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Permit
p ffivi Plumbing Permit Applica CEIVED Building Fixtures rOR OFI ICN: t st: ONI.v CityandReceives of Tigard SEPDate/By: 7 //11/ J`�"- Permit No.: MST2021-00093 ■ 13125 SW Hall Blvd.,Tigard,OR 97223 II _ ry Plan Review Phone: 503.718.2439 Fax: 503.50I1 bGF TIGARD 9/9 l p l AG6 Other Permit No.: Inspection Line: 503 639.4175 Dare sy / i I"A R tJ Date Read/B Juris. ® See Page 2 for Internet: www t1 and-or ov y y g g g BUILDING DIVISION Notified/Method �����"� -Ga Supplemental Information TYPE OF WORK ,r), 611 .--- 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) �y�ssa:, CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑Q 1-and 2-family dwelling I.:Commercial/industrial SFR(2)bath 437.78 ID Accessory buildingSFR(3)bath 500.32 ❑Multi-family Each additional bath/kiJchen 25.02 ❑Master builder CI Other: / Fire sprinkler(2408sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:14130 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 J 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.:165 Fixture or item: Tax map/parcel no.: Backtlow 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 7 © 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 ❑ APPLICANT RI 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 1 Plan review (25%of permit fee) CCB Lic.:184601 Plumbing Lic.no.:PB732 /� ��� State surcharge(12%of permit fee) /Authorized signature: TOTAL PERMIT FEE (g3 Q I 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. 1:1BuildingAPermitsVPLMU-PermitApp.doc 10/0I/IS) 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 (eel 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 VStorm&Rain Drain-1st 100' 62.54 alua an 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 Inspections or Fees Fee(ea) Total• each additional$100.00 or fraction thereof,to 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: 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 Baptistry/Font ❑ Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car lCar Wash: -Each Stall New exterior plumbing site utilities for any complex structure Drive Thru as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial El 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: -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: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 II a 4111 Transmittal Letter 1 (, lc 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 DECEIVE® APC 2 0 Z021 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 examiner's 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:, y l`3 21 Initials: Fees Due: ❑ Yes No e Descripti n: Amount Due: N..) O P & l...---- $ fZc.„ Special Instructions: Reprint Permit(per PE): 0 Yes ,No ❑ Done Applicant Notified: ` _ _ -- Date: 414 74_ ( Initials: ��o� I W CITY OF TIGARD MASTER PERMIT III 1 COMMUNITY DEVELOPMENT Permit#: MST2021-00093 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/18/2021 T 1 c;A i2 C7 9 Parcel: 2S107AA16500 Jurisdiction: Tigard Site address: 14130 SW 165TH AVE Subdivision: ROSHAK RIDGE Lot: 165 Project: Polygon at Roshak Ridge, Lot 165-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: 22.5 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 Drywell-Trench Drain: 0 Other Fixtures: 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'I 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 Ecom asin Y Other: N Other Description: p g 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 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 Fire Rated Conditions 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. Issued By: Holly VANVDPiwP.�E Permittee Signature: Oyu AppLt,( (TVL 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. _ '' ^ W—r 1teS--- adding Permit Application RECEIVED fe..-wit,/2 Residential MAR 1 6 2021 FOR OFFICE t si:O.,L.l eceived ,�-�—^ City of Tigard QITY OF 1 iCiAR y: 3 2 i N Permit No.: rt7�f21' Q204 7 IIIate/B �it/w 13125 SW Hall Blvd.,Tigard,OR 97223 ❑Review Phone: 503,718.2439 Fax: 503.598.1960 BUILDING DIVISI eiBy.; & `Lit Mk Other Permit: 5U322Ca1••°COO P I G AIt D Inspection Line: 503.639.4175 Date Ready/By: .. ' Es See Page 2 for Internet: www.tigard-orgov No" d/Method: ./�/�' Q. Supplemental Information TYPE OF WORK REQUIRED DATA: -AND 2-FAMILY DWELLING 2 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 0 Other: equipment,materials,labor,overhead,and the profit for the work indicated on this application. CATEGORYCO OF NsTRI:CTION �� Valuation: $ 31 1 eta ® 1-and 2-family dwelling Ti Commercial/industrial ❑Accessory building El Multi-familyNumber of bedrooms: 5 0 Master builder ElOther: Number of bathrooms: 4 JOB SITE INFORMATION AND LOCATION dotal number of floors:2 2g8T- Job site address: 14130 SW 165T1-1 AVE Pr;m - New dwelling area: +�gtjisquare feet I1�3'1 City/State/ZIP:Sherwood, OR 97140 I Garage/carport area: 477 . " ' square feet CI1 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. _ / Nev Single Family Valuation: $ 4 t t_.- �T_e. Existing building area: square feet -y rl On ,,16' ,J t 7k s-,„,„New building area: square feet ® PROPERTY OWNER El TENANT Number of stories: Name:Polygon Homes WLH LLC Type of construction: Address:703 Broadway St., Ste 510 Occupancy groups: City/State/ZIP:Vancouver, WA 98660 Existing: Phone:( 360 946 8674 Fax:( )360 693-4442 New: ® APPLICANT ❑ CONTACT PERSON 00 BUILDING PERMIT FEES* (Please refer to fee schedule) Business name:Polygon Homes WLH LLC • Structural plan review fee(or deposit): Contact name:Omar Alami Abouhafs - - FLS plan review fee(if applicable): Address:703 Broadway St., Ste 510 Total fees due upon application: City/State/ZIP:Vancouver, WA 98660 Phone:( )360 695-7700 Pax: :( )360 693-4442 Amount received: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: Commercial and residential prescriptive installation of CONTRACTOR OR 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 510 Solar Installation Specialty Code checklist. _ City/State/ZIP:Vancouver, WA 98660 Permit Fee(includes plan review $180 00 and administrative fees): Phone:( )360 695-7700 Fax:( )360 693-4442 State surcharge(12%of permit fee): $21.60 CCB lie.:207247 Total fee due upon application: $201.60 Authorized signature: 3I44.t22- 4 46efreediaild, 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: 02/15/2021 *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) • • -- a mec RECEIV hanical Permit Application 1,01(of I ICE LSE ONL1' City of Tigard 14 MAR 1 6 2021 Rece'ved $/1 i,1 it t NT Permit No.' McS9,004_.b,30:76 j 13125 SW Hall Bvd.,Tigard,OR 97223 DaterBy: i Lou'' Review -. 7•, • Phone: 503.718.2439 Fax 503_598.1960 CITY OF TIGAi-weiBy: Other Permit:sm.um-ax) '''‘ I 1 Inspection Line: 503.639.4175 ii.uu fa Ste Page 2 for Ili.ifi.C.1*.r • BUILDING DIV1Stv ,icciai:e13,tiodY', Internet: www.tigard-or.gov Supplemental Information _..... _ _ . . — TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST 1 Mechanical permit Ices*are based on the Value of the work 1, El New construction 0 Addition/alteration/replacement performed.Indicate the value(rourided to the nearest dollar)of Al 0 Demolition 0 Other mechanical materials,enliipment;labor,overhead and profit„._ Value:S CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES* Fs7 and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist Multi-family u Master builder 0 Other: Illicriotion Qty. Ea. 1 Total ; JOB SITE INFORMATION AND Heating/cooling LOCATION _ ... I i Air conditioning I 46.75 k.1 l . ..... _ Job site address. 14130 SW 165TH AVE 1 Fimiace 100.000 BTU(duets/vents) 46.75 ,! City/StateJZIP:Tigard,OR 97224 Furnace 100,000+BTU(duets/vents)Suite/bldg./apt.no.: ! Project name: Polygon at Roshak Ridge Beat pump _ , 61.06 - 1 . Duct work 23.32 I Cross street/directions to job site: mile hot s water ystem 1 Residential boiler(radiator or 23.32 • ji h dronic 23.37 I Unit heaters(fuel-type,not electric), iin-wall in-duct sus ends etc. 46.'75 I Flue/vent for any of above 23.32 I __. I.,Other 23.32 Subdivision; Polygon at Roshak Ridge Lot no.: 165 , 1 Other fuel appliances: t— Tax map/parcel no,: -- —.------ ---- I Water beater 23.32 ,..,„.. DESCRIPTION OF WORK Gas amine/insert 33..39 i Flue vent for water heater or gas New Single Family 1 fireplace ,.. 2332 •.._ _ _ _ Log lighter(gas) • 23,32 . Wood/pellet stove 1; 33.39 Wood fire lace/insert 73.32 , 1 Chimney/linertflue/vent 23,32 -- 1 Other I 23.32 LI" PROPERTY OWNER 1. • 0 TENANT -- Environmental eshaust and ventilation: Name:Polygon WI.F1,LLC 1 Range hood/other kitchen • L equipment 33,as Address:703 Broadway St.,Ste.510 i Clothes d er exhaust_ City/State../ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms, itoilet compartments,utilit rooms 23,32 Phone:(360)695-7700 Fax:( ) l Attic/crawls ace fans 23.32 I APPLICANT ' D CONTACT PERSON Otht.T: 23.32 ; ----I . Fuel piping: I I Business name:Polygon WI.,11.LLC $14.15 for first four$4.03 for each additional Contact name:Tonja Morris . Furnatie,etc I-Gas heat um Address:703 Broadvvay St.,Ste 510 .....__. ' -- - Wall/suspended/unit beater . City/State/ZIP: Vancouver,WA 98660 . ' Water heater ........- --- ... Phone:(360)695-7700 I Fax':(360)693-4442 i Fireplace t --j. Range i _._. E•mail;permitsubmittalsgjaylOrTflOffiSOrl.COM Barbecue I „......... lk_ CONTRACTOR Clothes d. er teas)._ , I i Business name.Pro Beating Sc Cooling, . LIOther: MECHANICAL PERMIT FEES* Address: NW Alociek Dr,Ste.1104 i , •SUbtotal City/StateIZIP:Hillsboro,OR Minimum permit'fee($90.00) -• _Phone: 1 r (360)270-1590 Fax;( ) State sin charge(12%of permit fee) I (CB tic.:209001 TOTAL PERMIT FEE ..„._1 This permit application expires if a permit is oat obtained witbin IRO days after it ham been accepted as complete. Authorized signature: C'11-" - ' 64---11-0-11- * Fcc methodology set by Tri.County Building Industry Service Board r--- I Print name:Ella Duran Date: 10/30/20 i AH•eilt1.0,Perrn*re,14F1 Vermoi Ano 11103 11 Ae, A 40,04,VI,,..',IN,.A a Electrical Permit Aupiica ' �~+ VEDI (iROFI.11 I I sI t)\I.\ City of Tigard V I Received Penn". -' 13125 SW flail Blvd.,Tigard,OR 97223 4 Plea Reviewz'1 ` • ' j Phone: 503.718.2439 Fax: 503.59819t Y 18 YO?I Uate,Riv. Related Permit k: Z Z+—Wit.. Inspection Line: 503.639.4171 -r� Read Date torts: w t 1 L i t 1:1J Internet: www.tigard-or.gov i,li I i OF TIGARD Notified/Method. Supplemental Information TYPE OF 1N(?l OMSi{al • _ .PL414 REVIEW ®New construction 0 Addition/alteration/replacement Please check all that apply(submit j sets of plans whims checked) ❑Sa WCC or feeder 400 amps cx more 0 Building over three stones 0 Demolition ❑Other: where the:mailable fault current ❑Marinas and boottauds CATEGORY OF CONSTRUCTION exceeds 10,000 amps nil5o volts or 0 Floating buildings ® i-and 2-family dwelling ❑Commercial/industrial ❑Accessory building lest to gr0und,or exceeds 14.010 ❑Commercial-use agncuinaal amps❑Multi-family 0 Master builder 0Other. for all other tnstauatiats buildings 0 Fur pump 0 Installation of I 50 KVA or JOB Sr1'E INFORMATION AND LOCATION 0 Emergency system larger separately doused Job#: Job site address:14130 SW 165th Ave 0 Addition of new motor load of system. 100I1P or mom. ❑"A","E","12","1-3", City/State/ZIP: Tigard,OR 97140 ❑sex or more residential units occupancy ^— -- ❑lrcalth-care facilities ❑Raaeaaonal vehicle parks_ Suite/bldgJapi#: Project name: Polygon at Roshak Ridge ❑llaznrdous locations ['Supply voltage lot more than 0 Service or feeder 600 amps or more 600 volts nnmunal. Cross street/directions to job site: FEE SCHEDULE — Descriphaa I Qty. I Each I Total 14`,...4 New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: 165 Includes attached garage. Tax map/parcel#: 1,000 sq ft.or less 168 54 4 Ea.add'1 500 sq.tt.or portion 33.92 1 DFSCRIPTTON OF WORK Limited energy,residential _ (with above sq.ft) 75.00 2 New construction.Type SFU Limited ' energy,multi•farmly 75.00 2 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 MI PROPERTY OWNER 1 0 TENA1ti 1' Services or feeders installation,alteration,and/or relocation Name: Polygon Homes WLH LLC 240 amps or less 100.70 27 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 601 amps to 1,000 amps 301.04 2 Phone:( 360 )946 8674 Fax:( ) Over i,000 amps or volts 552.26 2 TemEmail: OAlamiAbouhafs@taylomlorrison.com-PermitSubnuttals(a taytormorrison.com relocation services or feeders installation,alteration,and/or Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125 08 2 Owner signature:_ __ Date: 401 amps to 599 amps 168.54 2 0 APPLICANT ICI CONTACT PERSON Branch circuits-new•,alteration,or extension,per panel A.Fee for branch cucuits with Business name: Polygon Homes WI.H LI.0 above service or feeder foe, 7 42 " each branch circuit Contact name: Omar Alami Abonhafc B.Fee for branch circuits without Address: 703 Broadway St.,Ste 710 service or fccdce fee,first 56.18 2 branch circuit City/State/ZIP: Vancouver,WA 98660 Each add'!branch circuit 7.42 2 Phone:(360 )946 8674 Pam.. Miscellaneous(service or feeder not included) :( ) Each manufactured or modular 67 84 2 Email:OAlamiAbouhafs�dtaylormorrison,com-PermitSubmittals a)taylarmorrison.com dwelling.acre„tx anaior find« Reconnect only 67 84 2 CONI'RAC1 OR Pump or tnrgation circle 67 84 2 Business name: Wallace Electric Sign or outline lighting 67.84 2 S,0 nai circuit(s)or limited-energy Address: 105 Dresden St panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP:/State/ZIP: Each additional inspection over allowable In any of the above ty Astoria.OR 97103 Addtttonal inspection(1 hr min) 66 25/hr Phone:(503 3)8 0563 Fax:( ) Investigation(1 hr min) 90.00/hr Email: David@wallaccwires.com Industrial plant(I hr min) 78 18/hr inspections for which no fee is90 00/hr _ CCB Lie.:224868 Electrical Li•• C1441 Su . 1.' : 6363S specifically listed(fl hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: / Subtotal Print name:' ap_ • , r Date: /e /z 1 t ❑Plan Review Required(25%of permit fee): / _-- [! State surcharge(12%of permit fee) Authorized signature _ „/ TOTAL PERMIT Fi E This permit application expires it a permit is not obtained within 180 — Print name: ct Date: /[ / I days alter it has been accepted as complete. e "tr tip, if 4-1 + Number of tnspetaions allowed per permit. l.)Budding,Permilslbld_PartutApp FIR ERF.doc Rey Ohl 17/2015 4 Or4615T(11105ICOM+WFB .1 — ., . •• . . . . • 1 t . . ' Plufnbing Permit Application RECEIVED Building Fixtures MAR 1 6 202 rott oi4:1( i... vs}, 0 N I V City of Tigard 'I 13125 SW Ha Blvd. Tigard,OR 97223 L,t44 •ed CITY OF TIGAtifii:13,vy: 5/1,/, Iv tg Permit No.-. h rnsce4,2,_0[Doq ill , II, Phone: 503.718.2439 Fax: 503.598.1960 BUILDING DIVISICIIC'' ' Other Permit No:Cmckac$2\-an Inspection Line: 503.639.4175 __________ [IC A 14 VI Dale Reacty/By: itau: gi See Page 2 for Internet; www.tigard-orgov _ Notified/Method. _Supplemental Information TYPE OF WORK FEE* SCHEDULE t14 New construction 0 Demolition For special information use checklist .... ....... . - ' -- - --- Deseri2tion _j Q . 1 Ea. Total — 0 Addition/alteration/replacement 0 Other: New 1-2-fantilydwellints(includes 100 ft.for each utility connection) . - CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 1 ;(..1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath SFR(3)bath 500.32 0 Accessory building 41-Multi-family -Each additional bath/kitchen 25.02 0 Master builder 0 Other: _ Fire sprinkler( sq,ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 14130 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.: I Project nameAiieolosionRialitolpolygon at Roshak Ridge Manufactured home utilities : • . 50.03 1 Cross street/directions to job site: Manholes i 8.76 •. Rain drain connector I 18.76 i 1-- Sanitary sewer(no,linear ft.: ) Page 2 I 1-- Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 •,, Subdivision; Polygon a.t.Roshak Ridge . Lot no.: 165 1 Fixture or item: Tax map/paste)no., 'Backflow preventer , - 31.27 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 -- ; PROPERTY OWNER 0 TENANT Expansion tank 12.51 - Fixture/sewer cap 25.02 ) _Name;Polygon WLH,LLC -- Floor drain/floor sink/hub 25.02 Address;703 Broadway St.,Ste 510 1 Garbage disposal 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone:(360)695-7700 Fax:( ) Ice maker 12.51 , .71 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 1 Business name:Polygon WLH,LLC . Medical gas(value:S ) Page 2 • 12.51 Contact name:Tonja Morris Address;703 Broadway St.,Ste 510 Primer I 1 1 ) •: i-- , Roo'dram commercial 12.51 1 1 Sink/hasimiavatory 125.02 , City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone;(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:permitsubmittals@polygonhomes.com Urinal 25.02 CONTRACTOR Water closet 25.02 - Water heater 37.52 Business name:G&B Plumbing&Sorts Inc Water pipingiDWV 5619 i Address:P.O.Box 92 Faber; 25.02 1I City/Stare/ZIP:St.Paul,OR 97 137 Subtotal .._... Pilo=(503)868-1417 Fax:(971)727-8170 Minimum permit fee: S72.50 CCB Lie,:184372 Plumbing Lic.no.:0634 Plan review (25%of permit fee) .„, State surcharge(12%of permit fee) Authorized signature: .1.4111610 -17,144,1"--•---__. TOTAL PERMIT FEE Print name:Steve Fowler Date: 1 0/313 -01 • _ . 1 This perniiiapplication expires if a permit is not obtained within 180 days I 72 1„ after it has been aceepted BF complete. *Fee racihodoingy set by Tri-County Building'estuary Scriice Board. l'aiiidinecemitsTuMU.PenanApooec (..P01.05 440-46:6T(iOnX,'COMAVE8) 4 City of Tigard d COMMUNITY DEVELOPMENT DEPARTMENT ill ■ T 1 G A RD Building Permit Review — Residential Building Permit #: Mg-C"2,021-oo0°C3 Site Address: 14130 SW 165th Ave Project Name: Polygon at Roshak Ridge 'Pet, M A -/ Lot #: 165 Planning Review Proposal: New single detached house ❑o Verify address/suite#active in Accela. ❑r In River Terrace: ❑ No ❑ Yes, River Terrace Review Addendum Site Plan Elements: erosion Control 0: copies of site plan on 8-1/2"x 11"or 11 x 17"paper detained trees with drip line and tree protection measures O raven to scale(standard architect or engineer scale) footprint of new structure(including decks)and FFE O orth arrow •Jtility locations&easements(required for new and additions) D.ite address,project or subdivision name and lot number ° 'id alk/driveway approach O pplicant information(name and phone number) cation of wells/septic systems 0 •t dimensions and building setback dimensions street tree size,type and location !'.quare footage of buildings to be demolished Street names 1* II xisting structures on site °2omer 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 ° o 0 Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑Yes,applicant was notified ❑r No Received: ❑Yes ❑r No Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: ❑Yes,applicant was notified ❑✓ No Received: ❑Yes ❑r No ❑ SDC Exemption for ADU applied for: ❑Yes ❑r No Received: ❑Yes ❑r No 0 Public Facilities Improvement(PFI) Permit: Required: ❑Yes,applicant was notified ❑No Applied For: 0 Yes ❑No,stop intake ❑• Land Use Case#: SUB2015-00004 ❑• Zoning: R-4.5 0 Required Setbacks: Front: 8 Rear: IS Side: 3 Street Side: N/A Garage: 3 Xa B 'ding Height: Max.Height: 30 Actual Height: 25.5 ndscape Area: % of Coverage Max: % Entrance Set back no more than 8'from street-facing wall ❑✓ Parallel to street or offset 45 degrees or less Windows ° Minimum 12%of area of all street-facing facades Garage Gara e door is behind widest street-facing wall VD ❑Ye No,one of the following is met: tends no more than 5'from wall and ther ' covered porch extending beyond garage. Door extends e than 5' from w there is a 12 sq ft.window above garage on 2nd floor. ❑ Gara e door width is . 12'0 50%or less of facade 60%or less and includes 7 of following: Covered porch — ecessed entrance Wall offset ❑ 1'Roof eave Roof offset Fire es — Lap Siding ElRoof itch able,hi-3,or gambrel roof ❑ Dormer A Accent siding _ Window trim U Window recess ' dow projection ❑ Balcony QII Visual Clearance 0Urban Forestr ,Plan II Sensitive Lands: 0 Yes I.::1 No Type: 0 Conditions met prior to issuance of building permit Notes: El Approved By Planning: . Date: 2 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved 0 Not Approved I:\Building\Forms\BldgPermitRvw_RES_122419.docx Building Permit Submittal ' Original Submittal Date: 3/Ib/2", fV)SY2t> 21' ZX79 3 Site Plans: # 3 Building Plans: f2E.3-nter Building Permit#: building ermit# above. Workflow Routing: ZP nning Engineering ermit Coordinator ❑'Building Workflow Sign-off: gn-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. KJ Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: ---/tZw-- Date: 3/z/0/ Engineering Review ff /Slope at building pad: / Conditions "Met"prior to issuance of building permit /!e Easements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: �y Assess Water Quality Fee in-lieu: ❑ Yes LI No Assess Water Quantity Fee in-lieu: ❑ Yes No LIDA Facility on lot: ❑ Yes No IA/Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes:ot ll Approved by Engineering: , Date: 3/i 7 / Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review RConditions "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 a ly KSDC Fees Entered: Wash Co Trans Dev Tax: 2 Yes U N/A Tigard Trans SDC: , Yes ❑ N/A Parks SDC: , 'Yes ❑ N/A LIDA ❑ Yes N/A ciiiL OK to Issue Permit Approved by Permit Coordinator: (7" "IL' Date: 313D I Z0Z1 I:\Building\Forms\BldgPermitRvw RES_122419.docx a City of Tigard ■ a COMMUNITY DEVELOPMENT DEPARTMENT 1111 T l G A R D River Terrace Building Permit Review Addendum Building Permit #: MsT2o2t- OaOC Site Address: 14130 SW 165th Ave Project Name: Polygon at Roshak Ridge Lot #: 165 (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) rticulation: a minimum of 1 element per each street-facing façade 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 Gable. .ormer ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide ■ ❑ ❑ 0 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: ❑Parallel to street, . gle no more than 45° from street, El Max. 8 ft. setback from longes trees- facing wall or open onto por Entrance opens to a porch: ❑Yes U o IfUes,all the following apply: El25 sq.ft. ' . One street facing entry ❑12 f ax. roof above floor of porch ❑5 ft. depth min. ❑3 P/o min.porch roof coverage 4.Detailed Design:All buildings shall include a min. o v• of the following elements on all street-facing façades: ❑Covered porch min. 5 ft.wide x 5 ft. deep 1 Recessed entry area min. 5 ft.wide x 2 ft. deep ❑Wall offset min. 16 inches I P 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 de ❑Window trim •.. . 2 1/2'wide by 5/8"deep ❑Window recess min. 3 inches for 1 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: i 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 v. 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: 5 l -/ 1:\Building\Forms\BldgPermitRvw_RES_RT_121417.docx 1 - City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 111 Water Meter Fixture Unit Worksheet TIGARD 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 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. I:/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, lst one 1 1 1 3 x 2.5 = 7.5 Hose bib, each add'l x 1 = Kitchen sink 1 1 1 3 x 1.5 = 4.5 Laundry sink x 1.5 = Lavatory 5 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 1 1 1 3 x 2 = 6 Bath/shower combo 1 1 1 3 x 4 = 12 Total Fixture Unit Points: 86.5 Fixture Unit Points: 1to30=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