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Permit Plumbing Permit Applicat i EI 1/ ED Building Fixtures Cityof Tigard1 Received MST2021-00098 Date/By: 7 / ., '�� Permit No.: 11111 4 13125 SW Hall Blvd.,Tigard,OR 9722/I y OF TIGARD Plan Review C Phone: 503.718.2439 Fax 503.59S. 60' Date/By: 4. /q/ / AC4 Other Permit No.: Inspection Line: 503 639 4175 / [� !!! 1 i(iA}:ll p 1UILDING DIVISION DateReady/By. n r7 j 7uns: ® See Page 2 for Internet. www.tigard-or.gov Notified/Method:al -7Ili/ 4 de Supplemental Information TYPE OF WORK I651-i4 " O/y ,`'FEE* SCHEDULE 0 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 CONSTRICTION SFR(1)bath 312.70 ❑■ I-and 2-family dwelling SFR(2)bath 437.78 y g ❑Commercial/industrial ❑Accessory building El Multi-family SFR(3)bath 500.32 Each additional bath/kiychen 25.02 ❑Master builder El Other: Fire sprinkler(1625 ifsq.ft.) Page 2 JOB SIIE INFORMATION AND LOCATION Site utilities: .lob site address:14156 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.:ADU-1 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 Stone sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Lot no.166 Fixture or item: 1 Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION-OF WORK ' 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 I [,] 'TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name:Taylor Morrison 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 0 APPLICANT ® 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 �57� State surcharge fee) Authorized signature: TOTAL PERMIT FEE /34,r3' This permit application expires if a permit is not obtained within 180 days Print name:Gavin Thomes Date:8.25.2021 after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1.ABuildingVPermitsVPLMU-PermiiApp.doc 10/01/09 440-4616T(I0/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-l"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 Storm&Rain Drain-1st 100' 62.54 " Ideation: Permit Fes. $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 each additional$100.00 or fraction thereof,to Fee{ea) T tai i Other Inspections Fees '' and 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 825,001.00 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 Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ 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 -4„ ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. 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: -Lao/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:ABuilding\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 • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter ,: 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 AK20MI COMPANY: Taylor Morrison CITY OF TIGARD PHONE: (360)946 8674 BUILDING DIVISION By: .JZ, EMAIL: OAIamiAbouhafs@taylormorrison.com/PermitSubmittals@... RE: 14156/ 14158/ 14160 SW 165TH AVE. MST2021-00098/00099/00097 (Site Address) (Permit Number) Polygon at Roshak Ridge( lot 166 ) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: 7 i' a+t ' MI*':4' =Gw :fit,2 # `'Ts a r r '?bE t? 'Ex} 'Y IS kh ' +NOM 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 examiner's comment: Provide Radon Mitigation. Radon mitigation provided in an A4 document(8.5x11). Please attach this document to the plans referenced above. FOR OF ICE USE ONLY '".% k Routed to Permit Technic' n: Date• ZS 2) Initials: Fees Due: E Yes 7 o ee Desc 'ptio : Amount Due: $ ./(2. -__,----- p-D N.) e-- ,_ Special Instructions: Reprint Permit(per PE): 0 Yes `f No 6 ❑ Done Applicant Notified: Date: a46-10.2--7 Initials: 11111 "I CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2021-00098 T[GARE) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/18/2021 Parcel: 2S107AA16600 Jurisdiction: Tigard Site address: 14156 SW 165TH AVE Subdivision: ROSHAK RIDGE Lot: 166 Project: Polygon at Roshak Ridge, Lot 166-ADU 1 Project Description: New attached ADU 1 of 2. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 672 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 25.5 Bathrooms: 3 Second: 953 sf Garage: 287 sf Front: 8 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 1625 sf Value: $212,859.60 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 2 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: 4 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: 2 201-400 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 ADU VB R-3 1625 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 2 Fire Rated Conditions PHONE: PHONE: 360-695-7700 FAX: Total Fees: $25,547.61 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232..1987 or 1.800.332 2344. Issued By: .ally VavvDeilVege Permittee Signature: 0 VI,A►"p itrn 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. • Building Permit ApplicatioRECEIVED Residential i4AR 1 6 202l FOR OFFICE.USE ONLY City• of Tigard Received n/�2/�' Permit Na Habit• `t is v 1315W Hal Blvd.,Tigard,OR 9722 ITY OF TIGARD Date/B : 7 ! Epp g Plan Review Phone: 503.718.2439 Fax: 503.598.A DING DIVISION Date/By: ZS?,J t 4 Other Permit:Sw ��- 00 �j TIGARD Inspection Line: 503.639.4175 Dat Ready/By: uric Pe�++ H See Page 2 for Internet: www.tigard-or.gov l ed/Method: ' lic Supplemental Information lie TYPE OF WORK REQUIRED DATA: 1-AND__1I 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. ` 0 ❑ I-and 2-familydwellingValuation: $ `1 ,Qj �Y ❑Commercial/industrial c�=l ❑Accessory building ❑Multi-family Number of bedrooms: 3 `❑Master builder ©Other: ADU 1 Number of bathrooms: ?..‹..3 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 \CI ( a, Job site address: 14156 SW 165th Ave. New dwelling area: `(juare feet GS3. City/State/ZIP:Sherwood, OR 97140 Garage/carportafea: 287 . square feet (p'z 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 Lot no.: 166 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- Accessory Dwelling Unit(ADU 1) Valuation: $ /?"�rf/ j(2-e--,1(; e,, / to �I. �,/�cikiw+•e Existing building area: square feet 01 t)e- ,/J( # , New building area: square feet /1 0 PROPERTY OWNER'J ❑ TENANT Number of stories: Name:Polygon Homes WLH LLC Type of construction: Address:703 Broadway St., Ste 710 Occupancy groups: City/State/ZIP:Vancouver, WA 98660 Existing: Phone:(360)946 8674 Fax:( ) New: ® APPLICANT ❑ CONTACT PERSON U9 BUILDING PERMIT FEES* Business name:Polygon Homes WLH LLC (Please refer rn fee schedule) Structural plan review fee(or deposit):• Contact name:Omar Alami Abouhafs Address: 703 Broadway St., Ste 710 FLS plan review fee(if applicable): Total fees due upon application: City/State/ZIP:Vancouver, WA 98660 Amount received: Phone:( 360) 946 8674 Fax::( ) E-mail: PermitSubmittals@taylormorrison.com,OAIamiAbouhafs@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 tire department access,along with the 2010 Oregon Address:703 Broadway St., Ste 710 Solar Installation Specialty Code checklist. Fee(includes plan review City/State/ZIP:Vancouver, WA 98660 Permit and administrative fees): $180.00 Phone:(360 )695-7700 Fax:( )360 693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 // ` /_ Total fee due upon application: $201.60 Authorized signature: 7142Ce'i2.,cy E /019h1/Ga� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Omar Alami Abouhafs Date: 03/08/2021 *Fee methodology set by Tri-County Building Industry Service Board. I:ABuilding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) . ' , .Mechanical Permit;ApnlicatiDECEIVE I FOR OFFICE USE(>l1,1° City of Tigard Received 3 21 NT" r� Dale/By, / PemUNo' MSTZOZI- (,<Q ,i 13125 SW Hall Blvd Tigard,OR 97223 MAR 1 6 1021 Plan Review y Phone: 50.s 718 2439 Fax 503.595.1960 Dalc/By: Other Permit:S - 6v Y 1 tr rt It I, Inspection Line: 503.639,4175 CITY OF 1 IGARD pole Ready/l3y: luris 6l Sett Page 2 for Internet: twlw.tigard-oi'.goV BUILDING DIVISIONNoufied/Meihcxi? Supplemental lnforu,at on _ TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST- Mechanical permit fees"arc based on the value of the work Z New Construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition [j Other, mechanical materinls_egttipinenLtabor,overhead,and profit_____ Value:$ CATEGORY OF CONSTRUCTION . RESIDENTIAL EQUIPMENT/SYSTEMS FEES' ^` 1-and 2-family dwelling 0 CornmerciaUindusttial ❑Accessory building For special in/nrn,onon use checklist [ Multi-family 0 Master builder ®Other. ADU 1 Description Qty_ 1 Ea I Total JOB SITE INFORMATION AND LOCATION . Heatingicooling: Air conditioning MO 46.75 Job site adtlrets 14156 165th Ve Furnace 100,000 BTU(ducts/veats 46.75 City/State/ZIP:Tigard,OR 97224 Furnace I00.000t•BTU(ducs/vents' State/bldg./apt no.. ! Project name: Polygon at Roshak Ridge Beat 61.06 _ Ductwork 23.32 Cross street/directions to job site: 11 drone hot water system 23.32 _ _.._.___.__ _._ ---I Residential boiler(radiator or __._......_... .. —.... hydrortic) _ 23.32 Unit beaters(fuel-type,not electric), in-wal in-duct sus ended,etc. 46.75 Flue/vent for an of;above 23.32 i Other 23.32 _._ Subdivision: Polygon at Roshak Ridge Lot no.: 166 -- -_... _ t Other fuel appliances: Tax map!pareel no.: L Water heater 23,32 I DESCRIPTION OF WORK Gas fin lacetinsert _ 33.39 Flue vent for water heater or gas New Single Family-Accessory Dwelling Unit(ADU 1) fir lace 23,32 Lo lighter(gas) 23.32 Wood/ tact stove 33.39 Wood fireplace/insert 23.32 rChu nney/iincr/flue/vent 23.32 {____ El PROPERTY OWNER Q TENANT I Other: 23.32 - , — -- — ! Environmental exhaust and ventilation:Name:Polygon Will,.LLC ; Range hood/other kitchen Address:703 Broadway St.,Ste.510 Clot es dryer 33.39 ___-____._. ...__ Clothes dryet exhaust .._.._. 33.39 City/State/ZIP:Vancouver,WA 98660 I Single-duct exhaust(bathrooms, ___ _. __.--_.- _ toilet compartments,utility rooms) 23.32 Phone:(360)695-7700 Fax:( ) At,, ic%rawlspace fans 33.32 APPLICANT Oth+r: ❑ CONTACT PERSON .... 23.32 _-4 Fuel piping: Business name:Polygon WLEI,LLC 51.4,I5 for first four;S4.03 for each additional Contact name:Tonja Morris I Furnace,etc. Address:703 Broadway St.,Ste 510 ; Gas heat pump 1 Wallisuspended/un,t heater Ciry(S ate/ZIP.Vancouver,WA 98660 I Water heater Phone:(360)695-7700 Fax::(360)693-4442 I Fireplace I Ranr e Email:permitsubutittais(ataylormorrison.com € _ . Barbecue CONTRACTOR Clothes dryer(gas) . Business name:Pro Heating&Cooling Other: .- _ _.m _ ___ t MECHANICAL PERMIT FEES* Address: NW Alociek Dr,Ste.1104 ....__ _ Subtotal par Mini _ i City/State."ZID:Hillsboro,OR _Minimum atit;fec(S9'J.00) — I'laa rev iew(25%of permit fee) Phone:(360)270-1590 i Fax:( ) State surchar_e(12%of.email fee) 1111111.111 CCB tic.:209001 TOTAL PERMIT FEE — j """ This permit application expires if a permit is not obtained within 180 ,tci,. \u- days after it has been accepted as complete. Authorized signature J ' ice methodology an by Tri-County Building industry Service Board IPrint name:Elia Duran — Date: 10/30/20 1 /AFI.11,ri7nAYnrmvdld£r Yrrmi,•ne 416n171 Ana 60e JGirr,,,,ns uv,rr A,n:;r, Electrical Permit Application RECEIVE rust(lrr-it-r rwr O,.i ' City of Tigard r Reemednate/s S \t\Z,i \\J Peimd p in STz I n II 13125 SW Hall Blvd.,Tigard,OR 97223 MAY .( 8 2021 Plan Review Phone: 503.718.2439 Fax. 503.598.1960 /q Related Permit t r 1 c;A k D Inspection line: 503.639.4175 CITY OF + 1.1II`GAR[ Ready D�tlly� luris: , ®See Page 2 far Internet www.t gafil Af.gpY LJ1LDI VI V El � Nam. SuppietrmW Informal/Da TYPE OF WORK PLAN REVIEW ®New construction 0 Addition/alteration/replacement Please check all that apply(submit j sets of plans wlnows checked)- 0 Demolition 0 Other: ❑Same or fader 400 amps ea more ❑Building over three stones where the available fault eurmst 0 Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 159 volts or 0 floating buildings 0 I-and 2-family dwelling 0 Commercial/industrial ❑Accessory building h vs to ground,or exceeds I4.00 0 ❑Commercial-use agricultural amps ❑Multi-family ❑Master builder ® ❑Fin Other: ADU 1 fmpu other installations buildingsPAP 0 installation of 150 KVA or JOB sin INFORMATION AND LOCATION ❑Emergency system larger separately derived Job#: Job site address: 14156 SW 165th Ave CI Addition of new motor load of ,ems l001IP or more. ❑"A"-E","1-r,"1-3", City/State/7M: Tigard,OR 97140 0 Six of more residential sails occupancy 0 Health-care facilities 0 Recreational vehicle parks. Suite/bldg./apt#: Project name: Polygon at Roshak Ridge ❑Ilai ardour locations 0 Supply voltage for more than ❑Service or feeds 600 amps or more 6Do"Its nominal Cross street/directions to job site: FEE neseripfiae Faeb I Total I New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot 4: 166 Includes attached garage. _ Tax map/parcel#: — 1,000 ay ft.or less �- I68 54 4 Eri add'1500 sq.tit or portion 33 92 ! DESCRIPTION OF IN'ORK Limited energy,residential (with above mil.ft) 75.00 2 New construction. Type: ADU 1 Li mited reel energy.multi-family 73.00 2 residential(with above sq.ft.) ® PROPERTY OWNER i 0 TENANT Renewable or feedersEnergy ❑ Sec Cape 2 — Serviees or feeders installation,alteration,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 133.56 2 amp City/State/ZIP: Vancouver,WA 98660 401 to 600s ,_ 204 34 2 601 amps to 1,000 amps 301.04 2 Phone:( 360 )946 8674 Fax:( ) Over 1,o00 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: OA1amiAbouhafs@a taylormorrison.com-PermitSubmittals@a3taylormorrison.com relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I 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 APPIICANT _ ❑ CONTACT PERSON Branch circuits—new,alteration,or extension, r panel th Business name: Polygon Homes WI.H LLC A Feeb for branch circuitsee fwee, above service or feeder fee, 7.42 ' each branch circuit Contact name: Omar Aland Abouhafs B.Fee for branch circuits without_ serAddress: 703 Broadway St.,Ste 710 b brans e or feeder fee,first ranch circuit 56.18 2 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 67 84 2 dwellEmail:0AlamiAbouhtifs@taylormorrison.com-PermitSubmittal. ems.serviceyand/or feeder Y �taylarmorrison-con Reconnect only 67 84 2 CONTRACTOR TOR Pump or m agation circle 67 84 2 Business name: Wallace Electric Sign or outline lighting 67.84 2 SignaAddress: 105 Dresden St panel, t(s)or extension. energy 0 See Page 2 ( 2 panel,alteration,or extension. CttY/State/7Ip: Astoria OR 97103 Each additional inspection over allowable hi any of the above _ Additional inspection(0 hr min) 66 25/hr Phone:(503 3ti8 0563 Fax:( ) Investigation(I hr min) 90.00/hr canal!. David@wallaccwires.com Industrial plant(1 hr min) 78 18/hr Inspections for which no tee is CC131.ic,:224868 Electrical Li•• C 1441 Su I: 6363S specifically listed CA br min) 90 OW hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal — Print name:DAup.t2 .!Li..._', Date: it - f __CI Plan Review Required(25%of permit foe): '— j t State surcharge(12%of permit fee) Authorized signatureItaro.,124.4 1(1 i AL PERMIT f 1 L 'stir permit application empires if a pertain is not obtained within ill)Prins name �Wisk Date: 4{ / it I days after it has been accepted a.complete rffrio 'r Z 5...... • Number of Inspections allowed per permit ttltuilibngrernuts'4:1.(: `erinitApp_E R F1RF..dcc Rev 0617/2015 4(-1615T(11K151COM/WP8 • + I' M Plumbing Permit Aplicatt Building Fixtures MAR 16 202 FUR 0141{ �. I I. O,tiLl' Received Air' ,,p City© 1 l &Cd Permit No.: Msr 2 QUA t t 111 n�t�/fly. �l'LlZa �` ,e- r 13125 SW Hall Blvd.,Tigard,OR 971/2 OF TlU/1►HU Plan Review Phone; 503.718.2439 Fax: 503. Other Permit Nu.. 6ipb ��ING DIVISION 1-)me/BY' �� 9 PitiAP.D lnspex:tion Line: 503.639.4175 Date fieadl-By. Avis.: ! 0 Sec Page 2 for Internet: www_tigard-or.gov Notified/Method- J Supplemental Information TYPE OF WORK FEE* SCHEDULE ' t New construction. ❑Demolition. For silecialinformation use checklist. ... - Description --J__Qh'. J Ea, J Total ❑Addition/aiterari 0 Other:Addition/alteration/replacementNew 1-2-farrulr dwellings(includes IN ft,for each utility connection) CATEGORY OF CONSTRUCTION SFR.(1)bath 1 312.70 1-and 2-family dwelling 0 Commercial/industrial (2)bath J 437.78 _ -r ' 1_SFR SFR(3)bath i 500.32 ❑Accessory building ^Multi-family . .. - -- L.Each additional battukitchen 25,02-1 ❑Master builder ._... _ ):4 Other: ADU 1 Fire sprinkler( sq.ft.) Page 2 .____ • JOB SITE INFORMATION AND LOCATION Site utilities: F • Catch basin or area drain I 1.8.16 Job site address: 14156 SW 165th Ave - - _ , Diywell,leach line,or trench drain 18.76 City:State/'ZIP:Tigard,OR 97224 .-_ ---- --.~.--"' -...,.--, Footing dram(no,linear ft.; ) Page 2 Suite/bldg./apt.no.: Project name_ Polygon at Roshak Ridge manufactured home utilities. I 50.03 Cross street/directions to job site: Manholes ( 1.8,76 I € Rain drain connector ( 18.76 H Sanitary sewer(no.linear ft.: ) Page& F_______ _____, _,, ___ 2 i Storm sewer(no.linear ft.: ;) j Page 2 ' Water service(no,linear ft.:_) Page 2 Subdivision: i Lot nc 166 Fixture or item: Tax map/parcel no.: Backlow preventer 31.27 , DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 2.5.02 • j New Single Family -Accessory Dwelling Unit(ADU 1) _ Dishwasher __.._ __.__ Drinking fountain 25,02 Ejectorxisutnp 25.02 Pt PROPERTY OWNER 1 ❑ TENANT Expansion tank 12.51 ' Name:Polygon WLH,LLC Fixturelsewer cap 25.02 , • Floor drain/floor sink/hub 25,02 J Address:703 Broadway St.,Ste 510 Garbage disposai 25,02 City/StatetZIP:Vancouver,WA 98660 Nose bib 25,02 Phone:(360)695.7700 Fax:( ) ' Ice maker 12.51 r. APPLICANT 0 CONTACT PERSON laterceptorigreasc trap 25.02 Business name:Polygon'A LII,LLC - Medical gas(value $_) Page 2 Primer . 12.51 • ppr_.._... ......._.._. Contact name:Totrja Morris i Roof drain(commercial) .: • 12,51 Address:703 Broadway St.,Ste 510 1 Sink/basin/lavatory ! 25.02 City/State/ZIP; Vancouver,WA 98660 Solar units;potable water) 62.54 Phone:(360)695-7700 I Fax::(360)693-4442 Tublshower/shower pan 12.51 E-rnailPermitSubmittals@taylormorrison.com,OAIamiAbouhafs@taylormorrison.com Uriruil 25.02 ___._ Water closet 25 02 ____ CONTRACTORt — - - -- Water heater 37,52 Business name:G&B Plumbing&Sons Inc Water piping pVJV 56.29 Address:P.O.Box 92 Other: 25.02 '__ j City/State/ZIP:St.Paul,OR 97137 Subtotal Phone.(503)868-1417 Fax:(971)727-8170 Minimum permit fee: $72.50 - Plan_ _ ......_..___.....__._._. .__ _ _._ __� Plan review (25%of permit fee) CCB Lie.: 184372 , Plumbing I:1C no,-,pb634 I— t w _d__ ._ State surcharge(12%of permit fee) .kuthorwed signature: �l j; � TOTAL PERMIT FEE I his permit application expires If a permit is not obtained within 140 days Print name:Steve Fowler Date: O/301,Lo after it has been accepted aS complete. *Fee methodology set by Tn-Counry Building industry Service Board. 1:lauiiding'.PaxnitsiPLMLI-rcnutAppaoc IWWo:VI 45-46147t1oin,comNiv4) City of Tigard NI II DEVELOPMENT DEPARTMENT T 1 G A R D Building Permit Review — Residential 4 Building Permit #: Nigr2024"oCCAg Site Address: 1415(' SW 165th Ave Project Name: Polygon at Roshak Ridge Lot #: 166 Planning Review Proposal: New attached ADU 0 Verify address/suite#active in Accela. ❑o In River Terrace: 0 No ❑r 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 ClOrawn to scale(standard architect or engineer scale) , ootprint of new structure(including decks)and FFE 0 orth arrow ::,,,sJtility locations&easements(required for new and additions) Fite address,project or subdivision name and lot number sidewalk/driveway approach 12 pplicant information(name and phone number) _ocation of wells/septic systems 0 of dimensions and building setback dimensions .itreet tree size,type and location I quare footage of buildings to be demolished itreet names Ixisting structures on site ,_„orner elevations (2'contours if more than 4'differential 111 •t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? °�i 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: 0 Yes,applicant was notified ❑o No Received: 0 Yes ❑o No ❑ Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: 0 Yes,applicant was notified ° No Received: Yes ✓ No ElSDC Exemption for ADU applied for: ❑Yes ❑No Received: Yes No ❑r Public Facilities Improvement(PFI)Permit: Required: a Yes,applicant was notified 0 No Applied For: ❑r Yes 0 No,stop intake ❑o Land Use Case#: ADU2020-00014 ❑r Zoning: R-4.5 ❑r Required Setbacks: Front: 8 Rear: 15 Side: 3 Street Side: N/A Garage: 3 ❑r Building Height: Max.Height: 30 Actual Height: 25.5 ❑ Landsca e Area: % 0 Lot Coverage Max: Entrance Set back no more than 8'from street-facing wall ❑r Parallel to street or offset 45 degrees or less Windows ° Minimum 12%of area of all street-facing facades Garage Garage door is behind widest street-facing wall ❑Yes ❑No,one of the following is met: ElDoor extends no more than 5'from wall and there is a covered porch extending beyond garage. Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2"a floor. 0 Garage door width is 12'or less 0 50%or less of facade 60/o or less and includes 7 of following: Covered porch Recessed entrance o ❑Wall offset ❑ 1'Roof eave Roof offset Fire shingles Lap Siding ❑ Roof itch ❑ Gable,hi ,or gambrel roof ❑ Dormer _ Accent siding Window trim U Window recess U Window projection 0 Balcony 0 Visual Clearance ❑ Urban Forestr�Plan ❑ Sensitive Lands: ❑ Yes 12:1 No Type: O Conditions met prior to issuance of building permit Notes: ❑ Approved By Planning: — r Date: 3�ZL /Z/ Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPermitRvw RES_122419.docx Building Permit Submittal Original Submittal Date: 3/A&/2 i Site Plans: # 2j Building Plans: # 3 Building Permit#: Enter building}permit#above. Workflow Routing: Planning Al Engineering Permit Coordinator Building Workflow Sign-off: Q Sign-off for Planning(include notes from planning review) Route Application Documents: Q 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: 0,04. Date: '5/00(Z/ Engineering Review Slope at building pad: 2.14 J� Conditions"Met"prior to issuance of building permit l�" frEasements (encroachments)per engineering conditions of approval and plat , Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes No Assess Water Quantity Fee in-lieu: El No LIDA Facility on lot: El YesNo 133 Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: [Approved by Engineering: Date: ,_����/ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved 1P mit Coordinator Review Co s itions"Met"prior to issuance of building permit 1 0 ' pproved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Re .sion Notice 2: Date Sent to Applicant: P� 1 \ 1J 6 C Exemption: ❑ Received oes not ao 1y n SDC Fees Entered: Wash Co Trans Dev Tax: �es N/A Tigard Trans SDC: lkYes ❑ N/A Parks SDC: IZ Yes ❑ /A LIDA ❑ Yes UN/A OK to Issue Permit Approved by Permit Coordinator: Date: 5/�/2/ I:\Building\Forms\BldgPermitRvw_RES_122419.docx IIIII City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT ■ TIGARD River Terrace Building Permit Review Addendum 1 Building Permit #: rn�7d1t-00012 Site Address: 141E SW 165th Ave Project Name: Polygon at Roshak Ridge Lot #: 166 (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 Q 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 ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide Gable. .ormer I ❑ ❑ ❑ 0 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 ❑Parallel to street, . gle no more than 45° from street, ❑Max. 8 ft. setback from longer treet or open onto por Entrance opens to a porch: ❑Yes I o IfUes,all the following apply: ❑25 sq.ft. 'n. 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 iv- of the following elements on all street-facing facades: ❑Covered porch min. 5 ft.wide x 5 ft. deep 111 Recessed entry area min. 5 ft.wide x 2 ft. deep ❑Wall offset min. 16 inches I i ormer min.4 ft.wide ❑Roof eave min. 12 inch projection ❑R.- offset min. of 2 ft. ❑Roof shingles either tile or wood ❑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: ', 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 facade with 7 detailed design elements Notes: Approved By Planning: oti --- -- Date: ,j`.e hi 1:\Building\Forms\BldgPrnnitRvw_RES_RT_121417.docx