Permit CITY OF TIGARD MASTER PERMIT
INs ' COMMUNITY DEVELOPMENT Permit#: MST2021-00031
T[GAR!7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/23/2021
Parcel: 2S107AA15300
Jurisdiction: Tigard
Site address: 16692 SW SUNSHINE COAST ST
Subdivision: ROSHAK RIDGE Lot: 153
Project Polygon at Roshak Ridge, Lot 153
Project Description: New detached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 927 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26.5 Bathrooms: 3 Second: 1186 sf Garage: 422 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors. Yes
Total: 2113 sf Value: $279,322.04 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 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
Drywall-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Tvoes Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders 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: 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
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 2113
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 Cntd 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 One Hour Fire Rated Eaves
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $40,382.58
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.
Van/De.W On/AppiLC,axwn
Issued By: Holly Permittee Signature:
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.
1___ 0 1 1s,
• 1
Building Permit Application -. - 2.18121
Residential 9 FOR OFFICE USE ONLY �I�
CityTigardtECEIVED D teeBeydO� " �� PenatNo.�(ilsr z/-Gb�3�of d '�
13125 SW Hall Blvd.,Tigard,OR 97 p�Review �,./�7n-7r_ni/rl 7I
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 2 I7 /� Alk Other Perm : W L(l/J VWG1II
.i.i c l n a D Inspection Line: 503.639.4175 FEB 0 8 2621 Date Ready/By ' Jer 0 See Page 2 for
Internet: www.tigardor.gov 'Jot ed/Metho ��/ / `Ct' Supplemental Information
TYPE OF WO REQUIRED DATA:I-AND 2-FAMILY DWELLING
❑AUIl1D(NG Permit fees*are based on the value of the work performed.
®New construction emo ttion DIVISION
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement D Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. r7
IN1-and 2-family dwelling 0 Commercial/industrial Valuation: $ a, 13?i L
❑Accessory building ❑Multi-family Number of bedrooms: 3
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATIONg AND LOCATION Total number of floors: .G.J 7-5 35
Job site address: (66 9.2, S W Sy `Shi nit (0 l l ffi New dwelling area: 02 I (3 square feet ` \91
City/State/ZIP: Sherwood,OR 97140 Garage/carport area: 4,,2J.., square feet ei,2
Suite/bldg./apt.no.: Project name: Polygon At Roshak Ridge Covered porch area: �,,`J square feet
Cross street/directions to job site: Deck area: /yam- ` square feet
Other structure area: P."' square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Roshak Ridge I Lot no.: 15 3 Penult fees*are based on the value of the work performed.
' Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
NIew 51434. Ab Valuation: $
Existing building area: square feet
New building area: square feet
❑x PROPERTY OWNER 0 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 Existing:
Phone:( 360)695-7700 Fax:( 360)693-4442 New:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)Business name: Polygon Homes WLH LLC
Structural plan review fee(or deposit):
Contact name: Omar Alami Abouhafs
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
E-mail: pennitsubmittals@taylormorrison.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
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 Specialty Code checklist.
review
City/State/ZIP:: Vancouver,WA 98660 Permit Fee(includes plan $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: $201.60
Authorized signature:� — This permit application expires if a permit Is not obtained
within 180 days after it has been accepted as complete.
Print name: Omar Alami Abouhafs Date: O /Q si� *Fee methodology set by Tri-County Building Industry
u Service Board.
L:\Building\Permits1BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit ApplicapfE FOR OFFICE USE ONLY
City of Tigard CEIVED Received Date/By: Permit NoP,S/ZCJ21--0a03f
IIII_ 1 13125 SW Hall Blvd.,Tigard,OR 97223 plan Review
: : Phone: 503.718.2439 Fax: 503.598.1960 FEB 0 D 2021 Date/By: Other Permit:
Y Iii.A it l7 Inspection Line: 503.639.4175 Date Ready/By: Inns: E7 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method. Supplemental Information
�►� ING DIVISION
TYPE.OF COMMERCIA-L FEE* SCHEDULE USE 63ECKLIST`
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION. Valve.$
• _ • .:. - RESiDENTLAL EQUIPMENT/SYSTEMS FEES*
®1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist
1 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: 16692 SW Sunshine Coast St 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: Polygon at 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
hydronie) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Roshak Ridge Lot no.: 153 Other. 23.32
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 2332
® PROPERTY OWNER 23.32
El TENANT Other. 23.32
— Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
Address:703 Broadway St.,Ste.510 equipment 33.39
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/crawlspace fans 23.32
® APPLICANT. ❑ CONTACT PERSON Other- 23.32
Business name:Polygon WLH,LLC Fuel piping:
S14.15 for first four;S4.03 for each additional
Contact name:Tonj a 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
ermitsubmittals Range
E-mail:
p Ctaylormorrison.eom 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($90.00)
Phone:(360)270-1590 Fax ( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lie.:209001 TOTAL PERMIT FEE
This permit application expires if a permit Is not obtained within 180
Qqi� b days after it has been accepted as complete.
Authorized signature: Q * Fee methodology set by Tri-County Building Industry Service Board
Print name:Ella Duran Date: 10/30/20
r AAmldine.\Prcrnirelhfpi Pennii Ann net It Am. n,en•ar-rrnem�.rna.m.eor
' Electrical Permit Applicatiog EC E IVE . FOR OFFICE USE ONLY
✓ Cityo T� and Received ST��-fl�3C
IN 411 13125SW Hall Blvd.,Tigard,OR 97223 FEB 0 8 2G2 Plan Review
Permit#:
Phone: 503.718.2439 Fax: 503.598.19 Date/B : Related Permit#:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: ras: El See Page2 for
a Internet: www.tigard-or.gov E]UILIJIIVt9 nIUISION Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
O 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.
® l-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 0 Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:
16692 SW Sunshine Coast St I00HP or more. ❑"A","E","1-2","l-3",
City/State/ZIP: Tigard OR 97224 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Polygon at Roshak Ridge 0 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 ) (NY. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: Roshak Ridge Lot#:153 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
El PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: Polygon Homes WLH, LLC 200 amps or lesa 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
El APPLICANT El CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Polygon Homes WLH, LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Omar Alami Abouhafs B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
703 Broadway St., Ste 510 branch circuit
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 only67.84 2
CONTRACTOR 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 0 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/lir
Phone:( 360)314-4915 Fax:( ) Investigation(1 hr min) 90.00/hr
7 / Industrial plant(1 hr min) 78.18/hr
Email:paul@portlandelectric.biz 7JA.3
Inspections for which no fee is 90.00/hr
CCB Lie.: 194066 Electrical Lie.: C760 Suprv.Lie.: 49205 specifically listed(1/2 hr min)
/� �� ,; : ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: (l�.x XSry0 ,Q Subtotal:
Print name: Alex Shalya Da{e; )O/30/20 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: AQ f,azQ ii 4, TOTAL PERMIT FEE:
a (J This permit application expires if a permit is not obtained within 180
Print name: Serqey Mishchuk Date:10/30/20 days after it has been accepted as complete.
* Number of inspections allowed per permit.
l:\Building\Permits/sLC_PermitApp_ELR ERE.doc Rev 06/17/2015 440-4615T(I I/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 Description Qa. Each Total
3' Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed CA hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page I):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
El Data Telecommunication Installation
❑ Fire Alarm Installation
El HVAC
n Instrumentation
El Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
El Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
El Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I\BuildinglPermits1ELC_PemiVApp_ELR_ERE.doc 12ev06/17/2015
•
' Plumbing Permit Application
' Building Fixtures RECEIVE ' FOR OFFICE USE ONLY
City of Tigard Received Permit No.1/sr2/-�A/1 2l
II '8 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 0 8 2021 Date/By:Pl20CJCN-J
Phone: 5037182439 Fax: 5035981960an Review
. . . . Date/By: Other Permit No.:
TIGART) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: refs: 0 See Page2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WO FEE*DIVISION FEE" SCHEDULE
®New construction 0 Demolition For special information use checklist.
Description I 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(1)bath 312.70
t,)Hp 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
�" SFR(3)bath 500.32
❑Accessory building -Multi-family
Each additional bath/kitchen 25.02
0 Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16692 SW Sunshine Coast St Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 1 Project name:11-6.1,111.I,,.Polygon at 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.: 153 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
Ic PROPERTY OWNER I ❑ 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:Totija Morris
Roof drain(commercial) 12.51
Address:703 Broadway SL,Ste 510 Sink/basin/lavatoty 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@taylormorrison.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:G&B Plumbing&Sans Inc Water PP ting/t)W V 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: 572.50
Plan review (25%of permit fee)
CCB Lie.:184372 Plumbing Lic.no.:pb634
State surcharge(12%of permit fee)
Authorized signature: ; TOTAL PERMIT FEE
Print name:Steve Fowler Date: 1 0/30/20 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:snutltlmgTermiuWLNIII-Permi[App.doe 10/01/09 440.4616T(10/02/COM/WEB)
City of Tigard 2l�
COMMUNITY DEVELOPMENT DEPARTMENT 1ii
TIGARD Building Permit Review — Residential
c, , :moo:.: •.ice-liter':-*: -q .,.,4s-'3t'ny f:,
Building Permit #: M ST2_021-0 '33 ) /
Site Address: // lQ Q� a) � ' A,k.e Cia-S'7L— c
Project Name: rU n /dL (,` Lot #: l c3
P1. , ' g Review W
Pr, •osal: k2e110 ii-al
I Verify address/suite#active in Accela. In River Te e: El L� Yes,River Terrace Review Addendum
Site Plan Elements: (Erosion Control
copies of site plan on 8-1/2"x 11"or 11 x 17"paper 11 kf,'tained trees with drip line and tree protection measures
�( pawn to scale(standard architect or engineer scale) d! ootprint of new structure(including decks) and FFE
i'orth arrow %tility locations&easements(required for new and additions)
e address,project or subdivision name and lot number Sidewalk/driveway approach
plicant information(name and phone number) i:1:.cation of wells/septic systems
Lot dimensions and building setback dimensions eet tree size,type and location
114., ,are footage of buildings to be demolished TA S eet names
,%°.',fisting structures on site VCorner elevations (2'contours if more than 4'diffe tial)
Y Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaceer? L�Yes ❑I(o
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shownif.J^ Yes No
Clean Water Services—Service Provider Lettet(lot platted prior to 9/10/1995):
Required: 0 Yes,applicant was notified Cd'NoOK 1 Received: ❑ Yes No
Water Meter Fixture Unit Worksheet—Addi ' ns,Remodels and ADUs JJ
Required: 0 Yes,applicant was notified No Received: 0 Yes i. o
DC Exemption for ADU applied for: ❑ Yes Qd No Received: 0 Yes M No
Public FacilitiImprovement(PFI)Permit:
1tquired: Al Yes,applicantns was notified ❑ No . lied For: Cal Yes 0 No,stop intake
d Use Case#: c9C 0009 n Zoning. 1 ,L2
M 'equired Setbacks: Front Rear: /S= 1 Side: Street Side: arage: 2 0
ral/&uilding Height: `� Max. Height: f.119— Actual H ' ht: .260-
VJ Landscape Area: ..21) % Lot Coverage Max:
Entrance`R1 Set back no more than 8'from street-facing wall 0 Parallel to street or offset grees or less
Windows ❑ Mirmn' . 2%of area of all street-facing facades ^Q�
Garage 0 Garage door is widest street-facing wall 1 ❑ Ye No,one of the following is met:
0 Door extends no more 'from wall and ere ' oveted porch extending beyond garage.
0 Door extends no more than 5'fro ere is a 12 sq ft.window above garage on 2°d floor.
0 Garage door width is 0 12'or 50%or of facade 0 60%or less and includes 7 of following:
0 Covered porch ecessed entrance 0 Wall o s ❑ 1'Roof eave 0 Roof offset
0 Fire s ' s 0 Lap Siding ❑ Roof pitch 0 Gable, t , mbrel roof ❑ Dormer
ccent siding Window trim 0 Window recess 0 Window p ' 'on 17Balcony
II Visual Clearance Urban Forestry an
II ,Sensitive Lands: El Yes No Type:
aCon ' 'ons met prior to issuance of building permit
No
Approved By Planning: Date: —2 0 0..
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
I:\Building\Fonns\BldgPennitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: a2/40o2f ,
Site Plans: # 3
Building Plans: # 5
Building Permit#: Enter building permit# above.
Workflow Routing: [-"Planning P'Engineering E4--Permit Coordinator 1 T' uilding
Workflow Sign-off: Q/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.
ni/Building. original permit application,site plans,building plans, engineer and
beam calculations and st details,if applicable,etc.
Notes:
By Permit Technician: Date: 4/2/ 1'`202(
Engineering Review I
ej
)lope at building pad: 3/v
�londitions "Met"prior to issuance of building permit 8
I }casements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility: 1�
Assess Water Quality Fee in-lieu: ❑ Yes Lfd No
Assess Water Quantity Fee in-lieu: 0 Yes i?i o
/ LIDA Facility on lot: 0 Yes f No
12" Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: Z 9 2
Revisions(after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
hermit Coordinator Review
` l 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: 0 Received 134, oes not apply
r
I/ SDC Fees Entered: Wash Co Trans Dev Tax: Yes 0 N/A
Tigard Trans SDC: VI/Yes 0 N/A
Parks SDC: ® Yes 0 )/A
LIDA ❑ Yes �' N/A
OK to Issue Permit Z
Approved by Permit Coordinator: — Date: 494
I:Building\Forms\BldgPemritRvw_RES_122419.docx
City of Tigard
r COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: M ST2021 -C0031
Site Address: ieWa /�2 ,g1,6 775/Jl ( -C4 �"T-
Project Name: en� 4- ,q, a1.- eterA ,Pl� --e Lot #: icy
(((New.: g=subdivision name;Addition or Alteration sf name of owner)
Planning Review of River Terrace Plan Dis ct Design Standards (18.640.070.I.):
Is the project subject to the plan district design standards? YJ 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 fr deep Gabled dormer
ft. deep min. 2ft.,5 ft.wide min. 2 ft.,Eft wide
❑ ❑ 0 0
2. Eyes on the street: a minimum of12%of each street facing facade must include windows or entrance doors.
Percentage Shown: >2 0/
v
3. trances:At least one entrance must meet both of the follo g standards:
Max. 8 ft. setback from long t street- facing wall Parallel to street,angle no more than 45° from street,
or o n onto porch
En ance opens to a porch: Yes ❑ No
If e ,all the following apply: /5 sq.ft. min.
If
street facing entry x5 ft.max. roof above floor of porch
5 ft. depth min. ''-'° 300%min.porch roof coverage
. etailed Design:All buildings shall include a min. of five o; a following elements on all street-facing facades:
• overed porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft. deep
all offset min. 16 inches 0 Dormer min. 4 ft.wide
Roof eave min. 12 inch projection ❑ oof offset min.of 2 ft.
❑ Roof shingles either tile or wood /a e,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. orizontal lap siding min. 3-7 inches wide
❑ Accent siding min.40%of street facade Window trim min. 21/2"wide by 5/8"deep
❑ Window recess min. 3 inches for all street facing 0 Bay window min. 5 ft.wide by 2 ft. deep
O 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 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.
O 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)
0/12-foot-wide garage door 0 40%max. of street facade
ilg 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: Date:
I:\Building\Forms\B1dgPermitRvw_RES_RT_121417.docx