Permit Plumbing Permit Application Building Fixtures RECEI tl`r
ECFOR OFFICE USE ONLY
City of Tigard Date/Vyd
: �- WI Msz�7.0- 55
Date/By: ,Z ZZ -WWI Penult DOS
13125 SW Hall Blvd.,Tigard,OR 97223 DEC 15 2020 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By. I /61 De'1I AC� Other Permit No.:
Inspection Line: 50d-orgov CITY OF TIGARD y: r 61 See Page 2 for
TIGARD Date Rea tB . '1
Internet: www.tigaid-orgov Notified/Method:I ,t!' �/'1, ,� Supplemental Information
TYPE OF WORIBUILDING DIVISION ° FEE* SCHEDULE
I�1 New construction ❑Demolition Far special information use checklist
'' \ Description r Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
XI-and 2-family dwelling ❑Cotumercia]/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kit hen 25.02
❑Master builder ❑Other: Fire sprinkler ,ft.)\:3 BS Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: \L(Z,� ..i 0... .0 Gc41) !s�.��jv ` Auli,� Q_ Catch basin or area drain 18.76
�t-� ,�n1� �(jnl n 1,� Drywell,leach line,or trench drain 18.76
City/State/ZIP: t\�-]r7i31 . -- `?1-L��F
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: a
�� � ��`)z.,,k _ 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
J ,I Storm sewer(no.linear ft.: ) Page 2
Subdivision: G ) I FL .s:JiZ r C S. I 1,A Water service(no.linear ft.:_) Page 2
-, L � I J+vµ l Lot no.: `� 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
A OW-) C.i \k � ) Drinking fountain 25.02
111 �- � Ejectors/sump 25.02
0 PROPERTY OWNER 0 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
0 APPLICANT 0 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: '�oid...;y,\,>Q',)‘ ()v.•'(-WA L,L C3\Co.
Water piping/DW V 56.29
Address: ,p. W kli;S'U1C.,e_CJ ti�1'�1b1 to Q` z_ `,` 'l . Other: 25.02
City/State/ZIP:'Qc. ,Kato_ (1'f Subtotal
Phone:(j) IovUq_ -.101 Fax:Ia.).-5)(6-40-4 G1`NCI( Minimum permit fee: $72.50
CCB Lic.: k,.2,'Z'7('� Plumbing umg Lic.no.: '1 _ �'1Qb
Plan review (25%of permit fee)
__________
`*`�-J{,Avp` P State surcharge(12%of permit fee)
Authorized si a e. l ,, TOTAL PERMIT FEE
Print name: ik w�( Date: ri,1 1CIj,l-O 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:lBuilding\PermitstPLMu.PermitApp.dot 10/01/09 440-4616f(10/02/COM/WEB)
74CITY OF TIGARD MASTER PERMIT
`°'! 2 :' COMMUNITY DEVELOPMENT Permit#: MST2020-00155
. 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/24/2020
T E{aAR L3 Parcel: 2S107AA08700
Jurisdiction: Tigard
Site address: 14474 SW GOLD COAST TER
Subdivision: ROSHAK RIDGE Lot: 87
Project: Polygon at Roshak Ridge, Lot 87
Project Description: New SFA
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 76 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 35 Bathrooms: 3 Second: 675 sf Garage: 604 sf Front: 8 Smoke
Dwelling Units: 1 Third: 637 sf Right: 0
Detectors: Yes
Total: 1388 sf Value: $203,891.48 Rear: 5
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 0 Storm Sewer: 100
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0 I
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywall-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 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
in
Other: N Other Description: Ecompas 9: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA VB R-3 1388
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: $26,447.67
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 952-001-0090.1- `Yol/u�'m'ay obtain a copy of the rules or direct questions to OUNC by calling(5003�232.1987 or 1.800.332.234444..
Issued By: ' J 1 `lam W�'ed,L.� Permittee Signature: ul t � � "
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.
,... • L e" I-- LOT E37 ,2/,/,,
Building Permit Application3wi r?,,i 4 >w.
Residential FEB 3 2020 FOR OFFICE USE ONLY
Received, 7^
Cityof Tigard n �- F r f`^ (p / ZOZD Permit No. fX - I
14 g ,,c a�i J r i�v1r1 Dan Rev
• 1honeSW Hall
8.2439 Fax: OR +4`tt4 ll ��-. rr�� 1S ?7�` Plan Review /- n�„ (ji/�'�' 17�O0II
Phone: 503.7182439 Fax: 503.5 9W1 ,� ,r��y�" DateBy: l/ !N(i" fill. ONerPe" "t„ V
T I G AR D Inspection Line: 503.639.4175 Date Ready/By: ram: H See Page 2 for
Internet: www.tigard-or.gov NotifiedMethod// jam ,t;90 Supplemental Information
P1 i,9-7_ J Td Ak7? -
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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF C ONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercialindustrial Valuation $ 9763/ S41 1
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other Number of bathrooms: 3
of floors:
number oors:
JOB SITE INFORMATION AND LOCATION Total � 11q 1
Job site address: I dwelling area: ■
4'ly (�ocA Co�S`r T�2 2 New (...o ►r - square feet 1Q3-7
City/State/ZIP:Tigard,OR 97224 Garage/carport lea: it,• .. square feet k.2,5
Suite/bldg./apt no.: 1 Project name:Roshak Ridge Covered porch area: square feet 7(Q
Cross street/directions to job site: Deck area: 'l2 square feet
O e n pre3,re , C 1`„square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Roshak Ridge Lot no.: irl 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
tit, 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 ❑ 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 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee 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::( )
E-mail:permitsubmmittals@polygo¢homes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*.
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic 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/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $I80.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lie.:204238 Total fee due upon application: $201.60
Authorized signature: ` This permit application expires if a permit is not obtained
within 180 days after It has been accepted as complete.
Print name:Tonja Morris Bate:04/17/2019 *Fee methodology set by Tn-County Building Industry
Service Board.
' T\Rnildino\Pertnitc\RTTP-RFSPrrmitAnn dnr. 12/24/2011 440 4613TO 1/02/COM/WEB�
r
Mechanical Permit Applicati F ('r.-- 11 is FOR OFFICE USE ONLY
City of Tigard Received M ST2020. )01,55
Date/By:
No.:
'! 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 3 2020 plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B Other Permit:
Y I:.+r I,I i Inspection Line: 503.639.4175 t o -FY OF 3!UNR L,)
Internet: www.tigard-or.gov t s Date Ready/By: hnh 0 See Page 2 for
31_111 nINC;DIViSl(a? Nonfied/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST.
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
of 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist
Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
3013 SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: tLtt414 LjcU &AS 'I-4_44_ Furnace 100,000 BTU(ductsivents) 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
^7 Other: 23.32
Subdivision:Roshak Ridge Lot no.:
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
El PROPERTY OWNER 0 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
® APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Polygon WLH,LLC
$14.15 for first four;$4.03 for each additional _
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
Wal1/suspended/unit beater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax: :(360)693-4442 Fireplace
Range
E-mail:permitsubmiitals@polygonhomes.com Barbecue
AA\ 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(590.00)
Plan review(25%of permit fee)
Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee)
CCB lic.:209001 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Ai days after it has been accepted as complete.
Authorized signature: ' ' • Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:04/08/2019
I:1Building\Pennds\MEC_PermitApp 040113.doc 440-4617T(11/02/COM/WEB)
•
Electrical Permit A licati n FOR OFFICE USE ONLY
- City o Tigard FEBReceived iv1ST,_020-w
`'r g L `3 2020 Date/By: Permit#: �-V
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598,1960 - 11 + i i Date/By: 155
Related Permit#:
TIGARD Inspection Line: 503.639.4175 ' i l� i {''' `-i' Readybate/By: Janis: El SeePage2for
c Internet: www.tigard-or.gov IdotiSed/Methed: Supplemental Information
TYPE OF WORK PLAN,REWEW „
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more ❑Building over three stories.
0 Demolition ❑Other
• where the available fault current 0 Marinas and boatyards.
CATEGORY._OF.-CONSTRUCTION_ - ,_ exceeds 10,000 snaps at 150 volts or ❑Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other. ❑Fire pump. ❑Installation of 150 KVA or
JOB SITEtirINFORMATION"AND LOCATION ❑Emergency system. larger separately derived
'r 14� ,3 N ^ �r a` g ❑100 Addition of new motor load of system.
Job#: Job site address: —1 11•1•l.Js.++ 1 Geri- IooEiP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. Cr Recreational vehicle parks.
Suite/bldg./apt#: _ Project name:Polygon At Roshak Ridge 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. 1 Each I Total
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: 46.1 . 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 75.00 2
(with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
®•PROPERTY OWNER ❑ TENANT Renewable Energy ❑ See Page 2
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
Address:703 Broadway St Suite 510 service or feederfee,first
br ananch 56.18 2
circuit
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,service and/or feeder
Email:permitsubmittals@polygonhomes.com 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
Inspections for which no fee is 90.00/hr
CCB Lic.: 199188 Electrical Lie.: c923 Suprv.Lie.: 487$ specifically listed 01 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):
f�- State surcharge(12%of permit fee):
Authorized signature: ,(� 7�/ __.-V TOTAL PERMIT FEE:
'^ Date: 03/08/2019 This permit application expires if a permit is not obtained within 180
Print name: Kile Rood _ days after it has been accepted as complete.
_ • Number of inspections allowed per permit
I:tBuildine\Permits\ELC PamitAsr ELR ERE.doc Rev 06/172015 4aM(.15711iflt/Cr1M/WF11
e
Plumbing Permit Application
°°
RE.0
Building Fixtures `.�,R /a .,i, FOR OFFICE USE ONLY
Cltr,of Tl and Received
rt ``r g FEB 3 202C Date/By: Permit No.:�STWW-011�
1111 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review vv
m Phone: 503.718.2439 Fax: 503.598 960Date/By: Other Permit No.:
Inspection Line: 503.639.4175 ' ) 1.ri r-,' Re
T I GARD Date Ready/By: Inds: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist
Description 1 Qty. Ea. Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
1CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building ®Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder El Other: Fire sprinkler( sq.ft.) Page 2
k la , 3
, JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: I, f 414 @tcU e�`pgT �Q,, 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.:_) Page 2
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
Q Water service(no.linear ft.:_) Page 2
Subdivision:Roshak Ridge I Lot no.: 51 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
On � � �, Clothes washer 25.02
V 11\J 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 dtain/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 Ur nal 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
CCB Lic.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee)
State surcharge(12%of petmit fee)
Authorized signature: TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days
Print name:Robert Dishman Date: after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permit PLMU-PermitApp.doc 10/01/09 4404616T(10/02/COM/WEB)
i
City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
III 11
T I G A R D Building Permit Review — Residential G d /
Building Permit #: fST2OZO-DDl 55
Site Address: /�19"f �� /? oat-)L �fr�C'.e
Project Name: ,vNAn /-e-CL,C , -e- Lot #: _ g 71--
Planning Review
Pro. 1 sal: iii),/,1 J
Ir.' Verify address/suite# active in Accela. IZi In River Te .ce: ❑ No Yes, River Terrace Review Addendum
Sit- 'Ian Elements: a Erosion Control
Yopies of site plan on 8-1/2"x 11"or 11 x 17"paper N!r --Mined 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
15 .rth arrowty locations&easements(required for new and additions)
12,,Site address,project or subdivision name and lot number Sidewalk/driveway approach
VII plicant information(name and phone number) II�: ation of wells/septic systems
dimensions and building setback dimensions !S eet tree size,type and location
uare footage of buildings to be demolished VS,ratet names
sting structures on site VComer 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? IVI es ON
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water .uali facili -shown j , ■Yes . o
r
1 Ill Clean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
i WWater Meter Fixture Unit Worksheet—Addis,Remodels and ADUs
Required: ❑ Yes,applicant was notified lQ No �� Received: ❑ Yes ❑ No
\ 110 ,BC Exemption for ADU applied for: ❑ Yes td No Received: ❑ Yes ❑ No
M1 Public Facilitis(Improvement(PFI) Permit:
quired: ( Yes,applicant was notified ❑ No A..lied For: L/J Yes ❑ No,stop intake
i2: and Use Case#: Se/.asQO/.c= LX 0O l► j oning: k.�
quired Setbacks: Front: g Rear: � 11 )) Side:_C/ Street Side: ' Garage: foe
ding Height: Max. Height: gv/ Actual Hei
ht:—
Landscape Area: —26) % ❑ Lot Coverage Max: rit/
Entrance et back no more than 8'from street-facing wall ❑ Parallel to et or offset 45 degrees or less
Windows ❑ Minim %of area of all street-facing facades
Garage ❑ Garage door is be ' widest street-facing wall V Yes ❑ No,one of the following is met:
❑ 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 2nd floor.
❑ Garage door width is ❑ ' r less ❑ 50%o of facade ❑ 60°/u or less and includes 7 of following:
❑ Covered por Recessed entrance ❑ Wall o s ❑ 1'Roof eave ❑ Roof offset
❑ Fir ' gles ❑ Lap Siding ❑ Roof pitch ❑ Gable, ambrel roof ❑ Dormer
Accent siding , Window trim �'� ❑ Window recess ❑ Window ' ction CI Balcony
Visual Clearance VJ Urban Forestry]Iran
4"` nsitive Lands: ❑ Yes No Type:
Conditions met prior to issuance of building permit
No s: C
Approved By Planning: \, Date: 4///U/-2 G
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
1`_1Building\Forms\B1dgPermitRvw RES 122419.docx
•
Building Permit Submittal
Original Submittal Date: 02-03-2020
Site Plans: # 3
Building Plans: # 3
Building Permit#: [ Enter building permit# above.
Workflow Routing: 2"Planning 11' Engineering LI Permit Coordinator 12'Buulding
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.
Building: original permit application,site plans,building plans,engineer and
beam calculations Id trust details,if applicable,etc.
Notes:
By Permit Technician: i7/��� _ Date: e✓$-/3 Z020
En,ineering Review
It S�pe at building pad: Z®P
Conditions "Met"prior to issuance of building permit 'V l,
y,r Easements (encroachments) per engineering conditions of approval and plat
[ater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: E Yes No
Assess Water Quantity Fee in-lieu: ❑ Yes ( No
LIDA Facility on lot: E Yes
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
'Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
X 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 X Does not apply
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ,, Yes ❑ N/A
Tigard Trans SDC: I Yes ❑ N/A
Parks SDC: Yes 0 N/A
LIDA 0 Yes X N/A
OK to Issue Permit
Approved by Permit Coordinator: f v c Date: 61 ill 1°
1:\Building\Fonns\BldgPermitRvw RES 122419.docx
- -
, •
City of Tigard
IIII COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: 11/1791 .L) c4/ O -C4 .-7- 1��el
Project Name: aD04 ,e>7 . 2 J e/ Lot #: g�
(New dwe subdivision name;Addition or Alteration= t -
name of owner)
Planning Review of River Terrace Plan D-i styiet Design Standards (18.640.070.I.):
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 wss 2 Window Projection Vertical Wall ffset a
Porch min. 5 deep ft. de min. 2ft., 5❑ft.wide min. 2 ft.,6f wide Gabled dormer
2. Eyes on the street: a minimu of 12%of each street facing facade must includ windows or entrance doors.
Percentage Shown: /2°A)
3.jtrances:At least one entrance must meet both of the follo g 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 0 No
If y s,all the following apply: V475 s .ft. min.
e street facing entry 1 t max.roof above floor of porch
5 ft. depth min. 30%min. porch roof coverage
4. etailed 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 0 Recessed entry area min. 5 ft.wide x 2 ft. deep
lYall offset min. 16 inches p S 0 Dormer min.4 ft.wide
1a Roof eave min. 12 inch projection /� ) ❑ of offset min. of 2 ft.
0 Roof shingles either tile or wood le,hip or gambrel roof design'/ j-i--
❑Ioof pitch oriented south min. 500 sq. ft. (� nzontal lap siding min. 3-7 inches wide
14 Accent siding min. 40%of street facade Lld'Window trim min. 2 '/"wide by 5/8" deepfM
❑ window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
1/, Balcony min. 5 ft.wide x 3 ft. deep with inside access'. 0 Attached garage is 35%or less of street facade
5. Garages and Carports:May face the front or side lot line on a corn r 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.
0 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.
Wid : (Check one)
12-foot-wide garage door ❑ 40%max. of street facade
O 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: V/�i - Date: � /A.
1:16uildmg\Forms 1Bld5PormitRvw_RES_RT_121417.docx