Permit (99) CITY OF TIGARD MASTER PERMIT
; . 12.,-.-11COMMUNITY DEVELOPMENT Permit#: MST2017-00460
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 12/19/2017
TE 'aa'1PLS 9
Parcel: 2S106DA01000
Jurisdiction: Tigard
Site address: 13285 SW 169TH AVE
Subdivision: RIVER TERRACE EAST Lot: 10
Project: River Terrace East, Lot 10
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: 30 Bathrooms: 3 Second: 562 sf Garage: 456 sf Front: 8 Smoke
DwellingUnits: 1 Detectors: Yes
Third: 562 sf Right: 0
Total: 1221 sf Value: $163,630.89 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
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'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. Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA VB R-3 1221
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: $23,947.64
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
AIssued By: .. Permittee Signature: fGeGtR
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. ,v
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application �-_C/ / 0
Residential tz FOR OFFICE I SE ONLY
City .g AUG 2 207 // �7
of Tigard Received
it Date/By: G6' PermitNo.:Ai� �/�_/�Lf/�
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
�l�l �/!� Gf/ rrK1
■ Phone: 503.718.2439 Fax: 503.598.I9P < < t Date/By: �jpt•S' r Other Permit:5/6���, )l/�,_•,/Y7?7TGta. Inspection Line: 503.639.4175 ryer> 'c q'"�� Date Read B H See Page 2 forr/r/JInternet: www.tigard-or.gov (t' a 's'a Notified/Method/-,/� � E J°ris:
G
Supplemental Information
As/6v,,
mob,
AFA.i �.._ , . vra<ufi��l�,�e .:�Ar `_ : ,moi ..-,�.. •^;,,�,' „$
ry
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other:
equipment,materials,labor,overhead,and the profit for the
a ) � work indicated on this application.
1-and 2-family dwelling 0 Commercial/industrial Valuation: $
❑Accessory building Multi-family Number of bedrooms: 'L 1 G 3 /'3 0
❑Master builder ❑Other: Number of bathrooms:tet, 6
v V
... t . ;,,k.. . � .._:€ Total number of floors:
Job site address: l 31 �
5 SW I q'� Ne_, New dwelling area: al square feet
City/State/ZIP:Tigard,OR 97224 W Garage/carport area: 4�`gn square feet(g6 ,
Suite/bldg./apt.no.: Project name:River Terrace East OC Covered porch area: I ZL square feet 5 60%.,
Cross street/directions to job site: _ Decarea:k J� �� square feet C)
Other structure area: square feet
Subdivision:River Terrace East Lot no.:1 O 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
t ,, equipment,materials,labor,overhead,and the profit for the
? 1 " 1' work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
� . _ gar
.., „ -- x 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 ' "
Structural plan review fee(or deposit):
Contact name:Nichole Thorpe
Address: 7 03 p --(w S� suL S i i1 FLS plan review fee(if applicable):
City/State/ZIP:Vancouver WA 9866 tV Total fees due upon application:
Phone:(360)695-7700 Fax::( ) Amount received:
E-mail:Nichole Thorpe amt - 7 a
• .
Commercial and residential prescriptive installation of
roof-top mounted Photovoltaic Solar Panel System.
Business name: D n I 1 l m Nu-1111c_ Submit two(2)sets of roof plan with connection details
Address: -y k�3 'Q and fire department access,along with the 2010 Oregon
� W ��U�IT�- Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 986 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: $201.60
Authorized signature: -/ This permit application expires if a permit is not obtained
•
within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name:Nichole Thorpe Date:06/16/2017
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application ! : ,' 0 4.); 7017 FOR OFFICE,USE ONLY
City of Tigard ,Received
Permit No.:
IR 13125 SW Hall Blvd.,Tigard,OR 97223 l-'•:' . - ' ',01"Date/B.L.
• w• Phone: 503.718.2439 Fax 503.598.1960 ''' &Tory:ew
111
Other Permit:
Inspection Line: 503.639.4175 .
TIGARD Date Ready/By: habe la See Page 2 for
Internet www.figard-or.gov Notified/Method: Supplemental Information
-."'1.717-VVfrelPIAtPk4ii4W-6111 -:1'7.24"4 -' ?4,IiiifliiiNTiirlAU-Sii WtOlitinRC444FER,f-Sqligklit:ODSR CaciaaSyy
Mechanical permit fees*are based on the value of the work
E1 New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
...,*-_-,,,,WIPVI-141aY-ingAti.L4.Y8-"MIS t.M.5..t. ..44.k,
1-and 2-family dwelling 0 Commercial/industrial El Accessory building For special&formation use checklist
.IRIMulli-fAmiiy 0 Master builder 0 Other: Description Qty. Ea. Total
44i'?24-4X-1::::;';51ttii*Ilitriti:FIND-."1:ii-e-kiiititi$MIVW-:7-7:igiggi:: Healingic°°ling:
Air conditioning 1 46.75 46.75
Job site address: I a,P;S.- SVN) tfi Grrh N& 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
Suite/bIcigiapt no.: Project name:River Terrace East 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 2332
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 2332
Other: 23.32
Subdivision:River Terrace East Lot no.: j
Other fuel appliances:
Tax map/parcel no.:
Water heater 2332
,i7:;-'1.,,:jr..5•41::-.;ISY,,SCitiri- IoittO'F.,WD-RX-54-.:41::1. --J;;11:,.'1'''tc..-4';',.P.:i..,,,,i_.:;_t,1 ::efirevreforawsztr heater or gas 1 3339
-
fireplace 23.32
—
Log lighter(gas) 23.32
Wood/pellet stove 3339
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
.,,,„„- „,..---- .„„•...,....3. ,,, ir,4.-.4„,_--4:,-„..._-:;:i).-1,17rd4;;;,vitif.,'t'Al•--4,f4;.:?4,2:-`, °thel: 2332
l'Illit::.• '''. /''x•- 49"Z731:"f•R :.:9;'-`:::;:-' '''';-11:71:2:f::-.7..3-"I '""' "..:'.:-41`44::'-':"? *1 ”4 Environmental• exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment 1 33.39
Address:7600 E Doubletree Ranch Road
Clothes dryer exhaust t 3339
City/State/LP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, -
toilet compartments,utility rooms) 2332
Phone:(602)694-4031
23.32
...s..,...,;..,..zli:,,,,... .,..:::,2.-,..... .• -• • v.',.•.-• F7(:::44) AlliNieeir: 2332
cravisPace fans
•' - ':-- ' 41-ATPLICANitk-6.' •t .,,-- •.0
Fuel piping:
Business name:William Lyon Homes,Inc.
$14.15 for first four;$4.03 for each additional
Contact name:WI- CiV10k,ItA0nX Furnace,etc. 1
Adch.slt-6 mod,ujol 3t ska , STO Gas heat pump
Wall/suspendedhmit heater
City/State/ZIP:Vancouver,WA 98660
Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace 1
— Range ue 1
E-mail: a7ce S •tn'
lki iGote. 71.W 1 Ivicmhornt ABarbec
'-----4571tEiNkklifi. .i?:1W:1; . ietr:-_'.1,i4.f-At-t; Clothes dlYer(gas)
Business name:Pyl)),AUZIn
41', 7,:;ariz-5,...F. . .4.1130.10:41-stegyxg.i.1::.,;::,:f;f•
Address: PDDRc N\\)4 0\$..\ ‘L De g,'„\i 'Ail Subtotal
City/State/ZIP: t-VAStObtrO i g)V__,. U, \ktui lormimum permit fee(S90.00)
Elm review(25%of permit fee)
Phone:567D)L.H3 cloAl..., Fax:(Sil)Oil\1... ctS1S- State surcharge(12%of permit fee)
CCB lie.: ) OD) 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: thelbeet0"...iszy-- * Fee methodology seeby Tri-County Building Industry Service Board
!
Print name:t0(,4 0 j.e. 1 typr..., Date: i
1
- . ••
-, • ....: - -., ' 7
•
Electrical Permit Anplidation ,,, o .,,, 2 01, FOR OFFICE USE ONLY
11
City of Tigard
„.,-' ' '. ' Cate/B Permit al:
,..a TR 13125 SW Hall Blvd.,Tigard,OR r/24.1 , ' pion rte,;iow
1 6t Phone.: 503.718.2439 Fax 503.598.1960 Datem. Related Permit ik
Inspection.Line: 503.639.4175. Ready Date/By: age 2 for
T1GAM btmmeemovnatigml-cam Mailed/Method: ha= g S"P
Supplemental Information
irg,,,',-_,,,-Sh.-,-,-,-.7.a.f,.•-=-alti.-------1-_ - 1 -..:,401m\•tc•ik-1-0!&-i- -;--i-L.-g-t -W.''.1-,--ii-=i-- .5 -1'.--'t -'-..i%X.'1..1c-':-,'-',!:--7=tV;-4-2st"0:46-- --Patkfai":-4-r--'-'''Zig-'sftl-r•--4)'-'
Igl New construction 0 Addition/alteration/replacement Please chock all that apply(submitl Bets of Plums Wfitocis checked):
CI SLI ervice or Seeder 400 amps°more 0 Brag oves.r tbree stdrie
0 Demolition El Other: .
where the available fault=rad 0 1;farinas and boatyards.
F.2., ,.;;;;;,,A',:.,,,;?_:',1 ,.;;:-,,,,-'••14f-'91'Tfig- ---"'64-t•aW..g.~11LORr'-'7,-i:-.`'-'1=---7-4-.=:2-1:,;=-.2iiW.,;it-.•::::1 meeda 10,000 amps at 150 eelb or °liming buildings.
and 2-family dwelling 0 Commercial/iidtistrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. . buildings.•
•t:.!Multi-family -- 0 Master builder 0 Other 0 Fire pump. 0 Installation of ISO KVA.er.
'-,,z;k7=';`,",:•"=,---"ji.:.---;-:-.,2-,-A-- 0,g,--ii-ujzi,--LA--g,qq:9-i-qactsgulgo c.--7.7-toz7f-- --::kirt-in,-.. 0BmergancY$Ystem. larger separately derived
0 Addition dam motor load of system.
Job#: Job site addre-7 310S- 3,1 ,• AMP or more. 0"A","E","I-2"4"1-3",
0 Six or mom residential mils. occupancy.
Cify/SbiteiZIP:Tigard,OR 97224
011ealth-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt#: I Project name:givo -T- (....e , °Hazardous locations. 0 Supply voltage farmers than
0 Service or feedee 600 amps or more. 600 volts nonunaL
Cross street/directions to job site: 1•-,r,g71-77i. -f-rji--,-'1'74.4F3gL..iir-Ck61-61-.^.,-, „, f-,.. .-7.---,
Descrintien Qi.r. Estrit I Total
New residential single-or multi-family dwelling unit.
Subdivision: r.: , • ., I , , Lot iv Includes attached garage.
'1.000 sq.ft.or less I 168.54 4
Tax map/parcel#: i -
Ea_ad'1500 sq.ft.or portion 1 33.92.
0.:.",,-7,2:-.r. ,726-•;=,-;-_- "_-.-- .5.-zz;-=--.4111TW RaLs-RA.I.:Rat.f.,12-151"-qe---4'.1 . -;:i.-AVref-
Limited energy residential
75
(with above sq.fc.) .00 2
Limited energy,multi-family
75-00
residential(with above sq.ft) 2
_ Renewable Energy 0 See Page 2
.---,`,", i':-.-laq.-zi•IlgAlfAl_q'm_qi.Z,i.'T.,03.:1."..:71:?:: ..4',1rezieT.:- '-:;'-'1:2D-:'01-Aii,RF.'-'Z'7.-3C:'';'''7•- ;, Services or feeders installation,alteration,and/or relocation
Name:ADVL Land Holdings,LLC • 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address:7600 B Doubletree Ranch Road
401 amps to 600 amps 200.34 2
City/State/ZIP:Scottsdale AZ 85258
601 maps to 1,000 amps 301.04 2
Phone:(6a2)694-4031 Far( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
E233141: relocation
Owner installation:This installation is being made on property tail own which is not 200 amPs er less 1 59.36 I I
intended for sale,lease,rent,or exchange,according to ORS 447,44-9,670,and 701. ' 201 amps to 400 amps 125.08 2
Owner signature: Date: . 401 amps to 599 amps 168.54 2
-'-'-',"•:•'•-,:':..1.,.-:_-:-'tFr.,r,i_ il`ifIxLk-,i0,-- -,1:::,-`z,,,f.-=. 9_71r-MiT.tk l',1,4KI:lzhik-.7,-;1-,-';,..i,A -:. 3347::Igibreuits--."en wthaitexatiDn'or"tension'per panel
Business name:William Lyon Homes,Inc. above service or feeder fee,
742 2
each branch circuit
Calatwbame; ki ich o k:Th n rile, B.Fee for branch aircuits without
saline or feeder fee,fast
Addvtss: "103 EY1)(101,1/Jal St Skk-t, S Up branch circuit 56.18 2
City/StatetZJP:Vancouver,WA 98660 Bach add'l branch circuit 7.42 2
• Misec4leneons(service or feeder not included)
Phone:(360)695-7700 - -•' Fax:(360)693-4442
dwelling,servicezinc:Id/or ruodular 67.84 2
Email:,; I h Dit. il D•to_ 0 p. 4#.4 A MP A.44 RecemmetenlY 67.84 2
Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC • Siga or outline righting 67.84 2
..._.
Signal cirrnit(s)or limited-ronergy
AddressR 4 02- \loA1 ,.\ce,‘, ..N.)_Lu'k\-E. \lip panel,alteraticm,cr eatemsion. 0 See Page 2 2
Each additional inspection over allowable in any of the above
City/State/ZIP:'p,kkia,u14 i V.*. geS1 I
Additional inspection(Ihr min) ' 6625/hr
Phone:(253)320-1657 1 I Fax.:( ) Investigation(1 hr min) 90.00/1z
Industrial plant a hr min) • 78.18/hr
PATIO'bdaniels@g,weusa.com
Inspections forwhich fee is
CCB Lie.: C1158 Electrical Lic.: 208174 Suprv.Lin.: 4496S .- ific- limed%Iambi) 90.00/hr
_
---t.- qii:--1-T lifIL'V;'-----.'ft<V:1
Sugv.Electrician signature,=Fared. fl/i17)-; 4 .
Print name: loan?Albert •• - Date: 4/26/2016 0 Plan Review Required(25%of permit fxse):
e.- State surcharge(12%of permit fee):..
'...!;.;
Authorized signature: -77'----'-‘-4•111111."- ---":. . TOTAL PERMIT FEE:
This penult application expires ifs permitis not obtained svitbhr In
Print name: Bill Daniels Date 4/26/2016 days after It has been accepted as complete.
!.1.11....,. * Number efinspeotions slowed per permit
e.,r1:-:*:113alldiriglPerralogg.c_PerairApp SIR/Meer
Rev D6f1712015 440-461ST(11/05/C0INWEB
, •
Pluinbine Permit Application i.')‘, (I ':), 7 u!/
-• •
Building Fixtures ',...'d t .y - ., - ,,, :,
-: , , ....iv.d - • •
ity of Tigard
Dara/By: Parent No.: •
• 13125.SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 OtherPennit No.:
•,,,.__. ' Dttrl
T I G A R D Inspection Line: S°3.639A175 Date Ready/Br Airli: el See Page 2 for -
_ Internet www.tigard-or.gov NoriftedMethorl: Sapplentesirst Information
i':',V,i;::•-;- •41'":'';..--' ..r... . ':? III*:iSt.:WOjkle: ;]-4,-;.i.,::-..7:;.' .
_
la New constmction 0 1"../entolition For special Wormation.use checklist
"
.Description I Qty. I Ea. J Total --
0 Additiontallemtionfreplacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
...,;:,%:.••,--:..... ..,:: •:aktittoltilii.fakiiitteittiNi-;.14o:„!f.,I;;;;;At7,-22*;, SFR(1)bath I_ 31270 ' -1
1-and 2-familydwelling 0 Cornmercialimdustrial • SFR(2)bath • . 437.78 : ..
1 ..,
SFR(3)bath- . V 50032 ,
0 Accessory buildMg Alvialti-Family -
Each adrlltional bath/kitchen 25.02
. .
0 Master builder DOther: Fire sprinkler(....___sq.tt.). '
1 Page 2 ' I
•;01:*4:,;•-1 *W7::'rtl'•:.' :•-•-•..':'.1••••:. Site utirldes:
Job site address: i'51_,e,s-- \N____Iiik______Nf., Catch basin or area drain • I 18.76•.
I. . Drywell,leach line,or trench drain . 18.76
City/State/ZIP:Tigard,OR 97224
• • . Footing drain(no.linear ft.: ) Page 2
• Suiteiblcigiapt.no.: Project name: p4Wr Tex (e exs-4- I Manufactured home utilities 50.03
Cross street/directions to job site: ' I Manholes 18.76; •
Rain drain connector 18.76
Sanitary sower(no.linear ft.:____) , Page 2
Storm sewer(no.linear fl.: ) Page 2
_.,... , "Water service(no.linear ft.: ) i Page 2 : 1
Subdivigipn: P-vex 1e- 'care.. (--,as-i-- I Lot nal 0 ) Fixtureor Been
_
Tax map/pared no.: Backflow premier • I ° 3127
- -v4 50"-• 1114K••L.4,--^.- 12
tDESCRWTION4311"-WORIC:,' • -•• ! •- •• _ I_ ., .51 '.
Clothes masher 25.02
Dishwasher 25.02
Drinking fountain 25.02
@odors/sump ' 25.02
.
, '-:..f:;7'' :1;1***4.0.Ci ::::•;',..:-1..---;5::;-'2'i:tttfitikt.-..1.::::: :.f.''. ;;/': ExPansim tank 12.51
Fixture/sewer cap 25,02
Name:ADVL Land Holdings;LLC
Address 7600 E Doubletree Ranch Road Floor drain/floor sirduhub 25.02
Garbage disposal 25.02
City/State/Z1P:Scottsdale,AZ 85258
; Hose bib ,
. Phone:(602)694-4031 Fax:( ) Ice maker 12.51
.,-...::7! ,ii*Tilia,:ptsggi.: :.:;-,: Interceptor/grease trap 25.02
-• • •‘- •• -
Business name:William Lyon Homes,Inc Medical gas(value:S ) Page 2
. , Primer : 12.51 •
Contact name;V%
Roof drain(commercial) 12.51
Address:1 b3 ?oboctkool‘iA—SAi 1-e_ svc) • Sink/basin/lavatory 25.02
Chy/State/ZIP:Vancouver,WA 98460 Solar units(potable water) 62.54 I
Phone:(360)695-7700 : Fa=:(360)693-4442 Tobtshower/showerpan . 12.51
thine! 25.02
1,VVIAVlbrne...E...(...1)Or) -w 01
'...:-•-1":".',-.•=70.t-fibt7i-•:: 14.-g -::;•;:, -,•,...vrtirr;-..v,;, ::: . ---- .1, • , . .. ;i:F.:,.. ger met . 25.02
-'-'--',', Water heater • 37.52
Business name:Alliance Plumbing LLC
..i, Waterpipirtg/DWV 56.29
Address:146W Historic Columbia River Hwy • Other 25.02 '
City/SW/ZIP:Troutdale,OR 97060 Subtotal •
.
Phon=(503)492-3490 Fax:(503)912-6438 MinliM1111 permit fee: $7230
.. Plan review(25%of permit fee)
CCB Lie.:184601 Plumbing Lie.no.:PB732
Statestocharge(12%of permit fee) ,
Authorized signature: ihd„... TOTAL PERMIT FEE
I Print name:Robert Dishman ' Dater 5/2312016 ibis permitapplisalion expires it'a persakia set obtain' ed within 1811 days
star kb=bees steepled as somplete.
,fee methodology serby Tri-Couaty Sledding Industry Service Beard.
I.V3u1idiniffermiaaPIMPPorwitApp4oc 1009/09 44e4e15n'5ete2iCONVWEM
A
* City of Tigard
r COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
Building Permit #: zfrj T� ma tl e,
Site Address: ,; i / / A .e0K-e.,
Project Name: !�-' �V� &et. 4,_s7 -- Lot #: �-
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review /
Proposal: ��.i ) 4/1._ /�C itiJi—
r
Verify site address/suite# exists and active in permit stem.
527
12 River Terrace Neighborhood: ❑ No r i Yes,See River Terrace Review Addendum Attached
S. e Plan Elements:
ree(3)copies of site plan
: :sting structures on site
it
plan must be on 8-1/2"x 11"or 11 x 17"paper Ni Footprint of new structure(including decks)with finished
raven to scale(standard architect or engineer scale) I.or elevations
Id
orth arrow NA 'ty locations&easements(required for new and additions)
e address,project or subdivision name and lot number tdewalk/driveway approach
pplicant information(name and phone number) bio anon of wells/septic systems
l�t dimensions and building setback dimensions IP sting trees to be retained with drip line,and tree
I!C,,are footage of buildings to be demolished otection measures
lit Lot area,building coverage area,percentage of coverage and lap S eet 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? 11dYes o
4 foot differential) If yes,is a storm water .uali facility shown?, ❑ es OLIN,
06 an Water Services-Service Provider Let r(lot platted prior to 9/10/1995): /rDV'F & 07/1/ t -
equired: CIY ,applicant was notified No Received: ❑ Yes 1:1 No ,,�.���
Public Faciliti Improvement(PFI) Permit: pP,2 t)/{_ cez c)
Required: Yes,applicant was notified ❑ No {{ Applied For: Yes El No,stop intake
1,6 nd Use Case#: �hagQ(DI lri d 1/ Q_,( '�(DiCo_a )O.1 P)Pc c-) S-oZ (e
ltd Zoning:
'Required Setbacks: Front Wo Rear `s Side g Street Side 3 Garage..,. 0Landscape Requirement: c�c)
of Coverage Maximum: r9 /o
1) '/o
iV Building Height: Maximum Height N.) - Actual Height '�j
IIKisual Clearance
ensitive Lands: ❑ Yes tiNo Type
[ Urban Forestry Plan
❑ Conditions "
"Me prior to issuance/of b ding permi
Notes: eat?0‘,/''1/27)-2,4K <�' / /lA__ oft
A__ ) .r JAI S - Ce____
i
Approved By Planning: Ley
/M Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:1Building\Forms\BldgPermitRvw RES 061417.docx
Building Permit Submittal l
Original Submittal Date: X7,22./
Site Plans: ## i
Building Plans:
Building Permit#: Enter building permit#above.
Workflow Routing: Planning Engineering 97Permit Coordinator , Building
Workflow Sign-off: /2 Sign-off for Planning(include notes from planning review)
Route Application Documents: Ft' 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:
By Permit Technician: Date: / ,Z
Engineering Review !
'Slope at building pad: /0
❑ Conditions"Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
21 Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes eNo
Assess Water Quantity Fee in-lieu: 0 Yes erNo
LIDA Facility on lot: 0 Yes j-,:i- No
0 NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: IA 6 ,j 4-7 Date: /I (3 /
L7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
Conditions"Met"prior to issuance of building permit
0 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 0 N/A
Tigard Trans SDC: Yes 0 N/A
Parks SDC: 14 Yes 0 N/A
LIDA 0 Yes N/A
OK to Issue Permit j\AAJ
Approved by Permit Coordinator: % '4 (2 Date: 12 u I i 1
I:\Building\Forms\BldgPermitRvw_RES 061417.docx
r
City of Tigard
IICOMMUNITY DEVELOPMENT DEPARTMENT
1
T I G A R D River Terrace Building Permit Review Addendum
'J. (f'x:,r3'a3,..,;,,. ; _:.,41. _ 2-Pf,^ nr.lner,f ' t21NetS9 t *241&5eTE:.5 : ".i. , *`.4 4:,i,+ :s-_,. .A r,.e st8'6 ,M. a4�Y:w
Building Permit #:
Site Address: e -- ) / C t ,�j,,{,j
Project Name: le Ar e.-- ii,) _ Lot #: /7)
(New dwelling=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? Yes ❑ No
1.Articulation:a minimum of 1 element per each street-facing façade 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
❑ ❑ ❑ ❑
2. Eyes on the street:a minimumJof 12°/ of each street facing facade must include windows or entrance doors.
/
Percentage Shown: . g e
3. trances:At least one entrance must meet both of the foll 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 0 No
If es,all the following apply: sq.ft.min.
ne street facing entry2 ft.max.roof above floor of porch
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
❑ Wall offset min. 16 inches ❑pormer min.4 ft.wide
0 Roof eave min. 12 inch projection [/Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood ❑ Gable,hip or gambrel roof design
❑ oof pitch oriented south min. 500 sq. ft. ❑yorizontal lap siding min. 3-7 ft.wide
viRAccent siding min.40%of street façade VWindow 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:
Nloser to front or side lot line,than longest street-facing wall. ❑ Yes No. If No (Check one):
o :
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.
Wid�i: (Check one)
12-foot-wide garage door ❑ 40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes: J
Approved By Planning: c� — Date: /// 9 J/ '-
I:\Building\Forms\BldgPermitRvw_RES_RT_031416.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
1111
Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATE RECEIVED: �'
DEPT: BUILDING DIVISION RECEIVED
Nov 1 .42017
FROM: Nichole Thorpe
CITY OFTIGARD
COMPANY: Polygon Northwest
BUILDING D17SION
PHONE: 360-989-40204 Bg
RE: 132 ,13-2-8-3,I,3273,13259,13247 SW 169TH
(Site ess (Permit Number)
River Terrace East LD1- 3 — La T /0
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Des ription:
0 Additional set(s) of plans. 3 Re isions: Bulletin, Plan Sets
0 Cross section(s)and details. 0 W 11 bracing and/or lateral analysis.
0 Floor/roof framing. 0 B ement and retaining walls.
0 Beam calculations. 0 ngineer's calculations.
0 Other(explain):
REMARKS: Please pay fees owed with Trust Account.
Adding 3rd Bathroom Option
FOR OFFICE USE ONLY
4.j.)
Routed to Permit Technician: Date: J 2.— - )/ Initials:
Fees Due: I Yes ❑No Fee Description: Amount Due: �.-
) r p) ."v, r'cv: cw $, fl
$
$
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes i3No 0 Done
Applicant Notified: 4','C i t Date: 42//91/7 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:
13285 SW 169TH AVE, BEAVERTON, OR, 97007
Record Type: Record ID:
Residential - Master Permit MST2017-00460
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:
13285 SW 169TH AVE, BEAVERTON, OR, 97007 August 9, 2018 at 1 :19:37 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00460
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Water pressure = 70 psi
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13285 SW 169TH AVE, BEAVERTON, OR, 97007 August 16, 2018 at
1 :23:26 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00460
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - CofO
Comments:
Final erosion control passed
Moisture content 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:
13285 SW 169TH AVE, BEAVERTON, OR, 97007 August 13, 2018 at
10:19:41 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00460
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
A/C installed
Violation Summary:
Inspector Contractor
Plumbing Permit Applic j C I)/
Building Fixtures FOR OFFICE ESE ONLY
City of Tigard FEB 6 ZB18 Received /��� ._ _
41 Ilii r. Date/By: Permit N f57 7 sl/ O� 11
13125 SW Flail Blvd.,Tigard,OR 97223 Plan Review ` �`V t_/
Phone: 503.718.2439 Fax: 5tt ®F TIGARD Date/By: n?(�j/�jty2 Other Permit No.:
TIGARD Inspection Line: 503.639.4175 j�jDIVISI® Date Ready/By:/
Internet: www.tigard-or.gov 9UILDI J DIVISION orris, H See Page 2 for
Notified/Method: Supplemental Information
TYPE OF: WORK • FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist
Description Qty. Ea. Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)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(1,221 sq.ft.) Page 2
JOB SITE INFORMATION AND'LOCATION Site utilities:
Job site address: 13285 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.: 1 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: I Lot no.:10 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OP WORK Backwater valve 12.51
Clothes washer 25.02
Multipurpose Fire Sprinkler System
Dishwasher 25.02
Permit#
M5-rtol7- OOy60
Drinking fountain 25.02
Ejectors/sump 25.02
ell PROPERTY OWNER I ❑ 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 12.51
il APPLICANT 0 CONTACT PERSON ` Interceptor/grease trap 25.02
Business name:Alliance Plumbing,LLC Medical gas(value:$ ) Page 2
Contact name:Gavin Thomes Primer 12.51
Roof drain(commercial) 12.51
Address: 146 W Historic Columbia River Hwy
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:Gavini)AlliancePlumbing.net Urinal 25.02
CONTICTOR Water closet 25.02
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 Fax:(503)912-6438 Minimum permit fee: $72.50
CCB Lie.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee)
/�--" �/ State surcharge(12%of permit fee)
Z
Authorized signature: r V 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:\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:
Site'Utilities Qty. ; Fee( .1 Total Square Footage: Permit fee: -
Footing drain-1s'100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
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 it 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
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.-Tub/Shower pp y.
Jacuzzi/Whirlpool ❑ Any new commercial building with water service 2"and
Car Wash -Each Stall greater,except systems designed and stamped by licensed
-Drive Thru engineer.
Cuspidor/Water Aspirator 0 New exterior plumbing site utilities for any complex structure
Dishwasher -Commercial as defined in OAR918-780-0040.
-Domestic 0 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.
-4"
Car Wash Drain Isometric or.RiSerDiagram
Garbage -Domestic-non-food
Disposal -Domestic-food related 0 Isometric or riser diagram is required for new buildings
-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: I
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 Extractor
Water Closet-Toilet increase of sewer EDUs,a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
https://allianceplumbing-my.sharepoint.com/personal/gavin_allianceplum12ng_net/Documents/Documents/Fire Sprinklers/RT/City of Tigard
Permit.doc