Permit CITY OF TIGARD1111
MASTER PERMIT
■ COMMUNITY DEVELOPMENT Permit#: MST2020-00313
Date Issued: 03/23/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S107AA23800
Jurisdiction: Tigard
Site address: 16894 SW ROCKHAMPTON LN
Subdivision: ROSHAK RIDGE Lot: 238
Project: Polygon at Roshak Ridge, Lot 238
Project Description: New detached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 3 First: 948 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1166 sf Garage: 422 sf Front: 8 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right 3
Detectors:
Total: 2116 sf Value: $279,689.42 Rear: 10
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: 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: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Fum>=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: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL.RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All v
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2116
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 98860 VANCOUVER,WA 98660 2 One Hour Fire Rated Eaves
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $39,495.87
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 503.232.198877�or 1.800.332.2344.
Issued B : HOUy Vct.'vD&Wege Permittee Signature: OvvApp tO-Yl
Y
Call 503.639.4176 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
3cf'
RECEIVED 8_ ON
Residential FOR orrlcL USE ONLY
PP City of Tigard NOV 0 3 2020 Received /
13125 SW Hall Blvd.,Tigard,OR 97223 DateBy: ��' /T Permit No:MST�zd�Ob3�
Phone: 503.718.2439 Fax: 503.598.19 Plan Review i ��
�°ITY OF TIGARD Da eBy ( Other Permit JyV ZQZ(j—will
TIGARD Inspection Line: 503.639.4175 GARD 1
Date Read B
Internet: www.ti ard-or. ov BUILDING DI y y' luris page2 for
g g VISION Natified/Method: / / / q
1 �( ne; Supplemental Information
�J` TI' E OF WORK (:l^1.+3-/c.- Ti. e. �A-
P
�• r ll � REQUIRE.DRA TA: I-.AND2-PAMHLYDWELLING
®New construction ❑ Demolition Permit tees arc based on the value of the work performed.
❑Addition/alteration/re lacement Indicate the value(rounded to the nearest dollar)of all
p ❑ Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® I-and 2-family dwelling Valuation: 33 113 _ 7
❑Commercial/industrial $ �Q
❑Accessory building ❑Multi-family Number of bedrooms: 3
❑ Master builder ❑Other: Number of bathrooms 3
.IOR SITE INFORMATION AND LOCATION Total number of floors:2 253
Job site address:16894 SW Rockhampton Ln New dwelling area: 2116 square feet I (0'
City/State/ZIP: Garage/carport
erg arport area: 422 square feet 9'-i Suite/bldg./apt.no.: I Project name:Polygon at Roshak Ridge 9 Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
RIM.WED DATA:COMMERCIAL 1i �' E€KLIS'r
Subdivision:Polygon at Roshak Ridge I Lot no.:238 Permit fees*are based on the value of the work perlorrned.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
N OF WORK
: DESCRIPTION work indicated on this application.
Plan 3410B Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER
❑ TENANT Number of stories:
Name:Polygon Homes WLH LLC
Type of construction:
Address:703 Broadway St., Ste 510
Occupancy groups:
City/State/ZIP:Vancouver, WA 98660
Phone:( )360 695-7700 I'a.x:( )360 693-4442 Existing:
New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon Homes WLH LLC - (Please refer to file schedule)
Contact name:Tonja Morris Structural plan review fee(or deposit):
Address:703 Broadway St., Ste 510 FLS plan review fee(if applicable):
City/State/ZIP:Vancouver, WA 98660 Total fees due upon application:
Phone:( )360 695-7700 I Fax::( )360 693-4442 Amount received:
E-mail: PHOTOVOLI.A1CSOt AR PANEL SYS"fEM FEES*
- i g � a - Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Polygon Homes WLH LLC Submit two(2)sets of roof plan with connection details
Address:703 Broadway St., Ste 510 and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP:VanCOUVer, WA 98660 Permit Fee(includes plan review
and administrative fees): $180.00
Phone:( )360 695-7700 I Fax:( )360 693-4442
State surcharge(12%of permit fee): $21.60
CCB Iic.:207247
Total fee due upon application: $201.60
•
Authorized signature: %gy��y� , Q This permit application expires if a permit is not obtained
awithin 180 days after it has been accepted as complete.
Print name:Tonja Morris I Date:10/21/2020 I *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB)
Mechanical Permit Application
p� i�/ FOR OFFICE USE ONLY "s
City of Tigard 1� V t V E® Received
¢/ t� Date/By: PUMA No
131_5 SW HallBlvd.,Tigard OR 2
t Phone: 503.71$.2439 Fax: 503.598.19 PlanRemew
Inspection Line: 503.639.4175 NOV 0 3 ZOZO Date By' fltfiarpar" =MST yp7p^ Qb��3
7`hOAR.l7 DateReady/By: Juris: RI See Page i for
Internet: www.tigard-or.gov
CITY OF TIGARD Noti6ed/Metbod; Tiqr Supplemental Information
BUILDING DIVISION
TYPE,OF WORK COMMERCIAL FEE* SCHEDULE 1—'USE CHEtKLLST
®New constructionMechanical pemsit fees*are based on the value of the work
❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$
CI, 1-and 2-familyRESIDENTIAL EQIJIPhsg, r/SYSTEMS FEES*
dwelling g 0 Commercial/industrial ❑Accessory building For special information use checklist
j i Multi-family ❑Master builder ❑Other: Description f Qty. I Ea. J Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: 16894 NW Rockhampton Air
condtonng 1 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: Roshak Ridge Heat pump 61.06
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 electtic),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Roshak Ridge Lot ma.: 238 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater
23.32
DESCRIPTION Ofi 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
Name:Polygon WLH LLC Environmental exhaust and ventilation:
Range hood/other kitchen
Address:703 Broadway St.,Ste.510 e9u pment 133.39
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/crawlspacefans 23.32
® APPLICANT 0 corn-ACT PERSON Other. 23.32
Business name:Polygon WLH,LLC Fuel piping:
SI4,15 for first four;S4,03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
City/State/ZIP:Vancouver,WA 98660
Wall/suspended/unitteratr &eater
Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Ranee
E-mail:permitsubmittalstaylormorrison.corn
Barbecue
'IV 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)
Phone:(360)270-1590 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.:209001 TOTAL PERMIT FEE
(�\ This permit application expires if a permit is not obtained within I80
�(,�„ tJ -�1. days after it has been accepted as complete.
Authorized si ratu e: ' Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date: 10/30/20
Electrical Permit Applicati e/F p(� FOR OFFICE USE ONLY
City of Tigard M E C E I n E D Received Perot S
III 'a 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
10 Phone: 503.718.2439 Fax: 503.598.) 6UV 03 2020 DateB : Related Pemi r:PAST ZOZO'003%3
Inspection Line: 503.639.4175 Ready Date/By: MEM H See Page 2 for
1IGA.14't): Internet: www.tigard-or.gov CITY OF fIGARD Notified/Method: Supplemental Information
TYPE OF WITH'S F s ' k I. ;, 'AA W 741)'' i ft:' !1
VNewconstruction ❑Addition/alteration/replacement ('lease check all that apply(suhmil2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories
❑ 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.
® I-and 2-family dwelling ❑ Commercial/industrial ❑ .Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑ Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ['Emergency system. larger separately derived
16894 NW Rockhampton ['Additionm new motor load of system.
Job#: Jobsiteaddress:
I OOHP or more. ❑"A" "E"."l-2" "1-3"
City/StateiZIP: ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Roshak Ridge ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: Giill;
4
Description Qty. Each Total
I
New residential single-or multi-family dwelling unit.
Subdivision: Roshak Ridge Lot#:238 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 WORRY:- , Limited energy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75 00 2
residential(with above sq.ft.)
N I' In PROPERTY OWNER 0.TEN 'C'y,_, Renewable Energy ❑ See Page 2
�' - - 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
Email: Temporary services or feeders installation,alteration,and/or
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 I
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 16854 2
ia'll itd I i ? E APPLIC AYI 0 CONTACT PERSON Branch circuits—new,alteration,or extension, er panel
A.Fee for branch circuits with
Business name: Polygon Homes WLH, LLC above service or feeder fee, 7.42 2
Contact name: Tonja Morris each branch circuit
B.Fee for branch circuits without
service or feeder fee,first
Address: 703 Broadway St., Ste 510 branch circuit 56.18 2
City/State/ZIP: Vancouver WA 98660 Each add'l branch circuit 7.42 2
Phone: 360 816 7800 Fax: : Miscellaneous(service or feeder not included)
( ) ( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: permitsubmittals@taylormorrison.com Reconnect only 67.84 2
CONTRACTOR ''' '1
Pump or irrigation circle 67.84 2
Business name: Portland Electric Sign or outline lighting 67.84 2
Address: 1915E 5th St., Ste D Signal circuit(s)or limited-energy El See Page 2 2
panel,alteration,or extension.
City/State/ZIP: Vancouver, WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 360)314-4915 Fax:( ) C Investigation(1 hr min) 90.00/hr
2._0✓ Industrial plant(I hr min) 78.18/hr
Email:paul@portlandelectric.biz `- 1 1
Inspections for which no fee is 90.00/hr
CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lie.: 4920� specifically lisfted 'Ain min)
-ssSuprv.Electrician signature.required: IJWC.,�+i A�n p,� Subtotal:
Print name: Alex Shalya Da e:10/30/20 ❑Plan Review Required(25%of permit fee):
n State surcharge(1T %L PERf MIT
fee):EE
Authorized signature: J_ZJx7Th TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Serge)/ Mishchuk Date:10/30/20 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\Building\Permits\ELC PermilApp_E1.R_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Y
Plumbing Permit ApplicatiREnvEIVED
Building Fixtures FOR OFFICE USE ONLY
City of Tigard NOV 03 2020 Received
g DeteBy: Permit No.:
n 13125 SW Hall Blvd.,Tigard,OR 97 Plan Review
1 '41 Phone: 503.718.2439 Fax: 503.g OF TIGARD Date/By: Other PermitNMST -(fj��
TIGARD Inspection Line: 503.639.4175 ING DIVISION Date Ready/By: 7um: E7 Sec Paget for
Internet: www.tigard-or.gov Notified/Method: (� Supplemental Information
TYPE OF WORK FEE* SCHEDULE
IL/ New construction 0 Demolition For special information use checklist _
Description I Qty. I Ea. Total
0 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
X1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
0 Accessory =Multi-family
---- Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16894 NW Rockhampton Catch basin or area drain I8.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.:_) Page 2
Suite/bIdg./apt.no.: 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.: 238 Fixture or item;
Tax map/parcel no.: Back low 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
® PROPERTY OWNER f ❑ 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
h1 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/basiailavamry 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 6254
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
E-mail:permitsubmittais@polygonhomes.com Urinal 25.02
Water closet 25.02
CONTRACTOR --
Water heater 37.52
Business name:G&B Plumbing&Sons Inc
Water pipingjDWV 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: S72.50
CCB Lic.:184372 Plumbing Lie.no.:pb634 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: . TOTAL PERMIT FEE
Print name:Steve Fowler Date: 1 0�30�2� 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.
IM1Anildinr5Permits\PLINU-PermitAoo.doc 10/01/09 440-4616T(10102/COM/WEB1
City of Tigard
M COMMUNITY DEVELOPMENT DEPARTMENT
C
TIGARD Building Permit Review — Residential
Building Permit #: MST 207A - O03k3
Site Address: 16894 SW Rockhampton Lane
Project Name: Polygon at Roshak Ridge Lot #: 238
Planning Review
Proposal: New single detached house
QVerify address/suite # active in Accela. ❑r In River Terrace: ❑ No ❑r Yes, River Terrace Review Addendum
Site Plan Elements: ' Hr ion Control
It copies of site plan on 8-1/2"x 11"or 11 x 17"paper N .etained trees with drip line and tree protection measures
rawn to scale (standard architect or engineer scale) Footprint of new structure(including decks)and FFE
111 'orth arrow _,: tility locations&easements(required for new and additions)
Q.ite address,project or subdivision name and lot number ,Si walk/driveway approach
0 pplicant information(name and phone number) cation of wells/septic systems
t dimensions and building setback dimensions street tree size,type and location
\��;j are footage of buildings to be demolished `L'treet names
11.3'e,'sting structures on site °Corner elevations (2'contours if more than 4'differential
0 •t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? IYes o
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es ° o
❑ Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
\ Required: ❑Yes,applicant was notified ❑✓ No Received: 11 Yes CI No
Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: El Yes,applicant was notified ❑r No Received: El Yes ❑e No
El SDC Exemption for ADU applied for: El Yes ❑ No Received: ❑ Yes ❑e No
❑r Public Facilities Improvement(PR) Permit:
Required: 11 Yes,applicant was notified ❑ No Applied For: ❑r Yes ❑ No,stop intake
❑° Land Use Case #: SUB2015-00004 ❑o Zoning: R-12
❑r Required Setbacks: Front: 8 Rear: 10 Side: 3 Street Side: NSA Garage: 20
❑o Building Height: Max. Height: N/A Actual Height:
❑e Landsca.e Area: 20 % ❑r Lot Coverage Max: 80
Entrance 1 - ,. . no more than 8'from street-facing wall ❑ Parallel to street or offset 45 .-. --s or less
Windows I Minimum 1 ' i e ,rca of all street-facing facades
Garage II Gara e door is behind wil treet-facing wall \ ❑Yes I 1 o,one of the following is met:
Door extends no more than - .-• all and ere is a e .-red porch extending beyond garage.
Door extends no more than 5' from wall a .-. e is a 12 sq ft.window above garage on 2nd floor.
PP
❑ Gara•. door width is 12'or less 50%or less o a 60%or less and includes 7 of following:
Covered porch ' essed entrance ❑Wall offset '...f cave — Roof offset
Fire shin!, <c Lap Siding ❑ Roof itch ❑ Gable,hi or gam. .of _ Dormer
cent siding Window trim U Window recess U Window projection 1 Balcony
❑ Vis •carance ❑r Urban Forest Plan
diP Sensitive Lands: ❑ Yes L"I No Type:
❑r Co ttions met prior to issuance of building permit
No s:
Approved By Planning: — Date: n f r/-a
Revisions (after Building Submittal only) Reviewer // Date
Revision 1: El Approved ❑ Not Approved
Revision 2: El Approved ❑ Not Approved
I:1B ui I d i ng\F orm s1B I dgPern i tRv w_RE S_122419.do c x
'Building Permit Submittal
Original Submittal Date: \\\3\ZOZO
Site Plans: # 3
Building Plans: # 3
Building Permit#: Q Enter buildingermit# above.
R
Workflow Routing: L� Planning Lid Engineering [ Permit Coordinator 0 Building
Workflow Sign-off: 2'Sign-off for Planning(include notes from planning review)
Route Application Documents: 0 Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
�7,original plan review routing form.
u Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: �v cs,Pq_.j.L�yQ. Date: \\`SAZPZ o
En 'neering Review
Slope at building pad: 2/4;
Conditions "Met"prior to issuance of building permit/V7,
it Easements (encroachments) per engineering conditions of approval and plat
V. 'ater Quality/Quantity Facility:Assess Water Quality Fee in-lieu: ❑ Yes fr No
Assess Water Quantity Fee in-lieu: ❑ Yes 'No
� LIDA Facility on lot: ❑ Yes
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
A/pproved by Engineering: DateZo
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
J4Conditions "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:
ffSDC Exemption: ❑ Received Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: Yes I N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes ❑ N/A
J. OK to Issue Permit
Approved by Permit Coordinator: O Y Date: U l 12 o
C 1Bu ildin g\Forms1Bl dgPerm itRvw_RE S_122419.docx
City of Tigard
in COMMUNITY DEVELOPMENT DEPARTMENT
T►G A R D River Terrace Building Permit Review Addendum
Building Permit #: MST Saw- 00 3%3
Site Address: 16894 SW Rockhampton Lane
Project Name: Polygon at Roshak Ridge Lot #: 238
(New dwelling=subdivision name;Addition or Alteration= last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.070.L):
Is the project subject to the plan district design standards? ❑s 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. �ft. deep ft. deep min. 2ft., 5 ft.wide nun. 2 ft.,oft. wide Gabled dormer
1� ❑ ❑ ❑ ❑
2. Eyes on'the street: a minimum of 12% f each street facing facade must include windows or entrance doors.
Percentage Shown: >42-4)
3. E ances:At least one entrance must meet both of the folio ng standards:
Max. 8 ft. setback from longe street- facing wall Parallel to street, angle no more than 45° from street,
or op onto porch
Entra ce opens to a porch: Yes ❑No
If s, ll the following apply: sq.ft. min.
ne street facing entry ft. 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:
i.vered porch min. 5 ft.wide x 5 ft. deep E- ❑Recessed entry area min. 5 ft. wide x 2 ft. deep
7 • all offset min. 16 inches'/ ❑ rmer min. 4 ft.wide
J Roof eave min. 12 inch projection ❑' of offset min. of 2 ft {)
❑Roof shingles either tile or wood Gable,hip or gambrel roof desigife,,l"
❑Uoof pitch oriented south min. 500 sq. ft. ❑ rizontal lap siding train. 3-7 inches wide n
LuJ Accent siding min. 40%of street facade ' Window trim min. 2 1/"wide by 5/8" deep r��
❑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.
Seth cks:
N closer to front or side lot line,than longest street-facing wall. i'es No. If No (Check one):
jMay 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)
❑ -foot-wide garage door ❑40%max. of street Facade
50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: — \ Date: //�J/j 7
t.\Building\F orm s1Bi dgPermitRvw_RE S_RT_121417.docx