Permit (77) t, CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2017-00300
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/21/2017
Parcel: 2S106DA03200
Jurisdiction: Tigard
Site address: 13129 SW 169TH AVE
Subdivision: RIVER TERRACE EAST Lot: 32
Project: River Terrace East, Lot 32
Project Description: New SFA.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 97 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 562 sf Garage: 456 sf Front: 8 Smoke Yes
Dwelling Units: 1 Third: 562 sf Right: 0 Detectors:
Total: 1221 sf Value: $161,646.69 Rear: 5
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc!Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 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:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA VB R-3 1221
Owner: Contractor:
WILLIAM LYON HOMES INC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
109 E 13TH ST 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $22,789.64
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 AR 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. f
Issued By: — Permittee Signature: v� //7o7` �l 7�e7",,"
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.
J''uildin2 Permit Application L_ 0 7 3 2,
City of Tigard RECEIVED RerDat�Bived l7 ,e— Pe,�t No; �S. J/2—Gt),3C1�
13125 SW Hall Blvd.,Tigard,OR 972Plan ReviewQ v
' Phone: 503.718.2439 Fax: 503.598.1 L ' 2017 DateBy. O '�, Other Permit: ` ^G4 l7..002 57
i i(- R Inspection Line: 503.639.4175 CITY OF T!Ga�RD DateReadyBy '^, JAS: H See Page 2for
Internet: www.tigard-or.gov Notified/Method:////7 � 9 Supplemental Information
BUILDING DIVISION 474_ /vii ,G&-
s.
},. Y'a`m 'S -tr a F 9 41. j ' ,7': 4 £
• - R ... ,�<m �,,,x,t.��._£�,.�a.��.,-.k,:.,a..� =pdF �,' �".� '''rte' .�'X� �,, '�,..� �5. ��-6.� mss ?F F C _� 3„
..�,.__.,, ,..<...s, :.....::�....su..�.._..,�.,..:'.�,:.,.,:::,a,.,}:a.�.. ..,,��,�r�'..�.� �;.a.�,E�....s.�.:.�:`s��'�' F x ..��.= : ...A.�_:..�..�::u "� -��.�..e-.. � _ ...._,.«e. v ��.� :...t`,.,.i
®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
', `1 - , ':;t:`, r-,1.* : work indicated on this application.
arc 0 g;t.'i ,. ,,5, C t^' �$ ' 1
' re.w,dtt. ,..,,�' ��-'�m�'�,�""OS ;"y ;�^4v.ei�u�wn +a 4 � �l`.�I:�tr`e•`i
® 1-and 2-family dwelling 0 Commercialfmdustrial Valuation:
Number of edrooms: ' !
❑Accessory building 0 Multi-family 6 ) 61 b.
❑Master builder ❑Other: Number of bathrooms: '5
• ,- x e °l .1 6' , e e t r �. Total number of floors. 3 j c-2 7
Job site address: /3 j Z ) SW `►I . q ez__-_ ,` New dwelling area: /7?.f square feet
City/StateTLJP:Tigard,OR 97224 , East- Garage/carport area: I square feet
Suite/bldgJapt no.: I Project name: giVe,r Terrace. 4St Covered porch area:all"_ square feet S 6 Z
Cross street/directions to job site: Deck area: T7 square feet Cl b'7
Other structure area: square feet
a fc t t. k 412 t t°€ E c€ B $; ''
Subdivision R►v.c,,r Ter a.cs,Eas f- Lot no.: �Z 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 - r , G work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
, , .— ✓ - : .., " .;,,,,,,,,*"..,:,-.4.......,,,,,,,,,
,, E ." '
:r : s ��,r : � : f �€ G 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:
Business name:Polygon WLH,LLC
O Structural plan review fee(or deposit):
Contact name:N
FLS plan review fee(if applicable):
Address:109 East 13th Street
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(360)695-7700/ p I Fay:( ) Amount received:
E-mail:NI( 0ts, 14 $ I'Vli 111 f i $i/ • e��f �� l §tom E zsF
�- ., Commercial and residential prescriptive installation of
- ! ;, xs t,., ','4 ''::‘-'-'j::::42,-'.'' roof-top mounted PhotoVoltaic Solar Panel System.
Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 109 East 13th Street 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 lic.:207247
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: /� Date: �t *Fee methodology set by Tri-County Building Industry
�'ChWe .
7"4 - �ef�� Service Board
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COMIWEB)
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Mechanical Permit Applicki 1012 OFF10E USE ONLY
City of Tigard ')('T ? 6 aii7 Received
Date/By: Permit No.:
II 13125 SW Hall Blvd.,Tigard,OR 9722)I-, ---' .
Plan Review
II 11 Phone: 503.718.2439 Fax: 503.598.1960 .,r,1r 7 e ,, D,i-, Date/By: Other Permit:
TIGARD
Inspection Line: 503.639.4175 CITY 0 t,,' I,4',.;A ir',*-' Date Ready/By: inris: id See Page 2 for
Internet vvv/w.tigard-or.gov ,,-, ---„rkil,-.-.I(-IN Notified/method: Supplemental Information
siiti rt114aky, 1 9 4 31.
- -, - .-., ., r,-,,,i.,,',,1 9;7.4--,1- ' ' ' *.'''' - ':.,,:',.:7-7,,;:lEk4:, ,,,,, -',:L!• -ty.F..S,V.S;-.1,,;::.T.5:::,Lif.. AffttiMME' *OA_::t4F.S,e:ktFA4:Ckjj:SKO:t4ct4S'T;:::!''.:
'.:Y2R5I''%Iltg::-V'241:i4061:';P: 74T--KPF-i7rfq1W'1"4*41:7147:-.- --- - '': : Mechanical pet fees*are based On the value of the work
El New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit
0 Demolition 0 Other:
Value:$
Ra5.,ZNIgge*:000.*:.t otiloTwfRptvo$ pr.,a,4,:.-J,1 ,-i,.:i-:,--._-,..T2,-._ .. ,.= 04104ftiAtt-dt*4004i...#14sy:tioisa„,..
EI 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other Description Qty. Ea. Total
, .
JOB SITE:INFORMATION AN)---0:4o?Nzit _ci:iiil ,.... Mr conditioning,,,,-
1 46.75 46.75
Job site address: I (ICI Sy\) k tj Olth kit/ Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard,OR 97224 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 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 1 23.32
Other: 23.32
Subdivision:River Terrace East Lot no.:-5 2_
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
. '' Gas fireplace/insert 1 33.39
'''- ':''IE.'i ''1:':'''''. "''ij''''" '°PE$c'R7:714)?1 9"Y9 - i'''. ''''';'':-.r..4.e&. ' '''''' -'1. Flue vent for water heater or gas
MSTI/On - Otlut) fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32
PROPERTY OWNER '-:i'''.;:i;.-f-'i!ez--..":::::::*::•i,kOr'TE1441‘1 :.W.'' '' :'1.-" Ec...' Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment i 33.39
Address:7600 E Doubletree Ranch Road
Clothes dryer exhaust t 33.39
4
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, L
toilet compartments,utility rooms) 1 23.32
Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans 23.32
c.4.iiiikliI.16; ,:"-i:::!:;'. +.. ...ET .:'tt.CONTACT.tER:SON',1*-1...i:2..-..':,g::' ' 2332
Business name:William Lyon Homes,he, Fuel lung:
$14.15 for first four;$4.03 for each additional
Contact name: \)i C VI ove,1.11\0\Ve Furnace,etc. 1
Addressfr10) MitlottA j 01 ,.r.)t- S\ki dik. sio Gas heat pump
WaWsuspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace 1
Range 1
E-mail:1,6 1 61A 6 ke... 7:1)10\00 ., A 1)bkyrcylbOrnej , (Aril z, Barbecue
1
r: ..!'.,,1;;: 4:,'..:!:.tf-..00::.;;„:4;,:,:;,-::.:::::::::: Clothes dryer(gas)
Other
Business name:I-)it-bv\cozk)a ot,yy.A Qtri i in, -r,IN(, _ .
,..:-'.,-:::,f........1.1f q.';',....**-..i.4*p.„47.poo•row,: -...7..--;::;:,::::::-.....:',:„.:-;:,....
v"1 i IT I'l
Address: f)..0(15- Nv.1 Pi\DO,t Pf, Soul-tc, 1101 Subtotal
City/State/ZIP: -hiSbNrD kyL, ,- 1 V 1Jkl Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone: t)--)))(443- ( 41, Fax:(515) OkL.\ .... sis1S- State surcharge(12%of permit fee)
CCB lie.:2.0,9 00) 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: 444,5, ...10---- * Fee methodology set by Tri-County Building Industry Service Board
Print name:Mt%die:11 wpe_.. Date:
IABuilding\Permits\MEC PermitApp 040113.doc 440-46171(11/02/CONVWFB)
•
�,, 0
Electrical Permit Application • r m )11 FOR OFFICEUSE ONLY
City of Tigard Received Permit#:
,II q 13125 SW Hall Blvd.,Tigard,0r,l f: G`f1 Plate/B
Phone: 503.718.2439 Fax: 505498F1.960''' 1 !t 1C'v Related Permit#:
Inspection Line: 503.639.41711;`• z 'IIS �` I SIO Reemy D�/gy: Brie
TIGA''' Internet www.tigard-or.gov •l' 1--"Y 1`` � s l>� S See Supplemental
� Not3fied/Method: 5npplementalIaformation
"Y ffi S �.::'a... -m-cx 'Y..'.5. :467r,°'1' 1`.ir 7 n.t;-,'air,'•?6? a-r "��-&_
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ❑Other. •
0 Service or feeder 400 amps or more 0 Building over three stories.
whore the available fault current ❑1:Tarinas and boatyards.
V ,�9.0:�a4t.:(0:6-n,. . „,�„ exceeds 10,000 amps at 150 volts or Q Floating buildings.
2 1-and 2-family dwelling 0 Commerciailindustrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-family ❑Master builder 0 Other: for all other installations. . buildings.•
- ['Fire pump. ❑Installation of 150 KVA or
.. 7 Y jls- Jo ,r. : c emslb.*:e . : �F ;0;z:';4 0 Emergency system, larger separately derived
1311M S'J' \�P°+*' pay, 0 Addition more.f new motor toad of system
Job#: Job site address: looFtP or more.
City/State/ZlP:Tigard,OR 97224 ❑Six or more residential units. occupancy,
❑Health-care facilities. ❑Recreational vehicle parka
tage for more than
SuiteJbldgJapt,#: I Project name:giV� "�" �'A[�' ❑Hamrdorstocatinns ClSupply vol
Cross street/directions to job site: �� `-""' 1 0 Service or feeder 600 amps or more. 600 volts 0010100E
, ,•. ;- at { Pitil ? : u -
Description I Qty. I End Total
• New residential single-or multi-family dwelling unit.
Subdivision: [(1'J,,r 'TD. a f Q_ �as4- 1 Lot#: 32 Includes attached garage.
Tax map/pareel##'r L 1,000 sq.R or less 168.54 4
;1;;;.,''3V-. �,E 'x , i a?:001;JAW-al4,'"s;��"mss r 4r Ba.Limitedaddenergy,
sq.ft.or portion i
33.92. 1
w- „ . . energy resident[al 75.00 2
INA ' l�n- o03 (with above sq.R)
ti" iJ Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
r?r 4i�0a' J t t a;LL �E u Rr Renewable Energy 0 See Page 2
-0 `.-z.ti,_ Services or feeders installationalteration,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
Rmail: -. relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or Iess 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. • 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
r.„„,„„,,,,..„.,„...-' a-..: 1,,It� kL ,- t x,f „,,,,4,w-,--„,-;,,,,,,,,.r , ,l y ,� 11., Branch circuits—new,alteration,or extension,per panel
branch circuits with
Business name:William Lyon Homes,Inc. above A.Fee service or feeder fee,
Contact name: j chTh each branch circuit 7.42 2 _
^-� hit( 1) fl B.Fee for branch circuits without
Address: i�3 k Jy��� �+ q” service or feeder fee,fust 56.18 2
t vt�.t St Sk.aT�+ k.0 branch circuit
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 Nob manufactured or modular 67.84 2
dwelling,service and/or feeder
anal' ' h DI? !444,,, (' - �t ,,�� Reconnect only 67.84 2
12 • Jt .F tae t 3/o k r ,1v -'`` '-;.:7-,:v.:,1-7',')!,,-'-,,,,, Pump or inigation uncle 67.84
2
Business name:Garner Electric Washington,LLC ' Signor outline lighting 67.84 2
Address:t. 0Z \ u n ,1 S \C - Signal circuit(s)or limited-en. to gee Page 2 2
v •�,'IJ s..1\-4.e.,.‘,1,40 w Panel.alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:.OA �l t 14—pit 1► 1 9e31 ' Artditionalinspection(Ihrmin) 6625/hr
Phone:(253)320-1657 1 l•t W Fax:( ) Investigation(1 br m'm) 90.00/hr
Email:bdaniels@gwensa.eom Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
COB Lic.: C1158 Electrical Lie.: 208174 J Suprv.Lica: 4496S specifically listed rh hr mia)
/21/1) -4,4-, ''''''": 3 sa € s11e its t ��� spa= :
Suprv.Electrician signature,required:. Subtotal:
Print name: Joan P Albert SDate: 4/26/2016 0 Plan Review Required p.5%of permit fee):
(----
State surcharge(12%of permit fere):
Authorized signature: �- TOTAL PERMIT FEE:
This permit application expires if s permttk not obtained within 180
i Print name: Bill Daniels Date: 4/26/2016 days after It has been accepted as complete.
:if.'' * Number of inspections allowed per pemrit
:•1.•BaildiogTermirslEf.0 PermitApp_BLg ERfi dor Rev 06/17/2015 440-4615T(11/o5/coMNtBa
Y
1,-i' I.:,CV 4 I f)
Plumbing Permit Application
Building Fixtures ;( ; P.111- b�t��R (H 1 11-F t s l: tn.1.) F
Received .
City of Tigard _' 1,km,I may: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97213 A e Review
0 Phone: 503.7182439 Fax: 503.5q�g g6g n Dry!C' w iegy: mer Permit No.:
Inspection Line: 503.639.4175 IT)li ILA y' 'y
T i G A t Date rads ®
See Pa 2 for
Internet: www.tigarl-or.gov Notified/Method: Supplemental
information
< 'tet of watt
®New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. 1 Total
❑Addition/alteration/replacement 0 Other. New 1-2-fa rally dwellings(includes 100 IL for each utility connection)
^ CATEGORY OF CONSFR11C11ON{ '7:., ._ _ SFR(1)bath 312.70
®1-and 2-family dwelling 0 Contmereial/industriai SFR(2)bath 437.78.
SFR(3)bath r : 500.32 :
❑Accessory building 0 Multi-fancily
Each additional bath/kitchen 25.02
❑Master builder 0 Other Fire sprinkler(_____sq.ft.) Page 2 '
F ` , -JOB INFORMATION`AND I OCATION -. Site utilities: _
Job site address: I I 2,01 3kNi I W°col (N.-4e, Catch basin or area drain 18.76 .
City/Stale/ZIP:Tigard,OR 97224 DryweIl,leach line,or trench drain 18.76 {I
Footing drain(no.linear ft.: ) Page 2
Suite/bldgJapt.no.: I Project name: River TeX r e.. EQS-4-- Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76 J "
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2 _
Storni sewer(no.linear ft.:_) t Page 2
Water service(nc.linear ft,: Page 2
Subdivision: KTe Ce_ &� J+- IIot no.:
37 Fixture or hea;
Tax map/parcel no.: Backflow preventer , 31.27
Backwater valve12.51
*. ':DESCRIPTION:OF:WORK _ � '
M51-1A)11U D i.,t Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 3 25.02
. it 60Elit :-'1.TENANT Expansion tank I2.51
Fixture/sewer cap 25.02
Name:ADVL Land Holdings;LLC 1
Address:7600 E Doubletree Ranch Road Floor drain/Boor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02 I
Phone:(602)694-4031 Fax ( ) Ice maker 12.51
' ;y 1os+"q - Interceptor/grease trap 25.02
Business name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2
Primer • 12.51 .
Contact name 1 (G��h l�lE:.." iV�)��11P Roof drain(commercial) 12.51
Address: 3 17Y005A--S,Ai`"e-- SVO Sink./basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98664 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-444244 �+ p Tubfshower/shower pan 12.51
E-mail � O��r k tY\kr\ r 1 '\�m Urinal 25.02
Water closet 25.02
4 -
Water heater 37.52
Business name:Alliance Plumbing LLC • 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 I Fax:(503)912-6438 Minimum permit fee: $72.50
Plan review (25%ofpennit fee)
CCB Lie.:184601 4,/ Plumbing Lie,no.:PB732 n
State surcharge(12%of pe tit fee)
Authorized signature: TOTAL.PERMIT FEE
Print name:Robert Dishman ` Date:5/23/2016 This permit application expirm if a permit is not obtained within ISO days
after It has been accepted as complete.
*Fee methodology sot by Tri-County Building industry Service Bowel.
1.16uits5nglPetmhs1PLMU•PermitAppdoc 10/Dies 440.4614T(10/04/COMWEa)
City of Tigard
11111 Ill COMMUNITY DEVELOPMENT DEPARTMENT
rIGARD Building Permit Review — Residential
Building Permit #: M57).0/7-06
S�I7€A)30�)
Site Address:
%i/e_
Project Name: /2-f'�,o— 7--eiYace jv571--- Lot #: 5Q
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: i/U-A) .7 ii rh l
y_ -.274_14-024____V
/River
erify site address/suite# exists and active in permit stem.
Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached
Sits lan Elements:
L ree(3)copies of site plan 5 'sting structures on site
V,Footprint of new structure(including decks)with finished
oor elevations
ite plan must be on 8-1/2"x 11"or 11 x 17"paper
triyawn to scale(standard architect or engineer scale)
orth arrow U tility locations&easements(required for new and additions)
tid
o address,project or subdivision name and lot number IA Sidewalk/driveway approach
pplicant information(name and phone number) !t! •cation of wells/septic systems
Lot dimensions and building setback dimensions IT Atisting trees to be retained with drip line,and tree
• A1 s l uare footage of buildings to be demolishedotection measures
VI Lot area,building coverage area,percentage of coverage and Peet tree size,type and location
• pervious area(applicable if R-7,R-12,R-25&R-40) Street names
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? (VJYes ❑ •
4 foot differential)
If yes,is a storm water quality facility shown? ❑Y�e/s kVA No
Oklean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): 4 c // ""✓e1 fir/r-
Aequired: ❑ Yes,applicant was notified OVI No Received: ❑ Yes ❑ No u
Uti Public Facilitip Improvement(PFI)Permit: pri<20/6P �
equired: V Yes,applicant was notified ❑ No Applied For: (Yes ❑ No,stop intake
Ve/and Use Case#: , ,i)/3.2 r/ -- DOD / i �� ,,—06oo
V "Zoning /C—� P. /' S PO /
loi equired Setbacks: Front 0 Rear 6-- Side treet Side &A—Garage Qt
/Landscape Requirement: (�
0�
of Coverage Maximum:
T Building Height: Maximum Height 0pf. Actual Height
110 isual Clearance
111 .:ensitive Lands: ❑ Yes OD/No Type
I, Urban Forestry Plan
❑ Conditions "Met'prio4 to issuance of buiyitig permit //
Notes: a/?i>n� S'b // YAILJDr 7?7
/ 'J �P�/ - 7SS��_
Y
Approved By Planning: — _-`.- /..e.,7/ Date: a* --
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\Building\Forms\BldgPermitRvw_RES 061417.docx
• ,
Building Permit Submittal
Original Submittal Date: 61((1//2
Site Plans: #
Building Plans: #
Building Permit#: nter building avit#above.
Workflow Routing: Planning al Engineering 7 Permit Coordinator ,uilding
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
?g..13uilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
e
ByPermit Technician: ' Date: , ---.7,47,7
Engineering Review
45 Slope at building pad: 6 71)
❑ Conditions "Met"prior to issuance of building permit
0/Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes V No
111Assess Water Quantity Fee in-lieu: Yes No
LIDA Facility on lot: 111 Yes A No
❑ NOT Approved by Engineering: Date:
Notes: i
Approved by Engineering: \ Date: �(�/ 0Revisions (after Building Submittal only) Reviewer (((Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved 0 Not Approved
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
ily
Approved,NOT Released: �C42 //f' ,v� /���� 'Date: Z/ C.� �-
(Notes:
CcmdCitvns ��- - !i X20 I�� - Al.--
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:
rsDCFees Entered: Wash Co Trans Dev Tax: ► es ❑ N/A
Tigard Trans SDC: ►i Yes ❑ N/A
Parks SDC: ele Yes ❑ N/A
LIDA ❑ Yes * .'C)N/A
.OK to Issue Permit
Approved by Permit Coordinator: A `�,�.{ VL1 Date: 11 V20 ' 1
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
A-
•
f
City of Tigard
I' COMMUNITY DEVELOPMENT DEPARTMENT
S
IGARD' River Terrace Building Permit Review Addendum
TBuilding Permit #:
Site Address: 77,c2 a) 1(4 2 /e_
Project Name: .8-4/-e-r- ` -P�r1 c-e r --/ Lot #: 5r,' �
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Distpict Design Standards (18.660.070.1.):
Is the project subject to the plan district design standards? Fr Yes ❑ No
1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional
element required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Porch min. 5 dee Balcony w/access 2 Window Projection Vertical Wall Offset a
p ft. deep min. 2ft., 5 ft.wide min.2 ft., Eft wide Gabled dormer
I=1CI ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: /Z/, C/A
3. trances:At least one entrance must meet both of the follo g standards:
Max. 8 ft. setback from longe street- facing wall Parallel to street,angle no more than 45° from street,
or ope onto porch
Entrance opens to a porch: Yes ❑ No
If s,all the following apply: sq.ft. min.
ne street facing entry 4t.max.roof above floor of porch
p 5 ft. depth min. V30%min.porch roof coverage
4./{)etailed 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 ❑ Recessed entry area min. 5 ft.wide x 2 ft. deep
all offset min. 16 inches ❑ P ormer min. 4 ft.wide
Roof eave min. 12 inch projection Ir. 'oof offset min. of 2 ft.
❑ Roof shingles either tile or wood II Gable,hip or gambrel roof design
❑ : .of pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
_P Accent siding min. 40%of street facade ❑ Window trim min. 2 1/2"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:
N closer 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)
! 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:
1:\Building\Forms\BldgPermitRvw RES RT 062216.docx
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
INI 6. Transmittal Letter
etter
r!GARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATE RECEIVED:
DEPT: BUILDING DIVISION - sa/ 1
tit. 0--
FROM: Nichole Thorpe S
COMPANY: Polygon Northwest '1, o+
PHONE: 360-989-40204 BY:C-IIPA
RE: 13107 13129 13137,13143,13147 SW 169TH • ------z------wa.• _
(Site Ad 'ermrt umier 1
River Terrace East L ok 32_
(Project name or subdivision name and lot number) MS-21120 l`1.— 0 030 0
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
0 Additional set(s) of plans. 3 Revisions: Bulletin, Plan Sets
0 Cross section(s)and details. 0 Wall bracing and/or lateral analysis.
0 Floor/roof framing. 0 Basement and retaining walls.
0 Beam calculations. 0 Engineer's calculations.
0 Other(explain):
REMARKS: Please pay fees owed with Trust Account.
Adding 3rd Bathroom Option— /4/7- -224,0 itA,r/i3. e ‘,
71/
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: j — C-- i_7 Initials:
Fees Due: E Yes ❑No Fee 'Deescription: • Amount ue:
"7 r. ,P)` ‘ if t\/ ' e\ $ 96
---.---
$ _
Special
Instructions:
Reprint Permit(per PE): Yes ❑No ❑ Done _
Applicant Notified: ate: Initials:
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:
13129 SW 169TH AVE, BEAVERTON, OR, 97007 May 25, 2018 at 2:21 :59 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00300
Inspection Type: Inspector:
299 Final inspection Jeremy Burrows
Result:
PASS - CofO
Comments:
Final erosion control passed
Street tree certificate received
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:
13129 SW 169TH AVE, BEAVERTON, OR, 97007 May 24, 2018 at 8:40:59 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00300
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
ks t( cs'o
FOR OFFICE USE ONLY-SITE ADDRESS: 1'b\"-moi Sw \\SL-PV `e-
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
!PI g Transmittal Letter
GA R 1) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov
TO: Tom H. DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
L' D
AUG 14 2017
FROM: Angela Grajewski
Cm/OF TIGARD
COMPANY: Polygon Northwest
BUILDING DIMS N
PHONE: 971-212-2144 By:
A4.-S7).o 17-G0 4,29 4/
RE: 13147,13143,13137,13129,13107 SW 169t Ave .2
(Site Address) (Permit Number) .29,
River Terrace East Lot 29-33 70cs
(Project name or subdivision name and lot number) 30/
ATTACHED ARE THE FOLLOWING ITEMS:
,Copies: Description:
Copies: Description:
0 Structual Detail sheets
Additional set(s) of plans. 3 Revisions: included
0 Cross section(s) and details. 0 Wall bracing and/or lateral analysis.
0 Floor/roof framing. 0 Basement and retaining walls.
0 Beam calculations. 0 Engineer's calculations.
0 Other(explain):
REMARKS: Please pay fees owed with Trust Account.
(plans were submitted with out structual detail sheets)
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: n Yes n No Fee Description: Amount Due:
$
$
$
Special
Instructions:
Reprint Permit(per PE): H Yes H No n Done
Applicant Notified: Date: Initials:
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:
13129 SW 169TH AVE, BEAVERTON, OR, 97007 May 22, 2018 at 1 :05:47 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00300
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
No A/C installed
Violation Summary:
Inspector Contractor
Plumbing Permit Application
Site Utilities
FOR OFFICE USE ONLY
City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223 U' $ �^ y ��/7//T Permit N AC 2_,/yt '
a f fIII
Date/By: /0$1.---44..-- ,�'` ✓� (�L/
'� Phone: 503.718.2439 Fax: 503.598,1960 Plan Review
Ins ection Line: 503.639.4175 Date/By: f -a - (`� Other Permit No.:
TIGARD p 74 DateRead /B
Internet: www.tigard-or.gov -, Ready/By. Y Z ns I See Page 2 for
Notified/Method. 1{/// Supplemental Information
TYPE OF:WORK , FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist
❑Addition/alteration/replacementDescription Qty. Ea. Total
D Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath
312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building ®Multi-family SFR(3)bath 500.32
0 Master builder Each additional bath/kitchen 25.02
❑Other:
Fire sprinkler(1,221 sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION utilities:
utilities:
Job site address: 13129 SW 169th Ave Catch basin or area drain
18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Suite/bldg./apt.no.: I Project name:River Terrace East Footing drain(no.linear ft.:_) Page 2
Cross street/directions to job site: Manufactured home utilities 50.03
Manholes
18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Subdivision: Water service(no.linear ft.: ) Page 2
I Lot no.:32 Fixture or item:
Tax map/parcel no.: Backflow preventer
31.27
DESCRIPTION OF R ORI€. Backwater valve 12.51
Multipurpose Fire Sprinkler System Clothes washer 25.02
Permit# Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
tEl PROPERTY OWNER 0 TENANT Expansion tank
12.51
Name:Polygon Northwest Fixture/sewer cap
25.02
Address: Floor drain/floor sink/hub 25.02
City/State/ZIP: Garbage disposal 25.02
Phone:( ) Hose bib 25.02
Fax:( ) Ice maker
12.51
t"`t APPLICANT ❑ 'CONTACT PERSON Interceptor/grease trap
25.02
Business name:Alliance Plumbing,LLC Medical gas(value:$ )
Page 2
Contact name:Robert Dishman Primer
12.51
Address: 146 W Historic Columbia River Hwy Roof drain(commercial) 12.51
City/State/ZIP:Troutdale,OR 97060 Sink/basin/lavatory 25.02
Solar units(potable water) 62.54
Phone:(503)492-3490 I Fax::(503)912-6438 Tub/shower/shower pan
12.51
E-mail:robert.dishman@allianceplumbing.net Urinal
25.02
CONTRACTORWater closet 25.02
Business name:Alliance Plumbing,LLC Water heater 37.52
Address: 146 W Historic Columbia River Hwy Water piping/DWV 56.29
Other: 25.02
City/State/ZIP:Troutdale,OR 97060
Subtotal
Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50
CCB Lie.: 184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee)
Authorized signature: P-----r______.)--77State surcharge(12%of permit fee)
TOTAL PERMIT FEE
Print name:Gavin Thomes I Date: 12/6/2017 I 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.
1:\Building\Permits\PLMU-PermitApp.doc 10/01/09
440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Sitelitilite
Qty, -Fee(ea). Total Square Foota e: Permit Fee:
0 to 2,000 $121.90
Footing drain 15'100' 50.03 2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 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. 2valuation: 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
Total
Other Tnspeetio»s or Fees each additional$100.00 or fraction thereof,to
Qty. Fee(ea) 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- 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.
50,
0
$1.20
Additional plan review for revisions
90.00/hr $50,001.00 and up $74h 2.00 for thenal first
$$100.00 o00.0iandthereof for
ad(minimum charge-1/2 hour)
Subtotal:
Other Fixtures: I I I
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
Replace/ 'Plan Review for Plumbing Installations
Fixture Type forann Adder! Relocate
Work Performed: 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 ❑ New exterior plumbing site utilities for any complex structure
DishwasherC
uspidor/Water Aspirator as defined in OAR918-780-0040.
-Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic
Dr
® Any multipurpose fire sprinkler system.
EyeWashng Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye
Floor Drain/sink 2" Submit 2 sets of plans with any of the above.
-3"
4„ .. ,
Car Wash Drain Isometric or Riser Diagram
Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food relatedthat meet the qualifications above.
-Commercial-food
related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -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
ClosetExtractor
Toilet increase of sewer EDUs,'a sewer permit will be issued and
Water Closet- fees assessed for the sewer increase must be paid before the
Urinal
https://allianceplumbing-my.sharepoint.cpm/personal/gavin_allianceplumlIng_net/Documents/Documents/Fire Sprinklers/RT/City of Tigard
Permit.doc