Permit INCITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2O21-00141
T I GARL3 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/03/2021
Parcel: 2S 107AA17200
Jurisdiction: Tigard
Site address: 14320 SW 165TH AVE
Subdivision: ROSHAK RIDGE Lot: 172
Project: Polygon at Roshak Ridge, Lot 172
Project Description: New detached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1569 of Basement 0 sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1865 sf Garage: 688 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 3434 sf Value: $453,758.04 Rear: 15
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
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw 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: 4
Fum>=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!500 sf: 7 201-400 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 3434
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: $45,861.33
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 503.232.19872.9 or 1.800.332.2344.
Issued By: lU.Y L0Va iDe,Weg-e Permittee Signature: Dn/App1CCC On
Call 603.639.4175 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.
Building Permit Application , -CEIV f w-I
Residential FOR OFFICE USE ONLY
APR Received /prq^ /� '/
. City of Tigard Date/By: / /3 ?172/ , E Permit No.: p11 J12VZI-opp-1l
13125 SW Hall Blvd.,Tigard,OR 97223 �/
Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD nate
PlanBReview Iq (mil y: rl f erP ‘vazoit coo?,
T 1 G A R U Inspection Line: 503.639.4175 11, (+ (r��1,ffI r Date ReadyBy: r�s: H See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION 'fied/Method: �� �pf� I Irk Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®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 ❑Commercial/industrial Valuation: $ ✓/�5�'
❑Accessory building ElMulti-family Number of bedrooms: 4
❑Master builder ❑Other: Number of bathrooms: X.. jj� l
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 /j
Job site address: 14320 SW 165TH AVE New dwelling area: 3,434 square feet l y
City/State/ZIP:Sherwood,OR 97140 Garage/carport area: 688 square feet l 614
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: IS< 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 Lot no.: 172 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 Construction/Type: SFU /Elevation plan: 222700BR Valuation: $
Projected start: July 2021 Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Polygon Homes WLH LLC Type of construction:
Address:703 Broadway St., Ste 510 Occupancy groups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360) 946-8674 Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON 6:9 BUILDING PERMIT FEES*
Business name:Polygon Homes WLH LLC (Please refer m fee schedul)
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)946-8674 Fax::( )360 693-4442
E-mail:permitsubmittals@taylormorrison.com-0AlamiAbouhafs@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.
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 �/ A t - '_ Total fee due upon application: $201.60
Authorized signature: 0�-.rY .rY OBLG�C[ This permit application expires if a permit is not obtained
I(/J within 180 days after it has been accepted as complete.
Print name:Omar Alami Abouhafs Date: 04/07/2021 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Mechanical Permit Application [[��y, FOR OFFICE USE ONLY
Cityof Tigard IV D Received M Sr Zl9Zl LiG lei
g Date By: Permit No.:
'I 13125 SW Hall Blvd.,Tigard,OR 2 Plan Review
t Phone: 503.718.2439 Fax: 503.598.1960 O{� r, Dale/By: Other Permit:
YI{}{,Itti Inspection Line: 503.639.4175 „i '" Dale Ready/By: mcisr -
Intemet: www.tigard-or.gov H See Page 2 for
C,P OF TiiGffARDn( Notified/MetbM. Supplemental Information
TYPE OF 'Qtyr iiN G DI V ISI'Jtsj . ...COMMERCIAL FEE*.SCHEDULE:.- USE CEEChZIST
Mechanical permit fees.are based on the value of the work
®New construction D Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION_ RESIDENTIAL EQUIPIlfEN1'/SYSTEMS FEES'-
®I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information rue checklist
I j Multi-family ❑Master builder ❑Other: Description Qty. Ea. ] Total
JOB STTE INFORMATION AND LOCATION Heating/cooling:
Air conditioning I 46.75
Job site address: 14320 SW 165TH AVE 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
hydronicl 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: Polygon at Roshak Ridge Lot no.: 172
Other: 23.32
— Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK - Can fireplace/insert 33.39
"` Flue vent for water heater or gas
New construction.Type: SFU fireplace 23.32
Type:SFU/Elevation plan:222700BR Log lighter(gas) 23.32
Wood/pe0et stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other
El PROPERTY OWNER El TENANT
Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
Address:703 Broadway St.,Ste.510 equipment 33.39
Clothes dryerexhaust 3339
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(360)695-7700 Fax( ) Anic/crawlspace fans 23.32
. _...., :.. -
ElAPPLICA7Vf ❑ CONTACT PERSON. Other. 23.32
- Fuel piping:
Business name:Polygon WLH,LLC
$14.15 for first four;S4.03 for each additional
Contact name: Omar Alami Abouhafs Furnace,etc. 1
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 1
E-mail:per mitsubmittalsettaylOrmOITISOn.COm 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)
Plan review(25%of permit fee)
Phone:(360)270-1590 Fax:( ) State surcharge(12%ofpermit fee)
CCB lic.:209001 TOTAL PERMIT FEE
[ This permit application expires if a permit is not obtained within 180
A: a be „ ^ ,,, days after it has been accepted as complete.
Authorized signature: W LJ)w tM�f t • Fee methodologyset byTri-Coon Buildin Ind tY 8 usny Service Board
Print name:Elia Duran Date: 04/07/21
rvw„cu;nelPmmiornOPr P..nn Ann nam I Ann •nn <,-.r.,r m,rf..,.n000l
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard C E IV E D R3weeBi`wly Pen"#. Srad-t'11014'I
13125 SW Hall Blvd.,Tigard,OR 97 Plea Review
g
Phone: 503.7I82439 Fax: 503.598.1960 AqR 1, " 1>amrBy Related Permit r7:
inspection Line: 503.639.4175 Ready TIGARD' Internet: www.tigard-orgov 7 r,. �•�� N oficdA4erhod: reran la See Pages for
..Y QI"'I-1ufli'd) - Supplemental Information
TYPE OF ws419fi ri
�NG Ctt-I1C''`'"' PL JS•R)SVK`,
® ElIF New construction Addition/alte 1 acement Please check ell that apply(submtt j sets of dam w/items etuckcd):
El Demolition ❑Other: ❑ ti Sare or feeder 400 amps or inure Cl Building over three stones.
where the mailable fault current ❑Marinas and haetyarde
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Flaming buildings
® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building teem to sO1 d,Of exceeds 14.000 ❑Commercial-use agricultural
❑Multi-family ❑Master builderamps for as Om insffiuweos. buildings.
❑Other 0 Fire pomp. 0 Inshllatioa of 150 KVA or
JOB SITE INFORMATION AND LOCATION Cl Emergency system. larger separately derived
Job#: Job site address: 14320 SW 165TH AVE ❑Addition new matar lead of syuan
100f E or more.
City/State/ZIP: Tigard,OR 97140 ❑six or more residential oaks. °mammy
0ae.lm a facilities. ❑�v al vef parks
Ja t.#: Project name: Polygon at Roshak Ridge ❑ftavardon locatiers 0 voltage fat
mine than
--� In Service or t eSer 600 amps or more. 6e0 volts rnmineL
Cross street/directions to job site: FEE SCHEDULE '
Description I oar. I tack 1 Total I •
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot 4 172 Includes attached garage.
Tax map/parcel#: 1,000 sq.ft or lam 168 54 4
Ea.add'1500 sq_ft or portion 33-92 1
DESCRIPTION OF'WORK Limited energy,residential
New construction.Type SFU (with above sq.tt)
75A0 2
Limited energy,multi-family 75.00 2
Type: SFU/Elevation plan: 222700BR residaatiat(with above sq.ft.)
® PROPERTY OWNER 1 ❑ TENAN Renewable Energy 0 See Page 2
Name: Polygon Homes WLH LLC Services or feeders installatlon,alteration,and/or relocation200 amps or tees 10070 2
Address: 703 Broadway St,Ste 710 '201 amps to 400 amps 133.56 2
600
City/StaterLIP: Vancouver,WA 98660 401 empa 1s amps 200,34 2
601 amps to 1,000 amps 301.04 2
Phone:(360 )946 8674 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,andlor
Email; OAlamiAbouhafsgttaylommrrison.com-PermitSubmittals@taylotmorrison.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
0 APPLICANT J 0 CONTACT PERSON Branch circuits-sew.alteration,or extension,ear panel
A.Fee for brands circuits with
Business name: Polygon Homes WLH LLC above service or feeder foe,
each branch circus 7.42
Contact name: Omar Alami Abouhafs B.Fes for branch circuits witlmar -
Address: 703 Broadway St.,Ste 710 service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Each add'1 branch circuit 7.42 2
. Miscelta units(service or feeder not included)
Phone:(360 )94b 8674 Fax:
:( ) Each manufactured or modular 67.84 2
Email:0AlamiAbouhafs@taylormotrison.com-PennilSubmittal dwelling,scaly and/or feeder
�mY S(Q1laylnrm0rris(m.COlrl Kcxanrrmt' Y 6784 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Wallace Electric Sign or outline lidding 67.84 '2
Address: 105 Dresden Sc S W'n=t circuits)or limited-stingy
Nadi,alteration,or extension. 0 See Page 2 2
City/State/ZIP: Astoria,OR 97103 Each additional inspection over allowable in any of the above
Additional inspection(1 to min) 66 25/hr
Phone:(503 3)8 0563 Fax:( ) Investigation(1 fir min) 90.00/hr
Email: David(a�wal laccwirescom Industrial plant(I hr min) 78.18/hr
—
CCB Lie.:224868 Inspections for which h o!re is90.Wl M
Electrical Lie.: C1441 Suprv.Lie.: 6363S specifically listed(14 br min)
' ELECTRICAL PERMIT-'.FEES
Snprv-Electrician signature,required:
Subtotal-
Print name:'pity a)p LE.. _.. Date: Y/L t ❑Wan Review Required(25%of permit ice): -
fJ/ I Slate surcharge(12%of permit fee):_
Authorized signature �j� TOTAL PERMIT FEE:
Cr This permit application expires if a permit is not obtained within ISO
Print name: i\ 4, "lye�� Date: ,e( /L t ( says=mar It been accepted e s complete
! ' Number of tnspertims allowed per permit.
1.41wldingWerm;eLLC_Pmmrt,lpp_ELK CRFAcc Rev 0617f2015 a•04615T(il/051COMIWEB
r Plumbing Permit Application
a
Building Fixtures �ta. ",
REG
Cityof Tigard RiCdvrd (�STZ02i -[o I 1
. g D t. Permit No.:
1111 u 13125 SW Hall Blvd.,Tigard,OR 97223 �1 Date/By:
Plan Review
Phone: 503.7182439 Fax: 503.598.1 Omer Permit No.
Inspection line: 503.639.4175 OF IUA � DawBy.
TIGARD Dale Ready/By: Suns: RI See Page 2 for
Internet www.tiard-mr Ov
g g t1UILDIN'DIVISION NotiliedMtethod: Supplemental Information
TYPE OF WORK 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 I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
,I-and 2-family dwelling 0 CommerciaUndustrial SFR(2)bath 437.78
❑Accessory building %I-Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder El Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 14320 SW 165TH AVE 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.: I 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 R: ) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision:Roshak Ridge Lot no 172 _ Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New construction-Typer: SFU Dishwasher 25.02
Type: SFU/Elevation plan: 222700BR Drinking fountain 25.02
Ejectors/sump 25.02
n PROPERTY OWNER J 0 TENANT Expansion tank 12.51
Name:Polygon WLH,LLC Fixturdsewercap 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:Omar Alami Abouhafs
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
CONTRACTOR Water closet 25,02
Water heater 37.52
Business name:G&B Plumbing&Sons Inc
Water piping/DWV 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: $72.50
CCE Lie.: 184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature:
TOTAL PERMIT FEE
This permit application expires If a permit Ls not obtained within l88 days
Print name:Steve Fowler Date: 1 0/30/20 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
t 1B°ildingTenniM,PLMU-Perm tApp.doe 10/01.9 440-4616T 10002000MVEB)
City of Tigard
1111 11 COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
Building Permit #: M$r2oZI -QQ [41
Site Address: 14320 SW 165th Ave
Project Name: Polygon at Roshak Ridge Lot #: 172
Planning Review
Proposal: New house
M Verify address/suite # active in Accela. RI In River Terrace: ❑ No ® Yes, Fiver Terrace Review Addendum
Site Plan Elements: ®Erosion Control
l3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper $7Retained trees with drip line and tree protection measures
®Drawn to scale(standard architect or engineer scale) ®Footprint of new structure(including decks)and FFE
]North arrow El Utility locations&easements(required for new and additions)
®Site address,project or subdivision name and lot number ®Sidewalk/driveway approach
®.Applicant information(name and phone number) I'liaLocation of wells/septic systems
rj(lLot dimensions and building setback dimensions R]Street tree size,type and location
ilSquare footage of buildings to be demolished EStreet names
rIBExisting structures on site J OCorner elevations(2'contours if more than 4'differential)
®Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ieA No
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? OVes ❑No
® Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ® No Received: ❑ Yes ❑ No
® Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified ® No Received: El Yes ❑ No
l SDC Exemption for ADU applied for: ❑ Yes ® No Received: ❑ Yes ❑ No
® Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified E No Applied For: ❑ Yes ❑ No,stop intake
I Land Use Case #: SUB2015-00004 l Zoning: R-4.5
® Required Setbacks: Front: 8 Rear: 15 Side: 3 Street Side: na Garage: 20
® Building Height: Max.Height: 30 Actual Height: 27
® Landscape Area: 20 % ® Lot Coverage Max: 80
Entrance no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degree
Windows ❑ Minimum of all street-facing facades
Garage ❑ Garage door is behind wi cing wall ❑ Yes , e of the following is met:
❑ Door extends no more than 5' roSee River Terrace Addenmun ding beyond garage.
❑ Door extends no more than 5'froattached. we garage on 2"floor.
❑ Garage door width is ❑ 12' 3u r°or less or racaae u less and includes 7 of following:
❑ Covered por ecessed entrance ❑ Wall offset ❑ 1'Roof ea ❑ Roof offset
❑ es ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof
Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
® Visual Clearance ® Urban Forestry Plan
WI Sensitive Lands: ❑ Yes ® No Type:
I] Conditions met prior to issuance of building permit
Notes:
® Approved By Planning: ) E4 fvv.tri i Date: 4/12/2021
Revisions (after Building Submittal onl Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
1:\Building\Forms\BldgPermitRvw_RES_I224 19.docx
Building Permit Submittal
Original Submittal Date: ogloPizal
Site Plans: #
Building Plans: # �j
Building Permit#: Enter building pert#above.
Workflow Routing: Manning EI Engineering L>3 Permit Coordinator ( Building
Workflow Sign-off: LTSign-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.
R-Building: original permit application,site plans,building plans,engineer and
beam calculations an. trust details,if applicable,etc.
Notes: if
By Permit Technician: `/(�//% Date: i q/r3/i
Engineering Review
❑ „Slope at building pad: ,044
it-Conditions"Met"prior to issuance of building permit f/
[Easements (encroachments)per engineering conditions of approval and plat
IT/Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes eNo
Assess Water Quantity Fee in-lieu: ❑ Yes L"No
LIDA Facility on lot: ❑ Yes No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: y 2
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
ermit Coordinator Review
Conditions "Met"prior to issuance of building permit
0 pproved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
PS�41' DC Exemption: ❑ Received , oes not apply
1L SDC Fees Entered: Wash Co Trans Dev Tax: �es ❑ N/A
Tigard Trans SDC: es ❑ N/
Parks SDC: LuJ Yes ❑ /A
LIDA ❑ Yes /A
OK to Issue Permit
Approved by Permit Coordinator: Date: 1-S4//�/
1:\Building\Forms\BI dgPerm itRvw_RES_122419.docx
City of Tigard
illa COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: M sT 2Q24—D0)41
Site Address: 14320 SW 165th Ave
Project Name: Polygon at Roshak Ridge Lot #: 172
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Plarlxvirk review ofRRiver 1Terrace Mar/District Desi m Standards (18 640.070.4):
Is the project subject to the plan district design standards? E 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 ft. deep min. 2ft.,5 ft.wide min.2 ft.,6ft.wide Gabled dormer
® ❑ ❑ ® ❑
2. Eyes on the street: a minimum of 12%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:
lil Parallel to street,angle no more than 45° from street,
�l Max. 8 ft. setback from longest street- facing wall
or open onto porch
Entrance opens to a porch: M Yes ❑ No
If yes,all the following apply: Q 25 sq.ft. min.
® One street facing entry A 12 ft. max.roof above floor of porch
M 5 ft.depth min. R 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:
El Covered porch min. 5 ft.wide x 5 ft.deep ® Recessed entry area min. 5 ft.wide x 2 ft. deep
M Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide
l 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. 2 '/i"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
❑ 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. M 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 E 40%max.of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: A1646 Oetfrtebb Date: 4/12/2021
IdBuilding\Forms\BldgPsrmilRvw_RES_RT_121417.docx