Permit Plumbing Permit ApplicaFCEIVED
Building Fixtures
SEP 1 2321. FOR OFFICE USE ONLY
Received
City of Tigard patergy: q / 2/ Permit No. MST2021-00079
• 13125 SW Hall Blvd.,Tigard-OR 977 1TY OF TIGARD J ��
Plan Review //
: 7 Phone: 503.718.2439 Fax: 503. rg'4 t%'^ Date/By: Gf/4/�j rALGj Other Permit No.:
Inspection Line: 503.639 4175 41� IIYI'�DIVISION Date Read/B p /tz, Jwis. ® See Page 2 for
TIGARD Internet. wwwtigard-nrgov Not fled/Method: tf t/ � Supplemental Information
TYPE OF WORK G:"/- /r')r .- FEE* SCHEDULE
For special information use checklist.
❑� New construction ❑Demolition
Description I Qty. I Fa. I Total
❑Addition/alteration/replacement ❑Other- New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
ID I-and 2-family dwelling El Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kit1lten 25.02
❑ Master builder El Other: Fire sprinkler(1228 YYsq.ft.) Page 2
'2'
till �Ji l 8'SCTE INFORMATION AND LOCATION Site utilities:
Job site address:16656 SW Sunshine Coast 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 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: Lot no.:\151 Fixture or item: II
Tax map/parcel no.: Backflow preventer 31.27
.. - - Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02
Drinking fountain 25 02
Ejectors/sump 25.02
Nil PROPERTY OWNER ❑ 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 • CONTACT PERSON -,',-,'i Interceptor/grease trap 25.02
Medical gas(value.$_) Page 2
Business name:Alliance Plumbing, LLC
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
1--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 Lie.:184601 Plumbing Lie.no.:PB732
State surcharge(12%of permit fee)
Authorized signature: /---4,---7 r TOTAL PERMIT FEE (p,513
Date:8.25.2021 This permit application expires if a permit is not obtained within days
Print name:Gavin Thomes after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:1 Building\Permits\PLMU-PermltAppdu9 I0/01/09 4411-4616'1(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities m',m ;I1I1;lui 7•77-1 j 1 -7 rF+ t Total Sgt [ t Cage. Permit Fee:
Footing drain- I''100' 50.03 0to2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation:
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm K Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
each additional$100.00 or fraction thereof,to
Other Inspections or Fees Qty. Fee(ea) fetal
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 PP y'
ElBaptistry/Font Any new commercial building with water service 2"and
Bath: -Tub/Shower
greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash. Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918-780-0040.
Cuspidor/Water Aspirator IDMedical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3" Isometric or Riser Diagram
4 LI 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:
1:\Building\Permits\PLMF_PermitApp.doc 08/04/201 I 2
CITY OF TIGARD MASTER PERMIT
I COMMUNITY DEVELOPMENT Permit#: MST2021-00079
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/12/2021
TIGARD 9 Parcel: 2S107AA15100
Jurisdiction: Tigard
Site address: 16656 SW SUNSHINE COAST ST
Subdivision: ROSHAK RIDGE Lot: 151
Project: Polygon at Roshak Ridge, Lot 151 -ADU
Project Description: New attached ADU.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 3 First: 1228 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 2 Second: 0 sf Garage: 265 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 1228 sf Value: $163,294.33 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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: 3 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: 1 201-400 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 1228
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 One Hour Fire Rated Eaves
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $24,346.14
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 maymay obtain a copy of the rules or direct questions to OUNC by callin+g�503.232.1987 or 1.800.332.2344._ .3
Issued By: �JX4f )90 l�1]t . t Permittee Signature: V 1" 3erf.:[A 1' .(
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.
r-
Rutilding Permit Application IRECFVE -43_'a /7 --,,,,-/
Residential I "7 �OT FOR OFFICE USE ONLY
Received
- City of Tigard DateBy ''/ fZ Permit No.: O2IDOO °
13125 SW Hall Blvd.,Tigard,OR 97223 .31 I'` (,P i- I(7Atii_; Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 •
rN . DazeB : ��Z� Other Permit:
TIGARD Inspection Line: 503.639.4175 `II\,f� DIVISION.Dat-ReadyBy: /i r ® See Page2for
Internet: www.tigard-oI.gov i -d/M-thod: /j I (.7 Supplemental Information
TYPE OF WORK REQUIRED DA A:1-AND 2-FAMILY DWELLING
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ ((Q i 3 X y
E I-and 2-family dwelling ❑Commercial/industrial
IDAccessory building El Multi-familyNumber of bedrooms: 3
o Master builder ®Other: ADU Number of bathrooms: 2
JOB SITE INFORMATION AND LOCATION Total number of floors: 1 I 13
Job site address: 16656 SW Sunshine Coast St ,,'!6-,t/�. New dwelling area: 1228 square feet t aa,$
City/State/ZIP:Sherwood,OR 97140 Garage/carportarea: 265 square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: pe n `�. k ,y .e Deck area: square feet
�(/ C�Ja^ Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: 151 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Accessory Dwelling Unit Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ 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:( )360 695-7700 Fax:( )360 693-4442 New:
® APPLICANT 0 CONTACT PERSON 09 BUILDING PERMIT FEES*
(Please refer to fee schedule)
lk. 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: )360695-7700per:: _ Amount received:
( ( )360 693 4442
E-mail: permitsubmittals@tay1ormorrison.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Polygon Homes WLH LLC Submit two(2)sets of roof plan with connection details
and 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°/a of permit fee): $21.60
CCB lic.:207247 Total fee due upon application: $201.60
Authorized signature: 00/.42 L A A /7BLLIL C This permit application expires if a permit is not obtained
II// within 180 days after it has been accepted as complete.
*Fee methodology set byTri-County Building Industry
Print name:Omar Alami Abouhafs Dale: 02/12/2021
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
b �� Date/By: Permit No.: 1-00677
'! 13125 SW Hall Blvd.,Tigard,OR RE V M Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Dalt/3y: OdmrPermic
1 KCAlt 12 Inspection Line: 503.639.4175 MAR 2 9 2021 Dale Ready/By: tea: 83 See Page 2 for
Internet: wnvw.tigard-or.gov Noti6ed/Mettwd: Supplemental information
'�CypIT�Y OF TIGARL
TYPE OF{3UILLJING DIVISIOR comninic L FEE* SCHEDULE - umoiceCKLLST
®New construction Mechanical permit fees*are based on the value of the work
❑Addition/alt. �•-4, performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: '` ` t mechanical materials,equipment,labor,overhead,and profit
Value:S
CATEGORY OF CO R r r re' " , 'T
— RESIDENTIAL EQU7PDLEN'f!SYSTEMS FEES*
1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.'
Multi-family 0 Master builder ®Other: ADU -Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning ( 46.75 li
Job site address: 16656 SW Sunshine Coast St Furnace I00,000 B'UJ(ducts/yews) 46.75
City/State/ZIP:Tigard,OR 97224 Pomace 100,000+BTU(ductatvents) 54.91
Heat pump 61.06
Suite/bidgJapt.no.: Project name: River Terrace Northeast Due 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit beaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot n04: 151 Other. 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplacefinsett 33.39
- Flue vent for water heater or gas
IJ€* t.O1 it q � ' ` Vo teje A fireplace 23.32
Log lighter(pas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
_, PROPERTY OWNER 0 TENANT Other: 23.32
• Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
equipment 33.39
Address:703 Broadway St.,Ste.510 Clothes dryer exhaust 33.39
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(360)695.7700 Fax:( ) _ Attic/crawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:Polygon WLH,LLC Fuel piping:
S4.03 for each additional
Contact name:Tonja Morris Furnace,etc 1 14.15 14.15
Address:703 Broadway St.,Ste 510 Gas heat p®+
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace .
E-mail:permitsubmittalsCtaylormotriSOD.COm RBOa` 1 14.15 14.15
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Pro Heating&Cooling Other:
MECHANICAL PERMIT FEES*
Address: NW Alociek Dr,Ste-1104
Subtotal
City/State/ZIP:Hillsboro,OR Minimum permit fee(S90.00)
Plan review(25%of permit fee)
Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee)
CCB lie.:209001 TOTAL PERMIT FEE
r+ �u This permit appncater expires if a permit la not obtained within ISO
Ldays after It has bees accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building industry Service Board
Print name:Elia Duran Date: 10/30/20
f Vinileline1Perrnird14.4FC Pmmi Arm runt t%M. ••n•sr yr err nnrvh,mrea,
f: x v--g dam.-.
Electrical Permit Application FOR OFFICE USE ONLY"
° ' �
r• ' ' Received MSTZo21 —♦ � j
City of Tigard Date Pn mit ft:
III i 'I 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 .,_) Date/By: Related Permit#:
Inspection Line: 503.639.4175 ,.,,, Ready Date/By: Ions: I ® See Page 2 for
w
TIGARD Internet: wwtigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
O Service or feeder 400 amps or more 0 Building over three stories.
El Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
El 1-and 2-family dwelling 0 Commercial/industrial DI Accessory building less to ground,or exceeds 14,000 0 Conm ern al-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder x❑Other: ADU 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 16656 SW Sunshine Coast 100HPormore. ❑"A","E',"l-2","1.3',
Ci /State/ZIP: Tigard OR 97224 ❑Six or more residential units. occupancy.
Ty g ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: River Terrace Northeast ❑Hazardous locations. ❑Supply voltage for more than
O Service or feeder 600 amps or more, 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qtv. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: River Terrace Northeast Lot#:151 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
$] PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: Polygon Homes WLH, LLC 200 amps or less 100.70 2
Address: 703 Broadway St., Ste 510 201 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 )695-7700 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:permitsubmittals@taylormorrison.com relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
® APPLICANT El CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Polygon Homes WLH, LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Omar Alami Abouhafs B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: 703 Broadway St., Ste 510 branch circuit
City/State/ZIP: Vancouver WA 98660 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360 )816-7800 Fax: :( ) Each manufactured or modular 67.84 2
Email: permitsubmittals@taylormorrison.com dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Portland Electric Sign or outline lighting 67.84 2
•
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: 1915 E 5th St., Ste D panel,alteration,or extension.
City/State/ZIP: Vancouver,WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( 360)314-4915 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:paul@portlandelectric.biz Industrial plamph m ) 78.18 nr
Inspections for which no fee is 90.00/hr
CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lie.: 4920V5 specifically listed(/hr min)
/�} �� ELECTRICAL. PERMIT FEES
Suprv.Electrician signature,required: like,.,, A a. Subtotal:
Print name: Alex Shalya De e:10/30/20 ❑Plan Review Required(25%of permit fee):
pA Qo oo ,,•• L State surcharge(12%of permit fee):
Authorized signature: "A l�Q�h..C/!' 444, TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Seroey Mishchuk Date:10/30/20 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building1Permits\ELC_PermitApp ELR ERE.doe Rev 06/l7/2015 440.46I5T(1 I/05/C0M/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 ne Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
El Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance •
with OAR 918-309-0040) 552.26 2
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: F,ach additional inspection is 66.25/hr
charged at an hourly(I hr min)
Inspections for which no fee is 90,00/hr
specifically listed('L hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page I):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
12Building\Pennies\ELC_PemtitApp_ELR_ERE.doc Rev 06/17/2015
- Plumbing Permit Application 1 r . I-i V;,C-
---0
Fixtures [[rr,, FOR OFFICE USE ONLY
wEi7 i 7 ZOZr Received
City of Tigard Date/By: PermitNo.: MSr-.ov-��.9
tr 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.7182439 Fax: 503.598.1966' I Y U) iitafii�L Plan Review Other Permit No.:
Inspection Line: 503.639.4175 l /'; n I I O ,DatedRe.
T I C A R T) www.ti and-ar. ov - i �D ^•+Oaro ReadYBy: Juric: RI See Page 2 for
Internet: 8 B Notified/Method: Supplemental information
TYPE OF WORK FEE* SCHEDULE
®New construction 0 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 utili _connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building •Multi-family SFR(3)bath 500.32
Each additional batMcitchen 25.02
❑Master builder DI Other. ADU Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16656 SW Sunshine Coast St Catch basin or area drain 18.76
City/State/ZIP:Tigard OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
SuitelbldgJapt.no.: Project name: River Terrace Northeast Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: 1 Page 2
Storm sewer(no.linear It: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: ( Lot tic 151_ Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
. Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER l 0 TENANT Expansion tank 12.51
Name:Polygon WLH,LLC Fixture/sewer cap 25.02
Floor draiulf oor sink/hub 25.02
Address:703 Broadway St.,Ste 510
Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:Polygon WLH,LLC Medical gas(value:S_) Page 2
Primer 12.51
Contact name:Tonja Morris
Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solaruriils(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 beater 37.52
Business name:C&B Plumbing&Sons Inc Water pipinglDW V 56.29
Address:P.O.Box 92 Other. 25.02
City/State/ZIP:St.Paul,OR 97137 Subtotal
Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: S72.50
Plan review (25%of permit fee)
CCB Lic.:184372 Plumbing Lic.no.:pb634
State surcharge(12%of permit fee)
Authorized signature: , ,ft grs,u.b.'-..,„ TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days
Print name:Steve Fowler Date: 10/30/20 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
l'lnaiWistPermus4PLMU-PermitAppdos 10/01/09 440-4616T(In+U3/COM'WEa)
p-DU
Plan# YYl it 5--" (.tie fk
Floors C Large >K.
Bed rooms 3 Small
wc 2-
LAV R 3-- f 2Z.c X (-228 = I Sb, 3(80. e4
Tub Basement U / 1 G�
Vent 3 1st( 2ndFloor
Floor 1 S,73x Ll0S-= 21 ! 13 , 15-
Water Heater
AC y 3rd Floor 33
School � R-3 Total (a2-66
Garage 2(/
Z (9a5 O Total Iy93
,,ram, la��
2 6 bS #for Elec
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City of Tigard
illqe COMMUNITY DEVELOPMENT DEPARTMENT
II
•
TIGARD Building Permit Review — Residential
Building Permit #: MST2O U 600-i-q
Site Address: 16656 SW Sunshine Coast St
Project Name: Polygon at Roshak Ridge Lot #: 151
Planning Review
Proposal: New attached ADU
O Verify address/suite#active in Accela. 0 In River Terrace: 0 No El Yes, River Terrace Review Addendum
Site Plan Elements: ;(xosion Control
it copies of site plan on 8-1/2"x 11"or 11 x 17"paper _tetained trees with drip line and tree protection measures
ril Drawn to scale(standard architect or engineer scale) footprint of new structure(including decks)and FFE
Ell 'orth arrow ,,Jtility locations&easements(required for new and additions)
D.ite address,project or subdivision name and lot number �lidewalk/driveway approach
rill pplicant information(name and phone number) 1J/^ �oi_ation of wells/septic systems
•t dimensions and building setback dimensions street tree size,type and location
rS 1A 1.quare footage of buildings to be demolished !Street names
Mi
N IA • misting structures on site _„orner elevations(2'contours if more than 4'differential
t 0 of area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? es o
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es ° o
❑ Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: 0 Yes,applicant was notified 0 No Received: ❑ Yes El No
❑ Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑Yes,applicant was notified No Received: ❑ Yes 0 No
❑ SDC Exemption for ADU applied for: LJ Yes 0 No Received: ❑ Yes El No
0 Public Facilities Improvement (PFI)Permit:
Required: 0 Yes,applicant was notified ❑No Applied For: El Yes ❑No,stop intake
0 Land Use Case#: ADU2021-00002 0 Zoning: R-12
0 Required Setbacks: Front: 8/12 Rear: 10 Side: 3 Street Side: N/A Garage: 20
0 Building Height: Max. Height: N/A Actual Height: 26
0 Landsca•e Area: 20 % El Lot Coverage Max: 80 %
Entrance o Set back no more than 8'from street-facing wall 0 Parallel to street or offset 45 degrees or less
Windows Q Minimum 12%of area of all street-facing facades
Garage Q Gara e door is behind widest street-facing wall ❑Yes 0 No,one of the following is met:
Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2"d floor.
0 Gara e door width is 12'or less ❑ 50%or less of facade
Covered porch CI Recessed entrance60%or less and includes 7 of following:
❑✓ Wall offset
B 1'Roof eave El Roof offset
Fire shingles Lap Siding Roof itch 0 Gable,hi ,or gambrel roof Dormer
Accent siding Window trim Window recess Window projection 0 Balcony
❑ Visual Clearance 0 Urban Forestry Plan
❑ Sensitive Lands: 0 Yes LI No Type:
0 Conditions met prior to issuance of buildin permit
Notes:
0 Approved By Planning: Date: 3/1/21
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Build ing\Forms\B IdgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: Sit /201-1
Site Plans: #
Building Plans: # 3
Building Permit#: Enter buil errant# above. ��/
Workflow Routing: ' Planning Engineering ,,,2 Permit Coordinator Iuilding
Workflow Sign-off: ,t 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
original plan review routing form.
Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Bate: 3 /P z.ti
7g11
E ineering ReviewiSi
ope at building pad: Z/`
L�QI/Conditions"Met"prior to issuance of building permit ,/�
I}fl basements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility: y'
Assess Water Quality Fee in-lieu: Elma
Yes t No
Assess Water Quantity Fee in-lieu: ❑ Yes o •
LIDA Facility on lot: ❑ Yes No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
tApproved by Engineering: / Date: _VQ/Lf
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:
$21 SDC Exemption: ❑ Received kr Does not apjly
"SDC Fees Entered: Wash Co Trans Dev Tax: Yes U N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA Yes if2rN/A
viOK to Issue Permit
Approved by Permit Coordinator: Date: f31 G[I 202'
I:\Building\Forms\BldgPennitRvw_RES_122419.docx
City of Tigard
ligis COMMUNITY DEVELOPMENT DEPARTMENT
T i GARD River Terrace Building Permit Review Addendum
Building Permit #: MS1'2021- t3.00-3O1
Site Address: 16656 SW Sunshine Coast St
Project Name: Polygon at Roshak Ridge Lot #: 151
(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 ❑r No (Per MMD2020-00044)
culation: 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 :.;ft. deep ft. d❑eep min. 2ft., 5❑ft.wide min. 2 ft.,6❑ft.wide Gable. ..ormer
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 - ance must meet both of the following standards:
❑Parallel to street, , gle no more than 45° from street,
❑Max. 8 ft. setback from longes eet- facing wall
or open onto por
Entrance opens to a porch: ❑Yes Io
If yes,all the following apply: ❑25 sq.ft. . .
LI One street facing entry ❑12 f .x. roof above floor of porch
❑5 ft. depth min. 030/o min.porch roof coverage
4. Detailed Design:All buildings shall include a min. o v• of the following elements on all street-facing facades:
❑Covered porch min. 5 ft.wide x 5 ft. deep I Recessed entry area min. 5 ft.wide x 2 ft. deep
❑Wall offset min. 16 inches I *ormer min. 4 ft.wide
❑Roof eave min. 12 inch projection ❑R. , offset min. of 2 ft.
❑Roof shingles either tile or wood ❑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 Yi'wide by 5/8"deep
❑Window recess min.3 inches for .i street facing ❑Bay window min. ft.wide by 2 ft.deep
❑Balcony min. 5 ft.wide x 3 ft. .eep with inside access ❑Attached garage is 3 'o or less of street facade
5. Garages and Carports: ', ay face the front or side lot line on a corner lot.
Setbacks:
No closer to front o .ide lot line,than longest street-facing wall. ❑Yes ❑No. If No (Check o - :
❑May extend u. o 5 ft.if there is a covered front porch and garage does not extend beyond the fro porch.
❑May exten. p to 5 ft.where the garage is part of a two-story building and there is a window at the se : d story
above the age that faces the street with a min. area of 12 sq.ft.
Width: heck one)
❑ -foot-wide garage door ❑40%max.of street facade
111 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: • =i---- Date: 3/1/21
Ii BuildingTorms`Bld5Permiltvw_RES_RT_121417.docr.
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: OAlamiAbouhafs@taylormorrison.com
New Meter Address: SFU: 16654 SW Sunshine Coast /ADU : 16656 SW Sunshine Coast
Subdivision Name: Polygon at Roshak Ridge Lot#: 151
Building Permit#: MST2021-00078 / MST2021-00079
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
ADU SFU Total
Bar sink x 1 =
Bidet x 1 =
Clothes washer 1 1 2 x 4 = 8
Dishwasher 1 1 2 x 1.5 = 3
Hose bib, 1'one 1 1 2 x 2.5 = 5
Hose bib, each add'! 1 1 2 x 1 = 2
Kitchen sink 1 1 2 x 1.5 = 3
Laundry sink x 1.5 =
Lavatory 3 4 7 x 1 = 7
Water closet, 1.6 GPF 2 3 5 x 2.5 = 12.5
Bathtub/whirlpool x 4 =
Shower stall 1 1 2 x 2 = 4
Bath/shower combo 1 2 3 x 4 = 12
Total Fixture Unit Points: 56.5
Fixture Unit Points:
1 to 30= 5/8" 37.5 to 89= 1"
30.5 to 37=3/4"
Meter Size: 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
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
IMII!
is " Transmittal Letter
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: 9i 0/ 4,.( it 1r #ha/ MAR 2 9 Z021
COMPANY: / t r OR CITY OF TIGARD
r/ t 9 4 g61 BUILDING DIVISIQ) e
PHONE: CU 9I p Q
ist iEMAIL: eAgAbav�t�s GI( Ont:Yrtt el.C&
RE: /6656 //6654, SuJ sui-,siti' ( cg f- 14157-,0 .) - peas
(Si ddress) (Perini
(GI) Q� cc- RochQk Ay
Ms7 �oQ� — 000
47
(Prof r}itrie or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. 3 Revisions: Ai Si.0 5 9.Q O( 03
Cross section(s) and details. Wall bracing and/or lateral analysis '
Floor/roof framing. Basement and retaining walls.
Beam calculations. i E�j gineer's cal lations.
.41 Other(explain): median;6421 atQc , #�,? ent,r U„II-
REMARKS:,�trQ 1 64. 0 / ^ \� II P�
V� 3
`�eu:c e�I - a�ldRe rS ors c eJ .9tif -ix 4,, •2 1f S - 6 .
.40 -Z rm cgEtti? cvl VI- /o � 1 o, 90A etc��-r3�Un
p
FOR OF ICE USE ONLY
Routed to Permit Technician ate: L{((y 2-1 Initials: if-/- �
Fees Due: ,Yes ' T Fee Description: Amount Due:
$
/ -1K Ob e -.' $$ p�/
Special
Instructions:
Reprint Permit(per PE : ❑ Yes No ❑ Done
Applicant Notified: Date: '-/tl j�L) Initials:
/g----
I:\Building\Fonns\TransmittalLetter-Revisions_073120.doc
l _ — _