Permit 11 ' CITY OF TIGARD MASTER PERMIT
5 COMMUNITY DEVELOPMENT Permit#: MST2021-00032
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/23/2021
T 1 G h R D Parcel: 2S 107AA13800
Jurisdiction: Tigard
Site address: 16689 SW SUNSHINE COAST ST
Subdivision: ROSHAK RIDGE Lot: 138
Project: Polygon at Roshak Ridge, Lot 138
Project Description: New detached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1215 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1715 sf Garage: 485 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2930 at Value: $382,441.85 Rear: 10
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: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Tvoes Air Conditioning: Y Vent Fans: 5 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 SrvelFeeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add,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: NI HVAC: N Security Alarm: N Vaccuum System: NI Garage Opener: N All
Other: NI Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2930
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 98660 VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $43,643.10
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:HOBy:Hauy V74'VOe/W€ Permlttee Signature: OvvApp 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.
I__o- v:
-Building Permit Application '3- 2/43121
Residential RECEIVE , FOR OFFICE USE ONLY
RECEIVE V C Received�rf� Permit No.City of Tigard Dan 0°l 02( - S/2021-el 0 2_,
., is • 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 0 8 2021 Plan Reviews / i 1 Q�nr p . k/2 07.'O
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: 'Zit / �j' �i3fV'SLV
I i C A R I) Inspection Line: 503.639.4I75 Date Ready/By: //.. �-J` �j kris: El See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD No'fiedMeth )f / i 11G Supplemental Information
11 IILDING DIVISION (/414 Al
TYPI. OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
I 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
CATEGORY OF CONSTRUCTION work indicated on this application.
®1-and 2-family dwelling ElCommercial/industrial Valuation: $ "Y62-I 44 I
El Accessory building ❑Multi-family Number of bedrooms:
El Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: „Z., 34\,
Job site address: ([j 6 g 1 S W S t ri s l-'i rU cco s t .S-L New dwelling area: 233 0 square feet ,""l IS-
. City/State/ZIP: Sherwood,OR 97140 Garage/carport area: 4a✓ square feet \')`t5'
Suite/bldg./apt.no.: Project name: Polygon At Roshak Ridge Covered porch area: NI- square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Roshak Ridge I Lot no.: VIE,8 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
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
nlew 5 n3k Qctronl� Valuation: $
�V C•Y!"' Existing building area: square feet
New building area: square feet
❑x 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 Existing:
Phone:( 360)695-7700 Fax:( 360)693-4442 New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: Polygon Homes WLH LLC (Please refer to fee sehedu[
Structural plan review fee(or deposit):
Contact name: Omar Alami Abouhafs
FLS plan review fee(if applicable):
Address: 703 Broadway St.,Ste 510
City/State/ZIP: Vancouver,WA 98660 Total fees due upon application:
Amount received:
Phone:( 360)695-7700 Fax::( 360)693-4442
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: permitsubmittals@taylonnorrison.com
CONTRACTOR 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
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 $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: $201.60
Authorized signature: - This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Omar Alami Abouhafs *Fee methodology set by Tri-County Building Industry
Print name: Date: 02/�/�I Service Board.
1:\Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(l 1/02/COM!WEB)
•
• Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard RECEIVED Received T7
Date/By: Permit No.: S 3z
't 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Review
Phone: 503.718.2439 Fax: 503598.19ftB 0 8 2021 DatetBy. Other Permit:
Inspection Line: 503.639.4175 1�'CC Date Ready/By- Avis: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
TYPE.OB'WItbHi NG DIVISION COMMERCIAL FEE* SCHEDLR,E.- USE CHFCKLIST.
Mechanical permit fees*arc based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit
-.. Value:$
CATEGORY OF CONSTRUCTION ' RFSIDENTLAL EQUIPMENT/SYSTEMS FEES*
1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checkli.eL
Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
' - JOB SITE INFORMATION AND LOCATION Heating/coolin,g:
... Air conditioning I 46.75
Job site address: 16689 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
Heat pump 61.06
Suite/bldg./apt no.: Project name: Polygon at Roshak Ridge Ductwork 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other. 23.32
Subdivision: Roshak Ridge Lot no.: 138
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
... - _ Other. 23.32
PROPERTY OWNER ❑ TENANT
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 ❑ CONTACT PERSON Other: 23.32
Business name:Polygon WLH,LLC Fuel piping:
$14.15 for first four;S4.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
W allsuspended/mit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Range
E-mail:permitsubmittalsEr taylormorrlson.eom Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Pro Heating&Cooling Oti1er
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 150
days after it has been accepted as complete
Authorized signature: n n' * Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date: 10/30/20
rin,eldinelPermirctMPr Pnmil Arm nem It mine AAA AFrrr rrr m,xv�ssm.cos
)lectrical Permit Application FOR OFFICE USE ONLY
• J'
City of Tigard DateB :Received PPermit#: ST 'J 'Vwd32�
• 13125 SW Hall Blvd.,Tigard,OR 9 C E I V E D Plan Review
: Phone: 503.718.2439 Fax: 503.59 .1 Date/B ; Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: tads: ESSee Page 2 for
I1GARD ^r^?�
.. Internet: w�,vw.tigard-or.gov FEB O i . Notilicdi\1cthod: Supplemental Information
TYPE OF WO7p�7�� Tr'�AArr�t PLAN REVIEW
"'�OF I il2MrliJ Please check all that apply(submit 2 sets of plans w/items checked):
®New construction 0 Addition/alterarttion/r� ger�tr( (fit
`}l.Jlil_,t,'[TINGIN DIVISION? ❑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 CONSTRUC'llON exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling IDCommercial/industrial El Accessory building less to Bound or exceeds 14,000 ❑comma c al-nse ag cultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:
16689 SW Sunshine Coast St 100HP or more. ❑"A","E","l-2","1-3",
City/State/ZIP: Tigard OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Polygon at 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: FEE SCHEDULE
Description I Qtyv. I Each I Total I •
New residential single-or multi-family dwelling unit.
Subdivision: Roshak Ridge Lot#:138 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 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
El PROPERTY OWNER 0 TENANT 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
® APPLICANT ❑ 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, 742 2
each branch circuit
Contact name: Omar Alami Abouhafs B.Fee for branch circuits without
service Address: 703 Broadway St., Ste 510 branch irrcuit fee,first 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 Pump or irrigation circle 67.84 2
Business name: Portland Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: 1915 E 5th St., Ste D 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:( ) Investigation(1 hr min) 90.00/hr
7(/ /3 Industrial plant(1 hr min) 78.16 h
Email:paul@portlandelectric.biz � 1 Inspections for which no fee is
90.00/hr
CCB Lie.: 194066 Electrical Lie.: C760 Suprv.Lie.: 49205 specifically listed(Vs hr min)
Suprv.Electrician signature,required: //U� L��� ELECTRICAL PERMIT FEES
l.il.C.C.x �Q- ,r(J Q Subtotal:
Print name: Alex Shalya Dale:10/30/20 0 Plan Review Required(25%of permit fee):
p Q L State surcharge(12%of permit fee):
(/ Y I Authorized signature: AtAte i...i 'l.C/Il G(��L TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Ser iev Mishehuk Date:10/30/20 days after it has been accepted as complete.
' Number of inspections allowed per permit.
I\Building\Permits\ELC_PermitApp_ELR ERE.doc Rev 06/17/2015 4404615T(l1/05/COMWEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Descriptio *
Fee for all residential systems combined: $75.00 Qty. Each Total 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
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >too 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* >1013 kva-no additional charge 0.0 3
Each additional inspection over allowable to any of the above:
❑ Other: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%a hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 allowed
Subtotal per permnter on Page I):
• Number of inspections allowed permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:13uildingteesmits\ELC_PemiltApp_ELR_ERE.doc Rev 06/17/2015
. Plumbing Permit Application
Building Fixtures RECEIVED FOR OFFICE USE ONLY
City of Tigard Received Permit No��! L4//�Wa Z
'I 13125 SW Hall Blvd.,Tigard,OR 97223 [[ Dan R ��• iii"'���
rill 0 . - Phone: 503.718.2439 Fax: 503.598.1960 E8 Q Z02� Plan Review Date/By: Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: 88 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Medmd: Supplemental Information
TYPE OF WONILDING DIVISION FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
h-t CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
t-77 1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78
/❑I Accessory building V-Multi-family SFR(3)bath 500.32
Each additional bath/ldtchen 25.02
❑Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2
JOB STTE INFORMATION AND LOCATION Site utilities:
.lob site address: 16689 SW Sunshine Coast St Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywall,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:fReakalrOiLialgaPolygon 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 I Lot no.: 1 38 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
® 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:Tonja Morris
Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 S nk bas n 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@taylormorrison.com Urinal 25.02
Water closet 25.02
CONTRACTOR -,.
Water heater 37.52
Business name:G&B Plumbing&Sons Inc Water piping DW 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: $72.50
CCB Lic.:184372 Plumbing Lie.no.:pb634 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
This permit applicndan expires if a permit is not obtained within 180 days
Print name:Steve Fowler Date: 10/30/20 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:tBuildingOwmits1PLMU-PermitApp.doc I0/0l/09 440-4616T(t0'02/COM/WEB)
1 ll
i' City of Tigardum
2"' B l 2_i
COMMUNITY DEVELOPMENT DEPARTMENT
■
TIGARD Building Permit Review — Residential
Building Permit #: HST-02.( 'doe)37
Site Address: / p6 W - k RkArAjiky ,w �-. *—
Project Name: 0> , I L z ,e Lot #: i�g
Planning Review
Proposal: 11) , A -e
E Verify address/suite#active in Accela. LI In River Terr e: 0 No VJ Yes,River Terrace Review Addendum
Sine Plan Elements: [lefErosion Control
EV copies of site plan on 8-1/2"x 11"or 11 x 17"paper PI tained trees with drip line and tree protection measures
irawn to scale(standard architect or engineer scale) otprint of new structure(including decks)and FFE
L1A�Vorth arrow ty locations&easements(required for new and additions)
to address,project or subdivision name and lot number RSid alk/driveway approach
I'Igg0plicant information(name and phone number) , t, .lion of wells/septic systems
Lot dimensions and building setback dimensions ► et tree size,type and location
Pl p .re footage of buildings to be demolished q2S et names
10,:xisting structures on site Comex elevations(2'contours if more than 4'diffe�ntial)
Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ilE es 0I2Yo
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: 0 Yes,applicant was notified 0 No Received: ❑ Yes 0 No
\3,..sd
Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified 0 No Received: ❑ Yes 0 No
DC Exemption for ADU applied for: 0 Yes 0 No Received: ❑ Yes 0 No
Public Faciliitiyg Improvement(PF1) Permit /
cared: Yes,applicant was notified 0 No plied For: 'J Yes 0 No,stop intake
l d Use Case#: R iC- 17L Zoning. 12-12_ 2
uired Setbacks: Front: Rear: Side: Street Side: #O Garage: 0
I!/J :uilding Height: �l Max. Height: Actual Hei ht:
Landscape Area: 2C % Lot Coverage Max: 0/
Entrance et back no more than 8'from street-facing wall 0 Parallel eet or offset 45 degrees or less
Windows ❑ 1\ . 12%of area of all street-facing facades
Garage 0 Garage door is - d widest street-facing wall Yes 0 No,one of the following is met:
O Door extends no mo an 5'from w there is a covered porch extending beyond garage.
O Door extends no more than wall and there is a 12 sq ft.window above garage on 2"d floor.
0 Garage door width is 0 or less 0 less of facade 0 60%or less and includes 7 of following
❑ Covered por Recessed entrance ❑ set 0 1'Roof eave 0 Roof offset
O Fir ' gles 0 Lap Siding 0 Roof pitch 0 hip,or gambrel roof 0 Dormer
Accent siding Window trim ❑ Window recess ❑ w projection 0 Balcony
sual Clearance Urban Forestry r an
r ile. ensitive Lands: 0 Yes Y. No Type:
I/ Conditions met prior to issuance of building permit
No s:
Approved By Planning: Date:
_ 2/Y49 .L_
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved ❑ Not Approved
I:\Building\Fonns\BldgPermitRvw_RES_122419.docx
Building Permit Submittal '
Original Submittal Date: 2 a'/�ZJ
Site Plans: # 3
Building Plans: #
Building Permit#: fnEnter building permit#above.
Workflow Routing: [Planning Engineering 12'Permit Coordinator Building
Workflow Sign-off: [D- 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
o al plan review routing form.
Building: original permit application,site plans,building plans,engineer and
beam calculations st details,if applicable,etc.
Notes: y ;`726 By Permit Technician: ���/i/"�J' Date: a //G/
Engineering Review
s
[Slope at building pad: ,j
le Conditions "Met"prior to issuance of building permit ////1
[,�, `E•a•sements (encroachments) per engineering conditions of approval and plat
[ Water Quality/Quantity Facility
Assess Water Quality Fee in-lieu: ❑ Yes IV No
Assess Water Quantity Fee in-lieu: 0 Yes [ o
LIDA Facility on lot: ❑ Yes Lee'No
®"Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
P7Approved by Engineering: Date: , //y Z/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved 0 Not Approved
Permit Coordinator Review
16- 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:
X,SDC Exemption: 0 Received X1 Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: El' yes 0 N/A
Tigard Trans SDC: V Yes ❑ N/A
Parks SDC: .Yes ❑ N/A
LIDA ❑ Yes LL N/A
XI OK to Issue Permit
Approved by Permit Coordinator: ik7aNINIQ#4 Date: Z [1 2.b2
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
City of Tigard
ia COMMUNITY DEVELOPMENT DEPARTMENT
■
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: /57 2l-00032_
Site Address: Jw9 Oto QLP e/4,A 060,f7z- c?7L
Project Name: d. s ,n ,2/- /�'l- K.1,/ , Lot #: 237e)
(New• 4t,g=subdivision name;Addition or Alteration=las e of owner)
Planning Review of River Terrace Plan Dicta.Design Standards (18.640.070.1.):
Is the project subject to the plan district design standards?0 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 mineep ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide
Gabled dormer
❑ 0 0 0
2. Eyes on the street: a minim tusl of 12%o each street facing facade must include windows or entrance doors.
Percentage Shown: /\ 1.2-
3. ances:At least one entrance must meet both of the follo g standards:
Max. 8 ft. setback from longe street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
ice opens to a porch: Yes 0 No
all the following apply: VKs .ft.min.
e street facing entry
max.roof above floor of porch
WSJ,(5 ft. depth min. 30%min.porch roof coverage
etailed Design:All buildings shall include a min. of five of e following elements on all street-facing facades:
i
overed porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft. deep
10 Wall offset min. 16 inches ❑ Dormer min.4 ft.wide
❑ Roof cave min. 12 inch projection ❑ t sof offset min.of 2 ft.
❑ Roof shingles either tile or wood P cable, hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. 'P Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40%of street facade 0 Window trim min. 21/2"wide by 5/8" deep
0 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 co 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.
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)
O 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: — Date: -Iff
I:\Building\Forms,BldgPe mitRvw_RES_RT_121417.docx