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Permit (87) ,� CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2017-00401 13125 SW Half Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/12/2017 TIGARD Parcel: 2S 106DA01900 Jurisdiction: Tigard Site address: 13213 SW 169TH AVE Subdivision: RIVER TERRACE EAST Lot: 19 Project: River Terrace East, Lot 19 Project Description: New SFA. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 115 sf Basement: 0 sf Left: Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 646 sf Garage: 543 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 633 sf Right: Detectors: Total: 1394 sf Value: $187,339.23 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: 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 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: $23,419.40 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 throu.•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 B . Permittee Signature: c'V -/° Z,/6'9-770A/ 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. S Building Permit Application lacifii g:11 1 �;. R .I REEeJ d Permit NoAt S OO-C 4-iq City of Tigard / JUN 2 2 2017 D �l(1"3'`A i )iii . 131SWHallBlvdTigardOR 9 23ll ����(.610/)—G0?30 --t 17 Other Permit: JCJ Phone: 503.718.2439 Fax: 503.598.1960 . DateBy: ".Z/ �' Inspection Line: 503.639.4175 Date Ready/By: / inns: WI See Page 2 for 1.I A E:.i p Notified/Method:/Z/� �7 Supplemental Information Internet www.figard-or.gov ❑Demolition Permit fees*are based on the value of the work performed. ®New construction Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other equipment,materials,labor,overhead,and the profit for the E21' work indicated on this application. Valuation: $ I L-. 111 141— • —)) "-and 2-family dwelling 0 Commercial/industrial Number of bedrooms: 0 Accessory building lifMulti-family i 15, 3 3 9 0 Master builder ❑Other: Number of bathrooms: T' "'= Total number of floors: " Q i ,.� '�� &_ � � E � � mtiy ��„ Job site address: 132.13 Sv l(/)61111 New dwelling area: '4 square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: 543 square feet 633 Suite/bldg./apt no.: I Project name:River Terrace East Covered porch area: 8 0 square feet 6 4 6 Cross street/directions to job site: Deck area: C) C square feet 1 1 S 94s rP eJ: [ square feet Subdivision:River Terrace East ot .: —1 Permit fees*are based on the value of the workce I Lnoperformed_ Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the work indicated on this application. z �� , Valuation: $ Existing building area: square feet New building area: square feet 2-'m , , , _ =, . 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: 4 .. . ,. .., . �'"* -,2,-,•- ,; _ asst_ '�, n:� . � 7:t.,. `a "( 4ry _..r, 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)695-7700I Fax::( ) ) 't '. : F - � EmailNichole Thorpe �� � � m Commercial and residential prescriptive installation of '.: ` rc r , ` roof-to mounted Photovoltaic Solar Panel System. Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 109 East 13th Street Solar Installation Specialty Code checklist. Permit Fee(includes plan review $180.00 City/State/ZIP:Vancouver WA 98660 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: $201.60 Authorized signature: ` / 07,.t_._fr.______ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name:Nichole Thorpe Date:06/16/2017 Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 l/02/COM/WEB) 1 Mechanical Permit App! canqii tr.&„''t----, ', -.::1, FOR OFFICE USE ONLY 11 City of Tigard ' Received Permit No.. 47 /7,0e y„ Da./By: . • 13125 SW Hall Blvd.,Tigard,OR 97223 N't,-',v ) c,-,,, 2 P1/ man Review : 111 Phone: 503.718.2439 Fax 503.598.1960 bateigy: Other Permit TIGARD Inspection Line: 503.639.4175 , ', -.'4,- " . .:,-?'t Date Ready/By: lune 0 See Page 2 for Internet www.tigard-or.gov Supplemental Information -'"-' "'Aittoigiffilt&EV--giiSr -rk 7°14C.W*;:r4LIWa41:44 4--- V:::4*4:1-**4-114*-741e- ::*:•MeCecham--WIC.alpermit teeTs;'ar-'rebitse-ciOni;VIII-tedf the work El New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit Value:$ 4 WA:MaMVAA-titG7f.*Arkblifitii r3V-e-0--',-FgEirli ail; zi:*o**:*:rtor:jowiow::*s:::: :toms!, 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist 1 'Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total .., Wir=1;X:5:3-AfAYIESKOtt:W4**W.0.-*Ait 0-1:*120-rig2LAIffir.W Airifealei:garti 1 46.75 46.75 I Job site address: ( L t'5 SW ap Crtil kr& Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP:Tigard,OR97224 Furnace 100,000+BTU(deets/veats) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:River Terrace East Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 2332 Residential boner(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.: 1.9 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 :;i41.:ifat:Wrtai$:±=:1-!.4 000*#*.0::::*.0140,-, ..,4P.-Z141-.4Hii:VikAN NicTiefrePvent'foacer insert or gas 1 33.39 51-1)n-' F 604D fireplace 23.32 — Log lighter(gas) 2332 Wood/pellet stove 3339 • Wood fireplace/insert 2332 Chimney/liner/flue/vent 2332 ...."ZWL:‘:4:4;iidi&ti116'4;;:':A. i;41.1217 :::V-2• 16 Environmental exhaust and ventilation: 2332 Name:ADVL Land Holdings,LLC Range hood/other kitchen equipment I 3339 Address:7600 E Doubletree Ranch Road Clothes dryer exhaust t 3339 City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, 1j, toilet compartments,utility rooms) % 2332 Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans _ 2332 7-Vir..: '",;.'":':Erectil:40W-04,*.1.0'P Other 2332 Fuel piping: Business name:William Lyon Homes,Inc. 514.15 for first four;84.03 for each additional Contact name:W i CArt 0 k,-11A0i/V.e, Furnace,etc. 1 Address:11r) MODtit.k.)atil St akik(-- Si 0 . Gas heat pump WaR/suspendedhmit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Far:(360)693-4442 Fireplace 1 - — Range 1 E-mail:AO i Gk..°le. 1-11k, i rtZPIAvrifY\IrOntlej •4111 Barbecue _ ,5-FY %:;-.4L:Aytif;P4;;=, Clothes dryer(gas) Business name:pnv,tol cuyil Qpiltrvi .-T.,„,c1, Other. '..,V4 :Z457*.ckoiltRmar7 Address: ') ORS- W . c\Ovp V_ Dr Siol)if c. kol Subtotal City/State/ZIP: "Sl) kykl...., .q ki)..i -,— minimum peamit fee($90.00) Plan review(25%of permit fee) Phone:56.6)443. lokl...., Fax:( ' ) at Li ' c0-17- State surcharge(12%of permit fee) CCB lic.:2.0di CO) TOTAL PERMIT FEE This permit application expires ifs permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: illeatera ,....10--- * Fee methodology set by Tri-County Bidding Industry Service Board Print nameM6,14 0 ie....lel 01240 , Date: Muilimaermits\MEC Permit/on 040113.doe 44t1-4617T ell ffIlirfilur/WIZRI r ,i-14:::i p Electrical Permit Application FOR OFFICE USE ONLY City+�,f Tigard /'11,' Beodved III a 13125 SW Hall Blvd.,Tigard,OR 97223, :ate': .• Permit s v7-0` t Phone: 503,718.2434 Fac 503.598:p6o', P1aerB6wew YtG�itll Inspection hon03,718 43.639.4175. DateB Inteniet•www tigard-or.gov Ready s Furg122111/111111111ageen11or • Supplemental Information -moi 4' ',9„ -,,, 9-Tpsm-,iyt*--* "'-f _:4 •? ,-• r ' ,- L, 3st f ,` nl®New construction 0 Addition//alteration/nPlacement Please ceok ell that apply(submit 2 sots ofp]aas w/itams checked): 0 DeaiOimon 0 Other ❑Service or feeder 400 n e' amps or more ❑Melding over three sborieL ` t2__�,� a� a)kbr x c hef ',.:`,14',f3;_%7-L7,-,-5.,1, where the available fault cream ❑Marinas and boatyards. and 2-familydwellingexceeds 10.000 amps at ISO votes or Q Floating buildings. ❑CommerciaUilidustriai 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural Ivhnitt family 0 Master builder Q Oflier amps for all other installations. • buildings.- Vie .9 yw:a Zisit �� N`"7'.4:0.10 ❑Fire pump• 0Installation f Z,_ : _a u H r s- , ofI50KVAa Job#: .-.��'. �'�= ❑8mergency system, larger separatciy derived ( Job site addre,�^ �1r ❑Addition of new motor toad of City/State/ZIP:Tigard,OR 97224 S� ��.Q"►t" e lope or more. Ci' ,'I-2','1-3”, �o',. 0 Six ornate residential units. occupancy, Suite/bldg./apt# i�Vr r �r� ❑Heatfh-oarefacilities. 00 Recreational vehicle parks. I Project name: e r ❑xazardorto tions. ❑6toPP voltageformaroI- TOSs street/directions to job site: �-' r� ❑Savix orfaeder 600 amps or nroro. 600 volts nominal -= p ' t.:.-4-1-Y20,'�` ilNt`i•. 'a. • Descript os . Q . Rash Total Subdivision: , �, New residential single-or multi-family dwelling unit. tz..},if.r TT& ee_ Eas.}- 1 Lot# 9, Includes attached garage. ____ Tax map/parcel# 1,000 sq.R orless 168.54 4 ,:M ' ":..,;,,r'''.?-:::;-:-. i� etaa,..-6:16'Flo e cry j Ba.add 1500 sq.ft or portion 3392. Limited energy,residential I 1 (with above sq.fl-) 75.00 2 Limited energy,multi-family residergia(wi$l above sg$) 7S-� 2 4., �-1r Q o y,t 3 Dv-`-q :s' _ 2111 ;- w - :, _ Renewable Energy Q See ` " z ' Services or feeders Installation,alteration,an or relocation Name:ADPL Land Holdings,ILC • 200 amps or less 100.70 2 Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2 City/State/ZIP:Scottsdale,AZ$525$ 401 amps to 600 amps 20034 2 Phone:(602944631 F ( 601 amps to 1,000 amps 301.04 2 ) Over 1,000 amps orvolts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or -. Owner Installation:This installation is being made onrelocation00am Owner i for sale,lease,rcpt,or t property I own which is not 200 amps or less 593b 1 exchange,according to ORS 447,449,670,and 701. Owner signature: 201 amps to 400 amps 125,08 2 Date: 401 amps to 599 amps - },J�S j_LF�i `yr, ,- Tie/ tr.'r�J d�i. i ^ ' ' 16854 2 p x Brancheircuhts-new alteration or extension,per panel Business name:William Lyon Homes,Inc A Fee fnrbranch cdrenils with above service or feeder fee, Contactname: i rte �"�,,vim,a each branch circuit 7.42 2 ��� tY'1"i/`t (t'G B.Pee for branch circuits without 3 13YUr�t;.�,__ St' Sll�I,�-t, l 71 service r fee,fust blanch:bruit 56.18 2 City/State/21P:Vancouver,WA 98660 Bach add')branch circuit • 7.42 2 Phone:(360)695-7700 ( Fax (360)693-4442 • �neous(service or feeder not included) Email: ! Bach manufactured or modular '! r e' j I / (� r dwelling,service and/or feeder 67.64 2 '''''':7--:'-z--`:--4.--='-11--•-7-7- r �` �p 0 t") A MP 1 a Reconnect tiect671. >p 0- , - -y °� 67.84 2 Bess name:Garner Electric Washington, Pump or litigation circle 67.84 2 .r_. LLC y Signor outline lighting 67.84 2 Address:t L i,�7 `t n 1 l 4, St*circuks)or limited energy FF lU.r�6 elA i ks. U-k\-P� t banal,alteration,or extension, ❑ See rage 2 2 Cm'/State/ZIP:' p[q �1 1 Lt P' C�y�3,/ I Each aardonal inspection over allowable in any of the above Phone:(253)320-1657 LL �1 Additional inspection(I br mud 6625/1r Fax:( ) Investigation(1 hr min) Rrnstil 90,OO/iu bdaliielst awellsa.cpm Indnstrialplant(1 hr mitt) • 78.18/hr CCB Lic C1158 Electrical Lia: 208174Inspections for which no fee is 90.00h t1r y�,� -�- Suprv.Lio: 44968 ,. iiiealhy listed /lirmin)_ Suprv.Electrician signature,redluired:: .( l I' - ,� - N �� Kim8 s ' a E 1 a /m fr,.. .. v3 r Yom. • 1 Print name: ban?Albert Subtotal: !, Data: 4!2612016 CI Plea Review Rtxhnired(25%of permit feet A _ -- State surcharge(12%ofperrnit fee): A: uthorined signature: TOTAL PERMIT FEE `` Print name: Bili Daniels yi This patsnitappleadon expires if a parasitic not obtained within 180 Date 4/26/2016 a accepted as complete. !i4;.: day after it has buen ill,,1hmaildinglperminlgo p E.E ffi8.4oc Rev 05117/2015 440-4615711/0582014/COM * Namb�ofiaspeotioasallowodperpoIDrit Plumbing Permit Applicatjfi : _ .. . Building Fixtures i oR 01-1-1C L I!•;;I:. ONL'i ' City of Tigard ! Received mit rao. 13123 5'W Hall Blvd,,Tigard,OR 97223 / 17-a)ye' Phone: 503.7182439 Fax: 503.598`.1960 lean Review Date/By. OtlarPermit No,: 7.,c,, n Inspection Line: 503.639.4175 Dam R By Ju ®See Pa 3for Internet: www.tigard-or,goV Page .=is;T :•'• .-. : r�j�_- • -4-- •.- " •>_,:. Notified/Method: - Supplemental Information -_t..'• '.' ' 'Y' ii:.iar Vii# :-: ` `.7.10`: r''`rt..,!; . 4.: }y���yyy�-qfe} - " • • ,,.,_ •tr �-1�� 1�1�(Y$�' ®New construction ❑Demolition Fe special'tgfarJnafioa wse checklist ttfrGp 0 Other: .Description 1 Qty. 1 Ea ❑Additionfelteratio lacem+entTotal ,: _ 1� L.• jjy�}p�+..•/��;... New 1-2-family dwellings(includes 10011.,four each utility connection) = _ ',•;•'1Z,... :,...c-:;: lY';a.. zt:;;;is;,t#.,•;;*'::.= SFE 1 bath 312.70 - I-and 2-family dwelling 0 C • omrrtercialfmdus�lai SFR(2)bath 437.78 ' ❑Accessory building• $Mehl-fancily SFR(31 bath 4 500.32 0 Master builder.• ❑Other: Each addttiwtal heti/kitchen 25.02 : �._ Fire sprinkler(_____sq.ft.). Page 2 i :l r*:+r a ••• �1t . I 'IIOl t#D,. ,' {21Y"•#•`_• ....:,%•.;;•..... Siteu6iitixs: Job site address: L?iL • t a i Catch basin area drain✓ 18.76 qty/State/ZIP:Tigard,OR 97224 Dryvreii,leach line,or trench drain 18.76 �^n Footing drain(no.linear ft.: 1 Page 2 • Suite/bldg apt.no.: I Project name: KA I'T&rru t e et 4 Manufactured home utilities 1 50.03 Cross street/directions tojob site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.: 1 Page 2 •Subdivlsiom -- •Water service(no.lines ft.: ) .Page2 ' M'c& � •l-- Lot no:,+t 1 _ • Fixture er item: Tax map/parcel no.: r Eackfiow preventer . ( . .'-lie:!.. _• :-_-, ..•.� _... . • 31.27 ':•:A-' ., s, h,-::•,.- `.`1.CSCRTP Backwater valvc . =.•�'.' .. . .. ..: •l'iiSf-�l3)1�'WQjltiC•Y•r. . . .... �'� � 12.52 Clothes washer 25.02 Disimusher ] 25.02 . Drinking fountain 25.02 . .: • .W,".1":',.. .rt • ''...".....;:t., E /sump 25.02 ' •.."•r g�,' r "�; ..��.'`I'�dl�hritil'- '` � �•_ Expansion tank I2.5I . Name:ADPL Land Hoidmg%LLC Fvture/sewer cap 2303 Address:'7600 E Doubletree Ranch Road Floor sink/hub 25.02 - City/State/ZIP:Scottsdale,AZ 85258 Garbage disposal 25.02 Hose bib 3 25.02 . Phone(60294-4031 Fax:( ) lee maker 12.51 • ' �� :.. ,T:.�' �+� r tor/grease trap 25.02 Business name:Wil m Lyon Homes,Inc Medical gas(value S ) Page 2 :\ . Contact name:' '\ r\1 . Roof Primer ' 12.5 i : Address:i�3 l7YD� 'SA- i-c- O takidrain{vatuty ciao 15.52 Siitk�siuflavatnry 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 ' Phone:(360)695-7700 Fax::(360)693.4442 Tubfsltoworfshowerpan I2.51 : Frmaii::a. ` 4 i 14. b .+l o's u. _( p .c�(\l Urinal 25.02 -• :z..- °:a, �8'r9 ='s . `. Water closet 25.02 Business name:Alliance Plumbing - Vl'ster:heafer . 37.52 . WauspipingfDWV • 56.29 • Address:146 W Historic Columbia River Hwy Other City/State/ZIP:Troutdale,OR 97069 25.02 ' L Subtotal ' Phone+(503)492-3490 i.Fax:(503)91.2-6438 Minimum permit fee: $72.50 CCB tic.:184601 Plumbing Lie,no.:P8732 Plant review(25%ofpermit fee) Authr sized signature: 4 Statesurcharge(12%of peter fee) TOTAL PERMIT FEE I Print name:Robert Disburse I Date:5(33!2016 1 This perm&*PW on aspires.ifa-permitis not got iced within teal days atter him been accepted as complete. *Fee methodology set*Tri-County&Min industry Service Board. immad'ngnermin Permithppatoe lorotas 440-o1eT eteuppnAkem City of Tigard 'I COMMUNITY DEVELOPMENT DEPARTMENT I TIGARD Building Permit Review — Residential Building Permit #: , 7 /)/7 Cr '01 Site Address: I 3 Z 1 .' S v'v i (n '1 4-1—) Project Name: V T y'rrzi Czci S i-- Lot #: ,� 01 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: I v e.A / 5r-R- / 1=-R., / Verify site address/suite#exists and active in permit system. 0 River Terrace Neighborhood: ❑ No Yes,See River Terrace Review Addendum Attached Site Plan Elements: /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) f Site address,project or subdivision name and lot number 'Sidewalk/driveway approach .Applicant information(name and phone number) oca wells/septic systems Lot dimensions and building setback dimensions .8£Existingtrees to be retained with drip line,and tree quare footage of buildings to be demolished protection measures , Lot area,building coverage area,percenta.- of coverage and .l�Street tree size,type and location impervious area(applicable if R-7,R-1.. R-25 : R-40) EStreet names 1?roperty corner elevations(2 foot contour es if more than >1,000 sf of impervious area created or replaced? s of irA 4 foot differential) If yes,is a storm water quality facility shown? 0 No / Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified �:.:__ Received: ❑ Yes ❑ No Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake VLandUseCase#: ED12oI1,3--- 00001 , SUS Ecika L100041 7 Zoning: Z S " Required Setbacks: Front I Z Rear S Side 0/2 Street Side 3 Garage 3 - (p Landscape Requirement: 2-0 0,0 ,Z1' Lot Coverage Maximum: g 7 % Building Height: Maximum Height VI A Actual Height 3 AVisual Clearance ,O( Sensitive Lands: ❑ Yes X No Type j6 Urban Forestry Plan A Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: /11 (4/1"/"-� v-`, Date: i 0/ I I / 1 1 Revisions (after Building Submittal only) Reviewer Date Revision 1: El Approved El Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPermitRvw RES 061417.docx V Building Permit Submittal Original Submittal Date: # ( -//7 Site Plans: Building Plans: # Building Permit#: ►" nter building permit#above. Workflow Routing: it Planning Engineering Permit Coordinator Building Workflow Sign-off: 2 Sign-off for lanning(include notes from planning review) Route Application Documents: ► Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: - —� /07(P By Permit Technician: ��_L 1�,/� Date: Engineering Review 1-0 Slope at building pad: � 2 ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat .I"Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes eErNo Assess Water Quantity Fee in-lieu: ❑ Yes ri-No LIDA Facility on lot: ❑ Yes ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: t?i(, I ►<R, t, , Date: l 1 17 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 pproved,NOT Released: /lii Date: /Oi 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: >SDC Fees Entered: Wash Co Trans Dev Tax: ‘-',12rtes ❑ N/A Tigard Trans SDC: i'es ❑ N/A Parks SDC: 'es ❑ N/A LIDA ❑ YesT/A ►f K to Issue Permitgl( 1Ii Approved by Permit Coordinator: Date: ' I:\Building\Forms\BldgPermitRvw_RES 061417.docx 4 City of Tigard p COMMUNITY DEVELOPMENT DEPARTMENT 0 T I GA RD River Terrace Building Permit Review Addendum wassimalimsamw Building Permit #: Site Address: 13 21 3 S\Tv ( 2cj - 1-, at -z Project Name: (i Ve r T . ('I L.. G-cis +- Lot #: 1 vi (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of River Terrace Plan District 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 facade that has 30-60 ft. of frontage.An additional element required for lots with over 60 ft. of street frontage shall be provided every 30 ft. Porch min. 5 ft. deepBalcony w/access 2 Window Projection Vertical Wall Offset a ft. deep min. 2ft., 5 ft.wide m . 2 ft., 6ft.wide Gabled dormer in / ❑ ❑ / / 2. Eyes on the street: a minimum of 12°o of each street facing facade must include windows or entrance doors. Percentage Shown: 1 6 , 3. Entrances:At least one entrance must meet both of the following standards: Max. 8 ft. setback from longest street- facing wall Parallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porch: ,n Yes ❑ No If es,all the following apply: 25 sq.ft. min. One street facing entry Ef 12 ft.max. roof above floor of porch 5 ft. depth min. /30%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 71 Recessed entry area min. 5 ft.wide x 2 ft. deep Wall offset min. 16 inches /Dormer min. 4 ft.wide /Roof eave min. 12 inch projection /Roof 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. Horizontal lap siding min. 3-7 inches wide ❑ Accent siding min. 40%of street facade , Window trim min. 2 1/2"wide by 5/8"deep ❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep ❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35% or less of street facade 5. Garages and Carports:May face the front or side lot line on a corner lot. Setbacks: No closer to front or side lot line,than longest street-facing wall./Yes r` `4o. 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. Wicjth: (Check one) 412-foot-wide garage door ❑ 40%max. of street facade /50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: iM 0-'V'--:. t„,,"\------:-`- Date: r o/ 1/ / i 7 I:\Building\Forms\BldgPermitRvw_RBS_RT_062216.docx FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 111 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 EE FROM: Angela Grajewski AUG 1. 4 Z017 COMPANY: Polygon Northwest CITY OFT IGARD PHONE: 971-212-2144 BUILDING D1ViSbQ►N RE: 13213,13209,13205,13201 SW 169th Ave (Site Address) (Permit Number) River Terrace East Lot 19-22 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: ; Des r%h©n copies: s ripti©n 0 Structual Detail sheets Additional set(s) of plans. 3 Revisions: included 0 Cross section(s) and details. 0 Wall bracing and/or lateral analysis. 0 Floor/roof framing. 0 Basement and retaining walls. 0 Beam calculations. 0 Engineer's calculations. 0 Other(explain): REMARKS: Please pay fees owed with Trust Account. (plans were submitted with out structual detail sheets) 1\ ., ..s 1FICE` S.■:.tl Routed to Permit Technician: Date: Initials: Fees Due: ❑ Yes (1 No Fee Description: Amount Due: /, Special Instructions: Reprint Permit(per PE): ❑ Yes ❑No ❑ Done Applicant Notified: Date: Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13213 SW 169TH AVE, BEAVERTON, OR, 97007 July 31 , 2018 at 10:33:52 AM Record Type: Record ID: Residential - Master Permit MST2017-00401 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: 13213 SW 169TH AVE, BEAVERTON, OR, 97007 July 25, 2018 at 2:07:35 PM Record Type: Record ID: Residential - Master Permit MST2017-00401 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Seal electrical penetration in mechanical room back wall as noted on previous inspection. Will check at building final. Ac installed. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13213 SW 169TH AVE, BEAVERTON, OR, 97007 July 23, 2018 at 11 :12:28 AM Record Type: Record ID: Residential - Master Permit MST2017-00401 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS Comments: Previous corrections completed A/C installed Violation Summary: Inspector Contractor //7,�1'�' Plumbing Permit Application Building Fixtures R FOR OFFICE ESE ONLY City of Tigard Received 13125 SW:illHall Blvd.,Tigard,OR 97223 /r y �� Permit N �� `�DCS 5/ 7/ 1 r t n n Date/By: Phone: 503.718.2439 Fax: 503.598.1960 Da Plan By•Rev //� Date/By. /,2- ."--<-. t the Permit No TIGARD Inspection Line: 503.639.4175 Internet: www.tigard-or.gov bate Rea B /���jp ns ® See Page 2 forttl3ed/ od. f a z[4 t � 3 Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑Demolition For special information use checklist Description ❑Addition/alteration/replacement 0 Other: p Qty. Ea. Total 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(1,388 sq.ft.) Page 2 JOB SITE INFORMATION ANTI LOCATION Site utilities: /3/'4 Job site address: 13213 SW 169th 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.: I Project name:River Terrace East Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Lot no.: 19 Fixture or item: ax map/parcel no.: Backflow preventer 31.27 Backwater valve DESCIIIPTION OF WORK' 12.51 Multipurpose Fire Sprinkler System Clothes washer 25.02 Dishwasher 25 02 Permit# MST20/7 -OOL/O/ Drinking fountain 25.02 Ejectors/sump 25.02 ►i PROPERTY OWNER ❑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 ►, 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:Gavin@AlliancePlumbing.net Urinal 25.02 CONTRACTORWater 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) Authorized signature: t-1-----,---7Z____.1 State surcharge(12%of permit fee) TOTAL PERMIT FEE Print name:Gavin Thomes Date: 1/22/18 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.doe 10/01/09 440-4616T(I0/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site;Utilities Qty Fee t Total Square footage: Permit Fere:. . Footing drain 1"100' 50.03 0 to 2,000 $121.90 2,001 to 3,600 $169.69 Footing drain-each additional 100' 37.52 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 3752luation. Permit Fee, Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Fie(ea) Total each additional$100.00 or fraction thereof,to Other Inspections or Feesand including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof.to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: Other Fixtures: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type Fixture Type for Replace' Plan Review for Plumbing Installations Work Performed: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Please check all that apply. Bath -Tub/Shower CIAny new commercial building with water service 2"and -Jacuzzi/Whirlpool 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 Riser Diagram Garbage -Domestic-non-food 0 Isometric or riser diagram is required for new buildings Disposal -Domestic-food related -Commercial-food related that meet the qualifications above. -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Comments regarding fixture work: Shower -Gang -Stall Sink/f.av -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter Washer-Clothes *Note: If the fixture work under this permit results in an Water Extractor increase of sewer EDUs,asewer permit will be issued and Water Closet-Toilet Urinal fees assessed for the sewer increase must be paid before the https://allianceplumbing-my.sharepoint.com/personal/gavin_allianceplumb2'ng_net/Documents/Documents/Fire Sprinklers/RT/City of Tigard Permit.doc City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13213 SW 169TH AVE, BEAVERTON, OR, 97007 July 25, 2018 at 2:23:25 PM Record Type: Record ID: Residential - Master Permit MST2017-00401 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide guardrail at front porch exceeding 30" to grade measured 3' horizontal. Seal electrical penetration in mechanical room back wall. Violation Summary: Inspector Contractor