Permit City of Tigard • COMMUNITY DEVELOPMENT DEPARTMEN']BE t�I ED
Request for Permit Action 3aN �E9 2020
T I G A R l) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • .tieqmpt,of TIGARD
TO: CITY OF TIGARD
y D
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov
FROM: (l Owner 1 Applicant ❑ Contractor ❑ City Staff
Check(✓)one
REFUND OR Name:
INVOICE TO: (Business or Individual) TOC pa t-t) f g vA')/v�$I ' LLC•
Mailing Address: 102j `4 + ) S S I D
City/State/Zip: ViczAv n vui, " IN mil$lo(oO
Phone No.: iDO- (09 J " 1-1 OO
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
yr CANCEL/VOID PERMIT APPLICATION.
❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
Permit#: rA5-rW cow Z " '" Ai, A
Site Address or Parcel#: 41+.2Af.( w 'lr C10(.b 0-13k51-
Project Name: 1�1� pJ'pgV4p..k. Q,
Subdivision Name: p��o� < CL Lot#: f( Z-/O(p go e
EXPLANATION: Q5 u.,13 rl-€W O t‘A.k. a S Q C�--
Signature: Date: 1 2 , Zfl
Print Name: 0 '1 O rr i S
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
�`- /'EZ,-i> /0 T 7.S u
/4)oS 7 —i2 V/E&J A 1 vi )
FOR OFFICE USE ONLY
Route to Sys Admin: Date By Route to Records: Date // p Bye(/
Refund Processed: Date /V// By Le Invoice Processed: Date ,.31' ,/�J By .4177)f
Permit Canceled: Date, /,J� By, arcel Tag Added: Date By
I:\Building\Forms\RegPermitAction_ 205 8.doc
v 1
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q_____
Building Permit Application 3 ,, LOT I CL
Residential RECEIVE FOR OFFICE USE ONLY
City of Tigard FEB 2 5 2019 Received Permit No.:14sr702,0''00012,
. Date/By:a 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.196(;vi-I-Y OF TIGARD Plan DateBRevy:i ew ieihtk Other Perm0VtZO2.0-VO/!Z
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILYDWELLING
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
i
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement El equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
If® 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ 11 ,5, 2,Z
❑Accessory building ❑Multi-family Number of bedrooms: 2_,
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:3 , I ` t2
Job site address: I-1 \L U v i c.,6 6 o ot L V='1 a `J ► V t/`-/-, r r,' �Q , New dwelling area: square feete 43-2
City/State/ZIP:Tigard,OR 97224 Garage/carport area: , %;,,�jl4(psquare feet �lQ�
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: / square feet 1 11 1 S
Cross street/directions to job site: Deck area: 3 square feet
Other st :CPVNIZ 46square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Polygon at Roshak Ridge Lot no.: I O . Permit 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.
CZ) New SF Valuation: $
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER ❑ TENANT Number of stories:
Name:Polygon WLH LLC Type of construction:
Address:703 Broadway Street Ste 510 Occupancy groups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360)695-7700 Fax:(360)693-4442 New:
0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH LLC
fPlvo�rejerrojeeschedute}
Structural plan review fee(or deposit):
Contact name:Amanda Gavin
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:permitsubmittais@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* '
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:William Lyon Homes,Inc. 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)6934442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247
Total fee due upon application: $201.60
Authorize ignature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print n :Arran Gavin Date: a-l/ 2-/I/ *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPetmitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
'Mechanical Permit ApplicatiollIlECEIVE r FOR OFFICE USE ONLY
r City of Tigard Received- g Date/By:
Permit No.: '4SI Z020-a o 2_,13125 SW Hall Blvd.,Tigard,OR 97223 FEB 2 5 2019 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175
Internet: www.tigard-or.gov CITY OF 1luARD Date Ready/By: Juris ld See Page 2 for
BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
, 11 'l Air conditioning I 46.75
Job site address: 1 t_► I W V t LVc 1 ' cu� Furnace 100,000 BTU(ducts/vents) l 46.75
City/State/ZIP:Tigard,OR 97224 Fumace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above t 23.32
r� Other: 23.32
Subdivision:Polygon at Roshak Ridge Lot no.: v�
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
ID PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Polygon WLH LLC Range hood/other kitchen
equipment I 33.39
Address:703 Broadway St.Ste 510 Clothes dryer exhaust I 33.39
City/State/ZIP:Vancouver WA 9860 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(360)695-7700 Fax:(360)693-4442 Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Polygon WLH LLC
$14.15 for first four;$4.03 for each additional
Contact name:Amanda Gavin 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@polygonhomes.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:TBD Other:
MECHANICAL PERMIT FEES*
Address:
Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: TOTAL PERMIT FEE
' This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized si •
� * Fee methodology set by Tri-County Building Industry Service Board
t�Print name:Amand avin Date: 'a-a" f Q1
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/_/COM/WEB)
Electrical Permit Application RECEIVE I FOR OFFICE USE ONLY
City of Tigard FEB 2 5 2019 Received Permit#: t S fn�m -000 f
- • 13125 SW Hall Blvd.,Tigard,OR 97223 Dan By: ryc?' `-{/uvt Z
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
CITY OF TIGARD DateBy: Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: Suns: FB See Page 2 for
TIGARD Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction a Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more ElBuilding over three stories.
❑Demolition El OtheI:
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
1-and 2-familydwellingCommercial/industrial less to ground,or exceeds 14,000 ❑Commercial-use agricultural
® 0 0 Accessory building
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: )tot 1N /�a/,� ( I l�/� t ❑/,Additioo of new motor load of system.
• ma W✓"�� �� ►�"' "OOHPormore. ❑«A„ «E„ «1_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.#: J Project name:Polygon at Roshak Ridge ❑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
;E
Description I Qty. I Each 1 Total
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#:\u2_— Includes attached garage.
1,000 sq.ft.or less ' 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion I 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
(with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
El PROPERTY OWNER I 0 TENANT Services or feeders installation,alteration,and/or relocation
Name:Polygon 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 I Fax:(360)693-4442 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 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 WLH LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name:Amanda Gavin B.Fee for branch circuits without
Address:703 Broadway St.Ste 510 service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Vancouver WA 98660 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 Fax: :(630)693-4442 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: permitsubmittals@polygonhomes.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:TBD Sign or outline lighting 67.84 2
Address: Signal circuit(s)or limited-energy El See Page 2 2
panel,alteration,or extension.
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(4 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within ISO
Print name: Aman Dater-- / - 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 0-4615T(11/0/COM/WEB
' Plumbing Permit Applicatiol> ° V QED
ECEI`
Building Fixtures ' FOR OFFICE USE ONLY
City Tigard Ti and FEB 2 5 2019 Received
Permit No.:��V a .OL��o Q
3111 ® 13125 SW Hall Blvd.,Tigard,OR 97223 DateBy:
:
�TY OF TIGARD Plan Review
Phone: 503.718.2439 Fax: 503.598.1 Other Permit No.:
Inspection Line: 503.639.4175 8 FT DIVISION Date/By:
TIGARD Date Ready/By: Juris Ei See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SC.Ht.DULE
®New construction 0 Demolition For special information use checklist.
Description Qty. Ea. 1 Total
0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath ' 500.32
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: 1019 19 O K v @Dt0( + O 1 A/�/o ll e Catch basin or area drain 18.76
0000 KKK �vvv V�/ V r I/lJl(/' 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.: Project name: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:Polygon at Roshak Ridge Lot no.: I�� Fixture or item:
Tax map/parcel no.: 1 Backflow preventer l 31.27
DESCRIPTION OF WORK Backwater valve 1 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:Polygon WLH LLC Fixture/sewer cap 25.02
Floor 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:(360)693-4442 Ice maker 12.51
El APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Polygon WLH LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Amanda Gavin
Roof drain(commercial) 12.51
Address:703 Broadway St.Ste 510 Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
E-mail:permitsubmittals@polygonhomes.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:TBD
Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.: Plumbing Lic ..
State surcharge(12%of permit fee)
Authorized signature: ttt TOTAL PERMIT FEE
Print name:Am Date /J /O 1 This permit application expires if a permit is not obtained within 180 days
Jafter it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1'\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616TO 0/02/COM/WEB)
City of Tigard
111 411
COMMUNITY DEVELOPMENT DEPARTMENT
?I G A RD Building Permit Review — Residential
Building Permit #: M sT2D2o -0 Q0 ( 2..
Site Address: Lt1111 V q/I �-o y L -Terri
Project Name: �� � 1-p4-Lk - Lot #: 102
(New 40, g=subdivision name;Addition or Alteration t name of owner)
Planning Review
Pro sal: k1,0
Verify address/suite#active in Accela. ►L/J In River Terrace: ❑ No ICI Yes, River Terrace Review Addendum
Sit Plan Elements: Erosion Control
a
lai3 ..pies of site plan on 8-1/2"x 11"or 11 x 17"paper 14"‘ tained trees with drip line and tree protection measures
S ! .wn to scale(standard architect or engineer scale) r F otprint of new structure(including decks)and FFE
I. .rth arrow 'ty locations&easements(required for new and additions)
pke address,project or subdivision name and lot number k l Sidewalk/driveway approach
plicant information(name and phone number) ation of wells/septic systems
Lot dimensions and building setback dimensions ,:, , � ::'r 4,,..... y �t, a .t
\4 square footage of buildings to be demolished So eet names
t IA I.sting structures on site (Conier elevations (2'contours if more than 4'diffee ntial)
PI Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replac ? 1lJYes 0
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Yes No
Ot lean Water Services—Service Provider Lette (lot platted prior to 9/10/1995):
Pequired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
ublic Facili�ti mprovement(PFI) Permit:
R uired: �Z Yes,applicant was notified ❑ No Applied For: Yes ❑ o,stop intake
IL and Use Case#: .Q 0/ ooe2)9.
L'Zoning: --
2quired Setbacks: Front: /Q Rear: Side:_a_ Street Side: Garage: / .
'Liilding Height: Max. Height: ' Actual Hei ht: `g
andscape Area: c>2 0 % Lot Coverage Max: ()
Entrance t back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 d g>or less
Windows ❑ Minim 2%of area of all street-facing facades
Garage ❑ Garage door is . d widest street-facing wall OK ❑ Yes o,one of the following is met:
❑ Door extends no m an 5'from wall and there is a ed porch extending beyond garage.
❑ Door extends no more than m wall a re is a 12 sq ft.window above garage on 2nd floor.
❑ Garage door width is ❑ 12'or les ° or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch cessed entrance offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire s ' ❑ Lap Siding ❑ Roof pitch hi ,or gambrel roof ❑ Dormer
ccent siding Window trim ❑ Window recess ow projection ❑ Balcony
O1`visual Clearance Urban ForestryI<<,
OWensitive Lands: ❑ Yes Ad No Type:
❑ C nditionsAet pri,or to issuance of bull 'ng permit
No s: ( Jvii/i n q IX! .�s72- ? - 7) p/hi l9- /ZZ,(.74/C
Approved By Planning: Date: t t-t 15
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPennitRvw_RES_022819.docx
•
Building Permit Submittal .
Original Submittal Date: OZ-2S—20 t 9
Site Plans: # a
Building Plans: # 3
Building Permit#: la' Enter building permit#above.
Workflow Routing: Et Planning Eli'Engineering E'Permit Coordinator [ Building
Workflow Sign-off: E- Sign-off for Planning(include notes from planning review)
Route Application Documents: EE"Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
In- Building: original permit application,site plans,building plans, engineer and
beam calculations and st details,if applicable, etc.
Notes: ,�
By Permit Technician: ardiaLi Date: 11/`D 4'2620
Engineering Review
Lld' lope at building pad: 2.S ,
V Conditions "Met"prior to issuance of building permit �/lj�
Ltd'/Easements (encroachments)per engineering conditions of approval and plat
Ut'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ['No
Assess Water Quantity Fee in-lieu: El Yes (,tee No
�� LIDA Facility on lot: ❑ Yes YJ No
L Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
A Approved by Engineering: Date: l .,-,/%•
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ 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:
ision Notice 3:7Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: es ❑ N/A
Parks SDC: L✓J Yes OzN/A
/7 LIDA CIYes All N/A
OK to Issue Permit /G��9 '/�/?�
Approved by Permit Coordinator: Date:
1:\Building\Forms\BldgPermitRvw_RES_022819.docx
f
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
' C
T I G A R D River Terrace Building Permit Review Addendum
e
Building Permit #: tit S T 20219-OOP 1 Z
Site Address: 14319 ,_�Gf (77ea(c 7 o f
Project Name: Pd , ,I) -72 ✓< )i ,/ Lot #: l tl2
(New4 i g=subdivision name;Addition or Alteration t name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.070.I.):
Is the project subject to the plan district design standards? ❑ Yes ❑ No
1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional
element required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 ft. deep Gabled dormer
ft. de min. 2ft., 5 ft.wide min. 2 ft., 6ft de
❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facingfaçade r s or entrance doors.
'Percentage Shown: >/2%, e.' > 2 % S, -1,G; T(,} t= 71
3. trances:At least one entrance must meet both of the folio ' g standards:7 -SC �'Z-Z-��
VJ Max. 8 ft. setback from lon est street- in wall Parallel to street,angle no more than 45° from street,
g g or open onto porch
Entrance opens to a porch: ❑ Yes No
If yes,all the following apply: ❑ 25 sq.ft. min.
❑ One street facing entry ❑ 12 ft. max.roof above floor of porch
❑ 5 ft. depth min. ❑ 30%min.porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
❑ overed porch min. 5 ft.wide x 5 ft. deep ❑ Recessed entry area min. 5 ft.wide x 2 ft. deep
'Rall offset min. 16 inches.��� y�,, ❑ ormer min. 4 ft.wide
oof eave min. 12 inch projection ��" oof offset min. of 2 ft.f'i - ,c
❑ Roof shingles either tile or wood It able,hip or gambrel roof design f i �
❑ oof pitch oriented south min. 500 sq. ft. Vibforizontal lap siding min. 3-7 inches wide 4L S
VJ Accent siding min. 40%of street facade / 1�I Window trim min. 2 i/2tt wide by 5/8" deep F `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.
Setbacks: ��
No closer to front or side lot line, than longest street-facing wall. ❑ Yes E No. If No (Check one):
❑ lay 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.
Wi h: (Check one)
101 12-foot-wide garage door ❑ 40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: 'YpJ 1 '�'
Date: ' �,-1"1
L\Building\Forms\BldgPermitRvw_RES_RT_]21417.docx I _