Permit Plumbing Permit ApplicatiECEIVED
Building Fixtures
Cityof Tigard DEC 15 2020 Re ive \2 ZZ\ZOZA \1V 1 Permit No.: Ytr2Q'V W\ _
It 13125 SW Hall Blvd.,Tigard,OR 97223 Reced
Plan Review
Phone: 503.718.2439 Fax: 503.598.1 ao G Other Permit No.:
Inspection Line: 503.639.4175
�PfY OF TIGARD Date,By: 1 6 A (n
t-I 6i1 R!) Date Ready/By: B See Page 2for
Internet: www.tigard-or.gov BUILDING DIVISION - I Noll fied/Method:0 / , O �' Supplemental Information
TYPE OF WORK 1•`EE* SCHEDULE
[ New construction ❑Demolition For special information use checklist
Description I Qty. 1 Ea. [ Total
❑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
I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( .ft.)\\to 8 Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: \I-A LC C4,�� �' Vl D -3 '1 "ve�rL�c Q, Catch basin or area drain 18.76
ty IA( E i) '?,Z0- FootingDrywel railean(h line,netrenchdrain 1ge2
.76
City/State/ZIP: f S1C (�\
drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:f 1 Project name: �,l V`(k �7„^�j \A Manufactured home utilities 50.03
Cross street/directions to ob site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
�7 Water service(no.linear ft.:_) Page 2
Subdivision: �s �
1 E is �(� q1 : Lot no.: J Fixture or item:
Tax map/parcel no.: ^ Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
`.'c Q,,cva • QA c -Lc Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
El APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$_) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25-02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax:: ( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: UUF,kcjyv,Qf\# 1,\ciQ& \,1,,k ( cak
(�
V'eJ �a
Water piping/DWV 56.29
Address: ic-q w R(_1 V)c C-c d-03..q L1 c' , ci, Other: 25.02
City/State/ZIP: <A lcuc`a4� o, Q a__- (T'.>i f Subtotal
/ Minimum permit fee: $72.50
Phone:(��)`9 (O(c�I 1�� Fax:(tap.) (( ��'it
CCB Lie.: Ut 7 7 2� lumbing Lic.no.:L(e.n2`t T b Plan review (25%v of permit fee)
State surcharge(12/o of permit fee)
Authorized si e:
aj�t\ (� _ TOTAL PERMIT FEE
Print name: \ \aS^ C Date:V 7I V.k 1�lb This permit application expires if a permit is not obtained within 180 days
a 1 ` L l �l }i✓✓ after it has been accepted xs complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permirs\PLMU-PenntApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
�
CITY OF TIGARD MASTER PERMIT
' . COMMUNITY DEVELOPMENT Permit#: MST2020-00156
TtGAR o 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/24/2020
Parcel: 2S107AA08800
Jurisdiction: Tigard
Site address: 14470 SW GOLD COAST TER
Subdivision: ROSHAK RIDGE Lot: 88
Project: Polygon at Roshak Ridge, Lot 88
Project Description: New SFA
BUILDING
Floor Areas Required Setbacks Required
Stones: 3 Bedrooms: 2 First: 44 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 35 Bathrooms: 3 Second: 562 sf Garage: 500 sf Front: 8 Smoke
Dwelling Units: 1 Third: 562 sf Right: 0
Detectors: Yes
Total: 1168 sf Value: $169,152.92 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: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 3 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 add!500 sf: 2 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description:
Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA VB R-3 1168
Owner: Contractor:
POLYGON WLH LLC POLYGON WLH,LLC 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: PHONE: 360-695-7700
FAX: 360-693-4442
Total Fees: $25,262.57
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1,800,332.2344.
Issued By: t/20.,..14.\-(k.) l G l S• Permittee Signature: aP�� (Ca ��6�
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
or%This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application LCrit gZp
Residential _.% I .yi I"` L� FOR OFFICE USE ONLY
City of Tigard R Date Beceived., Q$-/3-Z02U if r _
14 • 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 3 202G Plan Review �� t) :�
C` Phone: 503.718.2439 Fax: 503.598.1960Di, „Ir Date/B : /, dl Other Pe .tt;�
Inspection Line: 503.639.4175 `1 (� th' k- Date Ready/By: tom: ® See Page 2 for
TIGARD Internet: www.tigard-or.gov �..'.1iNG FJ Iv C`,P )'N.,° Notified/Method: t' yet tir Supplemental Information
(3'-7 4-7 c . 7 .-t -;2 -
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ \ 1 I .52--
® 1-and 2-family dwelling 0 Commercial/industrial
ElAccessory building 0 Multi-family Number of bedrooms: 'L
❑Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 3 11�� ,le(e`g
Job site address: t 91410 ( p� (I_Dgg toe New dwelling area: square feet 02
JJJJ
City/State/ZIP:Tigard,OR 97224 Garage/carport area: -1116. square feet 5(2 2..Suite Bldg./apt.no.: Project name:Roshak Ridge Covered porch area: square feet 4L
Cross street/directions to job site: Deck area: -la square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Roshak Ridge Lot no.: *Viik 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.: OP 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
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Polygon WLH,LLC Type of construction:
Address:703 Broadway St.,Ste 510 Occupancy groups:
City/State/ZIP:Vancouver WA 98660 Existing:
Phone:(360)695-7700 Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer tofee schedule)
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Tonja Morris
FLS plan review fee(if applicable):
Address:703 Broadway St.,Ste 510
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:permitsubmmittais®polygonhomes.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:Polygon WLH,LLC 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/Zit':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.:204238 Total fee due upon application: $201.60
k This permit application expires if a permit is not obtained
Authorized signature:
within 180 days after it has been accepted as complete.
Print name:Tonja Morris Date:04l17/2019 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Petmits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
' Mechanical Permit Application FOR OFFICE USE ONLY
City ofTi and Fi I\iE Received MSr'2.O'A�IS�
g 4 Date/By: Permit No.:
... 13125 SW Hall Blvd.,Tigard,OR 97223
q(� Plan Review
' • Phone: 503.718.2439 Fax: 503.598.1960 FEB 3 2020 Date/By: Other Permit:
1.I ii r<I_t-[ Inspection Line: 503.639.4175 Date Ready/By: 7uria 0 See Page 2 for
Internet: www.tigard-or.gov CITY OF^t'(`5AC=�.y Notified/Method: Supplemental Information
TYPE OF WORK f S COMMERCIAL FEE* SCHEDULE USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑ Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition E Other: mechanical materials,equipment,labor,overhead,and profit.
---- Value:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
ut� Air conditioning 46.75
Job site address: 1 t-1-1a Grx..0 T�i
v(ti pp s3-� �� Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 �^ Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Roshak Ridge 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 23.32
Other: 23.32
Subdivision:Roshak Ridge Lot no.: 11
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
equipment 33.39
Address:703 Broadway St.,Ste.510 Clothes dryer exhaust 33.39
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32
7,2 APPLICANT El CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Polygon WLH,LLC
$14.15 for first four;S4.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax: :(360)693-4442 Fireplace
Range
E-mail:per mils ubmittalsCr poly gonhomes.com Barbecue
' t CONTRACTOR Clothes dryer(gas)
Business name:Pro Heating&Cooling Other:
MECHANICAL PERMIT FEES*..
Address: NW Alociek Dr,Ste.1104 Subtotal
City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee)
CCB hc.:209001 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Q��� �L days after it has been accepted as complete.
Authorized signature: `'^ (�'nn �V • Fee methodology set by To-County Building Industry Service Board
Print name:Elia Duran Date:04/08/2019
IABuilding1Permits\MEC PermiApp_040113.doc 440-46I7T(11/O2/COM/WEB)
Electrical Permit A licatto a�a V E I) FOR OFFICE.USE ONLY
Received �A
City of Tigard DateB Permit#: a r��Q�.
'I 13125 SW Hall Blvd.,Tigard,OR 97223 F_a 3 2 plan Review Related Permit#:
Phone: 503.718.2439 Fax: 503.598.1960 Date/B :
Inspection 503.639.4175 �� �7h1
Ins l M ttt'T) Ready Date/By: kris: 0 See Page 2for
TIGARD p r
c Internet: www.tigard-or.gov -i;'t Notified/Method: Supplemental Information
TYPE OF WORK ; .,;-1'LA14 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.
❑Demolition 0 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.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE.IIVFO11MATI0N-AND LOCATION<-:i 0 Emergency system. larger separately derived
k Litr1D ((bLQ C�ttiT 1N B ❑100PAddition mf ores motorload of system.
Job#: Job site address: l/ .t�-�' 10ollP or more. ❑..A,,..`E'.,"]_z,,..y-3,,,
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
0 Health-care facilities. Ef Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Polygon At Roshak Ridge D Hazardous locations. ❑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 1 "
New residential single-or multi-family dwelling unit
Subdivision:Polygon at Roshak Ridge Lot#: gt 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 mergy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft)
.. . . . Renewable Energy ❑-See Page 2
®.PROPERTY.tiVVNER'- . . ❑ 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
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 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
fee
Address:703 Broadway St Suite 510 servicer co r der fee,first 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 67.84 2
dwelling, orviceand/or feeder
Email:permitsubm Reconnect econ nnee t
Recct 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 ❑ 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 •
Indushialplant(lhrmin) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: 48715 specifically listed(h hr min)
. • ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Kile Rood Date: 03/08/2019 ❑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 obtained within 180
Print name: Kile Rood Date: 03/08/2019 days after it has been accepted as complete.
* Number of inspections allowed per permit.
' • Plumbing Permit Applicatiu IA-p
Building Fixtures _.6�/ ~'` FOR OFFICE USE ONLY
- City of Tigard FEB 3 ZU2U Received Permit No.:M O�Ob/5or
w 13125 SW Hall Blvd.,Tigard,OR 97223 P1 B. :
IN -.Ali r - Plan Review
Phone: 503.718.2439 Fax: 503.59$f1 15 F ,! rGAl El, Date/By: Other Permit No.:
T I GARD Inspection Line: 503.639.4175 < ;�•t ,r r!-v f r s' ;. Date Read /B
Internet: www.ti and-or. ov ' ' '.,11 y y. funs: El See Page 2 for
g g Notified/Method. Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist
Description Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSI RUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
ElAccessory building El Multi-familySFR(3)bath 500.32
Each additional bath/ldtchen 25.02
❑Master builder ❑Other:
Fire sprinkler(_sq.ft.) Page 2
JOB SIl'E INFORMATION AND LOCATION Site utilities:
Job site address: (4410. (�A Czy s-c 'r' Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:_) e Pa 2
g
Suite/bldg./apt.no.: I Project name:Roshak Ridge 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:Roshak Ridge Lot no.: TS Fixture or item:
Tax map/parcel no.: Baekflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
C,I �� V 1 ' � �` Clothes washer 25.02
� Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:Polygon WLH,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:703 Broadway St.,Ste 510 Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Polygon WLH,LLC Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Tonja Morris
Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
E-mail:permitsubmittals®polygonhomes.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Alliance Plumbing Water piping/DWV 56.29
Address:146 W Historic Columbia River Hwy Other: 25.02
City/State/ZIP:Troutdale,OR 97060 Subtotal
Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:184601 Plumbing Lie.no.:PB732
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Robert Dishman Date: 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.
L\Building\Permits\PLMti-PermitApp.doc 10/01/09 44046 I6T(10/02/COM/WEB)
City of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT •
II
TIGARD Building Permit Review — Residential
Building Permit #: M 8TWZO -001 S(0
Site Address: -DO I 2i �fia7C-?
Project Name: ged en < , L, je4 ( Lot #: 80—
Planning Review
Pro• I sal: �.(9/,0 Q
IVA Verify address/suite# active in Accela. trai In River Terr.ce: ❑ No Yes, River Terrace Review Addendum
Sit: Ian Elements: .I Erosion Control
IIII..„copies of site plan on 8-1/2"x 11"or 11 x 17"paper IV r-rained trees with drip line and tree protection measures
awn to scale(standard architect or engineer scale) !F otprint of new structure(including decks)and FFE
• ► .rth arrow l2 ty locations&easements(required for new and additions)
Vi a address,project or subdivision name and lot number ►,Sidewalk/driveway approach
VJ plicant information(name and phone number) �1 i; anon of wells/septic systems
L. dimensions and building setback dimensions S eet tree size,type and location
1\is.uare footage of buildings to be demolished l 'S)tet names
n1 ',.sting structures on site '[Comer elevations(2'contours if more than 4'differ tial)
• .t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 'es ENy
impervious area(applicable if R-7,R-12,R-25&R-40) If es,is a storm water .uali facili ' shown i i1' ■Yes o
al Clean Water Services—Service Provider Lett platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified Del No Received: ❑ Yes ❑ No
\Water Meter Fixture Unit Worksheet—Addis,Remodels and ADUs
Required: ❑ Yes,applicant was notified 44 No Received: ❑ Yes ElNo
,, 0" , ill Exemption for ADU applied for: ❑ Yes ld No Received: ❑ Yes ❑ No
It Public Faciliti(Improvement (PF1) Permit: ,�
quired: Yes,applicant wasg notified 0 No 2 Applied For: �r7L�J Yes ❑ No,stop intake
".2 and Use Case#: S�+J QfA� 00 tlG j oning: (�C_-12
quired Setbacks: Front: Rear: l Side: _ Street Side: 4)e—' Garage:/'
ding Height: Max. Height: / Actual Hei hr.—
Landscape Area: -20 % 0 Lot Coverage Max: 0/0
Entrance et back no more than 8'from street-facing wall 0 Parallel to et or offset 45 degrees or less
Windows D minim %of area of all street-facing facades\'{a/
Garage ❑ Garage door is be ' ' est street-facing wall ��11 Yes ❑ No,one of the following is met:
O Door extends no more 'from wall ere is a covered porch extending beyond garage.
❑ Door extends no more than 5' and there is a 12 sq ft.window above garage on 2"d floor.
0 Garage door width is 0 'or less ❑ 50%o of facade 0 60%or less and includes 7 of following:
O Covered po Recessed entrance 0 Wall o s ❑ 1'Roof eave 0 Roof offset
❑ Fir ' gles 0 Lap Siding ❑ Roof pitch ❑ Gable, mbrel roof 0 Dormer
Accent siding Window trim ❑ Window recess ❑ Window ' ction ❑ Balcony
II
A! Visual Clearance 1LJ Urban Forestry
0 nsitive Lands: 0 Yes No Type:
Conditions met prior to issuance of building permit
No s:
Approved By Planning: Date: 400/-2 0
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Fors\B1dgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 02 O3-Z020
Site Plans: # 3
Building Plans: # 3
Building Permit#: [ Enter building permit#above.
Workflow Routing: CfiPlanning O'Engineering l Permit Coordinator l�Building
Workflow Sign-off: 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.
C-Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: 06-15-2121)
Engineering., Review
LW-Slope at building pad: .d�
LAY Conditions "Met"prior to issuance of building permit "i/./
gr Easements (encroachments)per engineering conditions of approval and plat
A.-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: El Yes a"No
Assess Water Quantity Fee in-lieu: ❑ Yes Ia(No
LIDA Facility on lot: El Yes Ai\io
❑ Final Plat Recorded:
El NOT Approved by Engineering: Date:
Notes:
E Approved by Engineering: Date: .Sl4/ 2d
l
Revisions(after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: El 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:
SDC Exemption: ❑ Received Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: ,i Yes ❑ N/A
LIDA ❑ Yes 1g N/A
fl OK to Issue Permit
Approved by Permit Coordinator: / i(� Date: 5119 120
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
i , .
City of Tigard
71 1
r COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G n R D River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: �L1y .Q y D/ � - - rr�6(
Project Name: �d/ „aile,A.,/ e,\ Lot #: j
(New dweiir f subdivision name;Addition or Alteration= t name of owner)
Planning Review of River Terrace Plan Dist ' t Design Standards (18.640.070.I.):
Is the project subject to the plan district design standards? IUi'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/ a ss 2 Window Projection Vertical Wall ffset a
Porch min. 5�f deep ft. de min. 2ft.,5 ft.wide min. 2 ft.,6fywide Gabled dormer
0
0
2. Eyes on the street: a minimu of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: t,0
1trances:At least one entrance must meet both of the follog standards:
Max. 8 ft. setback from longes street- facing wall �' Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: Yes ❑ No
If y s,all the following apply: s .ft. min.
e street facing entry 1 max.roof above floor of porch
5 ft. depth min. 30%min.porch roof coverage
4. et !ailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
overed porch min. 5 ft.wide x 5 ft. deep f 0 Recessed entry area min. 5 ft.wide x 2 ft. deep
ialliyall offset min. 16 inchesc p 0 Dormer min.4 ft.wide
1� Roof eave m /r
in. 12 inch projectionc1v` ❑ lj,eof offset min. of 2 ft '/ `r
0 Roof shingles either tile or wood I� le,hip or gambrel roof design i
❑ of pitch oriented south min. 500 sq. ft. rdzontal lap siding min. 3-7 inches wide --
14 Accent siding min.40%of street facade f [ Window trim min. 21/2"wide by 5/8" deep
O `,indow recess min. 3 inches for all street facing 0 Bay window min. 5 ft.wide by 2 ft. deep
P. Balcony min. 5 ft.wide x 3 ft. deep with inside accessl.- 0 Attached garage is 35%or less of street facade
5. Garages and Carports:May face the front or side lot line on a corner lot.
Setbacks:
No closer to front or side lot line,than longest street-facing wall. Yes 0 No. If No (Check one):
O 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 - garage that faces the street with a min. area of 12 sq.ft.
Wi. .1: (Check one)
II. 12-foot-wide garage door 0 40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: f .11&- Date:
I:\Bui1dmg\Forms1BldgPamitRvw_RES_RT_121417.docx