Permit (76) CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT
Permit#: MST2018-00290
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/13/2019
'G Parcel: 2S 106 DA20100
Jurisdiction: Tigard
Site address: 16639 SW BIRDSONG ST
Subdivision: RIVER TERRACE EAST Lot: 240
Project: River Terrace East No. 2, Lot 240
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1128 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 28 Bathrooms: 3 Second: 1445 sf Garage: 385 sf Front: 8 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors:
Total: 2573 sf Value: $323,174.85 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 3 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: 2 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: 4 201-400 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: Y All
Ecompasing: Y
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2573
Owner: Contractor:
WILLIAM LYON HOMES INC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
BY POLYGON WLH LLC 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
703 BROADWAY ST STE 510 VANCOUVER,WA 98660
VANCOUVER,WA 98660
PHONE: 602-694-4031 PHONE: 360-695-7700
FAX:
Total Fees: $34,273.11
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: t, \.A.,)\._ C
Permittee Signature: :� $rO \
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application RECEIVED 1 21-10
Residential FOR OFFICE USE ONLY
City of Tiand APR 1 8 201$ Received } Permit No.:
`J g Date/By. I�1� L t k S� ,l-A4 —V" 7eAcj
IN 13125 SW Hall Blvd.,Tigard,OR 97223 611-y OF TIGARD Plan Review /�,��
Phone: 503.718.2439 Fax: 503.598.1 r� c Date/By: 1b A* Other Permi�r C`c.-1�3
T I GA E D Inspection Line: 503.639.4175 ILDiNG D1Vi'- DateBeadyBy: 644._ )oris: ® See Page 2 for Wv.J
Internet: www.tigard-or.gov Notified/Method: /7 7 /7 Supplemental Information
F'/9/c- ,a e)
TYPE OF WORK REQ D DATA:1-AND 2-FAMILY DWELLING
N New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ 37j3 1
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 -2,°1$2
Job site address: (lj3q SW Ca SI-- New dwelling area:7_ '73 square feet 1 t,,1 tiS
City/State/ZIP:Tigard,OR 97124 1 J Garage/carport area: -es-' square feet 1 ,z,t5
Suite/bldg./apt.no.: Project name:River Terrace East Covered porch area: square feet
Cross street/directions to job site: Deck area: • square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:River Terrace East Lot no.:2L4O Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
El PROPERTY OWNER 0 TENANT 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:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH,LLC (Please refer tofee schedule)
Structural plan review fee(or deposit):
Contact name:Nichole Thorpe
Address: 103 Brod/wallQQsi S(t ik.,q 0S plan review fee(if applicable):
8668Total fees due upon application:
City/StatetZlP:Vancouver WA 9
Amount received:
Phone:(360)695-7700 Fax::( )
II E-mail:Nichole Thorpe PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR 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:
g 4 ___ t 0 Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and admitkistrative 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: $201.60
Authorized signature:&M��%�w�"'�-aril-- This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
*Fe'metbvdol"gy V t by Tr-Comn*y grrnbli„g Ipdnsty
I. rant name:Nicnote I norpe Date:u6t16llul t Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit ApplicatioRECEt'JE• 1 OR Of11( 1 l SE O)vI_ti
Received
Cityof Tigard nate tly:
g 18 2.018
Permit t�,,.
■ 13125 SW Hall Blvd.,Tigard.OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 QPROther Permit,
i it, \tf, Inspection Line: 503.639.4175 �p'GAR11 . ,R.
-�/ R e Reach!By: tuns �See Page 2 for
Internet: www.tigard-or.gov Cl l 1 - tf i !,ificctAl IL
3UILDIN
131\n°V ls' , Supplemental Information
,i #` s4; _ae .*stet =_. >°l 4!!1 .? `.l r ! c_�< ,cl�*rkual T
.
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor.overhead.and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMSFELS*
Hal-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
( I Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
10$ 2F/E INFORMATION AND LOCATION licatint±lcooling:
'^ Air conditioning I 46.75
W
Job site address: I X31 S11/4/.) ��J 1 COLS J 5i--- Furnace 100.000 BTU(ductsAents) I 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100.000+BTU(doets%vents) 54.91
Ilea!pump 61.06
Suite/bldg./apt.no.: Project name: p. w.elr 1 . - ce -Ea.S4' 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 I 23.32
Subdivision: Lot no: Other: 23.32
iVPr1r're Anr(�e.. E 5-(r /�� Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert I 3339
flue vent for water heater or gas
fireplace 23.32
Lou lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER I 0 TENANT Other: 23.32
h®� Environmental exhaust and ventilation:
Name: pt,/®/`,�,a,�e l to 1 S i Range hood/other kitchen I
Address: "��0®O ' `4'lD 1, Ire ,�� equipment 33.39
oubt i`l`( e.12.ot-y[jt/t oac\ Clothes dryer exhaust I 33.39
City/StateTZIP: S('. ks...12,I P -Z- 2�"37 Single-duct exhaust(bathrooms,
�1�� 1 n Z� 3 toilet compartments,utility rooms) 23.32
Phone:,(o(, -l jO .4_-TQ�t Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT, 0 CONTACT PERSON Other: 23.32
Business name:Polygon Will,LLC Fuel piping:
$14.15 for first four.S4.03 for each additional
Contact name: 0 I eln0V. Oy pe_ Furnace,etc. I
Address:/I) B t j44001.A.ASTI su ,�t1 S11) Gasheat pump
SCJ Wall/suspended/unit treater
City/State/ZIP:Vancouver,WA 984160 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 , fireplace I
E-mail: ' Range I
Barbecue
_ =c9NTAAC104 t_ , , Clothes dryer(gas)
Business name:Apex Air LLC Other:
Address: 18004 NE 72 AveSubtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)326-1769
State surcharge(12%of permit fee)
CCB lic.:203034 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized sisnatttr • -
Print name:n .l Date: .0j•11.14.
1 4luitding\PermitsWEC_PermitApp_0401 I3.dec 440-401 Tr(I UIIJCOM W Enl
,
E;---, ------- - -"`”--u-v---11-1ECEIVED ,6:1Ij'-' 3:;46*:C.-V4'4It';:ti&;kaLNSZIili*:*gi:LAI;=la
,.,0-±----:-- '--../"-- Cigy of Tigard pel
Received
Pena II:
''''-11 13125 SW HMI Blvd.,Tigard,OR 97223 A PR 1 8 2018 PlanitilBZLIew
Phone: 503.718.2439 Fax: 503.598.1960
Date/By: Related Permit ii:
, . '...1 Inspection Line: 503.639.4175
Aids: El See Page 2 for
ARD1 NRoe atidayedDialytiee/tBa
CITY OF TIGARD
Supplemental Inform ation
‘,..,3U. 11..DING DIVISIO,..7 _., „ , _. , _ _ . , .... .. ,., ...... .. _ „ . .... ,. _ _
2.1tyripicc 4.0A ,.;,::.: 1 .::.,'0,-- a:,: :: ; ''' .- , '.: 'i:-... - :- • 04:*10YOVi
ISJ New construction 0 Addition/alteration/replacement Please check all that apply(submit g sets of plans wiitems checked):
0 Service or feeder 400 amps or more 121 Building over three stories.
ID Demolition 0 Other:
where the available fault current E1 Marinas and boatyards.
•,;:V441,,cfN-.:::.,•:-.,:il.:,,I,w,Y.;oftwilty,,,byttoglittierriiii,o,,,,.,,,,,,,;,,,,,,,,,,„,.;,:.,„,::.:,,,::-:,.,„:.:,,
4.... ,- '..,...,,,..., ...,....-:;,....., ;*:/.,,,'::: ,:--, : . - *:: exceeds 10,000 amps at 150 volts or El Floating buildings.
0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 CI Commercial-use agricultural
amps for all other installations, buildings.
ID Multi-family - 0 Master builder 0 Other:
D Fire pump. 0 Installation of 150 KVA or
,.40*::$1*CiRilOt.kitiii.*40.:;1.40:.0.14*tPiif: .';-',-;;i.• :::::: :'-:. .::::.,::'3- -',', El Emergency system' larger separately derived
0 Addition of new motor load of system.
Job#: 1 Job site address: to ,03.1 ,..5.g Rtificcyn, 4_ 0 slio.01:
notroielio-erseidential units. occupancy.
City/Ste/ZIP:Tigard,OR 97224
D Health-care facilities. L-.J Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: pi\jor--T-tryace,Ea5,4_ Oliazardous locations. 0 Supply voltage for more than
El Service or feeder 600 amps or more, 600 volts nominal.
Cross street/directions to job site: 50ggW.T:%.. .akktNakailtggaZi0.. .t .
Descriviell I Qty. I Each I Total I a
New residential single-or multi-family dwelling unit.
Subdivision: FiVeAr Tehretex._ I Lot#:-2_141) .includes attached garage.
Tax map/parcel#: No sq.R.or less 1 168.54 4
Ea.adcP1500 sq.ft.or portion L33.92 1
i.i..: •'Njii.A'.!:aViialUIViAt;:ill;: PFigOgRilkQP.tMcil.k1A1941C','::: ',':-',":: :::', ...-:;:.::'; ''',:s: Limited energy,residential i..
(with above sq.ft.) 75.00 2
Limited energy,multi-family
75.00 2
residential(with above sq.It)
FRMARP fibil*WAitO)M0 aM6C1.1 VV'fi;: :Mi.'4ikOXN:TiZ'; '';'.:Mg IsteernveileveasbZitrs instanatio„,alteration,nP,aagned/2or relocation
Name:, aVLizitry.A .triEDEVN&TU.... 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address; ;d i 1 tA,4 If" -I & 1 p 1 .._....i 401 amps to 600 amps 20034 2
City/State/Z1P: S
. mticria.te. f-4-?... ka52.5(3 601 amps to 1,000 amps301.04 2
Phone: D02-(.o1i 4-Ut 03 1 I Fax:( ) Over 1,000 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 559.0386 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 12
2
Owner signature: Date: 401 amps to 599 amps 168.54 2
-,. &:`•-,,, . .,--,, ,,,,,,,,,"iv.,-,-,40,..,,,,N?_;:,.1:1-5.a,7sijouirr,----wwisi,...-::,,,,, f,:. Branch dreads—new,alteration or extension,per panel
"'`"'''' -4 l''.:.!'"' l'''':' '''''' A.Fee for branch circuits with '
Business name:Polygon WLH,LLC
above service or feeder fee,
7A2
7
each branch circuit
Contact name; \)‘CAA0‘2_,Lialaonve.„
B.Fee for branch circuits without
Address: 1 0service or feeder fee,first
2, rby-Docki ja,u --'t-- viLe.. "="1."0 branch circuit 56.18 2
City/State/ZIP:Vancouver,WA 98660 J Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 I Fax:;(360)693-4442 dEwacehll;Inlinsufaelveticuereadnodrlomr feed
67.84 • 2
Email: td kalote.omm1n,-- 7
v -
0 "i
if mes
hios .cAnn Reconnect only 67.84 2
Pump or liTigation circle 67.84 2
Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2
..,
Signal circuit(s)or limited-energy
Address:402 Valley Ave NW Ste 106
panel,alteration,or extension. 0 See Page 2 2
Each additional inspection over allowable in any of the above
City/State/ZIT':Puyallup WA 98371
Additional inspection(1 hr min) 66.25/lir
Phone:(253)872-6051 I Fax:(253)872-1801 Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:bdaniels®gwettsa.com
Inspections for which no fee is
90.00/hr
CCB Lie.: C1158 1 Electrical Lie.: 208174 1 Suprv.Lic.: 4496S specifically listed(rA lir min)
.
[-..1':.-..!tifti:14:0KOWOrti''.. FEES!
tkga2. :.,:9 ,
...... .
Suprv.Electtician signature,required: "4 ip it - ' lirliM: •- •
Subtotal:
Print name: Joan P Albert • I Date: 0 Plan Review Required(25%of permit fee):
.------ . State surcharge(12%of permit fee):
Authorized signature: _
TOTAL PERMIT FEE:
This permit application expires if a permit is not°Wail
Print name: Bill Daniels
MI111.111111 . i as ,een accepte.as complete.
* Number of inspections allowed per permit.
LVEluildiag1PormitAILC PermitAppEIR.1112E.doo Rev 06/17/2015 440-4615T(11/05/CO/WWEE
11.11MMIMM.MMIMIMMIIMMIMMIr
t
Plumbing Permit Applicatit' ECEt V E
Building Fixtures APR 1 g 2018
City of Tigard lCl, Date/B�
13125 SW Hall Blvd.,Tigard,OR 972 '"�( (� R® Y: Permit No.:
' 1 Phone: 503.718.2439 Fax: 503.598, ` �V�S���Plan Review
Inspection Line: 503.639.4175 7 1�p�NC may. Otho Permit No.:
T I G A R D Internet: www.tigard-or.gov or.gov Date Ready/By: Jam: 0 See Page 2 for
Notified/Method Supplemental Information
' 7:°�«i.�.ds- 14.; z., t-R 'Vl £ 'S4 Ys n ' U!7p''.:
C .New construction ❑ For special information use checklist
Demolition
Description I Qty. I Ea. I Total
Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath
SFR(2)bath 312.70
® 2-family dwelling 1-and ❑ industrial
SFR(3)bath 500.32437.78
❑Accessory building ❑MultiCommercial/-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other. Fire sprinkler( sq.ft.) Pa e 2
g
JOB;SITEINFORMATION AND LOCATION Site utilities:
Job site address: V)1,2)q �� 1.4!),i rc S S5-1---- Catch basin chaise dram 18.76
\
City/State/ZIP:Tigard,OR 972241Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: ' 7- w-act, Es+ 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 p_,JeX l-eirrG ee. s.}- Lot no.:*VI 0 Fixture or item:
Tax map/parcel no.: Backflow preventer I 31.27
DESCRIPTION OF WORK Backwater valve 1 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
xP
`®4. P1&OPERf3t OWNER Expansion tank 12.51
Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02
Floor drain/' floor sink/hub 25.02
Address:7600 E Doubletree Ranch Road
Garbage disposal 25.02
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02
Phone;(602)694-4031 Fax:( ) Ice maker 12.51
�;APPI.IC:iINT,, .
CONTACT'PERSON Intetreptor/grease trap 25.02
as
Medical g (value:$ ) Page 2 name: PUII. 7`ii^ 12.51Contact name:N i^JVl 4C�-.^kI� 6Roof drain(commercial) 12.51
Address: 5316y0061
(A)0j4 e C�.1i--- C,i sl 0 Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 J Solar units(potable water) 62.54
Phone:(360)695-7700 I Fax::(360)693-4442 Tub/shower/shower pan 12.51
Email l�,C/�t7 to -Tin p,0\ ( i s..�'i,•NlY\ Urinal 25.02
�1HCTORWater closet 25.02
. - Water heater 37.52
Business name: +rt i i,S JD 1X1.1 et-60A$ Water piping/DWV 56.29
Address: ).t,. Box, 0.0, Other: 25.02
City/State/ZIP: ST, P g W1 ori- c1113-1 Subtotal
Phone:(,5•143.-Stat.- (1 411 Fax:(ell V..-7a,i....*? permit
11,0 Minimum fee: $72.50
CCB Lic.: + Plan review (25%of permit fee)
3'7 . Plumbing Lic.no. a
State surcharge(12%of permit fee)
Authorized signature: + TOTAL PERMIT FEE
Print name: At f...1/f_. w 1�� Date•S-3 b `10 I Thispermit application s=pire if a permit is not obtained within 180 days
after it has lxm accepted as en.aplW.
*Fee methodology set by Tri-County Building Industry Service Board.
1:1BuildingtPermitsPPLMU-PennitApp.doc 10/0/109 440-4 t6T(to/OJCOM/WEB)
14 City of Tigard
S
7 COMMUNITY DEVELOPMENT DEPARTMENT
TURD[ Building Permit Review — Residential
f1 Ya
Building #: k _._��Z.,� 3.:.���.� - ,
Permit �.,. ,_� -� _..: ; _
Site Address: L(Q(o361Svc a r-P5
Project Name: FAN& Toaetc.e. ,t+, No.2-
(New dwelling=subdivision name;Addition or Alteration=last name of owner) Lot #: 2 1 O
Planning Review
Proposal: Ne,1 STIP--
y
iv—?( Verify site address/suite# exists and active in permit system.
I,River Terrace Neighborhood: 0 No VI Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
three(3)copies of site plan
Nikxtsting structures on site
P35ite plan must be on 8-1/2"x 11"or 11 x 17"paper
of
..Drawn to scale(standard architect or engineer scale) floore le elevations
structure
ce(including decks)with finished
'<North arrow
Site address,project or subdivision name and lot numberty locations&easements(required for new and additions)
Sidewalk/driveway approach
NApplicant information(name and phone number) N
lot dimensions and building setback dimensions .ocation of wells/septic systems
xisting trees to be retained with drip line,and tree
'Al` quare footage of buildings to be demolished
.t area,building coverage area,percentage of coverage and protection measures
impervious area(applicable if R-7,R-12,R-25&R-40 treet tree size,type and location
reet names
. roperty corner elevations(2 foot contour lines if more than �00 sf of impervious area created or replaced? ¶l Y
4 foot differential)
p �� �L�No
If yes,is a storm water quality facility shown? A ''es '❑No
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: 0 Yes,applicant was notified
No Received: ❑ yeS ❑ No
41 Public Facilities Improvement(PFI) Permit:
Required: 0 Yes,applicant was notified
I No Applied For: 0 Yes 0 No,stop intake
'Land Use Case#: PPR:20 tt' —Dopbl
'zoning: Q— 4-&— CPD) (2 7 LPO
X Required Setbacks: Front Rear 10 SideStreet Side
'1 Landscape Requirement: 2.0 % 3 14/A- Garage 20
Lot Coverage Maximum: go
Building Height Maximum Height
N Actual Height
NA'Visual Clearance
At Sensitive Lands: 0 Yes .8. No Type
Urban Forestry Plan
C)tConditions "Met"prior to issuance of building permit
i1w .A11.4 I I ► /tip ' ► air 1 . . A 4 i__ •
`'Approved By Planning: �( j d
v Date: I))kil I,g
Revisions (after Building Submittal only)
Revision 1: 0 A rovedReviewer Date
Pp 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\Building\Fbrms\ 1dgPermitRvw_RES_061417.docx
irli-
Building Permit Submittal
Original Submittal Date: 1- Ir�tl
Site Plans: # L
Building Plans: # B
Building Permit#: Enter building permit#above. 3/Building
C�Engineering Er-Permit Coordinator g
Workflow Routing: 3/Planninggm g
Workflow Sign-off: 3/Sign-off for Planning(include notes from planning review)
Route Application Documents: 31 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:
� Date: 1�'1 u_ �1
By Permit Technician:
Engineering Review �'s`
,2' Slope at building pad: '2- f;
❑ Conditions"Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
Q Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 0 No
Assess Water Quantity Fee in-lieu: 0 Yes n No
LIDA Facility on lot: 0 Yes 3"No
• Final Plat Recorded:
Date:
O NOT Approved by Engineering:
Notes:
Date: /0 // / �'
0 Approved by Engineering: 11 t t i�; i t "` . t
Revisions (after Building Submittal only)
Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
0 onditions"Met"prior to issuance of building permit
Approved,NOT Released:
Date: ID(I$,le,
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
` .SDC Fees Entered: Wash Co Trans Dev Tax: V Yes 0 N/A
Tigard Trans SDC: AV Yes 0 N/A
Parks SDC: ›ir Yes 0 N/A
LIDA 0 Yes N/A
OK to Issue Permit
/ , Date:4,2i ?../ 1I
Approved by Permit Coordinator:
I:1Building\Forms\BldgPermitRvw_RES_010118.docx
A
City of Tigard
11111 COMMUNITY DEVELOPMENT DEPARTMENT
T l GA R D River Terrace Building Permit Review Addendum
Building Permit #: cx-NSTQUS, C i t O
Site Address: t .21P3'Ci area'
Project Name: Zwwr TeNTAGe E Nb.2_ Lot #: 2,40
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.070.1.):
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 dormer
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: 15°10
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: 94 Yes ❑ No
If yes,all the following apply: 2425 sq.ft.min.
One street facing entry - 12 ft.max. roof above floor of porch
0,-5 ft. depth min. 030%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 igaecessed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches Q Dormer min. 4 ft.wide
.Roof eave min. 12 inch projection ..Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood ,I 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 $4 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):
❑ 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.
Width: (Check one)
❑ 12-foot-wide garage door ❑ 40%max. of street facade
50%max. of street façade with 7 detailed design elements
Notes:
Approved By Planning: . J I ,, Date: 10 i(,
I:\Building\Forms\B1dgPermitRvw_RES_RT_121417.docx
Electrical Permit Application
RECEIVED/ED FOR OFFICE USE ONLY
City of Tigard Received
Date/By: k i i� -R-
Iliv 13125 SW Hall Blvd.,Tigard,OR 97223 �-j� Permit �� yt��Q COAD
JUN 2 8 2019 Plan Review ?� V D
Phone: 503.718.2439 Fax: 503.598.1960Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By:
TIGARL) Internet: www.ti and-or. ov CITY OF TIGARD Ready Date/By: Jars H See Page 2 for
g g Notified/Method:
gUI�pING DIVISION Supplemental Information
TYPE OF AVO PLAN REVIEW
®New construction 0 Addition/alteration/replacement ,w , h ` t t .. Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ❑Other: t°°`" 5" .. .i'..-�+- 1 0 Service or feeder 400 amps or more 0 Building over three stories.
\a( j where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION .k\\ '''''' exceeds 10,000 amps at 150 volts or
,,...-- 0 Floating buildings.
El I-and 2-family dwelling 0 Commercial/industrial 0 Acceksory'futlding less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
El Multi-family 0 Master builder
0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: ❑Addition of new motor load of system.
Job site address:`(ylp16(� � Sk,.
�f,Q+D 100HP or more. ❑"A","E","1-2","L-3",
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: East River Terrace 4'Z 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total ]
New residential single-or multi-family dwelling unit.
Subdivision:East River Terrace4e2__ Lot#: 2C'0 Includes attached garage.
Tax map/parcel#:
1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Change contractor on MST"La"" �2_S 0 (with above sq.ft.)
75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
® PROPERTY OWNER, 0:TENANT. Services or feeders installation alteration,and/or relocation
Name:Polygon WLH,LLC 200 amps or less 100.70 2
Address: 703 Broadway St,Ste510 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2
Phone:(360)695-7700 Fax:( ) Over 1,000 amps or volts 552.26 2
Email:
Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
® APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
- A.Fee for branch circuits with
Business name:Polygon WLH,LLC above service or feeder fee,
each branch circuit 7.42 2
Contact name:Tonja Morris B.Fee for branch circuits without
service or feeder fee,first
Address: 703 Broadway St,Ste.510 branch circuit 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 Fax: :(360)693-4442 Each manufactured or modular
Email:permitsubmittals@polygonhomes.com
- dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
CQl1l I'RAcTOR.; Pump or irrigation circle 67.84 2
Business name:Alameda Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:3415 NE 44u'Ave. panel,
nel,alteration,or extension. 1:1 See Page 2 2
City/State/ZIP: Portland,OR 97213 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)319-2192 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:solarpdx@me.com Industrial plant(1 hr min) 78.18/hr
- - Inspections for which no fee is 90.00/hr
CCB Lic.: 199188 Electrical Lic.: c923 I Sunrv.Lic.: 48711% specifically listed(%hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal:
Print name: Kirk Rood I Date: 05/09/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: /L i k. /24044. TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Kirk Rood Date: 05/09/2019 days after it has been accepted as complete.
* Number of inspections allowed per permit.