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Permit Plumbing Permit ApplicaRECEIVED Building Fixtures SEP 1 202 13125 of Tigard Received y g + Gj 2 Permit No.: 111 -• SW Hall Blvd.,Tigard,OR 4AlY OF TIGARD Date/By: / / T" MST2021 00096 _ �q® q�pPlan Review �y Phone: 503.718.2439 Fax: 50`�VLiUING DIVISION ////::1 ^ 6.6 Other Permit No.: Date/By: �J d Inspection Line: 503 639.4175 1 I G A R D Date Ready/By l Jur's ® See Page 2 for Internet www.tigard-or.gov Notified/Method: /� `L1 /V CJ Supplemental Information TYPE OF WO + Il-Y4. 41!'41-%-.'"' FEE* SCHEDULE 0 New construction 0 Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF'CONSTRUCTION SFR(1)bath 312.70 1-and 2-familydwellingSFR(2)bath 437.78 ❑ 0 Commercial/industrial 0 Accessory building El Multi-family SFR(3)bath 500.32 Each additional bath/kit en 25.02 ❑Master builder 0 Other: Fire sprinkler(1729 sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:14134 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-2 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.:1165 Fixture or item: fax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WOE Backwater valve 12.51 "" Clothes washer 25.02 MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 a 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 IN 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: f • _, ) TOTAL PERMIT FEE f/!/ r 3 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. I:A Building V Permits VPLMU-PermitApp.doc 10/01/00 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(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 Valuation: Permit Fee' $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 Other Ins ec ions or Fee' Qty Fee,(ea) Total each additional$100.00 or fraction thereof,to p 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 $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: M; 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 ID 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. ❑ Any multipurpose fire sprinkler system. Dishwasher: -Commercial 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: -Lay/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 Water Extractor fees assessed for the sewer increase must be paid before the 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 • COMMUNITY DEVELOPMENT DEPARTMENT III Transmittal Letter i !(,,,,i, I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Allyson A. DATE RECEIVED: DEPT: BUILDING DIVISION FROM: Omar Alami Abouhafs RECEIVED APR 2 0 2021 COMPANY: Taylor Morrison CITY OF TIGARD PHONE: (360)946 8674 BUILDING DIVISION By: EMAIL: OAIamiAbouhafs@taylormorrison.com/PermitSubmittals@... RE: 14130/ 14132/ 14134 SW 165TH AVE. MST2021-00093/00095/00096 (Site Address) (Permit Number) Polygon at Roshak Ridge (lot 165) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 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 O FICE USE ONLY Routed to Permit Technic'an: Date: Li(z /z..I Initials: ti-A- Fees Due: ❑ Yes No ee Descnpti n: Amount Due: \) D $ fsZI, $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes ,No ❑ Done Applicant Notified: Date: '-l�2.1/,L ( Initials: ' eG� CITY OF TIGARD MASTER PERMIT N . . , COMMUNITY DEVELOPMENT Permit#: MST2021-00096 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/18/2021 TIC;;112 f7 g Parcel: 2S107AA16500 Jurisdiction: Tigard Site address: 14134 SW 165TH AVE Subdivision: ROSHAK RIDGE Lot: 165 Project: Polygon at Roshak Ridge, Lot 165-ADU 2 Project Description: New attached ADU, 2 of 2. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 720 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 22.5 Bathrooms: 3 Second: 1009 sf Garage: 398 sf Front: 8 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 1729 sf Value: $230,956.74 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 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 addl 500 sf: 3 201-400 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 1729 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: $25,893.98 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: Holly v 'VC'W Permittee Signature: 0 AppUcG t o-n 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 Application RECEIVE Residential MAR 1 6 2021 Received I City of Tigard Date/By: 31./J I 1 J 1 Permit No.:Onc�.- 2 az 1_co , 111 a I3125 SW Hall Blvd.,Tigard,OR 97223 ���Y OF 1 IUHiiL` Plan Review p ti 1 r` ` LV �'n Other Permit: ,71/�+F'-xt Phone: 503.718.2439 Fax. 503.598.1960 Date/By: 21 (- 0c06,7 Inspection Line: 503.639.4175 3UILDING DIVISIC Nate Ready/By: lun 0 See Page 2 for TIGARD p Noti /Method: SupplementalInformation Internet: www.ngard-or.gov .Z-� �� I TYPE OF WORK REQUIRED DATA: ND 2-FAMILY DWELLING 0 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. lit El 1-and 2-family dwelling IIICommercial/industrial Valuation: $ i 95teS ❑Accessory building El Multi-familyNumber of bedrooms: 3 ❑Master builder I]Other: ADU 2 Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: 2 (')--/ . Job site address: 14134 SW 165th Ave. New dwelling area: 119 square feet 1 009 1 City/State/ZIP:Sherwood, OR 97140 Garage/carport area: ri(a square feet —1 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.: 165 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 2) Valuation: $ . / • Existing building area: square feet New building area: square feet ® PROPERTY OWNS' ❑ 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 a9 BUILDING PERMIT FEES* (Fictive refer to fee schedq/e) Business name:Polygon Homes WLH LLC Structural plan reyiew 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(o>taylormorrison.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic 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 710 Solar Installation Specialty Code checklist. Permit Fee(includes plan review City/State/ZIP:Vancouver, WA 98660 and administrative fees): $180.00 . Phone:(360 )695-7700 Fax:( )360 693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 �/ [ / /J Total fee due upon application: $201.60 Authorized signature: (3kit 2 icy E 4t o-L!/ZCa This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Omar Alami Abouhafs Date: 03/08/2021 *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) NIMMINOMMINNMs. --- } RECEI . It Mechanical Permit Application koti,o Flc:F.1.si: ONt..1 MAR 1 6 ��' - _�_ '., City �' ceived IN of Tigard Dau y 22 JQ Permit No,: ih5f'2o2t-t�W0tto ' 1 13125 SW Hall Blvd.,Tigard,OR 97223 [.-..� .....N_ a ;I l Y (7 TI . 11 ,,„ _ Su)V�21— 6� Phone: 503.718.2439 Fax; 503.598.t.960 ;,1c Other Permit: /„ f li1 rs,t;I) Inspection Line: 503.639.4175 BUILDING DI t .. (t s,yrByt 7aris. El See Page?for 1[/ Internet: www.ttgard-or.gov Notified/Method Supplemental Information • TYPE OF WORK COMMERC1Ala yEr, SCHEDULE USE CHECKLIST Mechanical permit fees*are based on the value of the work El New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all Demolition ❑Other: mechanical materials,equipment,labor,overhead and profit. ______„_ Value:$ CATEGORY OF CONSTRUCTION - `— _. RESIDENTIAL EQUIPMENT!SYSTEMS FEES* 1 I-and 2-family dwelling 0 Commercialtindusttial ❑Accessory building 1 For special information use checklist. Multi-family ❑Master builder Other: ADU 2 i Uescripdon Qty. Ea. Total �.A J _._l._ JOB SITE LNFORMATIO:N AND LOCATION I Heating/coolin!': I.Air conditioning UN 46.75 Job site address: 14134 SW 165th Ave. FFurnacc 100 000 BTU(ducts/vents 46.75 City/State/ZIP:Tigard,OR 97224 J {r furnace:00,000+BTU(ducts/vents) 54.91 Suitebldg./apt.no.: 1 Project name: Polygon at Roshak Ridge i Heat pump 61.06 ,I Duct work 23.32 Cross street/directions to job site: H drone hot water system —._..______..._ Residential boiler(radiator or ___.....— _._. _...............q__-_ _.. bydrontc) 23.32 Unit heaters(fuel-type,not electric), 1111 in-wall,in-duct,suspended etc. 46 75 j 1 Flue/sent for an 'af above subdivision: Polygon at Roshak Ridge Lot no.: 165 �C?tlycc ...._.._. 1 Other fuel appliances: Tax trap/parcel no.: ; Water heater M 23,32 all ' DESCRIPTION OF WORK Gas fire lacei:nscn 33.39 Flue vent for water heater or gas New Single Family -Accessory Dwelling Unit(ADU 2) fir dace � La. tighter(,•ors " li--- _ Wood;ieiletstove 33.39 Wood fireplace/insert _ Chime iliner/flue/vent— aii _ - 0 PROPERTY OWNER 1 V.._.._ 0 TENANT c►th : Ell - --- - Environmental exhaust and ventilation: Name:Polygon WLFI,LLC Range hood/other kitchen Address 703 Broadway St,Ste 510 1 e tuitnent 33 39 j i Clothes _ _ __.-._._._. .._____..___ dryer exhaust 3�39 1 City/State/ZIP:Vancouver,WA 98660 1 Single-duct exhaust(bathrooms, _____._.__._.. _ _.�. _ _ toilet corn armcnts.utili, rooms 23.32 Phone:(360)695-7700 Fax:( ) 1 Attic/erawlspace fans 23.32 I ® APPLICANT 0 CONTACT PERSON Other; 23.a2 -1 Business name:Polygon WLH,LLC Fuel i in ___ ______... ._._. . 514.15 for first four;S4.03 for each additional Contact name:Tonja Morris Furnace,etc. ' Address.70313rceadwrty St.,Ste 510 i Gas heat um. Walls ended/unit heater Milli Cif /State/ZIP.Vancouver,WA 98660 Y Water heater _ Phone.(360)695-7700 Fate::(360)693-4442 Fireplace Rome E-mail:permitsubmittalsCataylormornson.tom Barbecue MI CONTRACTOR Clothes dryer(gas) Business name:Pro.Pleating&Cooling I Other: 1 MISCfLANrICAL PERMIT FEES* t .i Address: NW Alociek.Dr,Ste.1.104 i • Subtotal E City/State/ZIP:Hillsboro,OR Minimum penult f©r(S4�J.00) - --.-..--_-. Plan review(25%of pert:.fee) Phone:(360)270 I59U Fax:{ ) State surcharge(12%of permit fee) CCB lie.:209001 TOTAL AL PERMIT FEE __^I ""'" " ' "' This permit application expires if a permit is not obtained wtthiu ISO e. b days after it has been accepted as complete. Authorized signature: C✓C(' • Fee methodology set by In-County Building,Industry Service-Board IPrint name:Elia Duran Date: 10/30/20 r•1nr.itAine1Perm'.rtukser Pon,'sem Mill 1:Ann .,all AL''-'-r,,'o -• arttrC,a, Electrical Permit Applicatioi ECEIVED City of Tigard kecelr Permit it T �' _ 71 . 13125 SW hail Blvd.,Tigard,OR 97223 qAY . 8 202 i Ran Review � �tl 'f`n�► �.I—(j-'�' 1 = Phone. 503.718.2439 Fax. 503.598.1960 OF i am?iv. Related Permit t: [t_;:�} ll Inspection Line: S03 639 4175 S I� TIGARD Ready Date/By- Ions: , El see Page 2 for Internet www.tigard-or.gov ���DIN�DIVISIONB� Supp1 ental Information TYPE OF WORK PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please cheek all that apply(subo n j sets of plans wlitems choked) ❑Demolition ❑Other: 0 Same or feeder 400 amps or more CI Building over three atones where the available fault currant 0 Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at I50 volts or 0 Moaning buildings ❑ 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building teat to ground,or exceeds 14.000 0 Commercial-,sse egrteutwna 0 Multi-family 0 Master builder ®Other. ADU 2 �pump all other installations Ibnstallation ❑Fire ptmip ❑]nstaltaiipn of 150 KVA or JOB SITE INFORMATION AND IAX"A7'lON ❑Emergency system larger separately derived 0 Job#: Job site address: 14134 SW 165th Ave Addition of new motor load of system_ 10011P or more. 0"A".-5-,"12","1-3", City/State/ZlP: Tigard,OR 97140 ❑Six or more residential units occupancy 0 Health-care facilities. 0 Rom:atonal vehicle parks. Suite/bldgJapt.#: Project name: Polygon at Roshak Ridge 0 flazardota locations ❑Supply voltage for more than ❑Service or feeder 600 amps or more 600 volts nominal Cross street/directions to job site: _ FEE SCHEDULE rriytio Fsch I 'fetal I New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: 165 Includes attached garage. Tax map/parcel#: 1,000*1 1t ar>Css J 168 54 4 Ea.add'1500 sq.ft or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 New construction. Type: ADU 2 (with above sq.R) , Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 ® PROPERTY' OWNER Q TENANT Services or feeders installation,alteration,and/or relocation Name: Polygon Homes WLH LLC 200 amps or less 100 70 Address: 703 Broadway St.,Ste 710 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200 34 2 City/State/ZIP: Vancouver,WA 98660 Got 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: 0AlamiAbouhafs@taylonnorrison.com-PermitSuhmittals@taylormorrison.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 anips to400 amps 125 08 2 Owner signature: _.. Date: 401 amps to 599 amps 168 54 2 Branch circuits-new,alteration or extension,per pants ❑ APPLICANT 0 CONTACT PERSON A Fee for branch circuits with Business name: Polygon Homes Wi.H LLC above service or fouler foe, 7.42 each branch circuit Contact name: Omar Alami Abouhafs B Fee for branch circuits without Address: 703 Broadway St.,Ste 710 smite or feeder fee,Brat 56.18 z branch circuit City/State/ZIP: Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Phone: 360 9$6 8674 Miscellaneous(service or feeder not included) ( ) Fax::( ) Each manufactured or modular 67 84 2 sEntail:OAlarniAbouhafs@-taylormorrison.com-PermitSubmittals@taylormorrison.com dwelling, Reconnect only and/or feederonly 67 84 2 CONTRA("TOR Pump or irrigation circle 67 84 2 Business name: Wallace Electric Sign or outline lighting 67.84 7 Signal etrcun(s)or limited-energy Address: 105 Dresden St panel,attcrauon,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 hr min) 66 25/hr Phone:(503 308 0563 lax:( ) Investigation(1 hr min) 9000/hr Email: David@wallaccwires.com s.com — - Industrial plant(I hr min) 78►S/hr CC13 i.iC.:224868 Inspections for which no tee is Electrical Li•- C 1441 Su .1; .' 6363S specifically listed(Y4 hr min) hr Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES Print name: �f�-�/'�� Subtotal- ("�liko•gyp c. Date: /e fL ft t 0 Plan Review Required(25%of permit fee): i/ State surcharge(12%of permit fee) Authorized signature r2dr,.lr ' TOTAL AL PERMIT T i t: This putt applicense expires if a permit is not obtained within 160 Print Hanle: n�� Date: tl f j r days after it has been accepted as complete_ '�ixv 7a{/8►f ( ' r of inspections allowed per permit 1.taititdingPetuutr'yLC l'ennatApp_E-R LRF.doc Rev06117f2015 4 646151(il/0S/C084RVFS ,- •.. • • • • Plirmbing Permit Application RECB/ED Building Fixtures • MAR 1 6 202 rou 01 IR :. 1. t, ON.I.1 City of l'igard Received , / / 1 Nr- Date/B . 5 Per.it N.,rnw2oz I-boocit„ , .... . 13123 SW Hall Blvd.,Tigard,OR 97223 Cii I Y 01.- I lu rpri /2270 — . n Review 1183 • 4 P 8 Phone; 503.718.2439 Fax: 503 BUILDING DMS• N .598.1960 Other Permit No. ...:,glft32,2021 Inspection Line: 503.639.4175 r- 1 li;ARD Date Ready/By: luris: 0 See Page 2 for Internet: www.tigard-orgov Notified/Method Supplemental Information TYPE OF WORX FEE* SCHEDULE ...4 New construction 0 Demolition 0 Addition/alteration/replacement 0 Other: Description TeS7Ierialitiformation use gieektisi. 1 . Ea. Total _ New 112-fainda.dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath _ i 312,701 4 437.78 L 1-and 2-family dwelling 0 Commercial/industrial - SFR(2)bath . — SFR(3)bath 500.32 CI Accessory building .Multi-family Each additional bath/kitchen 25.02 _ C]Master builder 7 Other: ADU 2 Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: i . . . Job site address: 14134 SW 165th Ave Catch basin or area drain 1876 _. . T. Drywell,leach line,or trench drain . 18.76 City.'StateZIP:Tigard,OR 97224 1 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 f. Sanitary sewer(no,linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water siNvice(no.linear ft.: ) Page 2 Subdivision: 1 Lot tic 165 Fixture or item: '..-.,' [ Back-flow preventer 111 31.27 Tax map/parcel no.: 'DESCRIPTION OF WORK Backwater valve 12.51 02 25 h as Clothes w er , New Single Family -Accessory Dwelling Unit(ADU 2) Clot ---- ''. Dishwasher 25.02 ' 1 Drinking fountain 25.02 Ejectors/sump ' 25.02 r PROPERTY OWNER 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name:Polygon WLH,LLC Floor drain/floor sink/hub 25,02 1 . Address:703 Broadway St.,Ste 510 Garbage disposal MO 25,02 , ,.. City/State/ZIP:Vancouver,WA 98660 Hose bib Num 25,02 ... Phone:(360)695.7700 Fax:( ) Ice maker 12.51 = ., L APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25,02 • ,,....._ _ Medical gas(value:S ) . • Page 2 ; Business name:Polygon Will,LLC Primer . . ' 1 12 51 I Contact name:Tonja Morris . 1 • IAddress:703 Broadway St.,Ste 510 Roof drain(commercial) 12.51 _ __,........_ _____ 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 1 ............____ E-mailPermitSubmittals@taylormorrison.com,0AlamiAbouhafs@taylormorrison.com Urinal 25.02 i1 Water closet 25.02 CONTRACTOR 1 - Water heater 37.52 Business name:G&B Plumbing 434 Sons Inc Address:P.O.Box.92 Watts piping/DWV 56.29 Other: 25.02 I 1 City/State/ZIP:St. Paul,OR 97137 1 Subtotal !__ J Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: 572.50 Plan review (25%of permit fee) CCB Lie.: 184372 1 Plumbing.Lic,no.:pb63-1 1 1-- 1 _...,.,...,..___________., -- State surcharge(12%of permit fee) t , ipw, , Authorized signature. ALIP MP .iritAiti,'"--,---___ r— TOTAL PERMIT FEE i • Print name:Steve Fowler I Dais: 10/30/20 •Chis permit application expires If a permit is not obtained nithin ISO days after it has been accepted as complete. *Fee methodology set by Tri-County Building industry Service Board, J ArkaaroPa mitsIPLMU-PcmitApp doc 10/01109 440,46 I 611,10,02,COMVE31 City of Tigard IIa COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential Building Permit #: msrana I- 000(Ab Site Address: 14134 SW 165th Ave Project Name: Polygon at Roshak Ridge Lot #: 165 Planning Review Proposal: New attached ADU QVerify address/suite#active in Accela. ❑° In River Terrace: ❑ No ❑'' Yes, River Terrace Review Addendum Site Plan Elements: erosion Control Illi copies of site plan on 8-1/2"x 11"or 11 x 17"paper ° etained trees with drip line and tree protection measures 13 Drawn to scale(standard architect or engineer scale) ootprint of new structure(including decks)and F1-J 12 orth arrow 'LJtility ocations&easements(required for new and additions) O.ite address,project or subdivision name and lot number v'i. alk/driveway approach 0 pplicant information(name and phone number) `F.'cation of wells/septic systems p .t dimensions and building setback dimensions „;Street tree size,type and location 01.quare footage of buildings to be demolished 'treet names IIxistin gg structures on site ° ororner elevations(2'contours if more than 4'differential II .t 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 ° To c.; Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑Yes,applicant was notified CI Received: CI Yes CI No �\ ❑ Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: ❑Yes,applicant was notified ❑ No Received: Yes No ❑ SDC Exemption for ADU applied for: ❑Yes 0 No Received: Yes No 0 Public Facilities Improvement(PFI) Permit: Required: ❑Yes,applicant was notified ❑No Applied For: ❑Yes 0 No,stop intake ❑r Land Use Case#: ADU2020-00013 Q Zoning: R-4.5 0 Required Setbacks: Front: 8 Rear: I * Side: 3 Street Side: NSA Garage: 3 ❑r : .ding Height: Max.Height: 30 � Actual Height: 25.5 1\,r 1 andscape Area: 0/0Dr i1.t Coverage Max: 0/0 E trance ° 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 ra e door is behind widest street-facing wall A\ ❑Yes , ne otf f the following is met: Do nds no more than 5'from wall aiMi. re is a co porch extending beyond garage. Door extends n e than 5'from wall and is a 12 sq ft.window above garage on 2nd floor. ❑ Gara e door width is 12'or 50%or less of facade 60%or less and includes 7 of following: Covered porch cessed entrance Wall offset ❑ 1'Roof eave Roof offset Fire • s Lap Siding ❑Roof itc Gable,hi-3,or gambrel roof ❑ Dormer Accent siding Window trim U Window recess indow projection ❑ Balcony Visual Clearance ❑r Urban Fores Plan Sensitive Lands: ❑ Yes L_J No Type: Conditions met prior to issuance of building permit Notes: ` ❑ Approved By Planning: c t__ Date: 3 D— Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: 3/j/Zf (YISc2O2t IY J Site Plans: # 3 Building Plans: Building Permit#: CJEnter buildin permit#above. Er Workflow Routing: Planning Engineering Coordinator I;Kilding Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: engineering: (1) copy of permit application, (1) site plan, (1) building plan and riginal plan review routing form. LA Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: '/Z z. z/ Engineering Review UN f7Y i!/Slope at building pad: X-/S Ionditions "Met"prior to issuance of building permit 11 1.9 Easements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes o Assess Water Quantity Fee in-lieu: ❑ Yes o �-�/ LIDA Facility on lot: El YesNo I Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: Date: /:S/2„/ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review KConditions "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 aly SDC Fees Entered: Wash Co Trans Dev Tax: ! vgYes U N/A Tigard Trans SDC: j Yes 0 N/A Parks SDC: 4 Yes N/A LIDA ❑ Yes E. N/A Jt OK to Issue Permit Approved by Permit Coordinator: Date: 3T f �4 1:\Building\Forms\B1dgPermitRvw_RES_122419.docx City of Tigard 111 COMMUNITY DEVELOPMENT DEPARTMENT C TIGARD River Terrace Building Permit Review Addendum Building Permit #: hitSi'2o2 - D0(901 Site Address: 14134 SW 165th Ave Project Name: Polygon at Roshak Ridge Lot #: 165 (I\cw dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of River Terrace Plan District Design Standards (18.640.070.L): Is the project subject to the plan district design standards? ❑Yes El No (Per MMD2020-00044) • rticulation: 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 ❑ ❑ ❑ ❑ 2. Eyes on the str- •t: a minimum of 12%of each street facing facade must include windows t entrance doors. Percentage Shown: 3. Entrances:At least one e ance must meet both of the following standards: ElMax. 8 ft. setback from longes treet facing wall El Parallel to street, , gle no more than 45° from street, or open onto por Entrance opens to a porch: ❑Yes I o IfLes,all the following apply: El25 sq.ft. • . One street facing entry ❑12 f ax. roof above floor of porch ❑5 ft. depth min. ❑3 i/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 Recessed entry area min. 5 ft.wide x 2 ft. deep ❑Wall offset min. 16 inches 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 Side 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 extent 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 y. 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 111 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: --`' Date: f' 2 I:\Buildi ng\Form s\BI dgPermitRvw_RES_RT_I21417,docx City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT I Water Meter Fixture Unit Worksheet Tlt ` RC?'; For New Buildings 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 live 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: Contractor 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: 14130 SW 165th Ave(SFU)- 14132 SW 165th Ave(ADU 1)- 14134 SW 165th Ave(ADU 2) Subdivision Name: Polygon at Roshak Ridge Lot#: 165 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 1 = 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 x 2.5 = 2.5 Hose bib, each add'l 1 x 1 = 1 Kitchen sink 1 1 1 3 x 1.5 = 4.5 Laundry sink x 1.5 = Lavatory 5 4 5 14 x 1 = 14 Water closet, 1.6 GPF 3 3 3 9 x 2.5 = 22.5 Bathtub/whirlpool x 4 = Shower stall x 2 Bath/shower combo 2 2 2 6 x 4 = 24 Total Fixture Unit Points: 85 Fixture Unit Points: 1 to 30= 5/8" 37.5 to 89= 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: 1:/Building/Forms/WaterMeters_010121_New.doCx —Page 2