Permit (81) 111 s�� CITY OF TIGARD MASTER PERMIT
I ' : COMMUNITY DEVELOPMENT Permit#: MST2017-00307
T1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/22/2017
Parcel: 2S106DA03600
Jurisdiction: Tigard
Site address: 13073 SW 169TH AVE
Subdivision: RIVER TERRACE EAST Lot: 36
Project: River Terrace East, Lot 36
Project Description: New SFA.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 240 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 562 sf Garage: 456 sf Front: 12 Smoke
Dwelling Units: 1 Third: 560 sf Right: 0
Detectors: Yes
Total: 1362 sf Value: $177,262.50 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
Drains: 0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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 add9 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: $23,186.50
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 95 -601-0090..y You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
e
Issued By: 4/- ®, ° "LC-- Permittee Signature: `f 7"/ /09---70-7nv
Call 603.639.4175 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 Application
RECEIVED` p-� L---,9 7 v
FOR OFFICE lse ()N Ll
City of Tigard JUN 14 2 017 may: 5/72 Permit No. 72• ✓7 ara
_I 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 1(�. i 7 pil,�Permit: /�/��jj�yy /
Phone: 503.718.2439 Fax: 503.598.195 TY OF TIGARD Date/By: I <CZA>r�YC'�2�
Inspection Line. 503.639.4175 BUILDING DIVISION Date ReadyBy:Ready/By:;:‘,„ ice. la See Page 2 for
T i G V:n Notified/Method: / G6 ,oi Supplemental Information
Internet: www.tigard-or.gov T ��
/L Ie 'Le,
-: S i` .31 �`t -': , d s-, F fin ,t'kr
a ,..!,,,:t .:.:...,,,, 'k," - �' 3.s'-r �' v;,�.�..v- ;e ..." ,L
� ,�.....,_.,..�......,.x...,.�.�. „`u`d..-:,,,2:: .-.. ..``d s.6,:..�s.� �.E.n.�-,�. "��sz..-S.x: .���- ro s�,�.:�A„_ .:�4� =� -,--.;� ¢ ,-.." ..�.
®New construction ❑Demolition _permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other. - equipment,materials,labor,overhead,and the profit for the
" ; s ,`1,. , -,-,,;.i "' ,; ^"s 3 work indicated this application. p�
„ _ � .,, ,�..� �, 7 .�� Valuation:
® 1-and 2-family�dwelling 0 Commercial/mdustrial
❑Accessory building 0 Multi-family
Number of bedrooms: )7 ) a 6 a.25-L)
❑Master builder ❑Other: Number of bathrooms: 3
a' : ' Ftiiii' Total number of floo
Job site address:j3n3 SV\1 New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet o
Suite/bldgJapt no.: Project name: riW,r TerYGtcGe FAS+ Covered porch area:rj square feet\S-..‘2
Cross street/directions to job site: Deck area:
_fa_ square feet ay a
Other structure area: square feet
Subdivision (ZWVxx Terrace. ' Lot no. (p 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
i g work indicated on this application.
Valuation: S
l Existing building area: square feet
New building area: square feet
Number of stories:
r € ,'� 1.,,,S:,-,1;,-,P, t ,� �(,�e. .,. ���.;� ��.� � �,, �' °,.,
Name:ADVL Land Holdings,LLC Type of construction:
Address:7600 E Doubletree Ranch Road Occupancy groups:
City/State/ZIP:Scottsdale,AZ 85258 Existing:
Phone:(602)694-4031 Fax:( ) New:
Business name:Polygon WLH,LLC
,_.��TA� Structural plan review fee(or deposit):
Contact name:N nW1•\
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 Fax::( )
E-mail:N 1 ( ti, Olio ^ ►�► ,141, ►1, 1 W :
, 5 Commercial and residential prescriptive installation of
` ; -� f— ..s , -:, k,• `r,1 roof-top 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.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247 Total fee due upon application: $201.60
Authorized signature: s This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
pi
Print name: ch O Date: *Fee methodology set by Tri-County Building Industry
v tQe�/ Service Board
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613/// �T(11/02/COM/WEB)
Mechanical Permit Appliatton FOR OFFICE USE ONLY.
Ci}, of'Tigard ,
1 �� 1 Received
Date/By: PermitNo.:
r 13125 SW Hall Blvd.,Tigard,OR 97221f.
Plan Review
17 Phone: 503.718.2439 Fax: 503 598. I '1 11 Other Permit.
Inspection Line: 503.639.4175 / 3'l' `` ".„' Date/Sy:Re
T 1 G A R D Date Ready/By: Ms: ®See Page 2 for
Internet www.tigard-or.gov „• Y(•• Illi, S t t j j Notified/Method: Supplemental Information
RIIIIAU o- ! t. -;: TYl'l1 OF WORK r COMME 04)4__ FEE*°.'SCHEDi1LEUSE CCHEECKLIST
Mechanical permit fees*are based on the value of the work
®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. ' CATEGORY OF COP1S17(UC TODD `" :zIRESjii.*1'ALEQI7IPMENV7,'-/SYSTEMSFEES*-+ ,,. -
®1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION.AND LOCATiQN ?:
Heating/cooling:
f 1 `i Air conditioning 1 46.75 46.75
Job site address: 1 D'1 J SW 1Y I e(Oil �ei Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name:River Terrace East Heat pump 61.06
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
Subdivision:River Terrace East Lot no.3U, Other' 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
1_ . DESCRIPTION OFWORD E • Gas fireplace/insert 1 3339
pAS1!-�^� 0 -�+31( Flue vent for water heater or gas
! ZIO— t fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplacelmsert 23.32
Chimney/liner/flue/vent 2332
Other 23.32
PROPERTY O 1. ..• Q.'IENAN',r':
- . "' - r ' '"' "'-'1;—.' Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment 1 33.39
Address:7600 E Doubletree Ranch Road Clothes dryer exhaust t 3339
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) LIr 2332
Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans 2332
APPLICANT; L; :;Q CONTACT.PERSON 2332
Other.
Fuel piping:
Business name:William Lyon Homes,Inc. $14.15 for first four,$4.03 for each additional
Contact name:N,Cin pve,-IV oe Furnace,etc. 1
Address:'', Ibylotlifj&1 `k •-\ Su 0 Gas heat pump
f Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace 1 ,
E-mail:'t(('1 Gl1/4ot� 1 Tho (oj" plyry*Nomcs . BBarbgeecue 1
'`, .. _. ONTKACTOR Clothes dryer(gas)
1� ",t, t f1 Other
Business name:PV v�t\p Ic 1 11(1rt oi/V+1 1 1)t1,to� 'T jyMECHA?.1.c4,PERiVIIT FEES*
Address: t15)"1c, `lv f` .`J1\ �� iJ� V�v skil. .c, kkSubtotal
City/State/ZIP: thiSbkYD k)/Q_,,. Minimum permit fee($90.00)
sIski_, Plan review(25%of permit fee)
Phone:503) 3" J uik Fax'(S11 ) O L`. �, State surcharge(12%of permit fee)
CCB lie.:f) Or11 poi TOTAL PERMIT FEE
_1 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: MG * Fee methodology set by Tri-County Bolding Industry Service Board
Print name:Nj L%t)I,moi Ole-, Date:
l'\Bu�lding\PenmiuUv4EC PecmitApp 040113.doc 1` 440-4617T(11/02/COM/WEB)
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard ;.; �� , ,71)t Received
13125 SW Hall Blvd.,Tigard OR Dan/B
R Tigard, ! � �+g j ! �-a' Plan Review
a Phone: 503.718.2439 Fax: 503.5V.8.1960 ( ' 1'' Related Permit a:
Date/$
TIGARD Inspection Line: 503.639.4175 l .ri.w!l '+F Rye% 3C*y ; ReadyDate/By: 11 See Page 2for
Internet .www.tigard-or.goV £� Notified/Method: IliiiMI Supplemental Information
`-F ` 1- '*1- -lifi:a- „ :.�RA •I:,•v s<.-rt: -�� - ati " i - <: ' - err",". .:t S) 1,.
1, New construction 0 Addition/alteration/replacement Please check all that apply(submit_2 sets of plans wtttems checked):
❑Demolition Other D Service or feeder 400 amps or more ❑Building over three stdries.
where the available fault current ❑NTarina-4 and boatyards.
0 . ,.�-�,. _, �-";-4. , �>;Pit :,n. -. .•-(-,xt_;t "seeds 10,000amps atl5Qvolts or QFloating buitdiags.
®1-and 2-family dwelling 0 Commercial/ilidustrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial use agricultural
❑Multi-family - 0 Master builder 0 Other: �umpfor ll other installations. buildings.atio
❑Fire pump. ❑Installation of 150 KVA to
` .' ;4, ;•.'ON.''4*9'.3a--,,,4. i co :::,;t- u a,-7 0`if-4-,. ,V-2,-.:N;y. ..,•. ❑Emergency system. larger separately derived
1 .),1 1 j e it ❑Addition of new motor load of system
Job#: Job site address'301 ' � pa100F1P of more. (�•`A••,•�'i,"12","I-3",
City/State/71P:Tigard,OR 97224 ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt#: I Project name: �* ❑Hazardous locations. 0 Supply voltage for more than, ~ � �r-� G600 volts nominal
❑Service or 600 amps or more.
Cross street/directions to job site 0 O�,:T
Description Qty. I Each Total •_
New residential single-or multi-family dwelling unit.
Subdivision: /Z4
'‘te r T6rrae49_ ' as-1- f Lot#:, ,p Includes attached garage.
Tax map/parcel#� `t' 1,000 eq.ft or less 168.54 4
3f i r"a ' 7� 3 Y { Ea.add'I500 sq.ft.or portion t 3392. 1
',., r " . '. 2,..,ov't i i �i %,'COL, ., ,. ,.`'yt : r^ ,` , Limited energy,residential
1)A fTl A t'1 . 004, 0")
c a.0"1 (with above sq.ft.) _ 75.00 2
V 171 (i(! I t' J / Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
= Renewable Energy ❑ See Page 2}3.4q fd? t 0ti s s —: " :ra ; VirL? ' s; 0 `
z Services or feeders installation,alteration,and/or relocation
Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2
Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2
,000 amps
amps to
City/State/ZIP:Scottsdale,AZ 85258 0 amps 200.34 2
m
661 amps to 11, ps 301.04 2
Phone:(602)694-4031 I Fax:( ) Over 1,006 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
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 168.54 2
"u,t 7- . r,ri-M;-., :z- + 14,: l7-a>` .,,.� - Branchcircuits-new,alteration,or extension,per panel
.,. �-,�,i 4�y.U�r6Zt���r&z...S;n Y��'rA � s.�� 3,�+�-�ti r! t33'�'�"1��0 s �'�
`' �° '��``- A.Fee for branch circaits wtrh
Business name:William Lyon Homes,Inc. above service orfeeder the,
Nicho��or 7.42 2
Contact name:^� 2 (� ,,- 1 �+� B.Fee for branch circuits without
{0 a7 IU CL&kJC St S1.&il,4.+ c,l) service orfeederfee,fust
Address: branch circuit 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each add't branch circuit 7.42 2
• Miscellaneous(service or feeder not included)
Phone:(360)695-7700 • ' Fax::(360)693-4442 Each manufactured or modular 67.84 2
Elea, t dwelling,service and/or feeder
p �, r me • nal Reconnect only67.84 2
$- ?- t r-V f, Ed C'"ig h 4i a .- - :` `4'::;:i'.,)`.� r _',14 `i'` Pump or inigat10n circle 67.84 2
Business name:Garner Electric Washington,LLC Signor outline lighting 67.84 2
r_.. Signal circuit(s)or limited-energy
Address:,4 DZ U � (�,,.\r o tt t, 1 S��-\.p `'�V /t panel,alteration,ore erasion. ❑ See Page 2 2
} >`tL�t�-air. 1�' {L.�i/ Each additional inspection over allowable in any of the above
City/State/ZIP:'Pe t yc�.U,14 p ppr. Res I Additional inspection(I hr min) 6625/hr
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:bdaniels®gweusa.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: C1158 Electrical Lic.: 208174 Suprv.Lic: 44965 speciftK listed 4hrmin)
4' ,,, 5._'-'..,&-'-',/, 3'.
�F 3i: 'y`Jy•d ttat-rd.D).h ,1 °r-�.
Suprv.Electrician signature,required::::"B!ti/ P. , '•...-.. _ Subtotal: _
Print name: loan P Albert Li I Date: 4/26/2016 ❑Plan Review Required(25%of permit fee):
•
<! _ State surcharge(12%of permit fee):
Authorized signature: - -
�- TOTAL PERMIT FEE:
This permit application expires if a permitis not obtained within 180
t Print name: Bill Daniels Date: 4/26/2016 days after It has been accepted as complete.
s Nnmberafinspeotionsallowedperpemit
:0.:-IEandiagiplamits\laz fermltAppj3LB.fltsdoc Rev 06117/2015 440.4615T(17AeIcoowna
7 r 4.
Plumbin; Permit Application
Building Fixtures yiti;; ii, .�.1�1 ° toR OH Kr. 1 SI. 0y1.)
City of Tigard gn_r r eceived
1 r x"1 r 4 '.1 Date/By: Permit No.:
1,111
13125 SW Hall Blvd.,Tigard,OR i Pian Review
`,� Phone: 503.718:2439 FaX 503.5 $ A�i 7 i' �'�t , 0, Date/By: Other Permit Na.:
inspection Line: 503.639.4175 J 12.1 } i s
T 1 G A R 1) Date Ready/Br Ms: 63 See Page 2 for
Internet: www.tigard-or.gov NatifiedlMahod: Supplemental Information
-
Fi E,OF WOax, FEE* 6CREDIJI
®New construction 0 Demolition For spade!information use checktisx
Description L Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-faintly dwellings(includes 100 it.for each utility connection)
CATFGORY OF CONN31''liiititijN - SFR(I)bath 312.70
•
® I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath t 500.32 ;
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
_ .. Fire sprinkler( sq.ft.))
Page 2
JOB liUFORMA'1'IONAND LOCATION Site utilities:
Job site address: '3 01-6 5� i W� (�j� Catch basin or area drain • 18.76
City/State/ZiP:Tigard,OR 97224 4 I '' Drywall,leach line,or trench drain 18.76
Footing drain(no.linear it.:,_,) Page 2
Suite/bldg./apt.no.: [ Project name: (Zt‘k r Te,Yro[e_CS -i- 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
Subdivision: �X Term t_ -1--- I Lot no.~app
Water eservice(no.[incur ft:�) Page 2
Fixture or hear:
Tax map/parcel no.: Backflow preventer 1 31.27
DESCRIITION=OF WORK Backwater valve ( 12.51
Clotheswasher 25.02
M 1 1 STili - V 0-- 0-1 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
,'Z P> O N [.;:: •- j`. .. .- U brENAh i Expansion tank 12.51
Name:AAVL Land Holdings;LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:7600 E Doubletree Ranch Road {} bags disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 tie bib 25.02
Phone (602)694-4031 Fax ( ) Ice maker 12.51
►��[ ,i J ( ,:ipjE,r +'yT y Interceptor/grease trap 25.02
Business Y .name:William Lyon Homes,Inc Medical gas(value:$ ) Page 2
Primer 12.51
Contact c name:/0\G�a� alp''
Roof drain(commercial) 12.51
Address: -t b3 B ock CC��k" ' =,4-e, S\c Sink/basinllavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(3i�6'0)695-7700 Fax::(360.)693-4442 Tub/shawerishower pan 12.51
&mail: ►GJ!1QleF; k4Q__ ZkY43° - .‘rfrs. Urinal 25.02
Water closet 25.02
Water heater 37.52 `
Business name:Alliance Plumbing LLC Waterpiping/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 ,.
Plan review (25%of permit fee)
CCB tic.:184601 Plumbing Lic.no.:PB732
m1
L State surcharge(12%of permit fee) ,
Authorized signature:
TOTA{.PERMIT FEE
Print name:Robert Disbman Date:5/232016 This permit application expires if a permit is not obtained within ISO days
after hive been accepted as'cempleh.
*Fee methodology sot by Tri-County Building industry Service Board.
1.lBaitdi rermltsiPt.MU4iomitApp.doc 1010109 440 4616T(1olo2/COM/WEB)
City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
111111C
T1cAR Building Permit Review — Residential
Building Permit #: 44 57 10/7- CO 307 ,,
Site Address: /�( j /( 4
Project Name: ,/ �. ac( - 5 )--- Lot #: <- (..e
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review //
Proposal: � S'/ri, k — ?� i I �7` �j��(47,/f
L1G erify site address/suite# exists and active in permits stem.
River Terrace Neighborhood: ❑ No V Yes,See River Terrace Review Addendum Attached
Sine Plan Elements:
Q ree(3)copies of site plan j I1 'sting structures on site
e plan must be on 8-1/2"x 11"or 11 x 17"paper MI Footprint of new structure(including decks)with finished
D awn to scale(standard architect or engineer scale) oor elevations
V ► orth arrow it/J .tility locations&easements(required for new and additions)
IA S' a address,project or subdivision name and lot number I.T.S..ewalk/driveway approach
V .plicant information(name and phone number) J; cation of wells/septic systems
.t dimensions and building setback dimensions 0 E� 'sting trees to be retained with drip line,and tree
f1 �uare footage of buildings to be demolishedyrotection measures
II Lot area,building coverage area,percentage of coverage and Vi eet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street names
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? l s ❑No
4 foot differential) If yes,is a storm water quali facili shown? II, es ❑No
1.€lean Water Services-Service Provider Lett (lot platted prior to 9/10/1995): 4. OY- ' 40 i
equired: ❑ Yes,applicant was notified t No Received: ❑ Yes ❑ No
2/1(
Public Facilitie Improvement(PFI) Permit: PF/QOAe
equtred: L 2Yes,applicant was notified ❑ No A hed Yes ❑ No,s For:n pp > stop intake
tv(R.
and Use Case#: ihI� CG)(,Q- d(r)/ Rlii��O/t-� '*0 P✓hoe,2O/,�= d000 ca
oning: >�- 9- 4 K_-,2,c- -j
e.uired Setbacks: Front _ Rear Side treet Side /4.—Garage andscape Requirement: C)
p q
Lot Coverage Maximum: 00
0/0
..l �v,uilding Height: Maximum Height Actual Height
isual Clearance
0 '-nsitive Lands: ❑ Yes No Type
it Urban Forestry Plan
❑ Conditions "Met"�Aprior to issuan e of buil ng permit
Notes: N),j't,/>3D Fisc. 57 .2 / pA /)pD-i' 74 -exA,/7L l,s-V-kairc-e
Approved By Planning: .�_ ��_ 4,, `i ✓ Date: god / ) -
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
Building Permit Submittal
Original Submittal Date: 6(14{/17
Site Plans: # 3
Building Plans: # 3
Building Permit#: Enter buildin pe t#above.
Workflow Routing: Planning Pi Engineering er5FPermit CoordinatorBuilding
Workflow Sign-off: Sign-off for Planning(include notes from planning review) 7
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
IrC .uilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: / /
By Permit Technician: , 4/I' Date: 1117i7
Engineering Review q
Slope at building pad: / b
❑ Conditions"Met"prior to issuance of building permit
O Easements (encroachments)per engineering conditions of approval and plat
0 Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 'No
Assess Water Quantity Fee in-lieu: 0 Yes Al No
LIDA Facility on lot: 0 Yes L' No
0 NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: `/j4 I VEL U---"t Date: g6at7
Revisions (after Building Submittal only) Reviewer e
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
O Conditions"Met"prior to issuance of building permit�it
pproved,NOT Released: �;,.,,,�t/l C�►.,,, Date: It7`f11/
(Notes: C,UY1art s r'-e- it 124 111 AL—
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: 4.e5Yes 0 N/A
Tigard Trans SDC: Yes 0 N/A
Parks SDC: airYes 0 N/A
LIDA 0 Yes D",i /A
LOK to Issue Permit
Approved by Permit Coordinator: AVAM 4_41'V Date: )1/14)/)i
I:\Building\Fonns\BldgPermitRvw_RES 061417.docx
City of Tigard
Ili COMMUNITY DEVELOPMENT DEPARTMENT
C
TIGAlza River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: /&)-9- 3 ? 1 M. /
Project Name: ..k_../-- `7-?97�,2 ce Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Distrt 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. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dorm
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum gf,12%of ech street facing facade must include windows or entrance doors.
Percentage Shown: / . z
3. trances:At least one entrance must meet both of the follo ' g standards:
Max. 8 ft. setback from longest street cing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: ❑ Yes No
If yes,all the following apply: ❑ 25 sq.ft. min.
❑ One street facing entry ❑ 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 nun. 5 ft.wide x 5 ft. deep ❑ ecessed entry area min. 5 ft.wide x 2 ft. deep
❑}ball offset min. 16 inches Dormer min.4 ft.wide
'Roof eave min. 12 inch projectionDormer
offset min. of 2 ft.
❑ Roof shingles either tile or wood 01 Gable,hip or gambrel roof design
❑ 'oof pitch oriented south min. 500 sq. ft. rizontal lap siding min. 3-7 inches wide
1,4 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 No. If No (Check one):
❑ ay extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
ii 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 e garage that faces the street with a min. area of 12 sq.ft.
W the (Check one)
12-foot-wide garage door ❑ 40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: _ c......_______.> Date: ____01/11 _
I:\Building\Forms\BldgPermitRvw REs 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
•
71
_ ' Transmittal Letter
T t G, R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom H. DATE RECEIVED:
DEPT: BUILDING DIVISION N I °0,
\!0V142017
FROM: Nichole Thorpe
COMPANY: Polygon Northwest ,t t `,'‘,i, ''-' --w '
PHONE: 360-989-40204 By:el'P i(Y\
051 2o%7--0030.7)
RE: 13059,13067 13073 3085,13093 SW 169Th �� �,� ��,i-��,_��„�.,_
(Site Address) F •ermit l um e- — J
River Terrace East `o' ' 1
(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 31-d Bathroom Option -- /4r ;n,� 4'/„,'7c el",/,'y
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: 1 ) — ) C— I-7 Initials:
Fees Due:j Yes ❑No Fee Description:
j14 r 13) C” r....v . <v-- ,,s 9,64________,_
$
$
Special
Instructions:
Reprint Permit (per PE): 151 Yes 0 No ❑ Done
Applicant Notified: Date: I Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
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. DAT
DEPT: BUILDING DIVISION
AUG 14 0t7
FROM: Angela Grajewski CITY OF TIGARD}
COMPANY: PolygonANY: PolygBI
oDIVISIO'
PHONE: 971-212-2144 By
RE: 13093,13085,13073,13067,13059 SW 169th Ave MST2017-00304 13093 SW 169TH, LOT 34
(Site Address) I MST2017-00305 13085 SW 169TH, LOT 35
River Terrace East Lot 34-38 MST2017-00307 13073 SW 169TH, LOT 36
(Project name or subdivision name and lot number) MST2017 00308 13067 SW 169TH, LOT 37
MST2017-00309 13059 SW 169T", LOT 38
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: , Description:
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)
FOR OFFICE US ONLY
Routed to Perm)
echnician: J)JI 6 — , .'tials
Fees Due: Yes ❑No Fee De Option: Amo _4ue:
3 ,yr j .=- v� r $ ) `
$
$
3 $
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:
13073 SW 169TH AVE, BEAVERTON, OR, 97007 May 15, 2018 at 9:32:29 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00307
Inspection Type: Inspector:
299 Final inspection Allyson Armstrong
Result:
PASS - CofO
Comments:
Collected
High efficiency lighting form
Moisture content acknowledgement form
Moisture barrier acknowledgement form
Air leakage test report
Left C of 0 on the counter
Violation Summary:
Inspector Contractor
Plumbing Permit Application
Site Utilities
FOR OFFICE USE ONLY
City of Tigardiyd1 //l
I r. '"n,r
13125 SW Hall Blvd.,Tigard,OR 97223 i DateReace/Bvi Permit N/"[ /�G�X36
w
■ Phone: 503.718.2439 Fax: 503.598.1960 Plan Revtew �I n
InspectionLine: 503.639.4175 h Date/By: la -f� �--+�T Other Permit No..
TIGARD
Internet: Line.www.tigard-or.gov
Date Ready/By: Juris I ® See Page 2 for
Notified/Method Supplemental Information
TYPE OF WORK
FEE* SCHEDULE
®New construction ❑ Demolition
For special information use checklist.
❑Addition/alteration/replacement Description Qty.
❑Other: Ea. 1 Total
New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION ' SFR(1)bath
312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath
437.78
ElAccessory building ®Multi-family SFR(3)bath 500.32
❑Master builder Each additional bath/kitchen 25.02
El Other:
`3�?3 JOB SITE INFORMATION AND LOCATION Fire utisprlities: (1 sq.ft.)���� Page 2
Site utilities:
Job site a dress: IJF93 SW 169th Ave Catch basin or area drain
18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain
18.76
Suite/bldg./apt.no.: I Project name:River Terrace East Footing drain(no.linear ft.: ) Page 2
Cross street/directions to job site: Manufactured home utilities 50.03
Manholes
18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Subdivision: Water service(no.linear ft.:_) Page 2
Lot no.:36 Fixture or item:
Tax map/parcel no.:
Backflow preventer 31.27
DESCRIPT• ION'OF WORK Backwater valve 12.51
Multipurpose Fire Sprinkler System Clothes washer 25.02
Permit# Dishwasher 25.02
Drinking fountain 25.02
�® PROPERTY OWNER Ejectors/sump 25.02
I ❑ TENANT Expansion tank 12.51
Name:Polygon Northwest Fixture/sewer cap
25.02
Address: Floor drain/floor sink/hub 25.02
City/State/ZIP: Garbage disposal 25.02
Phone:( .) Hose bib 25.02
Fax:( ) Ice maker
APPI ICAI 12.51
►, K
❑',CONTACT PERSON Interceptor/grease trap 25.02
)
Business name:Alliance Plumbing,LLC Medical gas(value:$
Page 2
Contact name:Robert Dishman Primer
12.51
Address: 146 W Historic Columbia River Hwy Roof drain(commercial) 12.51
City/State/ZIP:Troutdale,OR 97060 Sink/basin/lavatory 25.02
Solar units(potable water) 62.54
Phone:(503)492-3490 I Fax::(503)912-6438 Tub/shower/shower pan
E-mail:robert.dishman@allianceplumbing.net 12.51
Urinal 25.02
CONTRACTOR , Water closet 25.02
Business name:Alliance Plumbing,LLC Water heater 37.52
Address: 146 W Historic Columbia River Hwy Water piping/DWV 56.29
City/State/ZIP:Troutdale,OR 97060 Other: 25.02
Phone:(503)492-3490 Subtotal
Fax:(503)912-6438 Minimum permit fee: $72.50
CCB Lie.: 184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee)
41.--1 --T-71....._,JState surcharge(12%of permit fee)
Authorized signature:
Print name:Gavin Thomes I TOTAL PERMIT FEE
Date:12/6/2017 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
44046I6T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Qty Fee{ea
) Total Square Footage: .' permit Fee: ,
Site Utilities
Footing drain 1 oto 2,000 $121.90 100' 50.03 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' 37.52 Valuat on: 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
each additional$100.00 or fraction thereof,to
n pear. Inspections or'.Fens
Qty. Fey{eat, Total and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
each additional$100.00 or fraction thereof,to
which no fee is specifically indicated 90.00/hrand including$25,000.00.
(minimum chargetsie 1/2fo mal
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.hour) 00 $379.50 for the first$25,000.00 and$1.45 for
each additional$100.00 or fraction thereof,to
hours(minimum charge 2 hours) 90.00/hr and including$50,000.00.
Reinspection Fees
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: I I I I
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quantity by'Fixture Type
Replace/
Plait,i eview, for Plumbing Installations
Fixture Ty►e forgpt Adaea Refute
Work Performed: Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath -Tub/Shower ❑ Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive or ❑ New exterior plumbing site utilities for any complex structure
Dishwasher
her -Commercialoas defined in OAR918-780-0040.
Dishwasher ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ® Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-4',
Car Wash Drain isometric or Riser Diagram
Garbage -Domestic-non-food 0 Isometric or riser diagram is required for new buildings
Disposal -Comthat meet the qualifications above.
-Commmeeic rcifood ral-foodd rrelyelated
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this permit results in an
Water Extractor
Closet Toilet increase of sewer EDUs,a sewer permit will be issued and
Water fees assessed for the sewer increase must be paid before the
Urinal
https://allianceplumbing-my.sharepoint.com/personal/gavin_alliancepluml2ng_net/Documents/Documents/Fire Sprinklers/RT/City of Tigard
Permit.doc
CITY OF TIGARD MASTER PERMIT
II COMMUNITY DEVELOPMENT ` Permit#: MST2017-00307
T I , Ea 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 L7� Date Issued: 11/22/2017
;
Parcel: 2S106DA03600
Jurisdiction: Tigard
Site address: 13073 SW 169TH AVE
Subdivision: RIVER TERRACE EAST Lot: 36
Project: River Terrace East, Lot 36
Project Description: New SFA. 4/19/2018: REPRINT permit to remove(1)bathroom, reducing the total to(2)
bathrooms.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 240 sf Basement 0 sf Left: 0 Parking Spaces: 0
Height: 31 Bathrooms: 2 Second: 562 sf Garage: 456 sf Front: 12 Smoke
Dwelling Units: 1 Third: 560 sf Right: 0
Detectors: Yes
Total: 1362 sf Value: $177,262.50 Rear: 5
PLUMBING
Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 2 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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: $23,621.47
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 R 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: `l 1>-'' Permittee Signature: e7,1/ /9-7- '10(°6-/C7-70,V7
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.