Permit (89) CITY OF TIGARD MASTER PERMIT
11111
'' COMMUNITY DEVELOPMENT Permit#: MST2017-00402
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/12/2017
L£ Parcel: 2S 106DA02000
Jurisdiction: Tigard
Site address: 13209 SW 169TH AVE
Subdivision: RIVER TERRACE EAST Lot: 20
Project: River Terrace East, Lot 20
Project Description: New SFA.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 97 sf Basement: 0 sf Left: Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 562 sf Garage: 456 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 562 sf Right Detectors:
Total: 1221 sf Value: $161,914.53 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 Rain0 Storm Sewer: 100
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: 0
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Tvpes 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'l 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: $22,879.96
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
952-001-0Issued By:010 throug7h' 952-001-0090. You may obtain a copy of the rules or dirPermittee Signature:t questions oOUNC by calling�3.23�19871.800.332.2344. �®
[///%VV
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.
PermitZ
A plication 0 T-2
Building p
x l SE O\Ll
t i r � VES FOR OFFICE
Received Permit No.: ' Y
City of Tigard 2017 DateB : r i�r / ,�/ �r �L,
1,,,i . 13125 SW Hall Blvd.,Tigard,OR 9,743 JUN 22 Plan Review`` -y Other permit:gat/ /��v+/��
1 11 ' Phone: 503.718.2439 Fax: 503.598.1960 Date/By: I)-al- 1 / 1
"�f O F 'I I G I-PD Date Ready/By: / Juris: la See Page 2 for
Inspectionw Line:. 503.639.4175.gov1 J i / 7./I// Supplemental Information
13t t 1�
g g BUILDING DIVISION NotiSed/Method: /
Internet: www ti and or. ov L, / L iv r6f/z 6
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,' ``- t °' w �, Permit fees*are based on the value of the work performed.
®New construction ❑Demolition Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
.�. - work indicated on this application.
�� �` � ��' `�`�'' - _ gft ,.. :;,. ... Valuation: $
J 1-and 2-family dwelling 0 Commercial/industrial
❑Accessory building Multi-family
Number of bedrooms: 2.. I/'I) 4 1 1
v
Number of bathrooms: 3
❑Master builder 0 Other: 6,�
=�� �`,,R 4 �` --� Total number of floors:
,, -- a [b X 13 , a
l� il C w t�i New dwelling area: ral
square feet
lob site address: J ( �In
City/State/ZIP:Tigard,OR 97224 Garage/carport area: T✓W square feet,
J
Suite/bldg./apt no.: I Project name:River Terrace East Covered porch area:3 C square feet s 6a
Cross street/directions to job site:
Deck area: 7 square feet q..1
erpthereilku2tea:*/ square feet
aP- 1i t , 041 ."l
Subdivision:River Terrace East I Lot no.: 20 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
F 7 "- -work indicated on this application.
ai: '.':::5'1':-"-'
} ''';.'1'"- - %: ° 1 m e V-a— $
Valuation:
Existing building area: square feet
New building area: square feet
Number of stories:
Type of construction:
Name:ADVL Land Holdings,LLC
Address:7600 E Doubletree Ranch Road Occupancy groups:
City/State/ZIP:Scottsdale,AZ 85258 Existing:
Phone:(602)694-4031 Fax:( )
Business name:Polygon WLH,LLC Structural plan review fee(or deposit):
Contact name:Nichole Thorpe FLS plan review fee(if applicable):
Address:109 East 13th Street Total fees due upon application:
City/State/ZIP:Vancouver WA 98660 Amount received:
Phone:(360)695-7700 I Fax::( ) ;.--;,---'e ' ,t''',` °ft'i'` E•
� 'p�d��i"�L�3���r �" C" fr��Fa`J3lP.{.1�6 F? 1
rn kb' `
E-mail:Nichole Thorpe Commercial and residential prescriptive installation of
- � : c�ra s roof-top mounted Photovoltaic Solar Panel System.
�-._ a� �� ' 1': Submit two(2)sets of roof plan with connection details
Business name:William Lyon Homes,Incc and fire department access,along with the 2010 Oregon
Address: 109 East 13th Street Solar Installation Specialty Code checklist.
Permit Fee(includes plan review $180.00
City/State/ZIP:Vancouver WA 98660 and administrative fees):
Phone:(360)695-7700 I Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247 Total fee due upon application: $201.60
` This permit application expires if a permit is not obtained
Authorized signature:' /,L` ` ' =� * within 180 days after it has been accepted as complete.
L Fee methodology set by Tri-County Building Industry
Print name:Nichole Thorpe Date:06/16/2017 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
•
, ,
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
114
: " 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
Plan R
Phone: 503.718.2439 Fax: 503.598.1960eview
.111 - Date/By:.
rECCREIEREIM
Other Permit
TIGARD
Inspection Line: 503.639.4175 ., . .
Date Ready/By: Imis: El See Page 2 for
Internet www.figard-ongov Notified/Method: Supplemental Information
r:-tvk;-wmm*eae'gyfx':Awo::Rgs-mroxw.-zo.weia rav,iFA-4-40t-soloittigigaw- 70
Mechanics]permit fres*are based on the value of the work -
121 New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition El Other: mechanical materials,equipment,labor,overhead,and profit
Value:$
-",',-17,101WiieWIT-tC4fiTCT*tilittitriX4161;1?-W,ifi-')074iKifiteifi: iv,-1:..--..kw.,... -.--,-•-,•••.---=•,-.---...,... -,:e.._.
1-and 2-family dwelling El Commercial/industrial 0 Accessory building For special information use checklist.
'Multi-family 0 Master builder 0 Other: Description Qty. Ea Total
'44P2V-WA-t.....W.40:174-WftWijA04,764.**5-0:4-tMt-Agat Heatingimling:
1 46.75 46.75-
Air conditioning
Job site address: 1/5109 Sv\) \t)'rt" Ne,, -
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 2332
Other: 23.32
Subdivision:River Terrace East Lot no.:LC) -
Other fuel appliances:
Tax map/parcel no.:
Water heater 2332
iii,s,0*T'....iii.**0**-NAV:44.. .:-:,%;:tikiVi Gas fireplace/insert 1 3339
Flue vent for water heater or gas
•MsrW1T -bo-HA2. fireplace 2332
_ .
Log lighter(gas) 23.32
Wood/pellet stove 33.39
• Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
-AMTJAS1j10001:.tt:O.:,i**4t:R;--;2;.tf.454-gii. .: '.0 07,1V4i4i..1/414.921ort"sigi.e; °then 2332
Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment 1 3339
Address:7600 E Doubletree Ranch Road
Clothes dryer exhaust ll 33.39
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, ti
toilet compartments,utility rooms) 23.32
Phone:(602)694-4031 Fax( ) Attic/crawlspace fans 23.32
O:.' I,'a i';ITAIV;12-60.1407**WOZ:;-; Other 2332
Fuel piping.
Business name:William Lyon Homes,Inc.
$14.15 for first four;54.03 for each additional
Contact name:t'\k cmDk.-11i\o‘eve Furnace,etc. 1
_Address:70'7) Dn10,0t11k01 t 't- at.iitt, Si D . Gas heat pump
Wall/suspendedhmit heater
City/StatetZLP:Vancouver,WA 98660
Water heater
Phone:(360)695-7700 Fax:(360)693-4442 Fireplace 1
Range
B1
b
.
E-niall:AN 1 CAA 61C, -4)11,0\040:. pb_kory*Oryle,S •t Ani athecue
7,- iy- 66iffrj:,-:: :,-,..,,,,r, -14%4:•41::* fi'tk.7;1447 clothes drya(gas)
_ -ri`•4 :,' .',.7.:•',:::f.:g-7:I_P ., fZt..'
Business name:pnvtosvtr , kyyl uotnn -linc Other.
J I rr- 4w1.K.le skl-adiKC.1441-S,W1213:11KFTTES,w4,r";P;'....;7 v.':I.
Address:1.1)Cic t\VN!•1q1 .‘(‘ Dr, Sumf,-11.01 Subtotal
City/State/ZIP: .vAsbNro &)v_, ci in_)-1 lvfinimum permit fee($90.00) -
_
Plan review(25%of permit fee)Phone:56-6),443.. 9.941., Fm(S15)0o-\\ - cITIS State surcharge(12%of peimit fee)
CCB lic.:101 OD) TOTAL PERMIT It&
This permit application expires if a permit Is not obtained within 180
days after it has been accepted as complete.
Authorized signature: thekey6V."..1.0----- * Fee methodology set by Tri-County Building Industry Service Board
Print name: /(4.1 d/4....--11 type__ Date:
muleraelltemitonic Penuitano 040113.doc 44111.4K17T 111/111/MAAIWRR)
Electrical Permit Application ,
;" FOR OFFICE USE ONLY:
- City of"�2g�L-(� `rod Permitfk __C ,,,2e)/7-0,✓? e1,2....,
II 13125 SW Hall Blvd.,Tigard,OR 97223
Plea Review
0 Phone: 503.7182439 Fax 503.598.1964 Date/8 . RriatedPunal:
Ready Aate/By: Trete:
Inspection Line: 503.639.4175. Et SeePa 2for
TIGtiItD �
Internet:•wwln:tigard-or.gov �u5 ,.> NotiffedfMedhad; Supplemental Information
-:-.;f7---Z.r _!--"- �..3,-. 5 ; .-F1t.0 EA-0..a1,.,46, -',?.- 11 -., :..a-.-�' -Z-i- ';- ,L7c..::? '. z ' -4,5: t O-PZ:, yeA t"e }e .�....-t-.:t,',:','-'
i New construction ❑Addition/alteration/replacement Please chock all that apply(submit'sets of plans wjltems check:
❑Demolition 0 Other ❑Service or feeder 400 amps or more ❑Su ldmg over theca artifice.
ht ;v ; ,c"� a cr A a`.p.o r ' e ,- ,7 where use aveilabk faun oim ❑Ivlarinns and boatyards.
rds.
'^3�' + 1P? _ 3 , :. _ exoneds 10,000 amps at 150 volts or [J Floating buildings.
-and 2-family dwelling ❑Commerciai/ii diistrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
Math family ❑Master builder ❑Offer amp for other mBrallations.
B all
❑Fire pump. 1:3 Installation of 1501CVAor
y4rut 7;6:-u b.1,-eble%li qi o-',„4,et l 'ao r.'• q a ' u -k .,x� ❑Emergency system. lama separately derived
Job lob site a er f'�? n1 C Q-l'i/► /p ❑Addition efaewa�otortoad of system.
a.iiAvs �+� t " f 1v V 100BP or more. ❑A",`E","1-2","14",
City/StatelZlP:Tigard,OR 97224 ❑Six or mere residential anile, occupancy.
Oilcan-camfaoilitias. ❑Recrrationalvehiclepadcs.
Suite/bldgiapt#: I Project name:g1 Sp -'T' �(...e ❑Hemrdone lons. 0 supply voltage for more than
❑sauce orfeotieda 500 amps or more 600 volts nominal.
Cross street/directions to job Site: 7 •r y r f 1 v
Decetiotton I Qtr. leek Total 1 .-
New residential single-or multi-family dwelling unit.
Subdivision: 1j4'e r Twat"- E 1 Lot* 1iar) Includes attached garage.
Tax map/parcel#: W'c� r1.000 sq.R alms 1 168.54 4
r Ba.add'1500 sq.ft or portion 1 33.92. 1
x ,., ,- ft o`..! a! , .:, _ T 4 ''. Limited energy,residential
•
(with above sq.R) 75.00 2
Limited energy,multifamily 75.00 2
residential(with above sq.8.)
x4,' 1;2,?�aA�J �f1 fi,F>A ter y �i� 1,erar k Renewable Energy CI SeePage2
Services or feeders installation,alteration,and/or relocation
Name:ADVL Land Holdings,LLC 200 amps or less 10030 2
Address:7600 E Doubletree Ranch Road 201 to 400 t3336 2
City/State/ZIP:Scottsdale,AZ 85258 401 amps to 600 amps 200.34 2
I 601 amps to 1,000 amps 301.04 2
Phone:(602)694-4031 Fay:»( ) Over 1,000 amps orvolts 552.26 2
Email; Temporary services or feeders installation,alteration,and/or
relocation
Owner Installation:This installation is being made on property that'own which is not 200 amps or less 1 59.36 1
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 16834 2
--, ',S`.1-. I-I :
fi_^ TE11 v-..--_.=.,:,- 7,.-,:-,:•---.� :4,u,,!:",..222:
' 1,1
- first t r,i t,k,6.:F7d �%"`,,-F� 1 ABrFchcrlrcidh—new alteration,or
circaits wide extension,per panel -
Business name:William Lyon Homes,Inc. above serviceorder fee,
tach brand circuit fee7.42 2
Contact name: Ni(eh o1�T not B.Fee for branch ciratitswithrnd -
service or feeder fee,first
Address: ^t 03 IU cipJ st S UA& 1 t i branch 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each add')branch circuit 7.42 2
Phone:(360)695-7700 . Fax::(360)693-4442 Mtsceilaneous(service or feeder not included)
Each manufactured or modular
Fina7 , ' dwelling,service and/orfeeder 2
a •pl p a '4 A.}me Recosmectonly 67.84
84 2
s ` r ., Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC Signor outline lighting 67.84
Signal*asks)or limited-energy
Address:e4 CO U Q1�tp.�,. \ S U`Afid'., ` P�1,alteration,or extension. ❑ See Page 2 2
F 1 �- t�J i2
City/State/ZIP:' f ��1 J J ��" q�t1s—) I
Each additional inspection war allowable fn any of the above
Phone (253)320-1657 I Fax:Z Additional inspection(i hr min) 66.2_5/hr
( ) Investigation(1 hrmin) 90.00/hr
Frnall•bdanielsgowt=ensa.com Industrial plant(I hr min) 78.1S/hr
Inspections fm whichao fee is
CCB Liic�.: C1158 Electrical Lie.: 208174 Sbprv.Lica: 44968 .eoificely listed('k hrroin) 90.00/hr
Sl1prv,Electrician signature, ulred � !!r i _.. .s,_..� aer.. 1 ):5•;cY;_kgJ.YDlT 4ai
.-
Print name: loan P Alberta Subtotal:fee):
Date: 4/26/2016 El Review Required Cas/o of permit fee)
State surcharge(1295 ofpermitfee): -
Authorized signature: ~—�y TOTAL PERMIT FEE:
Print name:: B111 Daniels This permit application expires Ifs petmitia not obtained within 180
•:
Data 426/2015 days after It Lea been accepted as complete.
* Numberofinspeotione alowedperpermit
w ��' '� Pe +ppHRIIIBoRev o6fi7no15 ado-a6lsTW05/cDWS3
Plumbing Permit Application
Building Fixtures iiimoommirsitmaimmimon
r .�
City of Tigard Received P tgo.;
y 13125 SW Hall Blvd.,Tigard,OR 97223 �'1�% /� ` O `
Y Phone: 503.7182439 Fax: 503390.1960: ga etSy Other? mit Ida.:
Inspection Line: 503.639.4175
T I r r-fi Internee wa w.tigard-or.gov t IteadpiBy luta
®See Pagefar
..r'
�s�
_ _ H� : Sup}Ellemratsd InfsreastFoa
:'g+x:'` .e `ti=, it"I.-;i'Y:.':'' - ,:.4 " - . _ •
ISI New construction 0 Demolition For vadat information ate checklist
❑Additiodaitsratiomtreptacernez t ❑Other. •
Description i Qty. I Ea. � Total
New 1-2-family dwellings(includes 100 IL.for each utility connection)
,,, ' 1 -CA t iffir QF._``C23nigl'xtf• 4 _ y:"-A-V-1,' S (1)bath 312.70
•
_I-and 2-family dhveliing 0 Comntercialrmdust£Iai SFR(2)bath 437.78 '
❑Accessory building *Multi-family sFlt )bath-•
• 4 50032 q _
•
❑Master builder.' , Each add�onai bath/kitchen 25.02
0 tither
.-- Fire sprinkler(^_s9•�). Page 2
_g " . -,..�� 9) - �j_ try ' 130Kf:, 1•� +4**• '',., i Site utilities:
lob site address: L?2L0 i �ttf - Catch basin or area drain 18.76 .
City/State/ZIP:Tigard,OR 97224 Drywall,leach line,or trench drain 18.76
Footing drain(no.linear ft.: a Page 2
Suite/b14/apt.no.: I Project name: gtVW r i ,'�"ery i t� G„n,- M��home utilities
Cbl 50.43 .
Cross streedditections to job site: Manholes 18.76
-
Rain drain connector 18.76
Sanitary sewer(no.linear IL:_ J PaBe 2
Storm sewer(no.linear IL: I Page 2
• •Water service(no.linear ft.:_, Page 2 :
Subdivision 12.,,i r- "fiQ re.._ +_ Lot no:,•U Fixture•or item: ,
Tax map/parcel no.: Backflow preventer 1 31.27
• ;.5,4 .i'*;•.•4,-:-; - -'-DFSt3itP.-T'tt NtiE A'ORIC`• : B l water varve 12.51
Clothes washer 25.02
Dishwasher 25.02
_ lkiniang fountain 25.02
5 w.. .r... ;..
Ejectors/sump 25.02
,.r°'•5. ``��� tt'r 1 t)kt'r--...•?` i'- pansy tank
� � �Osr!`� r� . ._:�� F.x an I2.51
Name:ARYL Land HQitlagsi LW Fixture/secap 25 02
Address 7600E Doubletree Ranch Road Floor drain/floor sir Inb j 25.02
City/State/ZIP:Scottsdale,AZ 85258 Garbage disposal 25.02
Hose bib 25,02
Phone:(602)694-4031 Fax:( ) Ice maker I2,5I
:.i ',, '' 1, " `:' -• b : lateraeisgrease tail) 25.02 •
Business name:William Lyon Homes,Inc Madaad gas{value $ ) 2
Primer 12.51 , • .
Contact ....\.1 xlz.. y-bj QYDO �, �S.3,- s'... svosmk/basin/l
m'atorY 25.02
City/StatelZlP:Vancouver,WA 98660 Solar units(potable water) . 62.54
Phone:(360)695-7700 i Fax::(360)693-4442 Tub/shower/showerpan 12.51
E-mail: 1 � - 1/ 1 A�IP1I ( hl P?_•W Urinal _ ?5.02
"�22fA 4T.:,.U• "�,.h• r"t.i`:+�yA ;T • - .�_ ey .+K { - WaE:etCIOg� , 25.02
Business name:Alliance Plombtng•LLC Wata`heaza 37.52
Water.piping/DWV i 56.29
Address:146 W Historic Columbia River Hwy tither 25.02 '
City/St /Zate/'IP:Troutdale,OR 97860 "' Subtotal '
Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fog $7230
-CCB Lie.:184601 Numbing Lic.no.:PB732 Plan review(25%of pelt fee)
Authorized signature: State sure mrge(12%of permit fee)
TOTAL PERMIT FEE
Print name:Robert Dishonor Date:5/2312016 - This Permit-appiicatioa expires tf a pandas not attained within I80 days
._ er*las been accepted aseanpiett,
*Fee methodology serby Tri-County Building Industry Slice Board
tinalwicePen isTI du Permitr4pp,doe IWDII09 44O-4616T(181611cQM7WBb)
City of Tigard
111111 411COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
Building Permit #: 7 —09 1./(),
Site Address: I
3 2 Q ci s y'V' 16 ci T`h CAv v.,
Project Name: (1 VZ°r T-f'rr ca. v1 i Lot #: 2 a
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: NieNv 5 R.
/ Verify site address/suite# exists and active in permit system.
gi River Terrace Neighborhood: 0 No /or Yes,See River Terrace Review Addendum Attached
Site Plan/three(3)copies of site plan ung structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
Drawn to scale(standard architect or engineer scale) floor elevations
North arrow Utility locations&easements(required for new and additions)
Site address,project or subdivision name and lot number ,'Sidewalk/driveway approach
,Applicant information(name and phone number) --eLocatlou of wells/septic systems
,Lot dimensions and building setback dimensions .1;1-Existing-trees to be retained with drip line,and tree
$quare footage of buildings to be demolished protection measures
,eLot area,building coverage area,percenta.,- f coverage and ?1Street tree size,type and location
impervious area(applicable if R-7,R-1.,R-25 R-40) ZStreet names
! Property corner elevations(2 foot contour es if more than >1,000 sf of impervious area created or replaced? s o p/
4 foot differential) If yes,is a storm water quality facility shown? ❑ No
/ Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified .- -.4Ie-- Received: ❑ Yes ❑ No
XPublic Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
V'Land Use Case#: ('Di(- 2)0lca.-- °coot , SUBEot(ci '000Q'
Zoning: (2- Z y
Required Setbacks: Front [Z Rear S Side 0/2 Street Side 3 Garage 3 ro
izr Landscape Requirement: ZO %
71 Lot Coverage Maximum: 3 7 % ,,f n �)
Z Building Height: Maximum Height y V /r Actual Height 3
Zi Visual Clearance
,Z( Sensitive Lands: ❑ Yes gr No Type
gi Urban Forestry Plan
Z Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: , —�
ill �. . Date: 10 j I i l 1 1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Fonns\BldgPermitRvw_RES_061417.docx
Building Permit Submittal
Original Submittal Date: 6'/. 2 77
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: Planning Engineering A.J Permit Coordinator 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.
C;Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: / i4,A.,"�il/i i..4,T, Date: (0 // :)/7
Engineering Review
K Slope at building pad: /0
7.5
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
yi Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes / No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: l kn.- (,L) , Date: le/2—V/7
Revisions (after Building Submittal only) Reviewer Date
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
J� Date: !O 4 �`
Approved,NOT Released: f t'�
otes:
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:
WSDC Fees Entered: Wash Co Trans Dev Tax: , 'es ❑ N/A
Tigard Trans SDC: , 'Yes ID N/A
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes T/A
ZEN OK to Issue Permit f/ /��
Approvedby Permit Coordinator: /�1'"wd' Date: t //J '4 j‘
1:\Building\Forms\BldgPermitRvw_RES_061417.docx
IlliCity of Ti
COMMUNITYgard DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
Building Permit
Site Address: 13 Gi & w. / o q a\
Project Name: I i V e r 'Te r.^ e-Ci s +
(New dwelling=subdivision name;Addition or Alteration=last name of owner) Lot #:
Planning Review of River Terrace Plan District Design Standards (18.660.0701):
Is the project subject to the plan district design standards?,"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 required 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. 5 ft. deep
ft.deep min. 2ft., 5 ft. wide min. 2 ft., 6ft.wide Gabled dormer
2. Eyes on the street: a minimum of 127o of each street facing facade must include windows or entrance doors.
Percentage Shown:
3. Entrances:At least one entrance must meet both of the following standards:
Max. 8 ft. setback from longest street facing wall W'Prallel to street,angle no more than 45° from street,
Entrance opens to a porch: L1 Yes 0 No or open onto porch
If es,all the following apply:
One street facing entry f25 sq.ft. min.
5 ft. depth min.
12 ft.max.roof above floor of porch
X30%min. porch roof coverage
4. Detailed 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 xf Recessed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches
Roof eave min. 12 inch projection gDormer min. 4 ft.wide
❑ Roof shingles either tile or wood Roof offset min. of 2 ft.
� Gable,hip or gambrel roof design
0 Roof pitch oriented south min. 500 sq. ft.
?Horizontal lap siding min. 3-7 inches wide
0 Accent siding min. 40%of street facade
❑ Window recess min. 3 inches for all street facing �Window trim min. 2 �/z"wide by 5/8"deep
dow
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access 0 Attac0 Bay hed garage is 35%widen. 5 ft. lessby 2 ft. deep
$ g or of street facade
5. Garages and Carports:May face the front or side lot line on a corner lot.
Setbacks:
No closer to front or side lot line, than longest street-facing wall/Yes eo. 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.
0 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.
W9,th: (Check one)
12 foot-wide garage door
0 40%max. of street facade
V 50%max. of street facade with 7 detailed desi: elements
Notes:
Approved By Planning: V1 -
Date: /0/ y i / 17
I:\Building\Forms\BldgPermitRvw RES RT_o62216.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
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 '" "
{U;'1 1 4 2017
FROM: Nichole Thorpe
v1R
COMPANY: Polygon Northwest
PHONE: 360-989-40204 By:
RE: 13213 13209 13205,13201 SW 169TH
(Site Ad �1 e rt um er
River Terrace East lwt"T9=2z
Lo
t 20 Nisi-/017-0040i
(Project name or subdivision name and lot number)
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
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: 1 j — j ) Initials:
Fees Due: Yes No Fee Description: Amnount ue:
141.- p/G.1 rev c,‘" $ Q0
$
$
$
Special
Instructions:
Reprint Permit(per PE): fes ►v No ❑ Done
Applicant Notified: Ali i C t CCl1)ate: (Z-/ Inti,
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:
13209 SW 169TH AVE, BEAVERTON, OR, 97007 July 10, 2018 at 1 :34:59 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00402
Inspection Type: Inspector:
299 Final inspection Jeremy Burrows
Result:
PASS - CofO
Comments:
Final erosion control passed
Moisture content form received
Moisture barrier acknowledgement form received
High efficiency lighting form received
Insulation certification verified
Blower door and/or duct seal test certificate received
C of 0 left on counter.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13209 SW 169TH AVE, BEAVERTON, OR, 97007 June 28, 2018 at 2:53:56 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00402
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Re install broken strap for gas line in mechanical closet prior to building final inspection.
No ac installed.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13209 SW 169TH AVE, BEAVERTON, OR, 97007 June 28, 2018 at 2:54:44 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00402
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS
Comments:
No ac installed.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13209 SW 169TH AVE, BEAVERTON, OR, 97007 June 28, 2018 at 2:52:22 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00402
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Water pressure 60 psi.
Violation Summary:
Inspector Contractor