Permit (94) CITY OF TIGARD MASTER PERMIT
1III x' COMMUNITY DEVELOPMENT Permit#: MST2017-00407
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/12/2017
Parcel: 2S 106DA02500
Jurisdiction: Tigard
Site address: 13175 SW 169TH AVE
Subdivision: RIVER TERRACE EAST Lot: 25
Project: River Terrace East, Lot 25
Project Description: New SFA.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 240 sf Basement: 0 sf Left: Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 562 sf Garage: 294 sf Front: 12 Smoke
Dwelling Units: 1 Third: 560 sf Right:
Detectors: Yes
Total: 1362 sf Value: $170,032.44 Rear: 5
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 2 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA VB R-3 1362
Owner: Contractor:
WILLIAM LYON HOMES INC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
109 E 13TH ST 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $23,077.57
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 i4 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: Permittee Signature: Gid✓ 4'74./ 0"/
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.
*Building Permit ApplicLo ,2ation / J
` ‘ RFCRVED FOR OFFICE l SE O\Ll
EEew
// permit N ,/' -/ _gai J UN 22 2017 / (Il/2 t i / U�7 ' 7
111 8 131SWHall Blvd.,Tigard,OR 9 23 Other Permit: _
Phone: 503.718.2439 Fax: 503.598.19i.y �:..' GARD : I • ' - ' 7 ,r c
Inspection Line: 503.639.4175 1 i 1 I i Date ReadyBy: pppp - Iuris: ® See Page 2 for
r;c ,+:c. p BUILDING DIVISION Notified/Method:w�/4//7 4 Supplemental Information
-0r. ov
Internet www rigor g 4�i
;.c .� - �" m"""�'t�'`"' L-- ---cz7�E ""�€c� r� ��'.... 1a i r�E 4� !_,_,v�, '¢ � �� a �, �e{ £"
"El
......�. 4 4} .. » ._.. Yk.F' i "a� v?4z J.
❑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
�8 � work indicated on this application.
� � Valuation: $
j 1-and 2-family dwelling 0 Commercial/industrial f'
Number of bedrooms: `J"
❑Accessory building Multi-family "
Number of bathrooms: 3 )'p iO 3 Z 4y"
❑Master builder ❑Other ✓
�: Total number of floors: ' 3 6 s
s ei v,.`tl 1 (ie," g 0 Q� di P ! , 6 6
Job site address: / '3 1.75- SV'. l W I ftse New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area:149 19 Jquare feet'60
Suite/bldg./apt no.: I Project name:River Terrace East i a. Covered porch area:)quare feet s'6 a
Cross street/directions to job site: Deck area: ` "7a. square feet a(t„O
OthcgrCvarea: square feet
s is lam $" '''?4',;.
� ,2
Subdivision:River Terrace East I Lot no.:25 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
: : -0 work indicated on this application.
M - a Valuation: $
Existing building area: square feet
New building area: square feet
�� �• Number of stones:
Name:ADVL Land Holdings,LLC Type of cons ction:
Address:7600 E Doubletree Ranch Road Occupancy groups:
City/State/ZIP:Scottsdale,AZ 85258 Existing:
Phone:(602)694 4031 Fax:( ) New:
". , iiil"t 1? ,ai.
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-mail:Nichole Thorpe _ Commercial and residential prescriptive installation of
-'''''I'''"-';'4.v'''' roof-top mounted Photovoltaic Solar Panel System
Submit two(2)sets of roof plan with connection details
Business name:William Lyon Homes,Inc 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
` / This permit application expires if a permit is not obtained
Authorized signature: within 180 days after it has been accepted as complete.
Date:06/16/2017 I *Fee methodology set by Tri-County Building Industry
Print name:Nichole Thorpe 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
DateIBy: Pcallit14°•/1-5/A1/ 7-0090 7
.114 II 13125 SW Hall Blvd.,Tigard,OR 97223 '' Plea Review
• Il Phone: 503.718.2439 Fax 503.598.1960 Date/By: Other Permit
TIGARD Inspection Line: 503.639.4175 , Dare T. brit IB See Page 2 for
Internet www.tigard-or.gov ' Notified/Method: Supplemental Information
Milit:VMMAAW.WE#2*:OseSCOWNKATAtialaj ,:i4-7 .0-itt44.-41-COPAC$410114V16:rt
Mechanical. permit fees*are based on the value of the work
0 New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit
Value:$
- r:'''.'"-":"::' :17'-' ' 1-..v.7-14.332—•..•,,PWR-—:._ AT-S:EV 1 d- q V..7.4.x-,414,-k
. ..._, 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For spedal Information use checklist
qMulti-Thmily 0 Master builder 0 Other: Description I Qty. I Ba. I
, Total
t0-1**W-AtitOtor$YOY#06.1W9:1,;-*kat--41.0Stif-240.,..-fairSi#V Rea lingi"°Rug:
1 46.75 46.75
Air conditioning
Job site address: 13fic SW woitil tvei
Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,00N-BTU(ducis/vents) 54.91
Heat pump 61.06
Suite/bldgJapt.no.: 1 Project name:River Terrace East
Duct work 23.32
Cross street/directions to job site:
Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
• Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 1 23.32
Other: 23.32
Subdivision River Terrace East . Lot no.: 2._ .--
Other fuel appliances:
Tax map/parcel no.:
Water heater 23.32
Gas fireplace/insert 1
:;;e'A,'",-;010,107-At*.:ff,311--4;;A:.s0#1:idif W4:-.:14;: k1:74-FEA47.1 33.39
Flue vent for water heater or gas
_ MItLiili_-_-ici. 0403 fireplace 2332
Log lighter(gas) 2332
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
-W-1'?:..;10114i*Ticirt.6.-101410P-4ii' . -rq4.:: . '',',1.1:17:jtii-kkItii4.1 4!'!;of•v;:dX- ;.; 2332
Eroninentaj exhaust and ventilation:
Name:ADVL Land Holdings,LLC
Range hood/other kitchen
equipment I 33.39
Address:7600 E Doubletree Ranch Road
Clothes dryer exhaust t 33.39
City/Stale/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) q 2132
Phone:(602)694-4031 Fax ( ) Anic/crawlspace fans 23.32
;;',-42:4153:V47-i.:.`r#iii.*0-•:4:1ttill i i'%:1',$.,,f'y;Eag-:YridWO.:41'4:41ii cither: 2332
Business name:William Lyon Homes,Inc. Fuel piping:
$14.15 for first four;$4.03 for each additional
,
Contact name:W 1 C\I( llf\O(Ve, Furnace,etc. 1
Address:1 tr.), MekoA)Oil M- Skujcc, SI 0 V
Gas heel ptunp
Wall/suspended/tmit heater
City/State/ZIP:Vancouver,WA 98660
Water heater
Phone:(360)695-7700 Fax:(360)693-4442 Fireplace 1
- Range 1
7-1,01(pmea(30(\lt-NDIY161 . CZ)/ Barbecue
1.§s!-'- ':2-11t;::',-Ttl'Al,*.tt.-:::•1:'7:'!ft:4.;;;L:::.Co 1:_ c T4k '''ki:if::::;5:1:AZ.iy,',..1.i.i..,ilk:41.1 Clothes Myer(gas)
Business name:hro v\fob kyy,1 QoalniguTify Other:
...:111.. „_ ...._ • FRAly.--- - mzs.:.-• --e---,,,r,,-;..:,,--:,:c.1
Address: rugs- t\,\),1 A (,..),.,v.,.. 0, 1 ikc,)wl
Subtotal _
City/State/Z1P: A•iiSVDN(l) \(2_,.. CrA VIA Kmimum permit fee($90.00)
Plan review(25%of permit fee)
_Phone: )14.0. siAL I Fax':6 1. ) °0-\ - SIS.17- State surcharge(12%of permit fee)
CCB lie.:2_09 D )
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 150
days after it has been accepted as complete.
Authorized signature: ii.. . ' ,,,
* Fee methodology set by Tri-Cotmty Building Industry Service Board
Print name: / 4 d/4:71,elivik,
, I Date:
j
IAllundinalPermiteMln PermitArm Winn dna Adll-eir I IT ill InINVINEAVIIIII
Electrical Permit Atsplieaion
FOR orrice;11s>;ONLY
City of Tigard Repelved Permit�` #1
13125 SW Hall Blvd.,Tigard,OR 97223 Date/t3 - �— / J
' ' Phone: 503.718.2439 Pax 503.598,1960 Date/13. w
Inspection Line: 503.639A175.
Date/13 . Related Permit d:
TJGA-RD ReadpDate/By Joris S Sea len aI or
Intunet:•www tigard-or gov . '' N°60ed/Methed
w Supplemental Information
1 �: !its c y �L � 111T,;0 AV;(45 ; �s# �-� *:--S. ti I ,S'-r` .'. _>4'3:-- -91'/-��a�C s em; —'�}
New construction
fp n -ed):
0 Addition/alteration/replacement Please all that apply(sabot z sets of plans write=checked):
0 Demolition 0 Other: ❑Service or feeder 400 amps ormore 0 Building over three stories.
where the available fault current r❑-rMarinas and boatyards.
- V z ..w: exceeds 10,000 amps at 150 volts or r Fkficting buildings.
-and 2-family dwelling 0 Corumereial/hidustrial ❑Accessory building less to ground,or exceeds 14,000 0 commercial use agricultural
.• " amps for all other installations, , bardings..vnlh femilY 0 Master builder 0 Other ❑ re 01e
n of 150 VAd-'' rtk.:Sj iy0y"=e'`n6j rt A'?� ;p rc� Q - D ranergency system. LargersepardelYderived
Job Site adder El Pa
of new motor road of system.
Job#
c 131�ssv� U P
f iV� 1001iP or more. ❑"A".`B",‘1-2;"1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. 00011101110y.
/ t#: ❑Heelth•aacefaalities. 0 Recreational vehicle parks.
Subs/bldg./apt ap I Project name:giv ".7p (...e &.c- OHazardous locations. OSuppiyvoltagefor more than
Cross street/directions to job site • G� �-+�r(- L3 Service ertaeaer coo amps or mom. 600 volts nomsnat
f�.��; _.�- 1tit �- ,_.�,
Description I Qb. l Bath `I�-Total L.
New residential single-or multi-family dwelling unit.
fz.,F d er Tert"a r-,. has-}- Lot#Z� _" Includes attached garage
Tax map/parcel#: 1,000 sq.lt orless I 168.54 4
� .
Z". _ 's �Sc�ii r�i �� � 5 '-� y k.;. Ea add.'500 sq,ft.or portion 1 3392. 1
Limited energy,residential
(with above sq.ft) 75.00 2
Limited energy,multi-dimity
residential(with above sq.ft) 75.00 2
k ._ 49:3'lc, a.t1 � .tls .._4:•`�.rv� �;_ 'F.c -_,,..:>G� � � tt'�� c3,*-c r. Renewable Energy Q See Page 2
Services or feeders Installation,alteration,and/or relocation -
Name.ADVL Land Holdings,LLC
200 amps or less 100.70 _ 2
7600 201 amps to 400 amps 133.56 2
City/State/ZIP:Scottsdale,AZ 85258 401 amps m 600 amps 200.34 2
1 601 amps to 1,000 amps 301.D4 2
Phone:(602)694-4031 Fax ( ) Over 1,000 amps or volts 55226 2
Email: Temporary services or feeders installation,alteration,and/or
-.Owner installation:This installation is beingmerle onrelocationamps
o
intended for sal lease, g� g property that I own which is not 200 amps or less 59.36 1
e rent,or exchange,according to ORS 447 449 670,and 701. ' 201 amps to 400 amps 125.08
Owner signature 2
Date: • 401 amps to 599 amps 168.54 2
,.,;'1 ,.. .h.[9‘17r)C, ‘,/1 4,,.i_ +G-S-IT-: x �j0eiSi _ei-: c:tt i fi � .,,T,,,_11,-,
�`11 .} A
Br.Feanerch forcircuits—nebranch w,alteration,ith or extension,per panel
'-,-�_ Chz;aits w
Business name:William Lyon Homes,Inc. above service orfeeder fee,
Contact name: N i ch o k Th 0 r each branchbrcircuit 7.42 2
_ ^-� q. �- B.Fee for•brannh circuits,ptthnut .
Address: 103 b a.,p st Suck-t, ;,�o service or feeder branch circuit dee,first
"""1 56.18 2
City/State/ZIP:Vancouver,WA 98660 J Each add')branch circuit 7.42 2
Phone:(360)695-7700 • J Fax :(360)693-4442 - Miscellaneous(service or feeder not included)
Each manufactured or modular
Fina11, ' �� , ► / dwelling,service and/orfi b7.84 2
`t `. g�LB..,_44• i- P� l a* Reconnect only
f114- : .,..'s `_f.Pro % ...� 'c- `ii r- ..7 , .-Vic, Primp or hrigation chid 67.84 2
67.84 2
Business name:Garner Electric Washington,LW Signor outline lighting 67.84
Address: ()7 `1 l t -tl {Up panel cterati n or li xi nsionergy ❑ See page 2
\Q k ! P�1,alteration,or extension 2
-1 1
City/StatetZ1P.'pck uo. t 1 t 1 t ge3
Each additional Inspection over allowable in any of the above
Phone;(253)320-1657 { W Fax ( J) 1 Additional inspection(I hr mit) 6625/hr
Investigation(1 hr min) 90.00/hr
Rtnail bdaniels@gweusacom industrial phwt0 train) • 78.18/hr
CCB Lir C1158 Blearing Lie.: 208174 fm is 90.00/hr
Suprv.Lin: 44965 .coffin. listed 4hrmin)
Suprv,Electrician signature,required:.. J77^�` (n„ " 1cr a� 'ul s�� � '
LL c rx�_� ...n.
Subtotal:
Print name: Joan P Albert •. Date: 4/26/2016 0 Plan Review Required(25%of permit fee);
��e State surcharge(12%ofpermit>re):
Authorized signature: �� TOTAL PERMIT FEE
is L P ctrl II8Ine: Bill Daniels Tuts permit application expires if a permute not obtained within 180
'• Date: 4/26/2016 days after!that been aeeeptedas complete,
4xr ukuireistsandeei .Cjetaitapp_> �8dee ReyD5/17/2015 44D 615 01/0:201v0WER + NnmharofIDspectionsallowed parpo�iL
Plumbing Permit Application
Building Fixtures iiiii
City of Tigard g ae t r«l P•emhit Ivo-:
13125 SW Hall Blvd.,Tigard,OR 97223ow _ /4157;20. / Cad)gal
- ' Phone: 503.7182439 Fax: 503.598,1960 Dare/BY: OtherPermit No.:
r t r. Inspection Line: 503.639.4175 t�BxadyBy, ' rune m See Page2 for -
Internet: www.dgatd-orgov �
H ethod: Supplemental information
• ?1::
C-Ai;::';':':•-i::;17:..-• -f- i•." F,-. -6iyV. i`:.. .1- �^�:. k s'-`'•�`q_a65_:.' i;`:;s;',.e gEt:Sj).hV*:-7 "
®New construction 0 Demolition e use checklist
❑Additiot Tr/alteration/replacement 0 Other: .Description ( Qh. ( Ea 1 Total
_ New 1-2-family dwellings('mciudes 100 it for each utility connection)
. ; I�h'-,1 �,, 312.70 ;
_ t. .:.;,�"i�Y`I�fi7E�yY'�'a:�F.= � i.:a-<.•:::.R.jrr='�+ �a�:..-..°:� 5FR(i}bath
_ I-and 2-family dwelling. 0 CommercialTmdus al SFR(2)bath - 437.78'
❑Accessory building Multi-family SFR(3)bath 500.32. -
Master builder. Other:
Each adeiortal bath/kitchen25.02
14 _ Fire sprinkler{ ss}ft.) Page 2
•- '-ir. -y Site utilities: I
nob site address: 13 f 1 S 5w up� f\-4.e., Catch basin or area drain . 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain ; 18.76-
i Footing drain(no.linear ft,: ) Page 2
. Suite/bldg./apt.no.: Project name: 12.1 r TxJ?r e.Eos-1- Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76; '
Rain drain connector 18.76
Sanitary sewer(no.linear IL:_ J Page 2 a
Storm sewer(no.linear fi: } Page 2
_-..i ••Water service(no.linear it: ) Page2:
Subdivision p_ Ar- --cw X 54-- Lot no.,7 5- _ Rixture or Item:
Tax map/parcelno.: Backflow preveater 31.27 -
”' : '-t.-.•... ' .. 1 22.51
r.: ::�; ;f -4'. -1-.7: IIT° �lI>ST1t)15FIlr'11'O `' Backwater valve
Ciotlhes washer 25.02
Dishwasher • 25.02
Drinking fountain 25.02
Ejectors/swam 25.02
'' x £r�5 :` .-.1 .r y- 4:`tA•, ,- ...'; Expansion tank
..{ 12.51
Name:ADPL Land Holdings;LLC Fixture/sewer cap 25 02
Address:7600 E Doubletree Ranch Road Floor drain/floor sink/hub 25.02
City/State/a':Scottsdale,AZ 85258 Garbage ds 25.02
Bose bib 25.02`
Phone:(602))694-4031 Fax:( )
ceraker 1 12.51
.:n .:.� �� ,� s _.. s _, "alba{ '
T: -...i.,.: Interceptor/grease trap 25.02•
Business name:William Lyon Homes,Inc Medical gas(value:5 ) Page 2
•
5k
Contact name:' �\t(��)Y-00 hlal ', Prima 12.51
Address'1 63 g _ .i --SAA.k � Roof drain(commercial) - 22.51
0 Slnk/basinitavamry 25.02
City/St e/ IPatdZ :Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693.4442 Tub/shower/showerpan - 12.51 :
E-mail: 1 i i - 1. ► is 7‘ h[I}pS.(O urinal 25.02
J *.`moi T :;� 5+�a (:..�J F. Water closet
t Water:heater • 37.52 +
Business name:Alliance Plumbing LLC
WPIRW 56.29
1 .
Address:146 W Historic Columbia River Hwy Other 25.02 '
City/State/ZIP:Troutdale,OR 97060 Subs -
Phone(503)492-3490 Fax:(503)912-6438 Minimum permit fee: 57230 I
CCB is 184601 Plumbing Lac no.:PB732 Plan review (25%of pt t fee)
4,,,ii, Statesurcharge(12%of permitfee) ,
Authorized signature: d_____.-TOTAL PERMIT FEE
IPrint name:Robert!Ashman Dem 5/2312014 This permhtppiteattenmores Cavern*bnot obtained within t8Ddays
atter kites been aoc edaHmutiieay
`Fee meihnialagy qty Tri.Cauuty Bating industry Service Board
LIButi inglibrmltalaLi luakndtAppeto ttvorazo ,ya,getenp ,y
V
City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
p
TI ARD Building Permit Review — Residential
Building Permit #: /4s,T�o(? yo7
Site Address: IS I 1 S S vv t C son &N',It_
Project Name: R 1'V Terr €ciS 1— Lot #: 2 5
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: I V ,C.F.az
tVerify site address/suite# exists and active in permit s stem.
River Terrace Neighborhood: 0 No Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan 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
/1North arrow /KUtility 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) ,eeagoa-of. ells/septic systems
t dimensions and building setback dimensions �es to be retained with drip line,and tree
Square footage of buildings to be demolished rotection measures
/Lot area,building coverage area,percentage of coverage and ,Street tree size,type and location
impervious area(applicable if R-7,R-12, P ': R-40) treet names
t'rfoperty corner.
elevations(2 foot contour es if more than >1,000 sf of imppervious area created or replaced? 1:INo AV/A-
yes, T
4 oot differenal) If yes,is a storm water quality facility shown? Yes No
ief Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): NIA
Required: ❑ Yes,applicant was notified ❑ No Received:
❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit:
Required: ❑ yes,applicant was notified ❑ No Applied For: Z Yes ❑ No,stop intake
Land Use Case#: l'P j Z<) IL' -- 00 001 & U 4'7,=)$0 - 000 of
7 Zoning: 122-S
4 Required Setbacks: Front I 2... Rear S Side 0/ j Street Side 3 Garage so
Landscape Requirement: 2A) % w
ZLot Coverage Maximum: 0 %
,eJ Building Height: Maximum Height N1 A Actual Height 3 4
/1 Visual Clearance
Sensitive Lands: ❑ Yes ❑ No Type
Vq Urban Forestry Plan
,ICJ Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: ill l k./O.--® (/�� Date: 10/ /' 1—'
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\BuildingTorms\BldgPemutRvw RES 061417.docx
Building Permit Submittal ��1
Original Submittal Date: c Z���
Site Plans: #
Building Plans: #
1
Building Permit#: „}'-Enter building permit#above.
Workflow Routing: t "PlanningEngineering) Permit Coordinator _Funding
Workflow Sign-off: e Sign-off for lanning(include ores from planning review)
Route Application Documents: ':] Engineering: (1) copy of permit application, (1) site plan, (1)building plan and
original plan review routing form.
7. Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: /f
By Permit Technician: I' , A;-- Date: `/U/P/7
Engineering Review /
din pad: /
Slope at building
❑ 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 No
Assess Water Quantity Fee in-lieu: ❑ Yes g No
LIDA Facility on lot: 0 Yes No
❑ NOT Approved by Engineering: Date:
Notes: "
Approved by Engineering:
/�l i u iL i Date: /0 2-,- /?
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
pproved,NOT Released: d' Date: _iLL____
/0 2.*C. ) ,/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:
DC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
rs
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: 1, Yes ❑ N/A
LIDA ❑ Yes N/A
OK to Issue Permit �/�,�pproved by Permit Coordinator: Date: // /P-I
I:\Building\Forms\BldgPermitRvw_RES 061417.docx
t
IIICity of Tigard
C
p COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
Building .-.. ._
Permit #:
Site Address: 1 ''3 1 7 5 SW IUCI41,, Cl v-t_.
Project Name: i2.i t X Tit(21 t}1. &CI S t
Lot #: 2.s
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.660.070.L):
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. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a
ft. deep min. 2ft., 5 ft.wide min. 2 ft., Eft.wide Gabled dormer
❑ ❑ ❑
2. Eyes on the street: a minimpm of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: 17. 41
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: Yes No
If es,all the following app y: sq.ft.min.
One street facing entry 12 ft.max. roof above floor of porch
/-5 ft. depth min. f 30%min. orch roof coverage
ge
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 0 Recessed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches ,Dormer min. 4 ft.wide
ARoof eave min. 12 inch projection /i 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. 0 Horizontal lap siding min. 3-7 inches wide
AAccent 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
0 Balcony min. 5 ft.wide x 3 ft. deep with inside access 0 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. 0 Yes o. 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.
ay extend up to 5 ft.where the garage is part of a two-story buildingand there is a window at the s
above the garage that faces the street with a min. area of 12 sq.ft. second story
Width: (Check one)
712-foot-wide garage door 0 40%max. of street facade
50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: 0,4"....-:.,„ Vim, Date: 1 O/ I) /17
I:\Building\Forms\B1dgPermitRvw_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.
/111
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
TI ;, R tD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATE RECEIVED:
DEPT: BUILDING DIVISION
FROM: Nichole Thorpe `� `���
COMPANY: Polygon Northwest ),
PHONE: 360-989-40204 I By(i'
RE: 13159,13167,13169 3175 3181,13189 SW 169T1 ...-irturw "`."` ��•.r• tviNastgr
(Site Address) (Permit Number
River Terrace East Lot MEW ZS t\Si2,OIt 7— (7 04 0-7
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
I Copies: I Description: I Copies: I Description: J
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: J 'Z,-- L). 7 Initials:
Fees Due: Ezi Yes ❑No Fee Description: Amount Due:
. 0 Nrcvt;\. $
$
$
Special
$
Instructions:
Reprint Permit(per PE): I ❑ Yes No
Applicant Notified: /1!r ' � ❑Done
Lff E Date: /z/1,/i 7 .1Initials: AILIW
V"/.4"/
IABuilding\Forms\TransmittalLetter-Revisions.doc 05/25/2012
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13175 SW 169TH AVE, BEAVERTON, OR, 97007 June 12, 2018 at 1 :08:28 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00407
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Water pressure = 70 psi
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13175 SW 169TH AVE, BEAVERTON, OR, 97007 June 20, 2018 at 12:39:57 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00407
Inspection Type: Inspector:
299 Final inspection Jeremy Burrows
Result:
PASS - CofO
Comments:
Corrections complete
Violation Summary:
Inspector Contractor
Plumbing Permit Application
Building Fixtures ��
City of Tigard i" ., � t FOR OFFICE USE ONLY
i 't 13125 SW Hall Blvd.,Tigard,OR 97223IN
Received
Phone: 503.718.2439 Fax: 503.598.1960rdil, 'P, ��+(: Date/By: �� + permit N �1 �
TIGARD Inspection Line: 503.639.4175
Internet: www.tigard-or.gov • • Other Permit No:
r a Bate Ready/:y:
Ftotified/Method. • 8 See Page 2 for
1 YPLL i %`i Supplemental Information
►1 New construction i.I i•r7 ,, T
0 Demolition
FEE* SCHEDULE
❑Addition/alteration/replacementFor special in ormatian use checklist
0 Other: Desertstion
l
New 1-2-family dwellings(includes 100 each utility
•
CATEGORY or,CONS t RUCTT(dN
® I-and 2-family dwelling SFR(1)bath nil❑Commercial/industrial Mil
bath312.70
SFR(2)
437.78
❑Accessory building —
❑Multi-family SFR(3)bath 11111
111111 25.02 500.32
❑Master builder Each additional bath/kitchen —
0 Other: 11111111
OH SITEINFORMATION A LO AT ON ' Fire sprinkler �33�s9_ft.) _
111111111111
Job site address:13175 SW 169th Ave. Page 2 111111111
City/State/"ZIP: Tigard,OR 97223 Catch basin or area drain 11111111118 76
Drywell,leach line,or trench drain
Suite/bldg./apt.no.: Project name:River Terrace East Footing drain(no.linear ft.: all18.76 1111111111Cross street/directions to job site: ) Page 2 111111111Manufactured home utilities 11111Manholes 50.03 Mil
1111111
Rain drain connector 18.76 Mil
8 76 MIN
Sanitary sewer(no.linear ft.: Ell Ige
— 2
) Page 2 111111111
Storm sewer(no.linear ft.: ) _ Page 2
Subdivision:
Water service(no.linear ft.:_ Mil)
MilTax map/parcel no.: Lot no.:25 Fixture or item: 11111 Page 2
DESCRIPTION OF WO Backflow preventer
Clothes washer _®_
Multipurpose Fire Sprinkler System Backwater valve _®-
lin
Permit# M S720 1-1— 00407 25.02 Mil 11111Drinking fountain 11111 25.02 Mill
>�® PROPERTY OWNER Ejectors/sump 25.02 _
TENANT Expansion tank 1111111 25.02 _
111111111
Name:Polygon Northwest _®_
11111111111
Address:703 Broadway St.Suite 510 Fixture/sewer cap _
Floor drain/floor sink/hub 25.02
111111
City/State/ZIP:Vancouver,WA 98660 1111111 25.02
Garbage disposal _
Phone:(360)695-7700 Hose bib 25.02
1, APPLICANT0 - 1111 25.02 1111111111
CONTACT PERSON MEMIIIIIIIIIIIIIIII Interceptor/grease trap _®
Business name:Alliance Plumbing,LLC _
111111111
Medical gas(value:$ 25.02
Contact name:Gavin Thomes ) _ Page 2 —
Primer _®
Address: 146 W Historic Columbia River Hwy -
Roofdrain(commercial) _®_
City/State/ZIP:Troutdale,OR 97060 Sink/basin/lavatory
Phone:(503)492-3490 Solar units IIIIIIII Mil
25.02
MO
Fax::(503)912-6438 (Potable water) 1111111
Tub/shower/shower pan 62.54
E-mail:Gavin@glliancePlumbing.net _®—
Elliiii.
CONTRACTOR TOR Water closet 25.02 Mil
name:Alliance Plumbing,LLC 25.02 1111111111111Address: 146 W Historic Columbia River Hwy _®
1111111111
Water piping/DWV 11111City/State/ZIP:Troutdale,OR 97060 Other 5 1111111111111111Phone:(503)492-3490 25.02
.1111111
Fax:(503)912-6438 Subtotaltal 1111111111
CCB Lie.: 184601 Minimum permit fee: $72.50
Plumbing Lic.no.:PB732 Mil
Plan review (25%of permit fee)
11.1111
Authorized signature: __,--7/
State surcharge(12%of permit fee)
Print name:Gavin Thomes 111111111111
Date: 1/22/18 TOTAL PERMIT FEE Mil permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
I:\Building\permits\PLMU-Permi[App.doc 10/01/09 *Fee methodology set by Tri-County Building Industry Service Board.
440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
1 lYaaav---
Page 2 - Supplemental Information
Residential Fire Su i t ression S stems:
Fee Schedule: T; tore Foots e`,. Permit Fee:
-
Footing
Fee(iia). $121.90
Site Utilities-l' 11111 50.03 _ 0 to 2,000 $129.60
Footing drain-1s`100' ®_ 2,001 to 3,600 $233.20
3,6010to 7,200 $169 69
Footing drain each additional 100' _ 62.54 7,201 and•reater
327.54
Sewer-1st 100' 111111
Sewer-each additional100' 62.54 Medical Gas S stems:
Water Service-1st 100' 11111_®_ i .Permit Fee:
Water Service-each additional 100'
Storm&Ram Drain-1st 100' 62.54 111111 $1.00 to$5,000.00 Minimum fee$72.50
111111_®_ $5,001.00 to$10,000.00 $72.50 for the $5,000.00 and$1.52 for
Storm&Rain Drain-each additional 100' each additional first$1 $5,0 or fraction thereof,to
kee(ea) Total and includin.$10,000.00.
Other Ins t eng plumbing
s ng Fees $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
Inspection fee existing plumbing a for each additional$100.00 or fraction thereof,to
90.00/hr ■ and includin_$25,000.00.
minimuminis:e— /2 lly indicated III
or
cout i e 1/2fhour 90.00/hr $25,001.00 to$50,000.00 each9 additional0fothe first
25 000ac0iantnd$1.45 for
hours
Inspections outside ar normal business1111 and idin $10.0.0o
Reinspection0.
s minimum char_e 2 hours) _ 90.00/hr _ $742.00d incl for the first0,0$50,000.00 and$1.20 for
Adbona Fees $50,001.00 and up
Additional plan review for revisions
90.00/hr each additional$100.00 or fraction thereof.
1111
minimum char_e 1/2 hour Subtotal: IIIIIIIIIIIIIIII
Other Fixtures: 1111111111111111.
Commercial Fixture Work:
Are you capping,adding or replacing fixtures?If""yes",
please indicate work performed by fixtur
e. o
accurately report fixtures could result
in ni increaseb Fixtured
sewer fee *.
TRep,xeer Plan Review for plumbic m Installations
Fixture Type for upped Added Relocate Plan review is required for any of the following.
Work Performed: --- Please check all that apply.
Baptist /Font --- 0 Any new commercial building with water service 2"and
Bath Tu uzzi/ l r -- greater,except systems designed and stamped by licensed
Jacuzzi/Whirlpool engineer.
-Each Stall --= plumbing any complex structure
Car Wash -- [] New exterior lumbin site utilities for
-Drive Thru ---
s Dishwasher Aspirator _— as defined in OAR918-780-004 .
-Commercial --- ❑ Medical gas and vacuum systems for health care facilities.
Domestic =_— ® Any multipurpose fire sprinkler system.
Drinkin• Fountain --- 0 Any complex structure as defined in OAR918-780-0040.
Floor Drain/sink -2" --= Submit 2 sets of plans with any of the above.
3" --
-4„ 111111111111111111111= Is metri or Riser Dia,,raps
Car Wash Drain ---
Domestic-non-food --- 0 isometric or riser diagram is required for new buildings
Garbage -- that meet the •ualifications above.
Disposal -Domestic—food related -
-Commercial—food related --
Industrial-food related ==—
Oe Mach$tor :.Drains --=
Oil .Vehicletor Gas Station -- Comments regarding fixture work:
Rec. Dump Station --=
Shower -Gang --
-Stall
Sink/Lav -Non-food related ===
1111111111
-Bradley
-Commercial-food related =--
Service ---
Swimmin:Pool Filter --------- *Note: if the fixture work under this permit results in an
Washer Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor — paid before the
Water Closet-Toilet --- fees assessed for the sewer increase must be
in .sharepoint.com/personal/gavin_alliancepluml5�ing_net/Documents/Documents/Fire Sprinklers/RT/City of Tigard
https://allianceplumb g-m Y
Permit.doc