Permit Plumbing Permit Applic9
> cE1VED
Building Fixtures SEF 1 10Z1
City of Tigard ITY OF TIGARD Received 4,9 v Date/By: / 4 / 7e Permit No.: MST2021-00113
III • 13125 SW Hall Blvd.,Tigard,OR 97 ?y /+ A�
Phone: 503.718.2439 Fax 50 (9 1,DIVISION Plan Review
Date/By: 9/gla / ACG7 Other Permit No.:
Inspection Line: 503.639.4175
1 I(i A R D Date Redy/By: , tuns ® See Page 2 for
Internet. www.tigard-or.gov Notified aMethod��f�„y� Supplemental Information
TYPE OF WORK ' 6 f...-°t')i-? 2".. FEE* SCHEDULE
❑■ New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTIOiN SFR(I)bath 312.70
■ I-and 2-family dwelling SFR(2)bath 437.78
❑ y g 0 Commercial/industrial
IDAccessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kiyien 25.02
❑Master builder 0 Other:
Fire sprinkler(2408 ,q.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:14374 SW 165th Ave Catch basin or area drain 18.76
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.:SFU 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 ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.:174 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WO Backwater valve 12.51
Clothes washer 25.02
MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
®'PROPERTY OWNER ` ,' 0 TENANT Expansion tank 12.51
Name:Taylor Morrison Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:703 Broadway Street Suite 710 Garbage disposal 25.02
City/State/ZIP: Vancouver,WA 98660 Hose bib 25.02
Phone:(360 ) 695-7700 Fax:( ) Ice maker 12.51
❑ APPLICANT Ili CONTACT PERSON Interceptor/grease trap 25.02
Business name:Alliance Plumbing, LLC Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Gavin Thomes
Roof drain(commercial) 12.51
Address:146 W Historic Columbia River Hwy Sink/basin/lavatory 25.02
City/State/ZIP:Troutdale, OR 97060 Solar units(potable water) 62.54
Phone:( 503)577-6535 Fax: :( ) Tub/shower/shower pan 12.51
E-mail: gavin@allianceplumbing.net Urinal 25.02
Water closet 25.02
CONTRACTOR.
Water heater 37.52
Business name:Alliance Plumbing, LLC Water piping/DWV 56.29
Address:146 W Historic Columbia River Hwy Other: 25.02
City/State/ZIP:Troutdale,OR 97060 Subtotal
Phone:( 503)492-3490 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:184601 Plumbing Lic.no.:PB732
State surcharge(12%of permit fee) [
Authorized signature: r-���, TOTAL PERMIT FEE j Val.�T
Print name:Gavin Thomes Date:8.25.2021 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:A Building V Permits VPLMU-PermaApp.doc 10/01/09 44(1-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities QtY. Fee tea) Total Square Footage: Permit Fee:
Footing drain-1"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
felt) T Total each additional$100.00 or fraction thereof,to
Other Inspections car Feesand including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
• ❑ Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic El Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
-3" Isometric or Riser Diagram
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard 4, COMMUNITY DEVELOPMENT DEPARTMENT
IN Transmittal Letter
r ,c,,,c i 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Allyson A. DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Omar Alami Abouhafs APT, 2 0 202
COMPANY: Taylor Morrison CITY OF TIGARD
PHONE: (360)946 8674 BUILDING DIVISICIty.
EMAIL: OAIamiAbouhafs@taylormorrison.com/PermitSubmittals@...
RE: 14374/ 14272/ 14270 SW 165TH AVE. MST2021-00113/00114/00115
(Site Address) (Permit Number)
Polygon at Roshak Ridge (lot 174 )
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
_. �t.;.� .t 'a r u� e' 4 �#' cap cY x � w '-t vb, '"�.'ir.... "s�``.a;` �g4i*i t .aa --�
f I d 9uA `s f a ,k 'I K . °_ Yeti i.a } Ia . s _. ,
3
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
1 Other(explain): Radon Mitigation detail.
REMARKS: Plan examiners comment: Provide Radon Mitigation.
Radon mitigation provided in an A4 document(8.5x11). Please attach this document to the plans referenced above.
FO, OFFICE USE ONLY 1414.,
Routed to Permit Techni ian: D : ( 2$ "2---I Initials:
Fees Due: ❑ Yes No Fee Description. Amount Due:
po t - 6 -i- .- $ / E__
Special
Instructions:
Reprint Permit(per PE •• ❑ Yes ) I No ❑ Done
Applicant Notified: ate: �,�ZI L Initials: i��
CITY OF TIGARD MASTER PERMIT
• COMMUNITY DEVELOPMENT Permit#: MST2021-00113
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/18/2021
T f G A R T� 9 Parcel: 2S107AA17400
Jurisdiction: Tigard
Site address: 14374 SW 165TH AVE
Subdivision: ROSHAK RIDGE Lot: 174
Project: Polygon at Roshak Ridge, Lot 174 Primary Dwelling
Project Description: New primary dwelling with (2)attached ADUs on separate permits.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 971 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 25.5 Bathrooms: 4 Second: 1437 sf Garage: 477 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2408 sf Value: $317,922.78 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 7 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 2
Furn>=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: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2408
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 Fire Rated Conditions
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 Ersn Cntrl 503-639-4175
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $31,117.73
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.
Holly VafvDe'Wec e O w A 1icat'f o-vt.
Issued By: Permittee Signature: pp
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
1,'�c \�" `,
Buihding Permit Application _ _ 'g- 31 i( 12
Residential RECEIVED FOR OFFR'E I SE O\I.l'
City of Tigard MAR I S 2 21 Reteivea 3 29/zI Air. Permit No.:MS-�-2O21`Q(71i,3
111 't 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review yA� 1_�`` �`'
Phone: 503.718.2439 Fax: 503.598.19 ra r., Date/sy; ` '!� AK Other Permit:SAY22'�1-t23d
Inspection Line: 503.639.4175 Date Readyluy: iIwis WI See Page 2 for
IIC,ARD Internet: www.tigard-or.gov � I'� I '�" titled/Method: Supplemental Information
i
TYPE OF WORK REQUIRED DA:'A: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 CONSTRUCTIONValuation: $ 3 l�work indicated on this application. $
® I-and 2-family dwelling ❑Commercial/industrial
a as�
0 Accessory building 0 Multi-family Number of bedrooms: 5
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:2 .
Job site address: 14374 SW 165.141 AV L> New dwelling area: .2><A072 square feet 1,t31
City/State/'LIP:Sherwood, OR 97140 Garage/carport area: 477 square feet Cil
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
i
REQUIRED DATA:COMMERCIAL-11SE C'HECKI:1ST
Subdivision: Polygon at Roshak Ridge Lot no.: 174 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.
New Single Family Valuation: $
Existing building area: square feet
ec'7 t,kt e d- . . i New building area: square feet
® PROPERTY OWNER ' El '1I.N.'s'F 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: •
® APPLICANT 0 CONTACT PERSON C9
BUILDING PERMIT FEES*
lea e re r to lee schedule)Business name:Polygon Homes WLH LLC ,
Str ciur rl plan to re v fee(or deposit): �I
Contact name:Omar Alami Abouhafs I.s plan revievd fee cif 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
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: ti-g,417ilii- ,K (,Ili rncyleicirn,• car,
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:( 1360 693-4442 State surcharge(12%of permit fee): $21.60
CCB lie.:207247 �r Total fee due upon application: $201.60
Authorized signature: t ,rt"y�/ .l' 6efr b+ee 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: QY 021 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BOP-RESPenmitApp.doc 02/24/201 I 440-4613'f(I 1l02/COM/WEB)
.'
• Meehanical Permit ApplicatiFtECEIVED Foit OFFICE USENLY
ity C of Tigard Received
Date/By: 7 'Zi/2/ Permit Nu,' MEr-200- 031131
. .. '1 13125 SW Hall Blvd.,Tigard,OR 97223
MAR 1 Fiat Review , --1
Phone: 503.718.2439 Fax. 503.598.1960 6 2021
D ,By. other pennitswr22021- coul(0,1
Inspection Line: 503.639,4175 CITY OF TIGARD bateRaJ13Y .lurie El See Page 2 for
lilii.ARI)
Internet: www.tigard-orgov BUILDING. DIMON Supplemental Information
TYPE OF WORK COMIIIEROAL FEE* SCHEDULE - USE CHECKLIST
Mechanical penuif fees*are based on the value of the work
E] New construction O Addidottialteratorsireplacement perronmert Indicate the value(rounded to the nearest dollar)of all
0 Demolitio 0 Other: mechanical materials.eipment,labor,overhead and profits__
,Value.S
CATEGORY OF CONSTRUC I ION . , •_
RESIDENTIAL EQUII'MENT/SYSTEMS FEI.:S*
1-and 2-family dwelling 0 Commercial/industial El Accessory building For special inforniatiott use checklist,
T 1 -1 j Multi-family El Master builder 0 Other : Description QtY- I Ea,
flTotal
_
-JOB SITE INFORMATION AND LOCATION I Bea tingkoolin?:
Air conditionin,, 46.75
Job site address: 14374 SW 165TH AVE I Furnace 100 000 BTU ducteverns) 46.75.__
City/State/ZIP:Tigard,OR 97224 Furnace 100 0001-BTU duets/vents) 54.91
___ ------' Heat num. 61. 6
SurtePoldg./apt.no.: . Project name: Polygon at Roshak Ridge
Duet work 1111111111611
_ ..... .
Cross street/directions to job site: H . onic hot water- stem Iliiimar. 1
— _
- Residential boiler(radiator or
h dronic 23.32
Unit heaters(fuel.type,not electric),
11
in-wal in-duct sus.etided,etc. 46.75
_
Flue/vent for an of above 1111111111111111111111
I 1111111M21111111111 Subdivision., Polygon at Roshak Ridge .. )Othe Lot no.: 174 r
--- , ___ vi Other fuel appliances:
Tax map/parcel no.: I Water beater 1.111111111.111111
DESCRIPTION OF WORK [iris fireplace/insert. all 3 . 9 IIIIIIIIII
, Flue vent for water heater or gas El
New Single Family
1 fire.lace
Loa I.:• ter(gas . . 1/M11
Woodipellet stove all11 33.39 I
Wood fir..lace/insert MTN I
I Chimney/liner/floe/vent i 1M11 -I
h.. PROPERTY OWNER .
_ , TENANT I Other: 23.32
L 0
Environmental exhaust and ventilation:
Name:Polygon%VIA,LLC R2P ge hood/other kitchen
equipment 33,39I
Address:703 Broadway St.,Ste.510
Clothes er&must 33,39 ),.
_ ,
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
—-. - _., . toilet cormartments utili rcxnns 23.32
Phone:(360)695-7700 Fax:( ) Anic/crawls.nee fans 11111111=1111111111
.71 APPLICANT 0 CONTACT PERSON Other 11111 23.32
_....
Fuel piping:
Business name:Polygon WLH,LLC
_,.....
514.15 for first four:54.03 for each additional
:....„..
Contact name:Tonja Morris Furnace etc.
...i._.
[Gas heat pump
Address:703 Broadway St.,Ste 510
---- , WallIsuspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Waterheater
Phone:(360)695-7700 Fax: :(360)693-4442 Fireplace
_....._
R QC
F-mail:permitsubmittrilsgaylOrMOITISOD.COM
Barbecue _ 1
I ' ,
-I
'tV _ CONTRACTOR
... --- .. .
Clothes d.,,,,..r(gas)
. .
i ---f- •-- . i Business name:Pro Heating&Cooling • Other:
MECHANICAL P.ERMTr FEES*
Address: NW Alociek Dr,Ste.1104 '
. Subtotal
_ ....
_ — _
Minimum permit fee(590.00)
City/StateiZIP:Hillsboro,OR
„......... ....__ .. ...„,_ _,
Plan review(25%of permit fee)
........
Phone;(360)270-1590 Fax:( ) State surcharge(12%of permit fee)
CCB tic.:209001 TOTAL PERMIT FEE
— -ruis permit application expires if a permit it not obtained within 1*0
'1.'E„a. bc4A-ctit, days after it has been accepted as complete.
Authorized signature: • Fec methodology set by Tri.-C-ounty Building Industry Service Board
I Print name:Ella Duran Date: 10/30/20
t
T 114.4ikeitorlVerrntr2thiVi Penrrtii 4nin MAT 11 Are Alt 44,1T romiewlanu,,
Electrical Permit Application I Ou(►i i li I t SI 1)vI 1
City of Tigard RECEIVE ' Permit
1114 A 13125 SW Hall Blvd.,Tigard,OR 97223 Planpom Re 11 1L1 ��J � ,i -( ,\
s Phone: 503.71$.2439 Fax 503.59$1960 lOZ rP]aa�Review Related Permit fl
Inspection Line: 503.639 4175 Ready Date/Ay- lens: EfiSee Page 2 for
1ic :t h D Internet www.tigard-or.gov 'CITY OF TIGARD NutiaccliMeth°d Supplemental Information
TYPE OF wol tUILDING I)MSION PLAN REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit j sets of plans wittrms chocked)
0 Demolit. Other: Service or feeder 400 amps or more 0 Building over three stones
where the available fault current ❑Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Hearing buildings
01 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to mound,or exceeds 14,000 ❑Commercial—use agricultural
amps Ica all other tnstauatirxts buildings.
❑Multi-family 0 Master builder
0 Other. ❑Fare pump 0 Installation of 150 KVA or
JOB SfTE INFORMATION AND LOCATION ❑Exacrgenty system larger separately derived
Job#: Job site address:14374 SW 165th Ave 0 Addition anew motor toad of system.
loortP or more. ❑"A""1;-"1-2'."1-3^,
❑six
City/State/ZIP: Tigard,OR 97140 «more residential units occupancy
❑Health-care facilities ❑Recreational vehicle parks.
Suite/bldg./apt#: Project name: Polygon at Roshak Ridge ❑Hazardous locations 0 Supply vciltage for more than
❑Service or feeder 600 amps or more 600 volts nominal
Cross street/directions to job site: FEE SCHEDULE
nonentities I otv. I Each I rota I •
New residential tangle-or multi-fnttlly dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: 174 Includes attached garage.
Tax #: 1,000 sq Il.or less I 168 54 ' 4
map/parcelEa.add'l 500 sq.R.or portion tt 33.92 1
DESCRIPTION OF WORK Limited energy.residential
New construction.Type SFU
(with above sq.ft) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
® PROPERTY OWNER Renewable Energy 0 See Page 2
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 Si,Ste 710 201 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 )946 8674 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: OAlami/t bouhafsgtaylofmorrison.com-PermitSubmittals@taylormorrison.con relocation
Owner installation:This installation is being made on property that 1 own which is not 200 amps or less 59.36 I
intended for sale,lead 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 10_54 2
0 APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension, r panel
A Fee for branch circuits with
Business name: Polygon Homes WI.H LLC above service or fccakr fee,
each branch circuit 7.42
Cautact name: Omar Alami Abouhafs B.Fee for branch circuits without
service or feeder fee,that 710
Address: 703 Broadway St.,Ste branch circuit 2
branchcircuit
City/State/ZIP: Vancouver,WA 98660 Each add'!branch circuit 7.42 2
Phone: 360 946 8674Miscellaneous(service or feeder not included)
( ) Fax::( ) Each manufactured or modular
dwelling,service and/or feedex 67 84 2
Email:OAlamiAbouhafs l taylormorrison.com-PertnitSubmittals@taylormorrison_corn Rceotu,e,,t only 67 sot 2
CONTRACTOR Pump or irrigation circle 67 84 2
Business name: Wallace Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 105 Dresden St panel,alteration,or extension. ❑ See Page 2 2
Each additional inspection over allowable In any of the above
City/State/ZIP: Astoria,OR 97103 per,«,( ) 66 25/hr
Additional ins
Phone:(503 308 0563 Fax:( ) Investigation(1 hr min) 90.(xr/hr
Finail: David( wallaccwires.com htdustnai plant(I hr mil`) h 78 18t hr
Inspections for which nu tee is
CCI31.ie.:224868 Electrical Li • C1441 Su . I.. • 6363S specifically listed(V,hrmin) 9000Ihr
ELECIRICAI. PERMIT FEES
Suprv.Electrician signature,required:
Print name:' ,p Date: it/t /�t ❑Plan Review Required(25%of permit fee):
t I / State surcharge(12%of permit fee).
Authorized signaturec
o TOTAL PERMIT FEE:
-' — This permit application expires if a permit is not obtained within ISO
Print name: .a Date: gip f�{ days after tt has been accepted as complete.
..._ r , Number of inspections allowed per permit.
1.'suikangTernutsTLC_PsnadApp_I3.R 1SRE.doc Rev06'17/2015 4 0-4615T(11ro51C0Mt9VEB
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Plumbing Permit AppNlicatio ECFIVE •
Building Fixtures , ,..
rolz 01 ri,
City of Tigard MAR 1 6 2021 Received
alte/BY" 3 ?il il 1 or Pen'111 1\1'1' 14172a1
II " 13125 SW Hall Blvd,,Tigard.OR 9'7223
. 2 Phone: 503,718.2439 Fax: 503.598,1 GliTY Plan Review
OF TIGARD DateiBy: Other Permit No.:. 451/1422071-000-112 I
A P U
TIC
InspectionReaVar Ste Page 2 for
Line: 503.639.4175 BUILDING DIVISION Date d I
. t turn: El
Internet: www.tigard-orgov NotiftediMethod Supplemental Information
TYPE OF WORK FEE* SCHEDULE
1 New construction 0 Demolition For special information use checklist.
Description __FCitTi Ea, I Total
0 Addition/alteration/replacement _I.0 Other: -- New 1-2-family dwellings(includes 100 ft.for each utililconneetion)
CATEGORY OF CONSTRUCTION SFR(1)bath ! '312,70
I
pitl and 2-family dwelling I 0 Co SFR(2)bath 437.78
mmercial/industrial
r SFR(3)bath 50032
0 Accessory building 17-SrMulti-family , - .......... ___
Each additional bath/kitchen 25.02
0 Master builder _ [3 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 14374 SW 165TH AVE Catch basin or area drain 18,76
..
Drywell,leach line,or trench drain 18,76 i
City/State/ZIP:'Tigard,OR 97224
Footing drain(no.linear ft.', . ) Page 2
Suite/bldg./apt.no.: Project name:elisraisloiiiidesPolygon at Roshak Ridge manufactured home utilities 50.03
-- „,------ „ —„---------
Cross street/directions ta 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.: 174 Fixture or item:
Back/low prey enter 31.27
Tax map/parcel no.: ,
Backwater valve 12.51
• DESCRIPTION OF WORK
Clothes washer 25.02
New Single Family
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25,02
El PROPERTY OWNER I- 0 TENANT Expansion tank
12.51
Fixtum'sewer cap 25.02
Name:Polygon WLH,Lir . . .
Floor drain/floor sink/hub 25.02 I
Address:703 Broadway St.,Ste 510
Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 9g6b0 Hose bib _ 25,02 i
Phone:(360)695-7700 Fax:( ) lee maker 12.51
....
. .
El APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
I
Business name:Polygon WLH,LL Medical gas(value:S C ) . Page 2
- Primer 12.51
Contact name:'Fouls Morris —
Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 _._____ 1
Sink/basinflavatory 25.02
•
..........__________ _____ --1 - -
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
)
Phone:(360)695-7700 1 Fax::(360)6934442 Tub/shower/shower pan 12.51
E-mail:pertnitsubniittals*polygonhomes.com Urinal 25.02
Water closet 25.02 I
CONTRACTOR
Water beat.'r 37.52 ,
Business name:G&B Plumbing&Sons Inc i
Water piping/DM/ 56.29 I
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
Plan review (25%of permit fee)
CO Lie.:184372 Plumbing Lie,no.:pb634
- , State surchaige(12%of permit fee)
Authorized signature: IctECst, *-
1 TOTAL PERMIT FEE
Print name:Steve Fowler Date: 1 0/30/20
This permit application expires if a permit is not obtained within&Si}days
after it has been accepted as complete.
*Fee methodology set by Tri-Ccunty Building Industry Service Board
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.
City of Tigard
so
114 COMMUNITY DEVELOPMENT DEPARTMENT
■
T �,A«�� Building Permit Review — Residential
IBuilding Permit #: MS12OZI - 001\3
Site Address: 1 L(31-4 spJ 1(osti` AVE-
Project Name: Polygon at Roshak Ridge Lot #: 114
Planning Review
Proposal: New single detached house e 11M A 2y
O Verify address/suite#active in Accela. 0 In River Terrace: ❑ No 0 Yes, River Terrace Review Addendum
Site Plan Elements: erosion Control
11 copies of site plan on 8-1/2"x 11"or 11 x 17"paper &etained trees with drip line and tree protection measures
ISD rawn to scale(standard architect or engineer scale) •ootprint of new structure(including decks)and FFE
0 orth arrow �Jtility locations&easements (required for new and additions)
13 ite address,project or subdivision name and lot number °,idewalk/driveway approach
CRpplicant information(name and phone number) 0 .ocation of wells/septic systems
111 ot dimensions and building setback dimensions 'Street tree size,type and location
Mk. ;'square footage of buildings to be demolished 'itreet names
xisting structures on site ?r:orner elevations(2'contours if more than 4'differential
II ot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ° es o
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es ° o
❑ Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑Yes,applicant was notified 0 No Received: ❑Yes 0 No
❑ Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑Yes,applicant was notified 0 No Received: ❑Yes El No
❑ SDC Exemption for ADU applied for: ❑Yes 0 No Received: ❑Yes 0 No
0 Public Facilities Improvement(PFI) Permit:
Required: 0 Yes,applicant was notified 0 No Applied For: El Yes ❑ No,stop intake
0 Land Use Case#: SU B201 5-00004 0 Zoning: R-4.5
0 Required Setbacks: Front: 8 Rear: 15 Side: 3 Street Side: NSA Garage: 3
` 0 Building Height: Max. Height: 30 Actual He' ht: 25.5
`
ICI r M Landsca e Area: N ht % .4...
Lot Coverage Max: 1 %
Entrance ° Set back no more than 8'from street-facing wall 0 Parallel to street or offset 45 degrees or less
Windows ° Minimum 12%of area of all street-facing facades
ra e door is behind widest street-facing wall ❑Yes ❑ No,one of the folio . •
et+
Door ex ore than 5' from wall and there is a covered orc eyond garage.
Door extends no more than d sq ft.window above garage on 2nd floor.
Iv ❑ Garage door width is 12'or 50%or less o 60%or less and includes 7 of following:
Cover Recessed entrance ❑Wall offset 1' o Roof offset
Fire shingles Lap Siding 0 Roof itch ❑ Gable,Xp,or gambrel roo ormer
Accent siding Window trim U Window recess LI Window projection B co
Nr i n Visual Clearance 0 Urban Forestry Plan
0 Sensitive Lands: 0 Yes L'I No Type:
0 Conditions met prior to issuance of building permit
Notes:
O Approved By Planning: Date: TAOI
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 3/I 121
Site Plans: #
Building Plans: # �{
Building Permit#: Enter—buildin pe t#above. �/
Workflow Routing: Er PlanningEngineering I Permit Coordinator Building
Workflow Sign-off: Er Sign-off for Planning(include notes from planning review)
Route Application Documents: 121 Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: — Date: 3/2Vet
En ineering Review
LE/Slope at building pad:
in Conditions"Met"prior to issuance of building permit 71/1j9
Easements (encroachments)per engineering conditions of approval and plat
IR-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes V60
Assess Water Quantity Fee in-lieu: ❑ Yes o
LIDA Facility on lot: ❑ Yes No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:�
I�te Approved by Engineering: Date: ,'/C7�/
Revisions(after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ 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:
SDC Exemption: ❑ Received Does not a7 ly
ErSDC Fees Entered: Wash Co Trans Dev Tax: Yes _I N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes E.N/A
LIDA Yes N/A
g OK to Issue Permit [��
Approved by Permit Coordinator: Q7y \-..._ Date: 41 q2p21
1:\Building\Fomis\BldgPermitRvw_RES_122419.docx
T •
City of Tigard
41
COMMUNITY DEVELOPMENT DEPARTMENT
T l c A R D River Terrace Building Permit Review Addendum
Building Permit #: M5A-WA' COI\'
Site Address: 14374 SW 165th Ave
Project Name: Polygon at Roshak Ridge Lot #: 174
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.070.1.):
Is the project subject to the plan district design standards? ❑Yes El No (Per MMD2020-00044)
Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additio
ele -nt 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 :.. 5 ft. deep ormex
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide Gable
El ❑ ❑ ❑
2. Eyes on the str• • : a minimum of 12%of each street facing facade must include windows . entrance doors.
Percentage Shown:
3. Entrances:At least one e ance must meet both of the following standards:
facing wall CI Parallelto street, . gle no more than 45° from street,
El Max. 8 ft. setback from longes treet-
or open onto por
Entrance opens to a porch: ❑Yes I o
If es,all the following apply: ❑25 sq.ft. .
❑i One street facing entry ❑12 f ax.roof above floor of porch
❑5 ft. depth min. ❑3►%o min.porch roof coverage
4.Detailed Design:All buildings shall include a min. o v• of the following elements on all street-facing facades:
❑Covered porch min. 5 ft.wide x 5 ft. deep I Recessed entry area min. 5 ft.wide x 2 ft. deep
❑Wall offset min. 16 inches I ormer min. 4 ft.wide
❑Roof eave min. 12 inch projection ❑R.. offset min. of 2 ft.
❑Roof shingles either tile or wood 0 Gable, ..p or gambrel roof design
['Roof pitch oriented south min. 500 sq. ❑Horizont. ap siding min. 3-7 inches wide
❑Accent siding min. 40%of street fa ..e ❑Window trim , . 2 1/2"wide by 5/8"deep
❑Window recess min. 3 inches for .i street facing ❑Bay window min. ft.wide by 2 ft. deep
❑Balcony min. 5 ft.wide x 3 ft. .eep with inside access ❑Attached garage is 3 'o or less of street facade
5. Garages and Carports: '1 ay face the front or side lot line on a corner lot.
Setbacks:
No closer to front o .ide lot line,than longest street-facing wall. ❑Yes ❑No. If No (Check o :
❑May extend u. 0 5 ft.if there is a covered front porch and garage does not extend beyond the fro .orch.
❑May exten. p to 5 ft.where the garage is part of a two-story building and there is a window at the se : d story
above the age that faces the street with a min. area of 12 sq.ft.
Width: heck one)
❑ -foot-wide garage door ❑40%max. of street facade
I 50%max. of street façade with 7 detailed design elements
Notes:
Approved By Planning: ' — Date: ? 29 Zi
I:\Building\Forms\BldgPmnitRvw_RES_RT_121417.docx
City of Tigard • COMMUNITY DEVELOPMENT DEPA , 'R 2
.
w
Water Meter Fixture Unit Worksheet
;
0'1
T' A " For New Buildings CITY OF TIGARD
r lI!! nIgvr nprr, 1\9
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
LOCATION: City of Tigard—City Hall WATER METER SALES:
Utility Billing By Appointment Only: 503-718-2460
13125 SW Hall Blvd. (No more than five meter sales per appointment)
Tigard, OR 97223
METER: SIZE: FEE: Effective 01/01/2021
5/8" $9,495.00 Fee includes:
3/4" $13,554.00 water system development charge,
1" $24,886.00 water meter, and
1-1/2" $73,689.00 meter installation fee.
2" $119,333.00
Note: An additional charge will apply for water meters where an"existing water main"requires a new service line to be
installed by the City to the property address and is paid by the property owner as follows:
• Up to 1"_$3,815.00
• Over 1"=Cost+ 10%
DETERMINING METER SIZE FOR RESIDENTIAL CUSTOMERS
City of Tigard Water Service Area uses the American Water Works Association Manual and the Oregon
Plumbing Specialty Code to determine the size of meter needed to adequately serve new buildings. In
most cases, new residential buildings require a 3/4"meter, however,due to the size of homes built in the
Tigard area, we now count the fixture units of all homes prior to selling a meter. Buildings with 37 or less
fixture points can use a 3/4"meter. For those over 37, a 1" meter must be purchased. Use the worksheet
on Page 2 to calculate the number of fixture units.
DOCUMENTATION
Please provide the following items to the Utility Billing counter to purchase your meter:
• Completed water meter fixture unit worksheet(on back page).
• Copy of building or plumbing permit application date-stamped by building division.
• Copy of issued building or plumbing permit.
Your fixture count will be verified and your request will be processed upon receipt of these documents.
No exceptions.
INSTALLATION TIME
Most meters are installed within 10-14 business days. If your meter is not located within an existing
subdivision we may need additional time in order to verify the location of other underground utilities.
Please keep these time frames in mind when purchasing your water meter.
1./Building/Forms/WaterMeters_010121_New.dOCx Page 1
Water Meter Fixture Unit Worksheet For New Buildings
Please complete the following information:
Con tractor Name: Polygon Home, WLH LLC
Billing Address: Street/Suite#: 703 Broadway St, STE 710
City: Vancouver State: WA Zip: 98660
Phone Number: 360 946 8674 Email:
New Meter Address: 14374 SW 165th Ave(SFU)- 14270 SW 165th Ave(ADU 1)- 14272 SW 165th Ave(ADU 2)
Subdivision Name: Polygon at Roshak Ridge Lot#: 174
Building Permit#:
Please fill in the number of each fixture as detailed on the plans. Multiply the quantity by the point value
to arrive at the point total. Add all point totals together for total fixture unit points.
Fixture Unit Quantity Point Value Point Total
SFU ADU1 ADU2 Total
Bar sink x I =
Bidet x 1
Clothes washer 1 1 1 3 x 4 = 12
Dishwasher 1 1 1 3 x 1.5 = 4.5
Hose bib, 1st one 1 1 1 3 x 2.5 = 7.5
Hose bib, each add'! x 1 =
Kitchen sink 1 1 1 3 x 1.5 = 4.5
Laundry sink x 1.5 =
Lavatory 6 4 5 15 x 1 = 15
Water closet, 1.6 GPF 4 3 3 10 x 2.5 = 25
Bathtub/whirlpool x 4 =
Shower stall 2 1 1 4 x 2 = 8
Bath/shower combo I 1 1 3 x 4 = 12
Total Fixture Unit Points: 88.5
Fixture Unit Points:
l to30= 5/8" 37.5to89= 1"
30.5 to 37 = 3/4"
Meter Size: 1" Meter Cost: $ 24,886.00
*************************************************************************************
FOR OFFICE USE ONLY
Fixture Units Points verified with
Building (Master) Permit or Plumbing ❑Yes ❑ No ❑ Other:
Meter#: Sale Date:
Receipt#: Meter Cost:
Employee Name:
I:/Building/Forms/WaterMeters_010121_New.doCx Page 2