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Permit CITY OF TIGARD MASTER PERMIT UPI _ . COMMUNITY DEVELOPMENT Permit#: MST2021-00131 T I G A R f.7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/03/2021 Parcel: 2S107AA16700 Jurisdiction: Tigard Site address: 14190 SW 165TH AVE Subdivision: ROSHAK RIDGE Lot: 167 Project: Polygon at Roshak Ridge, Lot 167 Project Description: New detached dwelling. NO FINAL INSP UNTIL FEES PAID FOR SDCs DEFERRED TO OCCUPANCY. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 4 First: 2776 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 20 Bathrooms: 3 Second: 0 sf Garage: 684 sf Front: 8 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 2776 sf Value: $372,986.16 Rear: 20 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 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckfiw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types _ Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum<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: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr. 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2776 Owner: Contractor: POLYGON WLH LLC WLLIAM LYON HOMES INC Required Items and Reports(Conditions) 703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $43,242.88 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..11�978�7 or 1.800.332.2344. Issued By: 1LoU,ly Vcwti De,Wege Permlttee Signature: O W Ar�JLf c47tA1't Call 603.639.4176 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. Electrical Permit Application i t uc 1 l i•I I, I I ,i (0,1 , City of Tigard Received 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.7182439 Fax: 503.598.1960 l i +,F.1'i Inspection Line 503.639.4175 Ready may, ,, Internet: wwwAgrd-or•gov Noti5 od: TYPE OF WORK .. _.nkff• ®New construction e ) : ' ❑Addition/ahrnazion/replacematt plra■o Mack an than apply(aataoa j seas of whams ): 017emalitim ❑Other: Q Saran or fader 400 amps or some a Buildumover three stones. =sere the awolable Kook=went CI Moines and txissyyerdt, CATEGORY OF CONSTRUC'T[ON exceeds 10,000 empa at t 50 volts or aFloating buildings. ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building tese m vowel,or nmaedu 14.000 ❑^--- r eae agricalimal ElMtd6-family 0 Master builder 0 Other amps kit allothamdaBatioes =dimes. [Inn pomp. ❑Installation of 150 KVA er JOB SITE INFORMATION AND LOCATION ❑Emaseoey•» ►+rpm separately derived lob#: Job site address: 14190 SW 165th Ave. ❑Addition ef new motor load of system 10011P or more. ❑"A",'E-,"1-2","1 3", City/State/ZIP: Tigard,OR 97140 ❑Six es more nxu>mtist oaks oxvpsmy_ ❑Hatch-sac facilities. ❑xmaatironal whisk pads. Suite/bldg.apt.#: Project name: Polygon at Roshak Ridge 01Iaaardma locations 0 Supply voltage for more than ❑Service or Media 600 amps or more. 600'446.°slam Cross street/directions to job site: 188 qy,i,�prry��,t,{rr* „mod 1 our, I man 1 Tsar ' I • New raidenIW Bugle-or maid-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: 167 Includes attacked garage_ Tax map/parcel#: 1,000 eq.tl or less 168.54 4 Ea.add'1500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 New construction.Type SFU (wide above in.it.) Limited coup},milli-family 75.00 2 residential(with above sq.0.-1 l$Zt PROPERTY OWNER ❑ TENANT Renewable Racer/y 0 See Pale 2 Services or feeders Iastallatto.,atttral1o.,and/or relocation Name: Polygon Homes WLH LLC 200 amps or less 100.70 2 Address: 703 Broadway St.,Ste 710 201 amps to 400 amps 13336 2 City/State/ZIP: Vancouver,WA 98660 401 amps to 600 amps 20034 2 601 amps to 1,000 amps 301.04 2 Phone:( 360 )946 8674 Fax:( ) Over 1,000 amps or volts 552.26 2 Email: OAlamiAbeuhafsgtaylormorrison.cam-PermitSubanittals(�taylormorrison.com Temporary services or t2cdcaa iaataitatloo,alteration,and/or ttea Owner inetallatioa:This installation is being made on property that I own which is not 200 amps or less 5936 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 399 amps 168-54 2 0 APPLICANT T ❑ CONTACT PERSON Brash circuits—new,■Ileratiog or extension,per Panel b Business name: Polygon Homes WI.H LLC A above service or fender Foe, 7.42 2 Contact name: Omar Aland Abouhafs t branch O1m 1t B.Fee for'branch circuits without Address: 703 Broadway St.,Ste 710 service or fads fee first 56.18 2 branch mutt City/State/DP: Vancouver,WA 98660 Each add'!branch cavort 7.42 2 Phone:(360 )946 8674 Fax:: Miacell■neo.s(service or feeder ant alluded) ( ) Each manufactured or modular 67.84 2 Email:OAlamiAbouhafs®taylormorrisoacom-PelmitSubmittalsCa taylormortison.com dwelling a only mrmr rmeaar CONTRACTOR QOCO°r only 67.84 2 Pump or irrigation circle 67.84 2 Business name: Wallace Electric Sign Cr outline lighting 67-84 2 Address: 105 Dresden St Signal cueurt(s)or lid-smith' pal alteration,a comma Sea Page 2 2 City/State/ZIP: OR 97103 Each additional inspection over allowable la any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503 308 0563 Fax:( ) Investigation(1 hr min) 90.00/hr Email: David@wallaccwires.com Iadttatiiat plant(1 hr thin) 78.18!hr CCB Lie.:224868 Electrical Lic.: C1441 Suprv.Lie.: 6363S only l siedt hr )is90.00/hr f ELECTRICAL P I ftT_FEES Suprv.Electrician signature,required: Subtotal: Print name:'„„ap , Date: Ni itG, f 0 Plan Review Required(25%of permit foe): State surcharge(12%of permit fee): Authorized signature Awe, i TOTAL PERMIT FEE: Print name: 7)i„ _ O a+ a f// /Z f I This permit•ttP' a■expires 1r a pet is asN.at.lsea.ritil■tSa ?(err 4'd/c�f6( �°after a has beat eeeepted as complete. Number 0f inspections allowed pet permit twi etPu arla0 PentApp kind ERE Rev 06117n0t5 (5l'(71/05/COWWFB s ti Building Permit Application r Residential FOR OFFICE USE ONLY Cityipgof Tigard RECEIVE.•-`.eceived - Permit No -.— 7` y 6f �11 io / (Y71� 'r 131SW Hall Blvd.,Tigard,OR 97223 Plan Review MAR 2 3 2021 Other Permit: _ Phone: 503.718.2439 Fax 503.598.1960 Date/By: � 2/ 7517 .��IP4244-ofx1,71 TI GA RD Inspection Line: 503.639.4175 Date Ready/By: ` oi,. .'i',c� �S�eelage2 for Internet'. www.ligard-or.gov CITY OF TIGARD Non /Method: / Ob. i `�1 Supplemental Information // I ♦ '� E. , 1 Imo' •). �// a-/ L�/_-vital' TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING 0 New construction El 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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 4 0 I-and 2-family dwellingValuation: $ 31 . 1$ . ❑Commercial/industrial li❑Accessory building 0 Multi-family Number of bedrooms: ( 0 Master builder 0 Other: Number of bathrooms>r 3 JOB SITE INFORMATION AND LOCATION Total number of floors:2 34(.e O Job site address: 14190 SW 165th AVE New dwelling area: >°O1f1,square feet City/State/ZIP:Sherwood,OR 97140 Garage/carport area: 48U1 square feet Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Polygon at Roshak Ridge I Lot no.: 167 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. / New Single Family Valuation: $ 9 e'&'r s N os 1-O pee„��kt e� Existing building area: square feet kJ �✓C� C�-� New building area: square febl 0 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:(360 946 8674 Fax:( )360 693-4442 New: 0 APPLICANT 0 CONTACT PERSON CIO BUILDING PERMIT FEES* Business name:Polygon Homes WLH LLC (Please refer to fee schedule) 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:O 4(e rn(R b t)u hcfs tAay(Or m mri S on. urn 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 /1/J �1[ (_ / Total fee due upon application: $201.60 Authorized signature: 2NtCe2 . k.M.G. .rY IyBLLi:cz7rrd- 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: 03/19/2021 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) , Mechanical Permit Application is „._ FOR OFFICE USE ONLY .: City of Tigard Received J g UateBy: Pesmit Na.: 'I 13125 SW Hall Blvd.,Tigard,OR 97223 __.-.____ ate Phone: 503.718.2439 Fax: 503.598.1960 Plan By: Other Permit Inspection Line: 503.639.4175 Y l4i.41:17 Date Re ate ady/8y: lush: H See Page 2 for Internet: www.tigard-or.gav Notificd.Method: Supplemental Information TYPE OF WORK COMMERCIAL„FEE` SCREW/.E — USE CB'ECKLIST • 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 0 Demolition ❑Other mechanical materials,equipment,labor,overhead,and profit. Value:S CATEGORY OF CONSTRUCTION RESIDENTIAL EQUfPME[J'f!SYSTEMS FEES' ® I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist j Multi-family ❑Master builder ❑Other. Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heatlnglcoaling„: Air conditianine I 46.75 46.15 Job site address: 14190 SW 165th AVE Furnace 100.000 BTU(ducts/vems) 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 hydroaic) 23.32 1 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Polygon at Roshak Ridge I Lot no.: 16 7 Oer th 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 New Single Family fireplace 23.32 Log lighter(gas) 23.32_ Wood/pefet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 la PROPERTY OWNER 0 TENANT Other 23.32 • 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/L P:Vancouver,WA 98660 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(360)695-7700 Fax:( ) Atticicrawlspace fans 23.32 ® APPLICANT ❑ CONTACT PERSON Other: 23.32 Fuel piping: Business name.Polygon WLH,LLC 514.15 for first four;$4.03 for each additional Contact name:Tonja Morris Furnace,etc. I 01'15 Address:703 Broadway St.,Ste 510 ties beat pump W allisuspendedhavt beater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace ) E-mail:permitsubmIttalsttaylormorrison.cam Range J4'IS Barbecue ' CONTRACTOR Clothes dryer(gas) Business name:Pro Heating&Cooling Other: MECHANICAL PERMIT FEES' Address: N W Alociek Dr,Ste.1104 Subtotal City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00) Phone:(360)270-1590 Fax:( ) Plan review(256/a of permit fee) State surcharge(12%of permit fee) CCB tic,:209001 TOTAL PERMIT FEE tlatThis permit application expires if a permit Is not obtained within 180 (a; t\G days after it has been accepted as complete. Authorized signature: fff...•��wa I J • Fee methodologyset by Tri-Coup tynuildi4§bad uttry Service Board Print name:Elia Duran Date: 10/30/20 t-,a,.ilelin•11mmasl4l5r 6.m.ii snn Nni it an: Electrical Permit Application K r •�`?1 �' �N_ t 1, o tr ..wus as ' City of Tigard Received r Perrin it: 1 '�' a 13125 SW Hall Blvd,Tigard,OR 97223 Nu Review '- Phone: 503.7182439 Fax 503.5981960 Date/By: Related Permit8: Inspection Line: 503.639.4175 TIG'�S(D Internet: www.• m Rudy e td1T' See Page for uBd' gov Notified/method: - Supplemental Information ,-- TYPE OF:WORK;":`3. -' .-. ir ;" •: ;,.,_'�;.. . - . ®New cons actionthat+ °ly(su'�:et pla ixe s c.,ke. 0 Addition/alteration/replacement Please check all apply(submit 2 acts ofplam Vixens checked): ❑Demolition Other ❑Service or feeder 400 amps or more ❑Building over three stories. .yr _ where the available fault amens ❑Marinas end boa r :'2•n ,Irt: ::z,:p': ::CAIEGORY._OF CONSTRUCI'1ON. • `:'... • boatyards, . r •tea,..'-.'..-.. .: exceeds]0,000 amps at 150 molts or ❑Floating buildings. tEl 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑M y El Master builder 0 Other amps for all other installations. building,, 'fjfr; . .• JOB STrXi; O �. . .� 7 ❑Eme ❑lager separately yd derived or }?.trIATION"ANDY;OCATf02�1i '� ; ❑F�ergeayryalem. larger separately derived job#: rob site address: 14190 SW 165th AVE ID Addition of new motor load of system. 10012 or more. ❑"A","B","1_2","1-3", City/State/ZIP:Tigard,OR 97224 ❑Six or more residential omits. occupancy. • ❑Health-cam facilities. ❑Recce.~onus vehicle perks. Suitethl• dgJapt it: _ Project name:Polygon At Roshak Ridge ❑Hazardous locations. 0 Supply voltage for more than Cross street/directions to job site: IDService or fader 600 amps or more. 600 volts nominal FEE SCBE51ELE-,-:_•: . Descriptive I Qty. 1- axe 1 Total I New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot# 167 Includes attached garage. Tax map/parcel# 1,000 sq.it or less 168.54 4 Ea add'1500sq.S or portion 3392 1 . DESCRIPTION OF'WORK .: Limited energy,residential New SFU (with above sq.lt) 75.00 2 - limited energy,muld-family residential(with above sq.$) 75.00 2 ®.PROPER1/,-O`9VNER .1..:.: - • . ' ❑ TENANT Renewable Energy El.See Page 2 Services or feeders installation,alteration,and/or relocation Name:William Lyon Homes,Inc • 200 amps or 1ms 100.70 2 Address:703 Broadway St Suite 510 201 [0 400 amps 13356 2 • City/State/ZIP:Vancouver,WA 98660 401 amps to 600 amps 20034 2 601 amps to 1,000 amps 301.04 2 Phone:(360)695-7700 I Fax:(360)693-4442 Over 1,000 amps or volts 55226 2 V Thria 1; Temporary cervices or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 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 399 amps 16854 2 ' :..M-.APPLJCANI' ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,,er panel A.Fee for branch circuits with Business name:William Lyon Homes,Inc above service or feeder fee, each branch circuit 7.42 2 Contact name - B.Fee for branch circuits withoaa Address:703 Broadway St Suite 510 sett x or feeder fee,fast 56.18 2 branch circuit City/State/21P:Vancouver,WA 98660 Each acid'!branch c colt 7.42 2 Phone:(360)695-7700 I Fax::(360)693-4442 �mmmnmfacturedormod larrernotincludei) Fmml•perznitsubmittalst aylormorrison.com dwelling,service aadlor feeder 2 Reconnect only 67.84 2 • . .. CONTRACTOR . m m circle�p i 67.84 2 Business name Alameda Electric Sign or a,rrm lighting 67.84 2 Address: 15 NE 44th Signal circuit(s)or limited energy panel,dictation,or extension 0 See Page 2 2 Cit3/StatefGlP: rtland OR 97213 Each additional inspection over allowable in any of the above Additional inspection(1 hr men) 6625/hr Phone:(503)319-2 Fax( Investigation(1 br rain) ' 90.00/hr • F.mm'I•solarpdz@me.com Industrial plant(lhrmin) 78.18/hr Inspections for which no foe is CC.B Lic.: 199188 El • a: c923 Suprv.Lin: 48715 �y listed 04 hr min) �� Suprv.Electrician signature, ' ed EIECTRILAL PERMIT FEFS Subtotal: Print name Kile Rood . I Date: ❑Plan Review Required(25%ofpemrit fee): State surcharge(12%of peanut fee): Authorized t, TOTALPfiRMCUM: _--.._....... Dais permit application expire If a permit!"not obtained within 180 I Print name; a Rood ate: ' days after i<has been accepted es complete. . Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of Tigard Received ,� b Permit No.: v 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: C Phone: 503.718.2439 Fax: 503.598.1960 Plan Rev ew Other Penult No.: Inspection Line: 503.639.4175 Date/By:T I G A R D Internet: www.ti rd-0r. Ov Date ReadyBy: nuns See Page 2 for g Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE e4 New construction ❑Demolition For special information nse checklist. Description I Qty. I Es. I Total ❑AdditioWalteration/replacement 0 Other: New 1-1-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 X1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building lii-Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder 0 Off: Fire sprinkler( ,sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 14190 SW 165th AVE 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 R:_) Page 2 Suite/bldg./apt.no.: Project name:4iaeid.TiiirePolygon 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 I Lot no.: 167 Fixture or item: Tax map/parcel no.: Backflow pre-venter 31.27 DESCRSTION OF WORK Bacicwatervalve 12.51 New Single Family Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25,02 Ejectors/sump 25.02 .r PROPERTY OWNER I ❑ TENANT Expansion teak 12.51 Name:Polygon WLH,LLC Fixture/sewer cap 25.02 Address:703 Broadway St.,Ste 510 Floor drain/floor sink/hub 25.02 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 S_) Page 2 Primer 12.51 Contact name:Toaja Morris Roof drain(commercial) 12.51 Address:703 Broadway St.,Ste 510 Sink/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:permltsubmittals®apolygorhomes.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:G&B Plumbing&Sons Inc Water pip ngDW 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: S72.50 Plan review (25%of permit fee) CCB Lia:184372 Plumbing Lic.no.:pb634 State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Steve Fowler - Date: 10/30/20 This permit appaea6ea 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. 1:1Buadug\Permhs\PLMU-PemutApp.doc io,oiee 4404616T(IOWONCOMM'EB) Plan# C96736OZ) Floors I Large 11 Bed rooms 9 Small 53 WC LAV 5' Tuba Basement Vent 5_ 1st Floor 27-)(P Water Heater 1 2nd Floor AC YES 3rd Floor School l R-3 Total a-77 CP _ , Garage (�g4 llv� IC --/ Total 3 SaS 0 01j #forElec City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential Building Permit #: AS7 O oo 1 I Site Address: 14190 SW 165th Ave Project Name: Polygon @ Roshak Ridge Lot #: 167 Planning Review Proposal: new house ® Verify address/suite# active in Accela. L7 In River Terrace: ❑ No Yes, River Terrace Review Addendum Site Plan Elements: JiljErosion Control X 3 copies of site plan on 8-1/2"x 11" or 11 x 17"paper X]Retained trees with drip line and tree protection measures XDrawn to scale(standard architect or engineer scale) K]Footprint of new structure(including decks)and FF'F $]North arrow kiUtility locations&easements(required for new and additions) XSite address,project or subdivision name and lot number $7Sidewalk/driveway approach X]Applicant information(name and phone number) rlaLocation of wells/septic systems &`Lot dimensions and building setback dimensions ®Street tree size,type and location rfaSquare footage of buildings to be demolished ®Street names n®Existing structures on site %i Corner elevations(2'contours if more than 4'differential) XLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 144A❑No impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes ❑No E Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified Xl No Received: ❑ Yes ❑ No ® Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs Required: ❑ Yes,applicant was notified ® No Received: ❑ Yes ❑ No SDC Exemption for ADU applied for: 0 Yes [IX No Received: ❑ Yes ❑ No ] Public Facilities Improvement (PFI) Permit Required: 0 Yes,applicant was notified N No Applied For: 0 Yes 0 No,stop intake IN Land Use Case#: PDR2015-00002 ® Zoning: R-4.5 Il Required Setbacks: Front: 8 Rear: 20 Side: 3 Street Side: na Garage: 20 RI Building Height: Max.Height: 30 Actual He4tht: 20 ® Landscape Area: 20 % 87 Lot Coverage Max: 80 e ❑ Set back no more than 8' from street-facing wall 0 Parallel to street or offset 45 de Windows um 12%of area of all street-facing facades Garage 0 Garage d widest street-facing wall ❑ Y o,one of the following is met: ❑ Door extends no 'from wall and v red porch extending beyond garage. ❑ Door extends nSee River Terrace Addendum t.window above garage on 2nd floor. ❑ Garage door width i ❑ 60%or less and includes 7 of following: ❑ orch ❑ Recessed entrance 0 Wall o se ' oof eave ❑ Roof offset Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,o oof 0 Dormer ❑ Accent siding 0 Window trim ❑ Window recess ❑ Window projec Balcony XI Visual Clearance 117 Urban Forestry Plan ] Sensitive Lands: D Yes ® No Type: ® Conditions met prior to issuance of building permit Notes: l�� j�� g7 Approved By Planning: O Date: 3/23/2021 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Fomts\BldgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: V y/Pl Site Plans: # '3 Building Plans: # Building Permit#: nter building permit#above. Workflow Routing: lanning ngineering ermit Coordinator }d�I3utlding Workflow Sign-off: B— -off for Planning(include notes from planning review) Route Application Documents: sneering: (1) copy of permit application, (1) site plan, (1)building plan and origin plan review routing form. uilding: original permit application,site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: /6 irA — 3 Pi G/nct,i 7S ar ()Mar —4y f, ly SL By Permit Technician: Date: 10-19.1 Engineering Review Slope at building pad: 1,p [ ' Conditions"Met"prior to issuance of building permit y Easements (encroachments)per engineering conditions of approval and plat t Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes INo Assess Water Quantity Fee in-lieu: ❑ Yes Lr No i� LIDA Facility on lot: ❑ Yes t No IJd Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: _ II/Approved by Engineering: Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review kr 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 Does not apply X, SDC Fees Entered: Wash Co Trans Dev Tax: A Yes ❑ N/A Tigard Trans SDC: / Yes ❑ N/A Parks SDC: V Yes 0 N/A LIDA ❑ Yes N/A Er to Issue Permit r Approved by Permit Coordinator: —. Date: 4( 120/1 C\Building\Forms\BldgPerm itRvw_RES_1224I9.docx City of Tigard lifia COMMUNITY DEVELOPMENT DEPARTMENT C T i G A R D River Terrace Building Permit Review Addendum Building Permit #: Site Address: 14190 SW 165th Ave Project Name: Polygon @ Roshak Ridge Lot #: 167 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Plannn lteviety of lover ?terrace Plan District Desiin Standards (78.640.070.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. Porch min. 5 ft. dee Balcony w/ access 2 Window Projection Vertical Wall•Offset a p ft. deep min. 2ft., 5 ft.wide min. 2 ft., Eft.wide Gabled dormer IZ1 ❑ ❑ ® ❑ 2. Eyes on the street: a minimum of 12°/0 of each street facing facade must include windows or entrance doors. Percentage Shown: 16% 3. Entrances:At least one entrance must meet both of the following standards: If7e Max. 8 ft. setback from longest street- facing wall ® Parallel to street, angle no more than 45° from street, or open onto porch Entrance opens to a porch: ® Yes ❑ No If yes,all the following apply: K 25 sq.ft. min. M One street facing entry EXI 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: 3L Covered porch min. 5 ft.wide x 5 ft. deep ® Recessed entry area min. 5 ft. wide x 2 ft. deep ❑ Wall offset min. 16 inches E Dormer min. 4 ft.wide ❑ Roof eave min. 12 inch projection ❑ Roof offset min. of 2 ft. ❑ Roof shingles either tile or wood E Gable, hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal 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 ❑ 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.Tt7 Yes ❑ No. If No (Check one): ❑ May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch. ❑ May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story above the garage that faces the street with a min. area of 12 sq.ft. Width: (Check one) ❑ 12-foot-wide garage door IJ 40% max. of street facade ❑ 50% max. of street facade with 7 detailed design elements Notes: Approved By Planning: 04 G Date: 3/23/2021 C1BuildingWorms\BIdgPermitRvw_RES_RT_121417.dax I �"o'"