Permit Plumbing Permit ApplicEIVED
Building Fixtures FOR OFFI('F FSF ONl.1
City1
of TigardSEP21 Received
Date/By: 7//2i Permit No.: MST2021-001 11
II • 13125 SW Hall Blvd.,Tigard,OR 97 ? �F -IARd y
m Phone: 503.718.2439 Fax: 503. i. Plan Review
1 6 Date/By: 9/g/P 1 A t!4 Other Permit No.:
Inspection Line 503 6394175 3UILDING DIVISION
l!<i A R D Date Ready/By �, � Juns_ H See Page 2 for
Internet www.tigard-or.gov Notified/Methoytey(5/ / Supplemental Information
TYPE OF WORK ' -iI-- OA/r972.--FEE* SCHEDULE
El New construction ❑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 tt.for each utility connection)
CATEGORY OF CONSIRIJCTION SFR(1)bath 312.70
1-and 2-familydwellingSFR(2)bath 437.78
❑ 0 Commercial/industrial
buildingSFR(3)bath 500.32
❑Accessory 0 Multi-family
Each additional bath/k)t hen 25.02
0 Master builder ❑Other ✓✓
Fire sprinkler(1625sq.ft.) Page 2
JOB SITE INFORMATION ANTI LOCATION Site utilities:
Job site address:14344 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
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.:1173 Fixture or item: '
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 1 0 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
(1
%
f
�� State surcharge T L oERM T fee)
EE
Authorized signature: TOTAL PERMIT FEE j/3 4,rI 3
Print name:Gavin Thomes Date:8.25.2021 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1 ABuildingAPermitsVPLMU-PermitApp.doc 10/01/09 440-4616T(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
Footing drain-1'100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Storm&Rain Drain-1st 100' 62.54 Valuation: Perlla it: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 Qty 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'I stal ons,
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 El Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
-3" Isometric or Riser Diagram
❑ 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
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:ABuilding\Permits\PLMF PermitApp.doc 08/04/2011 2
CITY OF TIGARD MASTER PERMIT
NI - -
COMMUNITY DEVELOPMENT Permit#: MST2021-00111
13125 SW Hall Blvd.,Ti Date Issued: 05/18/2021
TIG,hI;I. and OR 97223 503.718.2439 9
Parcel: 2S107AA17300
Jurisdiction: Tigard
Site address: 14344 SW 165TH AVE
Subdivision: ROSHAK RIDGE Lot: 173
Project: Polygon at Roshak Ridge, Lot 173-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
Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 2
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!500 sf: 2 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-800 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Securely 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 503.232.17Y 9�8877 or 1.800.332.2344.
Issued By: }{D-UIyVaAvDe.We �
4e PermitteeSignature: 0AY ian
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.
•
' •Y
Building Permit Application �'+ yay� � y
Residential � 1A1 V �i� FOR OFFICE I]SEONLY
City of Tigard MAR 1 v 2021 paleaeya 3/29I21 0-r— Permit No mST2o1,,k- 01I
4 13125 SW Hall Blvd.,Tigard,OR 97223 n Rer ew 1
Phone: 503.718.2439 Fax: 503.598.196�i1 TY OFTIGAF1�i Dat
Plae y: y!'L'IJ/ M' Other Permit: 020—OW ii"
T1anRU Inspection Line: 503 639 4175 BLIP.DI 1G DIVISION Date Ready/By: /(-� J of to H See Pagc2 for ."
Internet: www.tigard-or.gov otified/Method 2.I Supplemental Information
TYPE'OF WORK REQUIRED IATA:I-AND 2-FAM#-,Y 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
work indicated on this application.
',i s .. i ZATLGORY.OF CONSTRUCTION (i
Ell-and 2-family dwelling ❑Commercial/industrial
Valuation: $ I p�i gj r
❑Accessory building 0 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 L 4/D—
Job site address: 14344 SW 165th Ave. New dwelling area: tjalquare feet 153
City/State/ZIP:Sherwood, OR 97140 Garage/carport area: 287 square feet es 7 a,
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.: 173 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.•
1 New Single Family - Accessory Dwelling (ADU 1) Valuation: $
Gfc`.1 fr,r'G(se ioeta epe44`NGGG✓ dl
K Ti?? ,v 4./i _e,az Existing building area: square feet
/ New building area: square feet
® PROPERTY OWNER 0 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 CIO BUILDING PERMIT FEES*
Business name:Polygon Homes WLH LLC (Please',eerie tee schedule)
Structural plan review fee(or deposit):
Contact name:Omar Alami Abouhafs
FLS plan review fee(if applicable):
Address:703 Broadway St., Ste 710
City/State/ZIP:Vancouver, WA 98660 Total fees due upon application:
Amount received:
Phone:( 36D 946 8674 Fax::( )
E-mail: Perm itSubmittaIs taylormorrison.com,OA lam iAhouhafs tay1ormorrison.corn PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Polygon Homes WLH LLC Submit two(2)sets of roof plan with connection details
and fire department,access,along with the 2010 Oregon
Address:703 Broadway St., Ste 710 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 tic.:207247 �//J �/[ / // Total fee due upon application: $201.60
Authorized signature: £2hta4...cY 0.M. -A CO 4J s .. This permit application expires if a permit is not obtained
(1 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:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB)
, -.
...
BECFNE
' Mechanical Permit Ann head — ' '' 'eQtg4,4';v:,,,,agyc,,u4-4.04;0Frieriustor.a.v,
2c)2l-00111 '
City of Tigard MR i •) 2021 P6Inje"yd, 3 z Permit No.:
'1 13123 SW Hall Blvd.,Tigard,OR 97223 Nan RVICNV
Phone- 503 71$2439 Fax: 503,5933.1960 C rry oF -11,6Hi; Date/By:
1114
Other Permit:
inspection Line: 503.639.41 75 BUILDING DIVISION nac Re'dY/BY' leis, Ea See Page I.far
laternet www.tigarti-Or.gOV Notified/Method- Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical pavan.fees*are based on the value of the work
New construction 0 Addition/alteration/replacement performed Indicate the value(romided to the nearest dollar)()tall
0 Demolition ID Other: mechanical materials,equIpmenijabor,overhead,and pnalit.
Value
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT f SYSTEMS FEES*
— I-and 2-family dwelling ti Commercial/industrial 0 Accessory building For special inforoution use theddist.
Multi-family 0 Master builder (id Other: ADU 1 Descri :ption Qv Ea. 1 Total
uukoolium
JOB SITE INFORMATION AND LOCATION Heatt
Air conditioren: 1111111 45 75
Job tht2 addreSs: 14344 SW 165th Ave. 1 Furnace 100,000 BTU(dact.Vvents4 MN 46.75
City/State/ZIP:Tigard,OR 97224 1 Funmec 100 000+13TU thictsiveatal 54.91
j flint*ems 6 . 6
Suite/bldg./apt.no.; ; Project name: Polygon at Roshak Ridge
_..I Dort work IIIIIIBrra
Cross ancerldirectious to job site: H drouic hot water s mean aningla ,
li Residential boiler(radiator or
h tt onto) 11111 23- 2....
......_
____
Unn heaters(fuel-type,rot electric), Ill
int.aut in-duct sus.ended etc. 46.75
Flue/vent for an af above 1111111111111111111111111
i Other 1.111=1111111111
Subdivision: Polygon at Roshak Ridge Lot no.: 173
. I other feet s..Unreal
Tax map/parcel no: 1 Water heater 23.32 MI.„..„.
DESCRIPTION OF WORK Gas fire>lacennsert NM 33.39 IIIIII
- Flue vent for water heater or gas IIIIIII
Single Family- Accessory Dwelling Unit(ADU 1) rr--ththe
New
La:lialner i as NUM
Woodi. llet stove MI 33.39
Wood fir ilacehriscri 11111111111111211 .
Chinni liner/flue/vent 111111M1
_
Other:
. ed PROPERTY OWNER 1-- 0 TF.N.4.1,rr
Ensironinental exhaust and ventilation:
Name:Polygon WER,LLC Range hood/other kitchen
•••ailment_ 33.39
Address:703 Broadway Si-,Ste.510 r —
I Clothes dryer exhaust 33,39
City/State/ZIP:Vancouver,WA 94660 I Single-duct exhaust(bathrooms,
.111111.__
j toilet amnion:meats mild rooms
Phone:(360)695-7700 Fax:( ) Attic/craw. .ace fata worm
21 APPLICANT 0 CONTACT PERSON Other IIIIIMMIIIM
Fuel il in::
Business name Polygon WLII,LLC
S1415 for first four 54.03 for each additional
Contact name:Tunis Morris Fttraa OW. IIIIIIIIIIIIIII
1 Gas IIIIIIUIIIIIII
Address:703 Broadway St,Ste 510 r--—heat oat:,
I Wall/sus ended/unit beater Imingingig
City/Stet-ear?.Vancouver,WA 98660 Waler:E53?5*....., 111111111111111M11111111
Phone:(360)695-7700 Fax::(360)693-4442 1
Rattun
E-mail:peemitaubmittalagtaYi0fM0111S011.COM
Barbecue
CONTRACTOR Clothes dryer(gas) -
.....
Business name:Pro Heating&Cooling Other:
[ MECHANICAL PEIIMIT FEES* 1
i_
Address: NW iklociek Or,Ste.1104
Subtotal
—
1 City/State/ZIP:Hillsboro,OR Minimum permit fee(S90.00)
_
Plan review(2S%of pennit fee)
Phone:(360)270-3590 I Fax:( ) --
3thie surcharge 1.12%of permit fee):_,
CCB tic..209001 : TOTAL PERMIT FEE
_ - DM permit applicanda expires if a peretit is eat obteiated within Ian
&ti,a... buitxtn. days after It has been accepted as camp:tete,
Authorized signature: * Fee reetherieiegy set by In-Cowry Building Industry Serwue Beard
Frith name:Elia Duran Date: 1 0/30/20
1 SP:Aitetiow+PretntrdMIPf P,Ing Ant,WO i 1 Mr A #4-,-",ff,1,11.10.(1)11 MRCVS,
:.. .
•
Electrical Permit ApDlication R EC E iv FOR OFF iCE PtiF r 1.1
T
City of Tigard nay. S \�Z, V'rtm,t A.MST la I-W\,\
li 13125 SW Hai!Blvd.,Tigard,OR 97223 y'° PI-Review
a Phone: 503.7182439 Fax: 503.598.1960 Ni T�7 I ur'Bv Rd,tsdl�ita:
CITY Inspection Lune: 503.639.4175 k la undny hair see Page 2 for
1'I ,�h 1,
Internet: www.tigard-or.gav Alt Il. No[ificdiMctlx d. SupplementalInformation
TYPE OF WORK t3UH-f *iG OIViSio,,, • • PLAN REVIEW -
®New construction ❑Addition/alteration/replacement ply cheek ail Mat cooly(submit 2 am of pl w/ma chodoody
❑Service or feeder 400 amps m mote 0 Balding over time atones,
❑Demolition 0 Other:
where the.Mailable fault current 0 Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 ads at 150 volts or ❑Flooring baldmgs
❑ I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building lei to motion,or exceeds 14.000 ❑Commercial-me agricultural
❑Multi-family ❑Master builder amps for all other installations bwldinr.
®Other: ADU 1 ❑Fire pomp. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. largo srymwely derived
❑Addition of new motor load of seem
14344 SW 165th Ave
Job#: Job site address: 100I0'or mom. 0"A",-E-,-1 I-,-1-3",
City/State/ZIP: Tigard,OR 97140 ❑Six or more residential units pox
❑health-care facilities. 0 Reaurioml vabxk parks.
Suite/bldg./apt,f: name: Polygon0 Supply voltage for true than
Project at Roshak Ridge Daa�rda,a l�ahna•
Cross street/directions to job site: ❑Service or feeds coo amp,or more ono volts oowmal
FEE, SCHEDULE
nacriptiaa 10tr. i Each I 'fetal i •
New residential single•or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot*: 173 ledades attaebed garage.
1,000 eq.1t or less 168.54 4
Tax map/parcel#: Pa add1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
New construction. Type: ADU 1 (cot h shove sq.tt)
Limited energy,multifamily 7s.00 2
residential(with above sq.ft.)
® PROPERTY OWNER ❑ TENANT _Renewable Energy 0 Sex Page 2
Services or fee dens installation alteration,aadlor rdocatioa
Name: Polygon Homes WLHLLC 200 amps or lee 100.70 2
Address: 703 Broadway SL,Ste 710 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2
Phone:( 360 )946 8674 Fax( ) Over 1,000 amps or volts 55226 2
Temporary services or feeders installation,alteration,and/or
Email: DAla miAbouhafs@taylormorrison.cam-PermitSubmivals(rttaylormorrison.com relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or Iris 59.36 1
i ntendcd for sale,lease,rent,or exchange,according to ORS 447,449,670 and 701. 201 amps in 400 amps 125.08 2
Owner signature: _ Dom: 401 amps to 599 amps 168,54 2
❑ APPLICANT - -❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch ciragbs with
Business name: Polygon Homes Wi.H LLC above service or feeder fee,
ck branch circuit 7.42
ra
Contact name: Omar Alami Abouhafa B.Fee far trench circuits withowa
service or feeder fee,first Address: 703 Broadway St.,Ste 710 branch circuit56.18 2
City/State/ZiP:Vancouver,WA 98660 Each add'1 branch circuit 7.42 _ 2
Phone (360 )946 8674 I Fax:: Miaeelaneons(service or feeder not included)( ) Each manufactured or`nodular
ing
Email:OAlamiAboubafs@taylormorrison.com-PermilSubmiltalst taylormolrieon.eom dwell '8C11OC and/or feeder 67.84 2
Reoennece only 67.84 2
CONTRACTOR pump«inigatiancircic 67.84 2
Business name: Wallace Electric Sian or outline lighting 67.84 2
Address: 105 Dresden St pineal iteration or extension. 0 See Page 2 . 2
panel,alteration,or extension. ,
City/StatefLLIP: Astoria,OR 97103 Eaeb additional inspection over allowable to any of the above
Additional inspection(1 hr min) 66.25/br
Phone:(503 3118 0563 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:DavidtJwallaccwires.com bsduatriai plant(I hr min) 7s.181 hr
Inspections for which no
CCB Lie.:224868 Electrical Li C1441 I Su 1' . 63635 specifically listed(X(ss hr pia 90_0W hr
Suprv.Electrician signature,required: i A ,y„ nine T ' PERMIT FEES
�'���"'CCCC ♦♦�' W� Subtotal:
Print name:D NE„ __. Date; K fL iirZ i ❑Plan Review Required(25%of permit foe): .
State surcharge(12%of permit fee):
Authorized ' /'�4�� Jr`� TOTAL PERMIT FEE:
L This permit ap liceliw expires If a permit k sal AI mined within 180
Print name: �1w _ 0 ee�� 4 Date: rt i days abet It has been+temptedas rota pktc.
C.Q;34j. •rVvr+'.-ere T �j. a Number of inspections allowed per permit.
1:18a'Y011"10itst c_PamrtAPP all.BE.dcc ter 06/7/2015 04615t(11165,COhiraED
. ."
Plumbing Permit Application
Building Fixtures „..ta:i4mx:,'' '''''k'''..v,`SAVOICOFFICEILSP;pNIN t
MAR i u" .,,,.....,..„,,,,,,,:,,,,.....i., ,,-timq.1-',s-q-,',0-11,..'-• '.:,,IV. C., '
•
City of Tigard 1 k,e,r,vcd ,-) na
1 Dawaiy. _Silt-I ti 1 Nr--
, . 13125 SW Hall Blvd,Tigard,OR 9722ry oF T1GAHD Plan Review
' 2 Phone: 503.718.2439 Fax: 503.59Fd ry.,!I-
li
"\ i n1V1VON' DamtBYi Other Permit No,.goi12071-0 Ins
ection tine: 503.619.4115 `-''
iiiii,s RI) p Date ReadyiDy. hem El Se Page 2 far
intaniets. www.ttgard-or.gov Natificidavierhoe, ..
Suppirreerital I aformation
TYPE OF WORK FEE* SCHEDULE
44 New construction 1 0 Demolition For speeloi Information use cheektist.
Description Qty. Ea. 1 Total —
El Addition/alteration/replacement ' 0 Other: New I-2-family dwellings(incintics 100 ft for each utility,connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312_70 I
,_____
•
1-and 2-faanily dwelling I0 CommerciaVindustrial SFR(2)bath 1437785
—'rr ' SFR(3)bath 500,12
L_1 Accessory building -Mufti-family
Each additional bath/kitchen _
0 Master builder .li Other ADU 1 25.02
.,..._..
Eire sprinkler( sq.IL) Page 2 :
JOB SITE INFORMATION AND LOCATION 1,,,,,,,_Site utilities: ----- _
Job site address: 14344 SW 165th Ave .......
Catch basin Or arta dnirl 18.76
Drywell,leach line.or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing Orem(no.linear tt _) Page 2
Suite/bldgiapt.no.: i Project name i Polygon at Roshak Ridge Manufactured home utilities ' 50 03 i
Cross street/directions to job site: Manholes 18.76
Rain drain connector I
18,76
—
Sanitary sewer(no.linear fa.:___) Page 2
Storm sewer(no.linear ft: i Page 2
Water service(no.)inear ft.: ) Page 2
Subdivision: Lot tic 173 ,,,,Fixture or item:
1 Backflow preventer 31,27
Tax mapitparcel no.:
Backwater valve , 12.51
DESCRIPTION OF WORK
Clothes washer .1.._. 25.02
_
- — Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
81.' PROPERTY OWNER 0 TENANT Expansion tank 12.51
Fixtureisewer cap 25.02
Name:Polygon WLH,LLC
- Floor Muirslloor sink/lush 25,02
Address:703 Broadway St.,Ste 510
Cuubege disposal 25.02
City/State/ZIP: Vancouver,WA 98660 Hose bib 25,02
Phone:(360)6954700 Fax:( ) Ice maker 12.51 /
i2. APPLICANT 0 CONTACT PERSON I linememongrease trap 25.02
.
Medical gas(value:S ) Page 2
Business name:Polygon WLII,LLC
Primer 12.51
Contact name:Toaja Morris
Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 Sink/basitalavatory j 25.02
City/State/ET:Vancouver,WA 98660 Solar units(potable water) 62_54
Phone:(360)695-7700 Fax: :(360)693-4442 Tub/shower/shower pan 12.51
E-tcadPermitSubmittals@taylorm23.02orrison.com,OAlamiAbouhafs@taylormorrison.com Urinal
Water closet 25,02
CONTRACTOR
Water heater 31.52 •
Business name:G&B Plumbing&Sons Inc
Water piping/D1W 56.29
,
Address:P.O.lios 92 Other: i
. . ' 25.02
City/State/ZIP:St.Paul,OR 97137 Subtotal
Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: 572.50
I CCB Lic.:184372 Plumbing Lie.no.:pb634 17 Plan review (25%of peamit fee)
— i State snrchatge(12%of permit fee)
Authorized signature: 15-,,t0),,,s41,,' 101.4-60•.*---,....,_ is.1 TOTAL PERMIT FEE
Print name:Steve Fowler Date: 1 0/30/20 This permit applicatine expires if a permit is not obtained within ISO days
after it has beam accepted ea complete.
*Fee 611.111OdolOg)set by linClutinty Mamma industry Service Bear&
I'Amidm01.-trmi&YLNIU-PatimApp doc 10.0.40 440461611 KelsCOIWASR).
t
UPI City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Tic:ARD Building Permit Review — Residential
Building Permit #: NNSC2O2\ - 00III
Site Address: 14344 SW 165th Ave
Project Name: Polygon at Roshak Ridge Lot #: 173
Planning Review
Proposal: New attached ADU At 1 A-
OVerify address/suite#active in Accela. ❑r In River Terrace: El No ❑r Yes,River Terrace Review Addendum
Site Plan Elements: l.rosion Control
DI copies of site plan on 8-1/2"x 11"or 11 x 17"paper •'.etained trees with drip line and tree protection measures
O li rawn to scale(standard architect or engineer scale) ''ootprint of new structure(including decks)and FFE
1 orth arrow ,Jtility locations&easements(required for new and additions)
rite address,project or subdivision name and lot number 'sidewalk/driveway approach
pplicant information(name and phone number) cation of wells/septic systems
•t dimensions and building setback dimensions "'itreet tree size,type and location
H.quare footage of buildings to be demolished ,.street names
orII xisting structures on site "Lllorner elevations (2'contours if more than 4'differential
V •t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 'j es o
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ones ' o
❑ Clean Water Services-Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑Yes,applicant was notified ❑r No Received: ❑Yes El No
❑ Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs
Required: ❑Yes,applicant was notified ❑r No Received: A Yes A No
❑ SDC Exemption for ADU applied for: ❑Yes ❑r No Received: Yes No
ElPublic Facilities Improvement(PFI) Permit:
Required: ❑r Yes,applicant was notified El No Applied For: ❑r Yes ❑No,stop intake
0 Land Use Case#: ADU2020 00015 ❑+ Zoning: R-4.8
ElRequired Setbacks: Front: 8 Rear:'' S Side: 3 Street Side: N/A Garage: 3
Nl ❑o Building Height: i(ittMax.Height: 30 Actual a ht: 25.5
0 Landsca e Area: al % Lot Coverage Max:
ntrance 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 door is behind widest street-facing wall ❑Yes ❑ No,one of the following is met:
ends no more than 5'from wall and there is a covered porch extending beyond garage.
_ Door extends no m ' om wall and there is a 12 sq ft.windo g rage on 2°d floor.
h ❑ Garage door width is 12'or less o ca a 60%or less and includes 7 of following.
Covered porch entrance Wall offse 1'Roof eave ❑Roof offset
ire shingles Lap Siding ❑ Roof itch ❑ Gable, _i ,or roof Dormer
Accent siding Window trim U Window recess U Window projection Balcony
❑ Visual Clearance 0 Urban Forestry Plan
❑ Sensitive Lands: ❑ Yes L'I No Type:
❑r Conditions met prior to issuance of building permit
Notes:
❑r Approved By Planning: Date: 3/29/Z07-/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: g/(C. /2 I
Site Plans: # g
Building Plans: # 5
Building Permit#: 0 Enter buildingy peerrmit#above.Workflow Routing: gry Planning I� Engineering tv
ermit Coordinator Building
Workflow Sign-off: VJ Sign-off for Planning(include notes from planning review)
Route Application Documents: 3'Engineering: (1) copy of permit application, (1) site plan, (1)building plan and
al plan review routing form.
al Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: � Date: '0'54 (
En,,.0,*veering Review
L Slope at building pad: 3'
amm�'Conditions"Met"prior to issuance of building permit
mlasements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility: �y
Assess Water Quality Fee in-lieu: ❑ Yes t No
Assess Water Quantity Fee in-lieu: ❑ Yes I'No
LIDA Facility on lot: ❑ Yes Er No
Pr/Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes: _
Approved by Engineering: r✓ Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
Conditions"Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
SDC Exemption: ❑ Received Does not a ly
SDC Fees Entered: Wash Co Trans Dev Tax: ,i:YesU N/A
Tigard Trans SDC: , Yes 0 N/A
Parks SDC: EYes ❑ N/A
LIDA ❑ Yes ja'N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: 4412.02
I:\Building\Forms\BldgPcrmitRvw_RES_122419.docx
r
IPI M . City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: wilco 02 t - 0 Oil 1
Site Address: 14344 SW 165th Ave
Project Name: Polygon at Roshak Ridge Lot #: 173
(New 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 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 Gable. .oomer
ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide
I ❑ 0 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, . le no more than 45° from street,
❑Max. 8 ft. setback from lunges treet- facing wall
or open onto por
Entrance opens to a porch: ❑Yes I o
Iff j es,all the following apply: ❑25 sq.ft. .
LJ One street facing entry ❑12 f ax. roof above floor of porch
❑5 ft. depth min. 0 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 I li 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 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 0 40%max.of street facade
III 50% max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: Date: 3/e 5/A
I'Building oma‘BldgPermitRvw_RES_RT_121417.donc
y
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT va.. .
NI Water Meter Fixture Unit Worksheet
"t" For New Buildings `� "r ''`�a
13125 SW Hall Blvd. • Tigard,Oregon 97223 • 503.718.2439 • www.tiaard-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
l-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 I"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
i
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: 14342 SW 165th Ave(SFU)- 14344 SW 165th Ave(ADU 1)- 14346 SW 165th Ave(ADU 2)
Subdivision Name: Polygon at Roshak Ridge Lot#: 173
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 ADUI 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, is'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 6 4 5 15 x 1 = 15
Water closet, 1.6 GPF 4 3 3 10 x 2.5 = 25
Bathtub/whirlpool x 4 =
Shower stall 2 1 1 4 x 2 = 8
Bath/shower combo 1 1 1 3 x 4 = 12
Total Fixture Unit Points: S8.5
Fixture Unit Points:
1 to30= 5/8" 37.5to89= 1"
30.5 to 37=3/4"
Meter Size: 1" Meter Cost: .$ 24,886.00
FOR OFFICE USE ONLY
Fixture Units Points verified with
Building (Master) Permit or Plumbing ❑Yes ❑ No D Other:
Meter#: Sale Date:
Receipt#: Meter Cost:
Employee Name:
1:/Building/Forms/WaterMeters_010121 New.dOC% Page 2