Permit CITY OF TIGARD MASTER PERMIT
•' COMMUNITY DEVELOPMENT Permit#: MST2020-00312
T t G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/23/2021
Parcel: 2S107AA24000
Jurisdiction: Tigard
Site address: 16920 SW ROCKHAMPTON LN
Subdivision: ROSHAK RIDGE Lot: 240
Project: Polygon at Roshak Ridge, Lot 240
Project Description: New detached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1248 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 29 Bathrooms: 3 Second: 1694 sf Garage: 486 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2942 sf Value: $383,960.10 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: I Water Lines: 100 Catch Basins: 0
Bckfiw 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: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodsloves: 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'I 500 sf: 5 201-400 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 2942
Owner: Contractor:
POLYGON WLH LLC WLLIAM 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: PHONE: 360-695-7700
FAX:
Total Fees: $42,797.58
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: '{O 4 17V� Prk1PoC Permittee Signature: O w A r71pUca t'wn
Call 503.839.4175 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 (= O 13-1103120
Residential RECEIVED FOR OFFICE USE ONLY
Received �r /vim
City of Tigard VOV 0 3 2020 Date/By: ``1 I'l 1�� Permit No. S�(.OZ. OD 2.
114 _� 't 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Rev ew�� ��� 'Z.d
Phone: 503.718.2439 Fax: 503.598. Date/By: Other Permit -�\1l
'dal—OF TIGARD
TIGARD Inspection Line: iO3.639.4175 Due ReadyBy: ) 1 9�' Iur ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: f�/2�/ c.ts ltd. Supplemental information
E-1''I 1I t-- 7Z'N✓.7--
Tl'PE OF WORK t REQUIRED DATA: I-AND 2-FAMILY DWELLING
® New construction ❑ 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
(A'FEfiORY OF I STRUCTION work indicated on this application.
❑ Valuation: $ 3�j3r 11,0
® 1-and 2-family dwellingCommercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:5
❑ Master builder El Other:
Number of bathrooms:3
.IOB SITE INFORMATION' AND LOCATION TION Total number of floors:2 347-
Job site address:16920 SW Rockhampton Ln New dwelling area: 2942 square feet\V19
City/State/ZIP: Garage/carport area: 486 square feet atfs
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REOt IR1/D DATA:COMMERCIAL-
Lot Polygon at Roshak Ridge Lot no.: Permit fees*are based on the value of the work pe ormed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
11$1 i t `t,: ^ ` work indicated on this application.
Plan 5A Valuation: $
I Existing building area: square feet
New building area: square feet
0 PRO RTY OWNS ❑'; !Vim- Number of stories:
��Ur�r � � � ram
Name:Polygon Homes WLH LLC Type of construction:
Address:703 Broadway St., Ste 510 Occupancy groups:
City/State/ZIP:Vancouver, WA 98660 Existing:
Phone:( )360 695-7700 1 av( )360 693-4442 No,,,:
PI APPLICANT D CONT&(T PERSON BL-ILD Ni f1'T FEES*
,II 11 t (Pt P ' I chedule)
Business name:Polygon Homes 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: :( )360 693-4442 , 411 .,:
PIIO CO VOLTAIC SOLAR RA !
E-mail: rCommercial and residential
ve
oof-top mounted PhotoVoltaic SoPartPaneltSyst installation
CON I RAC FOR pSystem.
Business name:Polygon Homes 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 Specially 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 lie.:207247 Total fee due upon application: $201.60
Authorized signature: 7g, z. 94A,� This permit application expires if a permit is not obtained
owithin 180 days after it has been accepted as complete.
Print name:Tonja Morris Date:10/21/2020 *Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building1 Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
,' Mechanical Permit Applicati EQ OFFICE USE ONLY �,"
F D Received n. ..-..,. ., .
City of Tigard Date/By:
Perni:No•:
'l 13125 SW Hall Blvd.,Tigard,OR 97223 _NO V A , �O to Plan Review
' 1 Phone: 503.718.2439 Fax: 503.598.19fi0other Permit;PAST PanRv M Zap'Ott'312
Ytir It 1) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: 7aru: El See Page 2for
Internet: www.ngard-or.gov Notified/Method: )Q-
[ UiLDINC DIVISION i �QQ Supplemental Information
TYPE OF WORK CO INIER('T tT 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:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building Far special information use checklist
l j Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning I 46.75
Job site address: 16920 NW Rockhampton Furnace 100,000 BTU(duets/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(dncts/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
bydronic) 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-: 240
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
tEl PROPERTY OWNER ElTENANT Other: 23.32
- Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchenI
Address:703 Broadway St.,Ste.510 equipment 33.39
Clothes dryerexItaust 33.39
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(360)695-7700 Fax:( ) Attic/crawispace fans 23.32
El APPLICANT 0 CONTACT PERSON Other. 2332
Business name:Polygon WLH,LLC pi p 514.15 for first four;S4A3 for each additional
Fueling:
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:permitsubmittals(taylormorrison.com Barbecue
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(S90.00)
Plan review(25%of permit fee)
Phone'(360)270-1590 Fax:( ) -
State surcharge(12%of permit fee)
GCB lic.:209001 TOTAL PERMIT FEE
^ This permit application expires if a permit is not obtained within 180
A: days after it has been accepted as complete.
Authorized signature: ( C(� ��'{ ' Fee methodology set by Tri-Comfy Building Industry Service Board
Print name:Elia Duran Date: 10/30/20
• E
Electrical Permit ApplicatioIi'iEC ��- D FOR OFFICE USE ONLY
City of Tigard NOV 0 3 20f.I. Received PermitII
#:
Da eBy:
a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 OF TIGARD Date/By: Related Permit u:MS3-ZD2O'Ob"5yZ
Inspection Line: 503.639.4175 r,ir usncioN Ready Date/By: 7uris: �I See Page 2 for
1ItIARil Internet: www.tigard-or.gov Notified/Method: 't`+'f Supplemental Information
TYPE OF WORK: ` PLAN R Orkv'
® New construction ❑ Addition/alteration/replacement :'lease check all that appl}(submit 2 sets afplans v.Items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition E Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRICTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-famiydwelling ❑ Commercial/industrial Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi-tainilr ❑ Master builder ❑ Other: 0 Fire pump. 0 Installation oft 50 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergencysystem. larger separately derived
0 Addition of new motor load of system.
Job#: Job site address:16920 NW Rockhampton 100HP or more. ❑"A","E","I-2","I-3",
0 Six or more residential units. occupancy.
City/State/ZIP: 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Roshak Ridge ❑Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: ) II K` 14E ,tj 1,I,
Description Qty. Each I Total 1
New residential single-or multi-family dwelling unit.
Subdivision: Roshak Ridge Lot#:240 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft_or portion 33.92 I
DESCRIPTION OF WORK Limited energy,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
('l *'R OTT OWNER ❑ T ENANI Services or feeders installation,alteration,and/or relocation
Name: Polygon Homes WLH, LLC 200 amps or less 100.70 2
Address: 703 Broadway St., Ste 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: ( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:permitsubmittals@taylormorrison.COm 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
"'.,lG ` "" ` • Branch circuits—new,alteration,or extension,per panel
l �14'41tr1' -.�w 61' A.Fee for branch circuits with
Business name: Polygon Homes WLH, LLC above service or feeder fee, 742 2
each branch circuit
Contact name: Tonja Morris B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: 703 Broadway St., Ste 510 branch circuit
City/State/ZIP: Vancouver WA 98660 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360 )816-7800 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: permitsubmittals@taylormorrison.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67 84 2
Business name: Portland Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy El See Page 2 2
Address: 1915E 5th St., Ste D panel,alteration,or extension.
Ci /State/ZIP: Vancouver, WA 98661 Each additional inspection over allowable in any of the above
h' Additional inspection(1 hr min) 66.25/hr
Phone:( 360)314-4915 Fax:( ) Investigation(I hr min) 90.00/hr
Email:paul@portlandelectric.biz Industrial plant(1hrmin) 78.18/hr
p @P Inspections for which no fee is 90.00/hr
CCB Lie.: 194066 Electrical Lic.: C760 Suprv.Lie.: 49205 s ecificall listed '%hr ram
�� �a �_ AA�� �- l( .._. '.. ltC.4I. PE 15
Suprv.Electrician signature,required: l./l/ ,x, Subtotal:.
Print name: Alex Shalya Da e:1 0/30/20 0 Plan Review Required(25%of permit fee):
Job Q State surcharge(12%of permit fee):
Authorized signature: �j. Q. J. ,. L TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Seroey Mishchuk Date:10/30/20 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Bailding\PermitsOELC_PermitApp_ELR ERE.doe Rev 06/17/2015 440-4615T(l 1/O5/COM/WEB
Plumbing Permit Application
Building Fixtures RECER�!ED FOR OFFICE USE t)NLV
City TigardNOV 0 3 2020 Received
of Permit No.:
t
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:Review MST2a01A-0531Z m Phone: 503.718.2439 Fax: 503.59$.1ti(r( t}=TI(aARi7 Date By^ Other Permit No.:
TICiARD Inspection Line: 503.639.4175 BMJILDir,{( DIVISION Date ReadyiBy:Internet: www.tigard-orgov Notified/Method: Jk Supplemental fIorfo rmation
TYPE OF WORK FEE* SCHEDULE
®New construction ❑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)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
l-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
/ SFR(3)bath 500.32
❑Accessory building Multi-family
Each additional bathlkitchen 25.02
❑Master builder 0 Other: Fire sprinkler( ,sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16920 NW Rockhampton 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
Water service(no.linear ft.:_) Page 2
Subdivision:Roslrak Ridge Lot no.: 240 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
Drinking fountain 25.02
Ejectors/sump 25.02
Cl 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 Interceptorigrease 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 A / 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@potygonhomes.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:G&B Plumbing&Sons Inc Water piping/DWV 56.29
Address:P.O.Box 92 Other. 25.02
City/State/ZIP:St.Paul,OR 97137 Subtotal
Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lie.: 184372 Plumbing Lic.no.:pb634
State surcharge(12%of permit fee)
Authorized signature: III - - TOTAL PERMIT FEE
I Print name:Steve Fowler Date: 10/30/20 This permit application expires if a permit is hot obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
rtawldine\Permiu\PLMti-Pe`mitAnn.doe 10/01/09 440-4616T(I 0/02/CONVWEB1
City of Tigard
■ COMMUNITY DEVELOPMENT DEPARTMENT
T,c n u n Building Permit Review — Residential
Building Permit #: (VAST SOLO- CO 3\2
Site Address: 16920 SW Rockhampton Lane
Project Name: Polygon @ Roshak Ridge Lot #: 240
Planning Review
Proposal: New house
k7 Verify address/suite #active in Accela. ® In River Terrace: ❑ No ® Yes, River"Terrace Review Addendum
Site Plan Elements: $]Erosion Control
M3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper ntaIRetained trees with drip line and tree protection measures
(]Drawn to scale(standard architect or engineer scale) &Footprint of new structure(including decks) and FFE
®North arrow $]Utility locations&easements(required for new and additions)
]Site address,project or subdivision name and lot number $]Sidewalk/driveway approach
®Applicant information(name and phone number) ntC.ocation of wells/septic systems
R]Lot dimensions and building setback dimensions &l Street tree size,type and location
niaSquare footage of buildings to be demolished lI Street names
ItilExisting structures on site E Corner elevations (2'contours if more than 4'differential)
XlLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? l�ys ENo
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Yes ❑No
® Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified X No Received: ❑ Yes ❑ No
K] Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs
Required: El Yes,applicant was notified E No Received: ❑ Yes ❑ No
® SDC Exemption for ADU applied for: ❑ Yes X No Received: El Yes El No
K] Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified ffl No Applied For: ❑ Yes ❑ No, stop intake
® Land Use Case#: PDR2015-00002/SUB2015-00004 1E1 Zoning: R-12
® Required Setbacks: Front: 8 Rear: 15 Side: 3 Street Side: n/a Garage: 20
® Building Height: Max.Height: 35 ft Actual Height: 29 ft
K Landscape Area: 20 % ® Lot Coverage Max: 80
Entrance El no more than 8' from street-facing wall ❑ Parallel to street or offset 45 degrees
Windows ❑ Minimum a of all street-facing facades
Garage ❑ Garage door is behind wi t-facing wall ❑ Yes ❑ , e of the following is met:
❑ Door extends no more t an 5'fen nd there is a rn nreh xtending beyond garage.
❑ Door extends no more t]See River Terrace Addendum above garage on 2"d floor.
❑ Garage door width is ❑ 12-or les )(rya or less of facade o or less and includes 7 of following:
❑ Covered porch essed entrance ❑ Wall offset ❑ 1'Roo ❑ Roof offset
❑ Fire s El Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel too ormer
ccent siding El Window trim ❑ Window recess El Window projection ❑ B c
!] Visual Clearance {,Os Urban Forestry Plan
® Sensitive Lands: ❑ Yes fl No Type:
KJ Conditions met prior to issuance of building permit
Notes:
l Approved By Planning: Date: Ill 1 I20
Revisions (after Building Submittal o y) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
1:\Building\Forms\BI dgPernt itRvw_RE S_122419.docx
Building Permit Submittal
Original Submittal Date: \\I.61 ZOZC
Site Plans: # 3
Building Plans: # 3
Building Permit#: Enter building permit#above.
Workflow Routing: [ Planning Cii'Engineering 2' Permit Coordinator Ga' Building
Workflow Sign-off: 7 Sign-off for Planning(include notes from planning review)
Route Application Documents: 12. 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:
By Permit Technician: \coMwj\O O )C Date: \\`4t742.0
En Oneering Review
Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit,
itzi Easements (encroachments) per engineering conditions of approval and plat
[Water Quality/Quantity Facility-.
Assess Water Quality Fee in-lieu: ❑ Yes VeNo
Assess Water Quantity Fee in-lieu: ❑ Yes �No
LIDA Facility on lot: El Yes gNo
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Ivy Approved by Engineering: Date: ///972.43
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: El Approved ❑ Not Approved
Permit Coordinator Review
gConditions "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: .Yes ❑ N/A
LIDA ❑ Yes N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: 0 f(if Of 2,0
I:\Building\Forms\BldgPermitgvw_RES_122419.docx
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
M
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #: MST 2_OZO-003\2_
Site Address: 16920 SW Rockhampton Lane
Project Name: Polygon @Roshak Ridge Lot #: 240
(New dwelling= subdivision name;Addition or Alteration=last name of owner)
Plannink RelrieW ofliiver ?'errace Ptah District Desk 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 w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 ft. deep Gabled dormer
ft. deep min. 2ft., 5 ft.wide nun. 2 ft., 6ft. wide
Front/ r ❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: F= 18% / R= 16%
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: XI Yes ❑ No
If yes, all the following apply: ® 25 sq.ft. min.
1_1 One street facing entry Xl 12 ft. max. roof above floor of porch
® 5 ft. depth min. al 30%min. porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing façades:
® Covered porch min. 5 ft.wide x 5 ft. deep F ® Recessed entry area min. 5 ft. wide x 2 ft. deep F
❑ Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide
$l Roof eave min. 12 inch projection FIR M Roof offset min. of 2 ft. R
❑ Roof shingles either tile or wood ® Gable,hip or gambrel roof designF/R
❑ Roof pitch oriented south min. 500 sq. ft. K,Horizontal lap siding min. 3-7 inches wide R
❑ Accent siding nun. 40%of street façade ® Window trim min. 2 Y' wide by 5/8" deep FIR
❑ 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 facade with 7 detailed design elements
Notes:
Approved By Planning: A7j6
Date: l i '4 I '�
I\BuildinglForms'�BldgPermitRvw_RES_RT_121417.docx t