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Permit (98) CITY OF TIGARD MASTER PERMIT FFA :'' COMMUNITY DEVELOPMENT Permit#: MST2017-00459 i tGAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/19/2017 Parcel: 2S106DA00900 Jurisdiction: Tigard Site address: 13293 SW 169TH AVE Subdivision: RIVER TERRACE EAST Lot: 9 Project: River Terrace East, Lot 9 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 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!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 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: $24,498.17 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: AZ: Permittee Signature: t' GZ-ivI G e4T1-L.-k 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. ' Bcif'ding Permit Application 1� ',;-,,.------,%,'„ �ddentia 1 �, FOR OFFICE t SE O\Ll Received City of Tigard f`2 7l) / Permit Ncl • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Rev ) 7-7 : AUG 2 2 2017 Dan Review Phone: 503.718.2439 Fax: 503.598.1960.�" , i 7 Other Permit:�/� )ID�<�/�_Lry�7�) Date/By: :& vim i! ic/� /1 T I G A R D Inspection Line: 503.639.4175 • Date Ready y: runs: ® See Page 2 for Internet: www.ti ard or, ov , { d! �7 fslig g g Notified/Metho t Supplemental Information BUsr 3`11 sG Di v2�! > , - .a.,,,..:, '; �r #fix t / , .H . ,k ,� k `4 ®New construction 0 Demolition Permit fees*are based on the value of the work performed. µ ❑Addition/alteration/replacement ❑Other: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the IN ! ,M work indicated on this application. imogiglitazzAINf'4;" 4 V1/4....x.w,,,,,,,,,,,-- '*g4Z:t, fii•ea.aurz4e.,-. 1 .04.a.r—A,OXE 1;,•:-•-• •:---)c--- 1-and 2-familydwelling 0 Commercial/industrial Valuation: $ 0 Accessory building �A Multi-family Number of bedrooms: 1 9� 1 (y�?! 9 7 ❑Master builder ❑Other: Number of bathrooms: 7 •7 � -° -t t r 6 'k' � rinTotal number of floors: 1931 Job site address: I • i I Al ` C., New dwelling area: /.29 39 Li square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: 543 square feet 6,33 Suite/bldg./apt.no.: Project name:River Terrace East W....Covered porch area: square feet 61i V Cross street/directions to job site: Deck area: 9 6 square feet i I S. DoSifr er structure • [ square feet I B I l `' rE 4 Subdivision:River Terrace East Lot no.: Permit fees*N 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 w I . ! T(1' 1 work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet '' �-:: � y �.�/H��r �+ .� `k fir,. ;� � •o W '. �� , 4, �a-.,;-,°� ', `- n ', 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: „i7,':44.,410141'41,47% y. Nom, "I.i - r - t S.. `I ' a P a, .: Business name:Polygon WLH,LLC `" - °. ' Structural plan review fee(or deposit): Contact name:Nichole Thorpe Address:. 0 rat L 4i. .. _ FLS plan review fee(if applicable): City/State/ZIP:Vancouver WA 98661 Total fees due upon application: Phone:(360)695-7700 Fax::( ) Amount received: E-mail:Nichole Thorpe , a a 4 I,: .,- Commercial and residential prescriptive installation ofPaidattfltili,ti,1`4411144.0astiVf,`, :'' F s: roof-top mounted Photovoltaic Solar Panel System. Business name: ,P i Ai ;i L Submit two(2)sets of roof plan with connection details Address: and fire department access,along with the 2010 Oregon 03 g awaL.� Lt A() Solar Installation Specialty Code checklist. City/State/ZIP:Vancouver WA 98660Permit Fee(includes plan review and administrative fees): $180.00 Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 Total fee due upon application: $201.60 Authorized signature: � - / -/ This permit application expires if a permit is not obtained • within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name:Nichole Thorpe Date:06/16/2017 Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) * '1 L7 (:) .', ;[1 i''' ' . Mechanical Permit Annlicatym FOR OFFICE USE ONLY 71City of Tigard L, ,., . , , Datear Permit140/457:20/7-pays 2 • 13125 SW Hall Blvd.,Tigard,OR 97223 '' Plan Review Phone: 503.718.2439 Fax: 503.598.1960 ful,„/By: 11 Other Permit TI GARD Inspection Line: 503.639.4175 , Date Ready/Br York 1 RI See Page 2 for Internet www.tigard-or.gov ' Notified/Method: Supplemental Information WirNkFgekret.Zlit*A*:2:4j:*faligpVfkrWn:tgPVtl TiU°S.1*-4d":**44-4114:441:14:7Z-47 Mechanical permit fees*are based on the value of the work 0 New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ rg467425YR:rtg.4:#710A§Kgqiiiik:C*7W-'WO-RitIAD_Zikii 'ec.,,•12_1"Z12:RIttiiii:llitgtglijiW.V;W:61**IsTi*Sinlyi : 1-and 2-family dwelling 0 Commercialimdustrial 0 Accessory building For spedat information use checklist 'Multi-fsmily 0 Master builder 0 Other: Description I Qty. I Ea. I Total W`!inW;;1$744:0C :FtViki,49:1<i*;1:1:4-644504:1;%10.W- iV HeatingicwillIV Air conditicming 1 46.75 4E75 Job sire address: [515:1 3 SW to oft Nei 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 Suile/bIdgiapt.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.:q . Other fuel appliances: Tax map/parcel no.: Water heater 2332 ::::a`tt:f44b1SZ:r-4WE'34:4157::5*-6-Ol'It 4. r0iig-4•"!'•M.AZI:47-•,i40:Vikitik;i1 Gas fireplace/insert 3339 Flue vent for water heater or gas 1 fireplace 2332 — . Log lighter(gas) 23.32 Wood/pellet stove 3339 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Environmental exhaust and ventilation: 2332 Name:ADVL Land Holdings,LLC Range hood/other kitchen equipment I 33.39 Address:7600 E Doubletree Ranch Road Clothes dryer exhaust t 3339 City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) ‘'''‘ 23.32 Phone:(602)694-4031 Fax( ) Attic/crawly=farts 23.32 04400i;:":.:+s•Vfi..,:77. . ,11 i Other 2332 Fuel piping: Business name:William Lyon Homes,Inc. $14.15 for first four;$4.03 for each additional Contact name:t\)I CA/0 .e.,.,11A OrK Furnace,etc. 1 Ado:ss:110) Drtaakooti 5t Sui.A-c- SID Gas heat pump Wall/suspended/unit heater City/Stale/Z2:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Far:(360)693-4442 Fireplace 1 • — Range 1 E-mail:AO i Cik 6 lc- IlitovveN,TEpbtklronries ni Barbecue -c•Sfsgf.,jk,:?e: bf,:,,,:-.'*;:, :ySii•-.11!k4...:1.4:r2, clothes dryer(gas) _ Business name:Fla)vvom or Qtd....." 1 i A-1 I Other: :.-4tV-11-K4774:::tEci**4**1:PvEgf4tr:V.!;,.--;:f7-i Address: Elipcts- t\v,,j .pAcpAR 0,r suulkc, 1.01 subtotal City/State/EP: tk:ASbNet %), q v1;1 Minimum permit fee($90.00) Plan review(25%of permit fee) Phune:56.6)414 - sli_., Fam(53) CA Li 1-' 9)17- State surcharge(12%of permit fee) CCB lic.:2_061 00) TOTAL PERMIT FEE This permit application expires Ifs permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: 444/era-gr..10----- * Fee methodology set by Tri-Ommty Building Industry Service Board 1 Print name:M/41 d/4;11 ovp,e_., Date: j Electrical Permit Application n • • liTf ,:.• . .:•.,..: - , t) ' i• r _ C t I 1 i FOR OFFICE USE ONI,Y: _ IICity of Tigard Receives I3125SW&llsma Tigard,OR P1/22t DatalB . Pemntd: /1-15 _ 7`001757 Phone: 503.718.2439 Fax: 503.398.1P60 Plea 1Review 3 Inspection Line: 503.639.4175. Date/13. T1GAItD Iatemtt•wwvr ., g41 Ready Date/Sy: 7arie E3 3ea P�e Z for trgard-or lT �-� Nohff th Supplemental Information ®New construction � s-�� -' ' ,r-�-'�&sca.,s;.s u'Y'>��AF�������C�'t�i�sE. - ❑Addii10n/a.1terati'a>1/replacelnent Please check all that apply c .r..> ( t sats ofplans wide=checked): ❑Demolition D Other: ❑Service or feeder 400 amps or more ❑Bmldnrg over three stories. F� :3 Y J �n �t E_ . where the available fault current ❑laminaandboatyards. .. _ exceeds 10.000 amps at 150 volts or QPloating buildings. and 2-family dwelling 0 Commercialadustrial 0 Accessory building less m ground,ar exceeds 14,000 0 Commercfa!-use agricultural ultural a Multifamily Q Master builder 0 Oilier amps for all other installations. , buiidinip . a -3(9):F;.,17,-131•10 ❑Fin 17 Installation ",,i-:�_-,'' m,..-'`�ja.::14:tis:= kjt.2 ' k 3(9)A%:?-`�, P©.. ® rut `'" ::4'''',.' syn Df I501�A� . 1.��."- � .��--.�'� "•d -�' ` ❑ tem, larger separately derived fob#: Job site addre� ❑Addition ofnawmotortoad of system �•7I) ! 100P2ormore. i2"A",'E",";2,"1-3, City/Stat/ZIP:Tigard,OR 97224 0 Six or mare residential wits. ooanpaney. Suite/bldg/apt (Project name: -�` Ci Health-cm facilities. ❑Reomational vehicle parks. gi 1 f^ilA/ t`-e a ❑IIazerdons to alien. 0 Supply voltage formore than Cross street/directions to job site: ❑Servirx or feeder 600 amps or mom. 600 volts aaminaL Description 1 Qtr. I Rub 4 Total Subdivision: r. ' --� . / , New residential single-or multi-family dwelling unit. Lot tia Includes attached garage Tax IIisP/P J 1.000 sq.It.or less 1 168.54 1 4 , 'i s n A `� Ea adel500 sq.$or portion 1 3392. L >. P Limited : dentia/ 1 taxi (with above sq.ft) 75.00 2 Limited energy,multi-family --;'-'1'''--0'-1:41.9 , r residential(with above Sq.ft.) 75.00 2 _ tea`j tt.R"0.•+ a 4 1 - _. F f r.'.0 �` " r Renewable Ent:rgy ❑ See Page 2 Name:ADVL Land Holdings,LLC • Services or feeders imstaIlation,alteration,and/or relocation 200 amps or less 100.70 2 Address:7600E Doubletree Ranch Road 201 amps to 400 amps 133.56 2 City/Stag:Scottsdale,AZ 85258 401 amps to 600 amps 200.34 2 Phone (60294-4031 601 amps to 1,000 amps 301.04 2 Fax;( OM OI.000 amps orvolts 55226 2 Email: Temporary services or feeders installation,alteration,and/or -. Owner installation;This inetalTrliinn is beingmade on relocation intend for sal lease, property that own which is not 200 amps or less 59.36 e, reit,or exchange,according to ORS 447,449,670,and 701. Z011 Owner signature: amps to 400 amps 125.08 2 Date 401 amps to 599 amps 168.54 2 .;., €W '.. r 3 psi1:±MIl , $ranch circuits—new,alteration,or extension,per panel Business name:William Lyon Homes,Inc. A Fee Purer ice cirumits fee, above service or feeder fee, Contactname:�N eh o� each branch circuit 7.42 2 Q3 � B.Fa for blanch circuits withora Address; �+ q I 7� service or feeder fee,fust st Jonah-, S M branch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98660 Each add•l branch circuit 7.42 2 Phone:(360)695-7700 • Fax (360)693-4442 Miscellaneous(service or feeder not included) Email• 'j�„ Each manufactured ormodular 4 1 e i , :Ili f+ ".11 t r ,, mPr S i dwelling,service amdlorfeedet 67.84 2 only 67.84 2 �"''- ._ L ; ...:-.�.�.�t�Ul��•4�E:�',•P� t� �,..<'.�w r-s•�-.' .1 `�'� f Reconnect Garner Electric Washington,LLC Pump or irrigation chits 2 Business name: � 67.84 r_. Sign or canna lighting Address;t 4 1'(� Signal chnilit(a)or limited-en 67.84 2 r DZ `'a `�k �i kS w� S l P, 1:Up Pawl,alteration,or=tensio ❑ See Page 2 2 City/State✓ZIF':'p������f. JJJ� �� �� additional inspection over allowable in any of the above Phone (253)320-1657 Fax:( inspection(1 hr min) 6625/hr Investigation(1 brain) 90.00/hr Email:bdaniels@gwcnsa.com Induslaalplant(1 hrain) • 78.18/lir listed CCB Lice CLUB I Electrical Lic.: 208174inspections isted which no fee is Sttprv.LiG; 4496S =Emily ll %hrmm} 90.00/hr s f rv.Electrician signature,required; / §� �yti� chi rt F Y➢1� '''''-'--t-----' Printniimm JaanPAlbert Subtotal: Date: 4262016 ❑Plan Review Required(25%of penult fee) • 1 ---:--- •-• -�.� State surcharge(12%of permit fee): - Authorized signature: TOTAL PERMIT FEE: Print nano: Bill Daniels Date 4262016 This porn*application expires if s permitis ant obtained vie*:ISO days s Los been ac cepted as complete.a Number ofimpactions allowed per permit it 'TC_PPp BMWs Rev 05/17/2015 440a615zt11rostcME......• .x X Plumbing Permit Application , 2011 Building Fixtures °.y fR OH 1(L I i. ti 1..9 • ,, fi City of Tigard ,' Penni!No.://57 /7-!Jp I/5.?13125 SW Hall Blvd.,Tigard,OR 97223Plan ,__-� _ Phone: 503.718.2439 Fax 503398.1960 ti: OtherPermitlta„ T i Z-R R e Inspection Line: 503.639.4175 Dam Ready/By: Jude 0 See Page 2 for Internet www.tigard-or.gov Notified/Wuxi: 4 Supplements!lnfermadon ... T� div �a.w' � ,. CO New construction 0 Demolition Forspecial Information Ilse checklist. ❑Addition/siterationtreptaoetner f 0 Other: Desc tion f Qty. I Ea. j Toad Derr 1-2-family dwellings(includes 100 R for each utility connection) „,;.:„;‘..-,•••__ l:�.�_.., _k. _ ,�. .... �ae.- �eco-:._. _ p i _4 z;_,. CAr ge ill•- t1i t ritilCf-'1S=_.;.,, ;-• ; fr --.:. SFR(I)bath 312.70 1-and 2-family dwelling 0 Commercialrmdustria1 SFR( ) ' 437.78 SFR(3)baht- t 500.32 : ❑Accessory buildingIgtMuhi-family • . Each additional bath/kitchen 25.02 ❑Master builder.' 0 Other: Fire sprinklerl_s1•ft.), Page 2 ) - =3 , ' 7J1 1 1I+1_ fA'°1r**14 4)'.t .i Site etittties: Job site address: Ib Sw 1 ip 'L i�, Catch basin or area train 1$.76 . City/State/ZIP:Tigard,OR 97224 1 ," t)rywelt,leach line,or trench drain 18.76' Footing drain(no.linear IL: ) Page 2 Suite/bldg./apt.no.: Project name: fNt lr'1 e r e EjiS{{ Manufactured borne utilities 50.03 Cross street/directions to'job site: 1 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.: ) Patio 2- Subdivisiom ii r TeiKare_ 4-- Lot no 9 - lrixtureor iteur: Tax maplparcelno.: Backflow preventer • 1 31.27 s,+' •41!:;:•"''..t-.., 11ESCRI TIOfiP VOX : Backwater valve 1 12.51 l Clothes rasher 25.02 Dishwasher 25.02 Drinling fountain 25.02 Ejectors/sump 25.02 . ' :. :i Q#� % ._1 E. 1t: AlaT 71::, ' Enpansion tank 12.51 Name:ADVL Land Holdings;LLC t~urturstsawer 25.12 Address 7600 E Doubletree Ranch Road Floor drain/floor sink/hub 25.02 City/State/ZIP:Scottsdale,AZ 85258 Garbage 25.02 Bose bib ' 25.02 Phone:(602)694-4031 Fax:( ) lee maker 12.51 " „•":. , t -: «'` ' i1 ' . . Interceptor/grease trap 25.02 Business nine:VVi11ram Lyon Homes,Inc V Ivicdical Bar(value $ ) 2 Contact name` Primer • 12.51 1 i�IN\()11�,,2�-T `"' Com_. hoof drain(commercial) 12.51 Andiras: l U3 l7�UC%tPlJa SA'S j k-, c\40 • $inkibasinliaystory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) . 62.54 Phone:(360)695-7700 ' Fax::(360)693-4442 Tub/shower/showerpan 12.51 &mail:' o Q 171�i1� P ' .VU ' 35.02 .r-4,.;.:,,5,- ;. .. . _ -dt,. - . . Wats closer 25.02Y J - Water:heater • ' 37.52 Business name:Alliance Pinmbiag•LLC pyo pg/p „ir 1 56.29 Address:146 W Historic Columbia River Hwy 'Other 25.02 City/State/LIP:Troutdale,OR 97060 Subtotal Phone:(503)492-3490 Fax (503)912-6438 Minimum permit fee: $7230 I CO3 Lie.:184601 / Plumbing Lac,no.:P/1732 Plan review(25%ofperrait fee) ' Authorized signature: f � State surcharge(t2°/.of petmii fee) A.�l� ! TOTAL PERMIT FEE Print name:Robert Oishmau Date 5/234016 This permit application aspires if a permit is net obtained ivilbhe ISO days _ after ithas beer!ao as zionsplete. • *Fee methodology serby Th.-County Building huhuu3'Service Board. tlBulirrm RmmllelnA4U-PamitApp4a 10001109 406.9616T*et62/COMMEB) IIICity of Tigard I' COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Building Permit Review — Residential Building Permit #: A _ I`I `l Ste? Site Address: gJ / - A. / / h ' ' .. — Project Name: "or ' ,P-f--- �‘ a c Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: A.,2e4) i 4)7/// / c, jipi it— /Verify site address/suite#exists and active inp ermit, tem. NI Rr River Terrace Neighborhood: ❑ No pd Yes,See River Terrace Review Addendum Attached S' e Plan Elements: itli ree(3)copies of site plan : :sting structures on site ite plan must be on 8-1/2"x 11"or 11 x 17"paper YA Footprint of new structure(including decks)with finished �rawn to scale(standard architect or engineer scale) or elevations orth arrow 9 ity locations&easements (required for new and additions) pe address,project or subdivision name and lot number idewalk/driveway approach lJpplicant information(name and phone number) ation of wells/septic systems li .t dimensions and building setback dimensions 'P' sting trees to be retained with drip line,and tree IIF?,are footage of buildings to be demolished yrotection measures I!Lot area,building coverage area,percentage of coverage and VS reet tree size,type and location i4npervious 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? lltlYes ❑(o 4 foot differential) If yes,is a storm water a uality facility shown? ❑ es Ur/NI \ 6 an Water Services—Service Provider Letpr(lot platted prior to 9/10/1995): 'p L,--e- 0 cJ/1 (� —, equired: ❑ y ,applicant was notified `6/J No Received: CI CI No Public Faciliti Improvement(PFI) Permit: Yes ,J / --Ch-16. .c 6may, Required: Yes,applicant was notified ❑ No Applied For: intake Pp Yes ❑ No,stop intake di anise Case#: �� P 1' /lei7/rt-,r1/ ,j�( o'�C�1to-(21/)027 PA�' e-Dkc=�(e• v- g ( 'Required Setbacks: Front 0 Rear � Side g Street Side Garage�Q Requirement: c2 % VI/Landscape4( of Coverage Maximum: Yo Building Height: Maximum Height - Actual Height Kisual Clearance \kensitive Lands: ❑ Yes isi(No Type L1X Urban Forestry Plan ❑ Conditions "Me ")prior to issua ce of b ' ding permi Notes: s,d77 4, ' ._' 4rw it ' _0 ''' 1 _ Jiff . S_ L Approved By Planning: �- mummiWz _ Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: El Approved ❑ Not Approved Revision 2: ❑ Approved El Not Approved Revision 3: El Approved ❑ Not Approved t:\Building\Forms\BIdgpermitRvw_RES_061417.docx Building Permit Submittal / Original Submittal Date: r AA,/ Site Plans: # Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: Planning 7r Engineering 'Permit Coordinator At'Building 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. Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: /6(4. ,Wdyill(v Date: 1//A l/I? Engineering Review Slope at building pad: 7D ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ,0 No Assess Water Quantity Fee in-lieu: ❑ Yes !� No LIDA Facility on lot: ❑ Yes No ❑ NOT Approved by Engineering: Date: Notes: ' Approved by Engineering: 'v 4 d V� tit/ Date: P Revisions (after Building Submittal only) Reviewer ate Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 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: Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA ❑ Yes , N/A OK to Issue Permit Approved byPermit Coordinator: 4A MIL Date: 121`i`l 7 I:\Building\Fonns\BldgPennitRvw_RES_061417.docx IIICity of Tigard COMMUNITY DEVELOPMENT DEPARTMENT T l G A R D River Terrace Building Permit Review Addendum issimarrossemsimunmil Building Permit #: Site Address: --73 2 9 'PO /legik �UjProject Name: C9 )✓-/r0 Ce ,c---- __________ Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of River Terrace Plan Dist Design Standards (18.660.070.1.): Is the project subject to the plan district design standards?t1 Yes 0 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. Porch min. ft. deep Balcony w/access 2 Window Projection Vertical Wall Offset a ft. deep min. 2ft.,5 ft.wide min.2 ft.,6ft.wide Gabled dormer CI 0 0 ❑ 2. Eyes on the street: a minimumlof 12°/ of each street facing facade must include windows or entrance doors. / Percentage Shown: c/ 3. trances:At least one entrance must meet both of the fon wing standards: Max. 8 ft. setback from longstreet- facingParallel to street,angle no more than 45° from wall street, or o en onto porch Entrance opens to a porch: Yes ❑ No If es,all the following apply: 15 sq.ft.min. One street facing entry 2 ft.max.roof above floor of porch ft. depth min. U 30%min. e orch roof coverage g 4./Detailed Design:All buildings shall include a min. of five of e following elements on all street-facing facades: �I 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 ❑ ormer min. 4 ft.wide Roof eave min. 12 inch projection VRoof offset min.of 2 ft. ❑ Roof shingles either tile or wood ❑ Gable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. CI yorizontal lap siding min. 3-7 ft.wide Accent siding min. 40%of street facade Window trim min.2 '/z"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: No loser to front or side lot line,than longest street-facing wall. CI Yes GQ 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. Wid,t.K: (Check one) V12-foot-wide garage door ❑ 40%max. of street facade ❑ 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: � / 9 3— � �� Date: J� �� I:\Building\Fmms\BldgPertnitRvwRES RT 031416.docx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13293 SW 169TH AVE, BEAVERTON, OR, 97007 Record Type: Record ID: Residential - Master Permit MST2017-00459 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS Comments: Previous corrections completed Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13293 SW 169TH AVE, BEAVERTON, OR, 97007 August 17, 2018 at 10:24:44 AM Record Type: Record ID: Residential - Master Permit MST2017-00459 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: 13293 SW 169TH AVE, BEAVERTON, OR, 97007 Record Type: Record ID: Residential - Master Permit MST2017-00459 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: 13293 SW 169TH AVE, BEAVERTON, OR, 97007 August 16, 2018 at 1 :29:05 PM Record Type: Record ID: Residential - Master Permit MST2017-00459 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS Comments: A/C installed Violation Summary: Inspector Contractor Plumbing Permit ApplicationE1 CIV Building Fixtures 018 FOR OFFICE USE ONE}' City of Tigard ill ., g Received 7 13125 hone SW Hall Blvd.,Tigard,OR 9722 �t OF.f+rG�n Date/By: �� „1:60,4_..„ C %t� Permit N / Cj�7 4)c2 4/...52, Phone: 503.718.2439 Fax: 503.598,! i(jj TIGAR R Plan Review*� TIGARD Inspection Line: 503.639.4175 BUILDING n]�j((^� nnii ( to/By: vc )� ) /4e-6:7Other Permit No_ Internet: www.tigard-or.gov Y3UlL� V Ul�l�I� '.to Ready/By auris: Notified/Method: 0 See Page 2 for TYPE Supplemental Information FEE* SCHEDULE ®New construction ❑Demolition For special in ormation use checklist. El ❑ =II La Tl Addition/alteration/replacementDescri,tion Other: New 1-2-family dwellings(includes 100 ft.for each utility con ection) CATEGORY OF CONSTRUCTION ', SFR(1)bath ® I-and 2-family dwelling 312.70 ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ❑Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑ Master builder 0 Other: JOBSITE INFORMATION AND LOCATION Fire sprinkler 38g'sq.ft.) Page 2 Job site address: 13293 SW 169T"Ave Catch basin or area drain City/State/ZIP: Tigard,OR 97223 Drywell,leach line,or trench drain 18.76 Suite/bldg./apt.no.: 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 Lot no.:9 Fixture or item: Tax map/parcel no.: Backflow preventer 31 27 DESCRIPTION ION OF WO. , Backwater valve _ 12.51 Clothes washer 25.02 Multipurpose Fire Sprinkler System I Permit# MST10II — OO 4 S Dishwasher 25.02 Drinking fountain 25.02 1«' PROPERTY Y OWNEREjectors/sump 25.02 ( 'r 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 City/State/ZIP:Vancouver,WA 98660 Garbage disposal 25.02 Phone:(360)695-7700 Hose bib 25.02 Fax:( ) Ice maker LIAPPLICANT' 12.51 CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name:Alliance Plumbing,LLC _ Contact name:Gavin Thomes 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 Phone:(503)492-3490 Solar units(potable water) 62.54 Fax::(503)912-6438 Tub/shower/shower pan 1251 Urinal 25.02 E-mail:Gavin@AlliancePlumbing.net . CONTRACTOR Water closet 25.02• Business name:Alliance Plumbing,LLC Water heater 37.52 Address: 146 W Historic Columbia River Hwy Water piping/DWV 56.29 City/State/ZIP:Troutdale,OR 97060 Other. 25.02 Phone:(503)492-3490 Subtotal — Fax:(503)912-6438 Minimum permit fee: $72.50 CCB Lic.: 184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee) Authorized signature: •.---7./----7State surcharge(12%of permit fee) _ Print name:Gavin Thomes 1� TOTAL PERMIT FEE 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. 1:\Building\Permits\PLMU-Permit App.doe 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su• ,ression S stems: Site UtilieQty., Fee t")" TOt S rare `nota_e Permit Fee: s � oto 2,000 $121.90 Footing drain-151 100' 50.03 $169.69 2,001 to 3,600 Footing drain-each additional 100' 37.52 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and:seater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas S stems: 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 0 for the first Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.each5additional$1 0500 or00 and$1.52 for fraction thereof,to Other Inspections or!Fees Qty, '1Fee(ea) Total and includin.$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 90.00/hr each additional$100.00 or fraction thereof,to which no fee is specifically indicated and includin� $25,000.00. (minimum charge 1/2 mal ur) Inspections outsidee offnormal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for each additional$100.00 or fraction thereof to hours(minimum charge 2 hours) 90.00/hr and includin l $50,000.00. Reinspection Fees $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Additional plan review for revisions 90.00/hr each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: Other Fixtures: I 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 Plumbin T Installations Fixture Type for Capped Added 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 Jac Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drivepor ❑ New exterior plumbing site utilities for any complex structure Dishwasher her Comore as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ® Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. Car Wash DrainIsometric or Riser Dia,ram Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings Disposal -Domestic-food relatedrelated that meet the •ualifications above. -Commercial-food -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 Extractor Closet Toiletincrease of sewer EDUs,a sewer permit will be issued and Water fees assessed for the sewer increase must be paid before the Urinal https://allianceplumbing-my.sharepoint.com/personal/gavin_allianceplumlgng_net/Documents/Documents/Fire Sprinklers/RT/City of Tigard Permit.doc