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Permit (2) t q CITY OF TIGARD MASTER PERMIT 'Fg I_ COMMUNITY DEVELOPMENT Permit#: MST2019-00284 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/16/2019 Parcel: 2S107AA03500 Jurisdiction: Tigard Site address: 16883 SW TOWNSVILLE ST Subdivision: ROSHAK RIDGE Lot: 35 Project: Polygon at Roshak Ridge, Lot 35 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 809 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 26 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 8 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 1858 sf Value: $248,825.69 Rear: 0 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 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: 3 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 addll 500 sf: 3 201-400 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 SF VB R-3 1858 Owner: Contractor: POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) 703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: Total Fees: $33,685.50 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 Cent- . ••se 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 "N .232.19.7 or 1.:c I. .2.2344. Issued By: d --- Permittee Signature: A-litr ; %)—Ask r _ 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 Oil". Approved plans are required on the job site at the time of each inspection. \, rc_________.\ , 2. )t...,.: ,, Building Permit ApplicatioiRECEIVE .. Residential V DEC 6 FOR OFFICE USE ONL D C C ® 2018 Received - Clty of Tigard DateB : - \Ck Permit No(S'` ��i,`r ilia a 13125 SW Hall Blvd.,Tigard,OR 9 ►1: OF TIGARD Plan Review Phone: 503.718.2439 Fax: 503.59:. '.i DateB !: 7 CO 1 I Other Perm 1' ` ,a T I G A R t) Inspection Line: 503.639.4175 $U 4D G DIVISION Date Ready/By: • ® See Page 2 for Internet: www.tigard-or.gov Notified/Method/2. /2 4• 7 Supplemental Information 77t9097[-- .ii/y .9. t ` TYPE OF WORK ij fg%'r /0" /%'"'" RE+QII `°lAT'k 1AND2-FAMILY'1';';/)'''''''''1:L!1°411 tj ei � . _ ,,/, ,. . „ii _, ®New construction 0 Demolition Permit fees*are based onthevalue of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the i/j work indicated on this application. CATEGORY OF CONSTRU TION 7/ �;, Valuation: $ ` 2, q y (67,8 " ® 1-and 2-family dwelling 0 Commercial/industrial 4❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 111Other: Number of bathrooms: /OR SITE 1N1 OKRA LION AND LOCATION �i rej� Total number of floors: Z 27 1 Job site address: ' 1/cbt V`) D v3V\Sv l\ v New dwelling area: I t513 square feet lDlt City/State/ZIP: -Tto�°t 1/(kQP-- _ Garage/carport area: U1 square feet C60(11Suite/bldg./apt.no.: " Project name:Polygon at Roshak Ridge CA Kok L•- Covered porch area: square feet Cross street/directions to job site: Deck area: square feet _ Other structure area: square feet RFQ i s (ATA:COINER '. CHE 11ST Subdivision: '" -i2 f L Lot no.: �J 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,''''", Af:; ;< . `DESCRIPTIoN of WO d y' ii i r work indicated on thislapplicationeadand theprofit for the r /1/EA) /::: Valuation: $ /,g. Nom,, r /0/4� 1.:1","///7 ��// 70 �/-� — Existing building area: square feet "�v>�/�n/ l'AMZ. t�/O� /2-&1/1'&7--) �i ' ���blteNew building area: square feet !mo>.-�ry�. , '/ � E"PROPERTY OWNER i ENAN'I' Number of stories: Name:Polygon WLH LLC Type of construction: 't, Address:703 Broadway Street Ste 510 Occupancy groups: City/State/ZIP:Vancouver,WA 98660 Existing: Phone:(360)695-7700 Fax:(360)693-4442 New: -,,,k, CCANT CONi'A ` RSON BF,: 41,1,„', ..4-. .,„„,,,,�>l S* j� , lig d.,�, _, k',7.- , ,77 hedule, N . .0.fir.j Business name:Polygon WLH LLC Structural plan review fee(or deposit): Contact name:Amanda Gavin FLS plan review fee(if applicable): Address:703 Broadway St.Ste 510 City/State/ZIP:Vancouver WA 98660 Total fees due upon application: Phone:(360)695-7700 Fax::(360)693-4442 Amount received Email permitsubmittals a polygonhomes com PHOTOYOLTAICSOLARPANE STEM FEES* rA,, � / g o fo#" ,w4� , „ Commercial and residential prescriptive installation of ,,,��/ / CONTRA ! / ✓ ',����,��_,,.. ,,. �s�,.,, P: ., , 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:703 Broadway St.Ste 510 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: 1111111r This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Amanda Gavin Date: 12 t`T/18 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) % 4 .-_-----:-- , VEMechanical Permit Applicati°RECEII. FOR OFFICE LSE MIA . . . .City of Tigard Received. 1 IR . : -1'3125 SW Hall Blvd.,riga' rd.OR 97223 llama-v.: DEC 0 6 2018 , ;,ie, 11/4,,niN,Ax\s-72jock...()c),, Sck X Pita= 503.7111439Fax... YI.3-59/1.1960 DitieBy. Oliva P=iii: Inspection La= 3..6.39A 175 CITY OFTIGAItU t-ui Rea4Y,S :Y 'TIGARD tow, : 21 see Ps,.. 1 for .ittlentgt: v"ww.tigarti-or.goe NotiftediMethed: Supplemental information 1 • BUILDING DIVISI til L ....,.....;._... .... ,....: .... ... ..... ...... ........ ..... ... ..:, 4 -71:Wi:,-6,Piiii&7:77-7,7;,7.]:.;. :77.-75Z-::,:i7iTli--7.q57 :7,i7.47 7:7:97A. .Nr,)T,c1)k1f:E 77r" ; . cli-EPrt.. :7-1.-!st:c140(1'3.st 0 .7 ‘. .... Mechanical permit fees*are based on the value of the work fl: New coostrudicri 0 Additicalatrenidonireplacernent performed,inditiate the vaine1tounde4 to the nearest dollarl plea 1 0 Demolition D Other: . mechanical materials.equipment,labor.overhead_and profit. ' Value:S '..-..4.:''''''''' '.:'•3''.: ::1-"':''::'•?..r7-'' '..-"ztAtt .titi'lOF'7etY.i&-fititeiiiiiiI.:'-'"::-•''t7:::2.:.!±±::".±•••••:::':- ? ..!:'' • ' •• • ••-• - —;• - - - , ''.,•.-:''.• ' -, , •,:-- .., H '-;-.• :. •-.'•,. ':-.,. ::-"::''':.',.;..::7-:: ---:- - ;' ?::.::7-5-.1f,':,itigtbOdlgrtkgitrOid4 gi'S:TtitS4gEgfi'::':':'1.::,' 0 I-and 2-family dusering 0 ComsnercialtindoStrkti 0 Accessory buildint rats vecityl informatietr zae riffedist 1.‘41.tIti-famijy 0 Mastet header ID Other. Desetitalort I Qty, I .Ert- I Tow.1 .•:;-...::•"- -"''i,•;''4::'1':14.f21-i:iit.:::;:::;::::)011:****6104:4*idlir. .;," JOliII $b:;..444'..4(*.-!::-!:',--,H;jii,:7'4n-,-'c.::-:!!.!'t7-.'..:' . -• Air conditioning i 1 46-75 Job sir adthesst 1 bb3,,,,,--rov tA.c.23,1 le, -c-A-- Furnace 100_000 BTU tdartOeents) 1 ' 46.75 -. CityiStsteiZIP;Tigard,OR r2,24 Fume=100.0004 11Th(dacttivents) • 54_91 1 . . „ Heat psnup 61.06 1 I Saiteraldgiapt-no.: Pmject"nic...„-r . : 0‘‘) D (Al t VO .CA,C3kDuct work 23.32 I Cross strectidireetions to jOb site: 12_1(1 tjya 4' iivdtortie tau water system . -Residential boiler(nalintor or I • bydronic) 2137 ' Unit heaters(fuel-type,not electric), in-ntell.in-duct.sus.pesideet etc. 46.75 1 FlueNeat for ate of above • - 23,32 . . . • . 'IA/ _ _ -- S )divi5orc \u cr Tecr-ae_R. ECA.S ., Lot no.: - )S' ' Other , Otter tad applisetetea Tux=pipette!no.: - ' Water heeler 2-5.32 .. . i;i'; 1 : :..:,Z310-SCItirlifki.*,0'80itk,...;.:. ..:i;j,:??,';,7,:::.,Z,4,2].:..,:71.2.-.:, , ,:-,:,-.....:1,-2. Gas ftrePlaceliramt 3339 I 1 . • Flue vent for water heater**.gas &enlace ' 23.32 • Log'tidier(gas) 23_32 . . . .... Woodipellet stove 33.39 - Wood fireplaeorlasert 23.32 • : eldraue0 liter/flue/cern , 73.37 ''.: _...-;--1514RiiiiiiitriiiCa:F:.;4:'.;1* " :i..y...-k:st.,E,-.:;:..: .:..., .ri.., .‘...ii4 -.7.,..:::,:..,. Other: . 113/ • EtlyttlUgnental eleti*MeAuli ventlisi.i0iC 1+411e: ?ot AO\01A-1 UJUIA- LLL Range hoodiuther kitchen I i . equipment . 1 3339 Add : ' 10 vi5V-06k1 Wani St SIT. q D- I Clothes-dryer exhumq I 1 1 City iState1110'. .valAcov,vey- Loa ot.-g(r2(00 1 Sinele-duet exhaust(bathrooms, 1 toad compartments„utility rooms! 1 0 1132 Pim= (19 0 (t2°IC '1'7 DO fax:(120(00 woi .) qu 42- 1 Attiegerawlspam fans. 1 t 2137 .. 7.., 1iiiieth. ,7:•Z.,:‘•:::•-•.:Cl-•.iciikti .1iiStOther 32 usins rrame. Palygon W114, Fuelipnr SICIS far first faun SW for each addirmeal Contact name-, pcyr ?, _Govl.kk, F,,,,,.. et . 1 .. • Address: 10 3 -"RY(-00-Lkt.00,_ Sk-'• i 5ke. 1(), Gas beat pump I Waillstispenderiknit heater 1 1 CityiSmtaraP.Vancouver,WA 98660 \I/4=11w= • Phone:(160) -695-7700 I Fax::(360)693-4442 Fireplace • E-Trail7RerrY\kirSUOrrl,WakS asi- Ok•tO\MV\tkle\le,c5'"rn 1 Bat loro..ne I :T.:,..,,i•::Ti.:.-4.:;:..-„,...yi,.ii-7.-.4-.,,:-.,•,zily-y::,,...:::::,,-.:i;::::-7:, -E:i:'.;,f:COZORA.g.;13R3i?.,..:v-.-li-ar,z7..;a:.:::... .:-.i..'..:.".< '.7..ir':,PH,..=.:;-t4f...;:,....:,:. I rhes dryer(eta) 1 1 . Other. Bosiness roe=Apea Air LLC 7 : ; Alik:itgal447.;0'stiit--*1;ftnOr' ..:'..:. ...!..!:-.... .:;',.' • Address:131304 NE 72"Ave !..,subtrital 1 , City/Statellift Vancouver,WA 513686Minimum permit fee(S90,00) , I Mina.reviesi(25%of permit fee) Phoom1360)3424109 • Fax(360)32'6-1769 .State surcharge i 12%of permit feet CC-11 lie::203034 ..:a/.......__ 1 TOTAL PERMIT FEE 1 • This permitplicstinn es, it application pires if a permit'is not obtained-within tatt days.atter it has beta accepted as complete. ;1/4albotized nature: * Fee methaddiagy set by Tri-Cemay Befidiag Inths:dr,-Stroim Ncad .*..........,......-- Min name: 1 t" . 1 • 1 Dzw: A N.Li• li j rewii6a..4-4.t-tm.4.4'NEEC_Pet-MtA.pp....00 1 1.3 Azz MO-VA.:7 f i VOVCOMIWF.S;. -, RECEIVE �rr OR , A ; 1 � , t� Electrical Permit Applicati®n oR a usE o L�4 K{ ,� City of Tigard Received Permit L ' 13125 SW Hall Blvd.,Ti ard,OR 97223 DEC 12 2019 Date/By: / / � -� g Plan Review :t ., Phone: 503.718.2439 Fax: 503.598.1960 CITY Related Permit#: F`,; r,^ i) Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: runs: El See Page 2 for 3 D Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information . . TYPE OF.WORK PLAN;REVIEW.: ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards. , - : -.: ..:.'CATEGORY_OF-CONSTRUCTION .. exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling ❑ Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. 0 Multi-family ❑Master builder ❑ Other: 0 Fire pump. 0 Installation of 150 KVA or . JOB SITE':INFORMATION AND'LOCATIONr <. 0 Emergency system. larger separately derived Job#: Job site address: 0 Addition of new motor load of system. 100HP or more. ❑"A","E","1-2","1-3", City/State/LIP:Tigard,OR 97224 ❑Six or more residential units. occupancy. 0 Health-care facilities. D'Recreational vehicle parks. Suite/bldg./apt.#: - Project name:Polygon At Roshak Ridge ❑Hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCITFDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: 35 Includes attached garage. " 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential R 1 1 r.+ (with above sq.ft.) 75.00 2 "� Limited energy,multi-family ih 5TV()19--0 0 zgl residential(with above sq.ft.) 75.00 2 i Renewable Energy 0.See Page 2 ®'PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name:William Lyon Homes,Inc. 200 amps or less 100.70 2 Address: 703 Broadway St Suite 510 201 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:(360)693-4442 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 1 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: • Date: 401 amps to 599 amps 168.54 2 ® APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name:William Lyon Homes,Inc. above service or feeder fee, 7.42 2 each branch circuit Contact name:Nichole Thorpe • B.Fee for branch circuits without sAddress:703 BroadwaySt Suite 510 branche it feederitfee,first 56.18 2 branch circuit _ City/State/ZIP:Vancouver,WA 98660 Each add'i 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 Email:permitsubmittals@polygonhomes.com dwelling,service and/or feeder Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Alameda Electric Sign or outline lighting 67.84 2 Address:3415 NE 44th Signal circuit(s)or limited-energy 0 See Page 2 2 panel,alteration,or extension. 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 J� Inspections for which no fee is 90.00/hr CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: 487,1 ,� specifically listed(%hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Kile Rood • Date: 03/08/2019 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: ,(6®� �— TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Kile Rood I Date: 03/08/2019 days after it has been accepted as complete. , . Plumbing Permit ApplicatgjECEIVE1) Building Fixtures DCC 06 2018 City of Tigard Received Date/13y: Permit No \ N'').Q.C1-(..I -k 1 . 13125 SW Ball Blvd,.Tiaard,014A -' T211 OF tiGARD Plan'Review 1 m Phone; 503.718.2434 Fax:*13149,844k ry,„. Date/By: Other Permit No,: , Inspection Line: 503.639.417D U 1 Li./.1.11C Di V i sioN Date Ready/By: TIGARD 0 Jens: lid See Page 2 for Internet: u-arw.tigard-or.gov Notiflear,merhod: Supplemental Information TYPE OF WORK' - FM* SCHEDULE ir information use checklist ch um. New construction C Demolition For special , Description I Qty. I Ea- 1 Total El Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCtiON- , SFR(1)bath 312.70 2 1-and 2-family dwelling CI Commercial/industrial SFR(2)bath 437.78 SFR(3)bath \ 500.32 CI Accessory building LIMill-familyEach additional hathildtchen 25.02 0 Master builder El Other: Fire sprinkler( sq.ft.) Pant 2 JOB SITE ENFORMATION AND LOCATION Site utilities: Job site address: 1(0 leS 5,0---r,k/ovisu 11 Le 9- Catch basin or area drain 18.76 Drywell,leach line,or trench drain 1876 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name:litt‘ (10.111 R.,_31-)?....0f6N\j\k„, ManufacturNi home utilities 50.03 Cross street/directions to job site: Manholes 18.76 OlVe".A,T 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. VA\isey-,..,-c„?.iy\i' GLUQ, (..cfn -i- Lot no.: ?:›S _Fixture or item: Backflow preventer 31.27 Tax map/parcel no.: Backwater valve Ii 12.51 Clothes washer 25.02 Dishwasher 25.02 .... Drinking fountain 25.02 Ejectors/sump 25.02 gr.a I-1 12.51 '..to PROPERTY OWNER L j. TENA_NT Fixture/sewer tank 12,51 25.02 Name:, 17.01,,A64o\A...., IN tivA. ut, Floor drain/floor sink/hub 25.02 Address -I 0--4- \rD ov---\7\)- Til St S ID Garbage disposal 25.02 City/State/ZIP:1\IR VILOV,VOI V‘ til q y(0(90 Hose bib 25.02 Phone .' te) v0151/100 Fax:(3)0)(o 01/7 4i-1Ice maker I 12.51 ' ZI APPLICANT- D CONTACT' PERSON .. interceptor/greaseinterceptor/grease t"13 25.02 Medical gas(value:S ) Page 2 Business name:William Lyon Homes,Inc Primer 12.51 Contact name:Angela Grajewski Roof drain(commercial) 12.51 Address:109 East 13th Street Sink/basin/lavatory 25.02 City/StatetZTP;Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 1251 Urinal 25.02 E-mail:Angela.Grajewsid@polygonhoines-com 25.02 Water closet Water heater 37.52 Business name: G±:_..6 ;?1,,A,,s,A)0‘,As .4.-5.0visg, 1/IL- Water pipinuTOWV 56.29 Address: ,),6, f, 0)(4 Of Other: 25-02 City/State/ZIP: 1% f)4444 Cyrt, cifi 131 Subtotal Minimum permit fee: $72.50 Phone:(3-43 ,ISCL t- 1(4,11 Fax:(Ali t...,-741-47 no _ Plan review (25%of permit fee) CCB Lie.: jet-i 31a_ Plumbing Lie.no. (23q - State surcharge(12%of permit fee) Authorized sivrture: , ,..U)ot ..'i-eyo. ,/,'"'" TOTAL PERMIT FEE Print name: „s-i-tivt.. ,I.Dlec.e....._ Date.<1 '` a 1 1 1 This permit application expires if a permit is not obtained within 1.80 days after it has been accepted as complete. *Fee methodology set by'hi-County Building Industry Service Board. taildingkEtzmitsT1240-PamitApp.tioc 10,01111' 440-46t6T(10/021COMAVES) A. 1 City of Tigard lig " COMMUNITY DEVELOPMENT DEPARTMENT I TlGARD. Building Permit Review — Residential Building Permit #: `\-\ .--x- -c ct_0Jagt-{ Site Address: /6206 'fQ .--7-3ioi vjlj._ g+- Project Name: P6/�; n #- e ,4 Lot #: (New'e g=subdivision name;Addition or Alteration 1 st name of owner) Planning Review Pro osal: &te -F re Verify address/suite# active in Accela. In River Terr,ce: ❑ No 1a Yes,River Terrace Review Addendum Site lan Elements: 12 Erosion Control 3 opies of site plan on 8-1/2"x 11"or 11 x 17"paper D • .tained trees with drip line and tree protection measures R wn to scale(standard architect or engineer scale) VA Footprint of new structure(including decks)and FFE Forth arrow 101Uity locations&easements(required for new and additions) V}.tt address,project or subdivision name and lot number Sidewalk/driveway approach V. .plicant information(name and phone number) 1J I►,,-.lion of wells/septic systems rA Lot dimensions and building setback dimensions g yeet tree size,type and location It:: .re footage of buildings to be demolished 1,a,S pet names 9:.',-sting structures on site IIGCorner elevations(2'contours if more than 4'differ al) %Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? es ❑ im.- 'ous area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown?� es o 1\`IPk 1 an Water Services—Service Provider Le�tte of platted prior to 9/10/1995): equired: ❑ Yes,applicant was notified 1C1 No Received: ❑ Yes CI No iiPublic Facilitie provement(PFI) Permit: 4quired: Yes,applicant was notified ❑ No Applied For: Yes ❑ No,stop take ndUsdesCabse#: gtl 0/ LTJ Zoning: /2-1-2_ (' P equireetacks: Front: Rear: © Side: SSide: Garage: 37 wilding Height: Max. Height: Actual Hei ht:treet F Landscape Area: -20 % Lot Coverage Max: 0/0 Entrance n' ..- back no more than 8'from street-facing wall ❑ Parallel to street or offset 4 I. : ees or less Windows ❑ Minimum "°. .f area of all street-facing facades OK Garage ❑ Garage door is behin. - street-facing wall ❑ Y- ■ No,one of the following is met: ❑ Door extends no more than -•. wall and • a covered porch extending beyond garage. ❑ Door extends no more than 5'fro :1 . . -.-re is a 12 sq ft.window above garage on 2nd floor. ❑ Garage door width is ❑ ' . ess ❑ 50%or less o a : ❑ 60%or less and includes 7 of following: ❑ Covered .. - ■ Recessed entrance ❑ Wall offset • ' fp.f eave ❑ Roof offset ■ ..e shingles 1=1Lap Siding ❑ Roof pitch ❑ Gable,hip,or gam.r- •.f ❑ Dormer EIAccent siding eWindow trim ❑ Window recess ❑ Window projection E. ;alcony U;Tisual Clearance rban Forestry Plan // ,, JJ / ensitive Lands: Yes CI No Type: h-�1() '1/a�U Q /him j� '� 1� Conditions met prior to issuance of building permit Notes: Cl--Approved By Planning: -__ " ----- _,;(4,----- Date: 7//// , Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Forms\BldgPermitRvw_RES_022819.docx Building Permit Submittal Original Submittal Date: Ut Site Plans: # Building Plans: # Building Permit#: L/ Enter building permit#above. Workflow Routing: [Planning CR/Engineering ['Permit Coordinator Er.Building Workflow Sign-off: R"Sign-off for Planning(include notes from planning review) Route Application Documents: [Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. CYtuilding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: � Date: Engineering Review [? Slope at building pad: 0Z, ❑ Conditions "Met"prior to issuance of building permit %/s. R'Easements (encroachments)per engineering conditions of approval and plat water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 13'No Assess Water Quantity Fee in-lieu: ❑ Yes Er No LIDA Facility on lot: ❑ Yes E'No ["Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Er Approved by Engineering: Date: 7/,Ar/j5 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: 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: VDC Fees Entered: Wash Co Trans Dev Tax: 1-.13511›- Y s ''- + /A 11// Tigard Trans SDC: s ";;- /A Parks SDC: Q'Yes /A ^ LIDA ❑ Yes �N/A LOOK to Issue Permit Approved by roved Permit Coordinator: Date: 7- Z tq I:\Building\Forms\B1dgPennitRvw_RES_0228 19.docx City of Tigard g COMMUNITY DEVELOPMENT DEPARTMENT iMI TIGARD River Terrace Building Permit Review Addendum ® Building Permit #: t �•-C),YC"A ..4 Site Address: /eoe c ` / ()kNV,/l/ £:- Project Name: PO/,, " n 424- tO.gAc4_ piok Lot #: - (New d "v.g=subdivision name;Addition or Alteration=1st ame 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. Balcony w/ access 2 Window Projection Vertical Wall Offset a Porch min. 5 . deep Gabled dormer ft. deep min. 2ft., 5 ft.wide min. 2 ft. 6f de CI 111 2. Eyes on the street: a minimum of 1 % of each street facing facade must include windows or entrance doors. Percentage Shown: F:2( ' e g : 42 % 3. trances:At least one entrance must meet both of the folio ng standards: Max. 8 ft. setback from longes treet facing wall Parallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porch: Yes ❑ No If y ,all the following apply:G �sq.ft. min. Of rine street facing entry ft. max. roof above floor of porch T/ 5 ft. depth min. 30%min. porch roof coverage 4. etailed Design:All buildings shall includy min. of five of the following elements on all street-facing facades: d porch mi5 ft.wide x 5 ft. deep/ CI Recessed entry area min. 5 ft.wide x 2 ft. deep )allvereoffset mi . 16 n.inches ❑ ormer in. 4 ft.wide Roof eave min. 12 inch projectiot3�/poof offset min. of 2 ft. �� CI Roof shingles either tile or wood Gable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. 024orizontal lap siding min. 3-7 inches wide a CI Accent siding min. 40%of street facade 0Window trim min. 2 1/z"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. . : . •s and Carports: May face the front or side lot lin�czn a corner lot. Setbacks: No closer to front or side lot i -, ban longest street-faci g wall. ❑ Yes ❑ No. If No -c one): ❑ May extend up to 5 ft.if there is a covere. . t porch and garage do- •: extend beyond the front porch. ❑ May extend up to 5 ft.where the garage is part of a two :.*1 building and there is a window at the second story above the garage that faces the street with a '•. . ea of 12 sq.ft. Width: (Check one) ❑ 12-foot- .•- •.rage door ❑ 40%max. of street facade 1'/o max. of street façade with 7 detailed design elements Notes: Approved By Planning: .... . _ Date: VfdI:\BuildingFormsBldgPermitRvw_RESRT121417.docx o',.5\ \