear `e. Side d Street Side Garage'Q
Landscape Requirement: 0/0
of Coverage Maximum: 9r) '
1Ti Building Height: Maximum Height 01+. Actual Height
S Kisual Clearance
A,k/ensitive Lands: ❑ Yes �No Type
Lid' Urban Forestry Plan
❑ Conditions "Mer"prior to issuapce of b ding permi
Notes: ail D-2 S, // J& 27197 -- ,gg1, 1 _
Approved By Planning: -_ /;/j
Date: 11,
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
Building Permit Submittal r
Original Submittal Date: V1-�—/i7
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: Planning Engineering Permit Coordinator 7 Building
Workflow Sign-off: Sign-off for lanning(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.
7 Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
i
By Permit Technician: /( �l j� Date: ll 4-)//7
Engineering Review7
,' 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: 0 Yes ,B'No
Assess Water Quantity Fee in-lieu: ❑ Yes ,Q No
LIDA Facility on lot: ❑ Yes ..a-No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: M (KI co , Date: /( I.,:y, 7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
Nisenvoloannaum
Permit Coordinator Review
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: :d Yes ❑ N/A
Tigard Trans SDC: I. Yes ❑ N/A
Parks SDC: - Yes ❑ N/A
LIDA ❑ Yes X N/A
,M. OK to Issue Permit
Approved by Permit Coordinator: i ( ( Date: I Z{41(7
I:\Building\Forms\BldgPernritRvw RES_061417.docx
..
INI I City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T I c AR D River Terrace Building Permit Review Addendum
pc.....,,,—..,.. ti._.a —,sc-Wv:.,v: ... ,.... .4"o.,,3a'++s.' �w.p.,^w?,�c^Apv`m°'Cdti 2*nYl$,4?''�"$p-,3 3'pvs�4S2:t5pp`., .,s. .a-.:,:. '.4Y
Building Permit #:
Site Address: 23047 civ / / 4 ui
Project Name: yc- i7�Gc � -- Lot #:(New ling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Dist ' t Design Standards (18.660.070.1):
Is the project subject to the plan district design standards?Ai Yes ❑ No
1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional
element requir d 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. ft. deep ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide Gabled dormer
❑ III ❑ ❑
2. Eyes on the street: a minimumJof 12°/ of each street facing facade must include windows or entrance doors.
/
Percentage Shown: • g D
3. trances:At least one entrance must meet both of the fo wing standards:
Max. 8 ft. setback from long street-facing wall Parallel to street,angle no more than 45°from street,
or o en onto porch
Entrance opens to a porch: Yes ElNo
If es,all the following apply:
5 5sq.ft.min.
ne street facing entry 2 ft.max.roof above floor of porch
IV 5 ft. depth min. 30%min. porch roof coverage
ietailed Design:All buildings shall include a min. of five of e following elements on all street-facing facades:
overed porch min. 5 ft.wide x 5 ft.deep Recessed entry area min. 5 ft.wide x 2 ft. deep
❑ Vall offset min. 16 inches ❑ pormer min. 4 ft.wide
Roof eave min. 12 inch projection VRoof offset min.of 2 ft.
❑ Roof shingles either tile or wood El Gable,hip or gambrel roof design
❑ it
oof pitch oriented south min. 500 sq. ft. ❑ orizontal lap siding min. 3-7 ft.wide
Accent siding min. 40%of street facade indow 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 façade
5. Garages and Carports:May face the front or side lot line on a corner lot.
Setbacks:
No loser to front or side lot line,than longest street-facing wall. ❑ Yes 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.
WI. : (Check one)
1V 12-foot-wide garage door ❑ 40%max. of street facade
❑ 50%max.of street facade with 7 detailed design elements
Notes:
Approved By Planning: _ 1, _ Date: / /7j
I:'Building\Fonns\Bldgl ermitRvw_RES_RT_031416.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13247 SW 169TH AVE, BEAVERTON, OR, 97007 August 9, 2018 at 1 :14:48 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00463
Inspection Type: Inspector:
699 Mechanical 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:
13247 SW 169TH AVE, BEAVERTON, OR, 97007 August 9, 2018 at
12:27:32 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00463
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Previous corrections completed.
A/C installed
Violation Summary:
Inspector Contractor
Plumbing Permit Applic EIVE1
Building Fixtures FEB (� Q, FOR OFFICE USE ()NEN
City of Tigard B 6 2018 Received
114 2 't 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: ���� ��6 Permit N/1/...r,--26,-,/2�i�9/6
Phone: 503.718.2439 Fax: 50C5Iffvf) 'TIGARD Plan Review
h� Date/By: !'ph`, .4L6 Other Permit No.:
TIGARD Inspection Line: 503.639.4175 �IVl���l�l
Internet: www.tigard-or.gov BUILDING1 1�1 Date Ready/By: auris: ® See Page 2 for
Notified/Method Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist
0 Addition/alteration/replacement 0 Other: Description Qty. Ea. Total
New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath 500.32
0 Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler(lsq,
ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities: /35,g(
Job site address: 13247 SW 169T"Ave Catch basin or area drain 18.76
City/State/ZIP: Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:River Terrace East
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 ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Lot no.: 13
Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve
DESCRIPTION,OF WORK' 12.51
Multipurpose Fire Sprinkler System Clothes washer 25.02
Permit# MSTZO t 7- 004 lag
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
CI PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:Polygon Northwest Fixture/sewer cap 25.02
Address:703 Broadway St.Suite 510 Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660
Hose bib 25.02
Phone:(360)695-7700 Fax:( ) Ice maker
0 APPLICANT 12.51
❑ ONTAT FEI�SfJN Interceptor/grease trap 25.02
Business name:Alliance Plumbing,LLC Medical gas(value:$ ) Page 2
Contact name:Gavin Thomes Primer 12.51
Address:146 W Historic Columbia River Hwy Roof drain(commercial) 12.51
Sink/basin/lavatory 25.02
City/State/ZIP:Troutdale,OR 97060 Solar units(potable water) 62.54
Phone:(503)492-3490 ! Fax::(503)912-6438 Tub/shower/shower pan 12.51
E-mail:Gavin@AlliancePlumbing.net Urinal 25.02
CONTRACTOR Water closet 25.02
Business name:Alliance Plumbing,LLC Water heater 37.52
Water piping/DWV 56.29
Address: 146 W Historic Columbia River Hwy
Other: 25.02
City/State/ZIP:Troutdale,OR 97060 Subtotal
Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50
CCB Lic.:184601 Plumbing Lic.no.: PB732 Plan review (25%of permit fee)
/�..� 77E-.---, State surcharge(12%of permit fee)
Authorized signature: r {
TOTAL PERMIT FEE
Print name:Gavin Thomes Date:2/5/2018 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.
I'VBuilding\Permits\PLMU-PennitApp.doc 10/01/09 440-4616T(I 0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. F!e(ea) Total Square Footage: Permit Fee:
Footing drain-151 100' 50.03 0 to 2,000 $121.90
37.52 2,001 to 3,600 $169.69
Footing drain-each additional 100' 3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Qty. Fee(ea} Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
Subtotal:
Other Fixtures:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quantity by Fixture Type
Fixture Type for Replace/ Plan Review for Plumbing Installations
Work Performed: Capped Added Relocate
Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath -Tub/Shower ❑ Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru
Cuspidor/Water Aspirator ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
Dishwasher -Commercial
-Domestic ❑ Medical gas and vacuum systems for health care facilities.
Drinking Fountain ® Any multipurpose fire sprinkler system.
Eye Wash ❑ Any complex structure as defined in OAR918-780-0040.
Floor Drain/sink -2"
3„ Submit 2 sets of plans with any of the above.
Car Wash Drain Isometric or Riser Diagram
Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related
-Commercial-food related that meet the qualifications above.
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station)
Rec.Vehicle Dump Station Comments regarding fixture work:
Shower -Gang
-Stall
Sink/L.av -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this permit results in an
Water ExtractorWater increase of sewer EDUs,a sewer permit will be issued and
Urinal Closet Toilet
fees assessed for the sewer increase must be paid before the
https://allianceplumbing-my.sharepoint.com/personal/gavin_allianeeplumlng_net/Documents/Documents/Fire Sprinklers/RT/City of Tigard
Permit.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13247 SW 169TH AVE, BEAVERTON, OR, 97007 August 13, 2018 at
10:51 :41 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00463
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