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Permit Plumbing Permit ApplicatCE(VED Building Fixtures FOR OFFICE USE ONLY SEP 11T Received City of Tigard Date By: /�/2/ Permit No.. MST2O21-00078 a hone SW Hall Blvd.,Tigard,OR 97 TV OF TIGARD Plan Review / Phone' 503.718.2439 Pax: 503.598 0 Date/By -7/Vo i' Ace., Other Permit No.: Inspection Line: 503.639.4175 RUILDINIG DIVISION! / TIGARD Internee. www ti and-or. ov Date Reeds By .-,�` �7/ lads. See age 2 nr gr g Notified/Metbed / -�''/ Supplemental Information TYPE OF WORK .p914-,' ,, ,•rf I',;,w-'. FEE* SCHEDULE I:]New construction El Danulidon For special information use c/:ccklist. Description I Qty. I Ea. I Total ❑Addition/alteration/replaccment ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 I] I-and 2-family dwelling D Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 D Accessory building ❑Multi-family Each additional bath/k_ Ichen 25.02 ❑Master builder ❑Other: v Fire sprinkler(2023sq.ft J Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:16654 SW Sunshine Coast Catch basin or area drain 8.7[ 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 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.:151 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF.WORK T" 'if 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 [] TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name:Taylor Morrison Floor drain/foorsink/hub 25.02 Address:703 Broadway Street Suite 710 Garbage disposal 25.02 City/State/ZIP: Vancouver,WA 98660 Hose bib 25.02 Phone:(360 ) 695-7700 Fax:( ) Ice maker 12.51 0 APPLICANT © CONTACT PERSON Interceptor/grease trap 25.02 Business name:Alliance Plumbing, LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Gavin Thomes Roof drain(commercial) 12.51 Address:146 W Historic Columbia River Hwy Sink/basin/lavatory 25.02 City/State/ZIP:Troutdale,OR 97060 Solar units(potable water) 62.54 Phone:( 503)577-6535 Fax: :( ) Tub/shower/shower pan 12.51 E-mail: gavin@allianceplumbing.net Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business nanle: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 CCB Lic.:184601 Plumbing Lie.no.:PB732 Plan review (25%of permit fee) I . - State surcharge(12%of permit fee) Authorized signature: P---4. � V TOTAL PERMIT FEE 1,el ,`t7 Print name: This permit application expires if a permit is not obtained within ISa days Gavin Thomes Date:8.25.2021 after it has been accepted as complete. *Fee methodology set by TO-County Building Industry Service Board. 1:1Building1Permits\PLMU-PermitApp doe 1101l09 4411-4616T(10/021COMJWEB) Plumbing Permit Application - City of Tigard Page 2 -Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) total Square Footage: Permit Fee: Footing drain-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 Valuation: Permit Fee: Storm&Rain Drain-I s[100' 62.54 $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 l� 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$154 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$120 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 lbllowing. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate ElAny new commercial building with water service 2"and Baptistry/Font Tub Shower greater,except systems designed and stamped by licensed Bath: engineer. -Jacuzzi/Whirlpool Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive Thru as defined in OAR918-780-0040. ElCuspidoJWatcr Aspirator Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. -Domestic ❑ Any complex structure as defined in 0AR918-780-0040. 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 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 08/04/2011 2 CITY OF TIGARD MASTER PERMIT 3. . COMMUNITY DEVELOPMENT • Permit#: MST2021-00078 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/12/2021 T I{"�g'O g Parcel: 2S107AA15100 Jurisdiction: Tigard Site address: 16654 SW SUNSHINE COAST ST Subdivision: ROSHAK RIDGE Lot: 151 Project: Polygon at Roshak Ridge, Lot 151 -Primary Dwelling Project Description: New primary dwelling with (1)attached ADU on separate permit. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 82 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 26 Bathrooms: 3 Second: 1941 sf Garage: 415 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 2023 sf Value: $273,808.33 Rear: 10 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 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<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 addl 500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2023 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: $29,532.00 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 throughro/( OAAR`952(-001--00090. You may obtain a copy of the rules or direct questions to OUNC by callingr503.232.1987 or 1.800.332.2344. Issued By: �WA\SJU IJJUdI 9.14 Permittee Signature: u'l q2PlicatiN 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. 1 Mechanical Permit Application FOR OFFICE I_SE ONI.I' City of Tigard ! 13125 SW Hall Blvd.,Tigard,OR 97223 R I r ,. .2 Phone: 503.718.2439 Fax: 503398.1960 Other Permit: i,i',It E. Inspection Line: SD3.639.4175 Date Ready/By: Juris. II See Page 2 for Internet: www.tigard-or.gov pg Noti6ediMethod: f7AR 2 9 2021 Supplemental Information TYPE OF WORK JITY 01-TIGARD COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ®New construction ❑Additionialteration4eitaraM DIVISION Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of ail 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:S CATEGORY OF CONSTR RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling ❑Commercialfmd u ding Far special information use checklist i i Multi-family ❑Master builder ❑Other: Description Qty. Ea. _L Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning I 46.75 Job site address: 16654 SW Sunshine Coast St Furnace 100,000 BTU(dueu'v ts) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ductsNenu) 54.91 Suite/bldg./apt.no.: Project name: River Terrace Northeast Heat pump 61.06 Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Lot no.: 151 Other 23.32 Other fuel appliances: Tax map/parcel no.: Water hater 23.32 DESCRIPTION OF WORK Gas fireplace/insem 33.39 _ r,�1'/� L q, `� {� / p 4 Flue vent for water hater or gas • fisk, tsekSkUCH f 1� {H ST )up tx IA fireplace , 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 I PROPERTY OWNER El TENANT Other 23.32 Environmental exhaust and ventilation: Name:Polygon WLH,LLC Range hood/other kitchen Address:703 Broadway St.,Ste.510 equipment 33.39 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:( ) Attidcrawlspace fans 23.32 ® APPLICANT 0 CONTACT PERSON Other 23.32 Business name:Polygon WLH,LLC Fuel piping: or rst fou , .03 for each additional Contact name:Tonja Morris Furnace,etc. 1 14.15 14.15 Address:703 Broadway St.,Ste 510 Gas bat 1eiTtb Wall/suspended/turn heater City/State/ZIP:Vancouver,WA 98660 Water beater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace E-mail:permitsubmittals(aaylormorrison.com Range 1 14.15 14.15 MMI Barbecue rji CONTRACTOR Clothes dryer(gas) Business name:Pro Heating BeCooling Other. MECHANICAL PERMIT FEES* Address: NW Alociek Dr,Ste.1104 Subtotal City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(360)270-1590 Fax:( ) State surcharge(I2%ofpermit fee) CCB tic.:209001 TOTAL PERMIT FEE [` This permit application expires if a permit is not obtained within ISO Authorized signature: il� days after it has been accepted as complete. Fee methodology set by Tri-Couory Building industry Service Board Print name:Elia Durso Date: 10/30/20 I-\4,,iUiw;PmnildMPr Prnnb 4nn 11411111 An. AAA•[I n I,,m1MA,AI cn, , ` r., @ s f D e Electrical Permit Application FOR OFFICE USE ONLY B I TOT Received • • ,� City Of Tigard Date/B : Permit#: Li902(-oc -,R' 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review C Phone: 503.718.2439 Fax: 503.598.1960 1' OE l it_iAi-a. Date/B : Related Permit#: Inspection Line: 503.639.4175 r, / t ,• Read Date/B Aris: la See Page 2 for TIGARD P ii rX,`,l Y Y h Internet. www.tigard-orgov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked) 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. ❑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: 16654 SW Sunshine Coast 10011P or more. ❑"A"."E',"1-z","1-3", Ci /State/ZIP: Ti and OR 97224 ❑Six or more residential units. occupancy. ty g ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: River Terrace Northeast ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I * . 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']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.) El PROPERTY OWNER El TENANT Renewable Energy ❑ See Page 2 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 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 ® 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, 742 2 each branch circuit Contact name: Omar Alami Abouhafs B.Fee for branch circuits without service or feeder fee,first Address: 56.18 2 703 Broadway St., Ste 510 branch circuit City/State/ZIP: Vancouver WA 98660 Each add'I 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 Industrial plant(1 la min) 78.18/hr Email:paul@portlandelectric.biz Inspections for which no fee is 920$ specifically listed('Vs hr min) 90.00/hr CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lic.J1 5' p ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: a.�x xs Q Subtotal: Print name: Alex Shalya Da(T e:10/30/20 ❑Plan Review Required(25%of permit fee): !! State surcharge(12%of permit fee): Authorized signature: XS m�, /I^'L . 0 ,. iQ ll+ TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Sergev Mishchuk Date:10/30/20 days after it has been accepted as complete. * Number of inspections allowed per permit. 1:1BuildinglPenrtits'ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-46I5T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE DescriptionI Fee for all residential systems combined: $75.00I Qty. I Each I Total Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 El 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 552.26 2 with OAR 918-309-0040) ❑ 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: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed C/,hr min) ELECTRICAL PERMIT FEES COMMERCIAL WORK ONLY: Subtotal(Enter on Page 1). Fee for each commercial system: S75.00 * 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 ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* El Medical El Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations 1:1Building1Permits\ELC_PcnsitApp_ELR_ERE.doc Rev 06/17/2015 Plumbing Permit Application - -- . -- Building Fixtures ';:7 l " 10ja FOR OFFICE USE ONLY" City of Tigard Received Date/By: Permit No.: mst-?.o2t'bc6 III,- er 13125 SW Hall Blvd.,Tigard,OR 97223' 1 Ur I I Ur%r1 plan Review Phone: 503.718.2439 Fax: 503.5,,9&, y96p�i Older Permit Na.: Inspection Line: 503.639.4175 U'Li1�i�i C7 DIVISION DatelRe T I G A R D Spa Date ReadyBy: fern: PI See Page 2 for Internet: www.tigard-or.gov Notified/Method: _ Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ID Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 X1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory buildingSFR(3)bath 500.32 %�MUIt-fartuly Each additional hath/ldtcheo 25.02 ❑Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 16654 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 Suiteibldg./apt.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.: ) Page 2 Storm sewer(no.linear ft:, ) Page 2 Water service(no.linear ft.:, ) Page 2 Subdivision:Roshak Ridge Lot nc 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 I 0 TENANT Expansion tank 12.51 Name:Polygon WLH,LLC FiatmrrJsewer cap 25.02 Floor drain/floor 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 P51 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Polygon WL11,LLC Medical gas(value:$_) 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 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 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:G&B Plumbing&Sons Inc Water piping/DWV 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: 572.50 Plan review (25%of permit fee) CCB Lie.:184372 Plumbing Lic.no.:pb634 State surcharge(12%of permit fee) Authorized signature: ; ty`_. TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days Print name:Steve Fowler Date: 1 O/3O/2O after It has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. t:tBuildineenoiu(PLMU-PnsnsApp.doe 10)01109 4404616T(IOft2/COMrwEB) 1 Pr C w.a r / Plan# /W,I4 S� Dapp o Floors � Large Ii. Bed rooms 4 Small 52_ 5� we R3 _ 122 41e x Zo23= 217, 734,- LAVTub 3 v_ Li�.-73xyl�= dL', Z22 , 9S Basemen Vent 3 1st F oort tz- D1-Cik 241,37 x LLD,- 21 Ql a1./. 440 Water Heater I 2nd Floor I ict ( /� _ . _ / �� AC 1)......§ 3rd Floor DL Y t-00.< —Pt/.. 7x I l 2, 1'"�SchoMelAtg-kr- rio gyr R-3 Total Zo23 �7?� r� Q� 3 1f1 Garage L( i S 11 / ✓ ► Do v ' Total 2,1133 Z G$ 0J�( _ o #for Elec 3 ( )C)� f -- I\ok\6s 115I'VL.- tAlk. cy-i,e, (2.6LA--j 6‘,vii--- Ft r,L 5ert,We 1..- S ✓C s1 I 1 City of Tigard 1111 a COMMUNITY DEVELOPMENT DEPARTMENT T 1 GA R D Building Permit Review — Residential Building Permit #: MS1'2O2I — 000—+% Site Address: 16654 SW Sunshine Coast St Project Name: Polygon at Roshak Ridge Lot #: 151 Planning Review Proposal: New single detached house QR 1 M A ca•-•// 0 Verify address/suite# active in Accela. ❑ In River Terrace: ❑ No Q Yes, River Terrace Review Addendum Site Plan Elements: ✓ rosion Control Iii: copies of site plan on 8-1/2"x 11"or 11 x 17"paper etained trees with drip line and tree protection measures I�J riYawn to scale(standard architect or engineer scale) ✓ ootprint of new structure(including decks)and FFE Q orth arrow ✓ tility locations&easements(required for new and additions) !:ite address,project or subdivision name and lot number ✓'idewalk/driveway approach 11 pplicant information(name and phone number) cation of wells/septic systems ••``,, G of dimensions and building setback dimensions ✓'treet tree size,type and location !kVA :.quare footage of buildings to be demolished ✓ trees names wi4 2- sung structures on site ✓ caner elevations (2'contours if more than 4'differential Il 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 ❑ Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: 0 Yes,applicant was notified ❑✓ No Received: ❑Yes ❑✓ No ❑ Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: El Yes,applicant was notified ❑✓ No Received: Yes ❑✓ No ❑ SDC Exemption for ADU applied for: ❑Yes ❑✓ No Received: Yes ❑✓ No ❑ Public Facilities Improvement(PFI) Permit: Required: Q Yes,applicant was notified 0 No Applied For: ❑✓ Yes ❑No,stop intake ❑✓ Land Use Case#: SUB2015-00004 Q Zoning: R-12 El Required Setbacks: Front: 8/12 Rear: 10 Side: 3 Street Side: N/A Garage: 20 ❑✓ Building Height: Max. Height: N/A Actual Height: 26 ❑✓ Landsca.e Area: 20 % ❑✓ Lot Coverage Max: 80 Entrance IO Set back no more than 8'from street-facing wall El Parallel to street or offset 45 degrees or less Windows Il Minimum 12%of area of all street-facing facades Garage 0 Gara e door is behind widest street-facing wall ❑Yes ❑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 2nd floor. ❑✓ Garae door width is I 12'or less ❑ 50%or less of facade 60%or less and includes 7 of following: [1g Covered porch ID Recessed entrance ❑✓ Wall offset a 1'Roof cave ✓Fire shingles 0 Lap Siding Roof itch Gable, Roof offset hi ,or gambrel roof 8 Dormer Accent siding Window trim ❑ ElU Window recess U Window projection El Balcony ❑ Visual Clearance ❑✓ Urban Forestaylan ❑ Sensitive Lands: ❑ Yes LI No Type: ElConditions met prior to issuance of building p rmit Notes: 0 Approved By Planning: Date: 3/1/21 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: 0 Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: Z/4 /202I Site Plans: # 3. Building Plans: # 3 Building Permit#: a Enter buildin ermit# above. Workflow Routing: lylanning g Engineering LEI P/ermit Coordinator LJ Building Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1)building plan and 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: Date: 3/8/2o2/ En eering Review I'Mi�I�Slope at building pad: 2 2 L7 Conditions "Met"prior to issuance of building permit /1h` Easements (encroachments)per engineering conditions of approval and plat &Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: 0 Yes IIK o . Assess Water Quantity Fee in-lieu: ❑ Yes E , LIDA Facility on lot: ❑ Yes Li No 2/Final Plat Recorded: ❑ NOT Approved by Engineering: Date: ,N,ottees: i L{d" Approved by Engineering: Date: _'S fp/�/ / Revisions (after Building Submittal only) Reviewer C Date/ Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review ,a 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 apply SDC Fees Entered: Wash Co Trans Dev Tax: Yes LI N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA Yes 12r N/A 4 OK to Issue Permit Approved by Permit Coordinator: Date: 3 ICI (1.0Z' 1:1B uild ing\Forms\BldgPermitRvw_RES_I22419.docx • City of Tigard IIICOMMUNITY DEVELOPMENT DEPARTMENT TIGARD River Terrace Building Permit Review Addendum Building Permit #: ms-raoal -voo--4g Site Address: 16654 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 :.. 5 ft.deep ft. deep min. 2ft., 5 ft.wide min. 2 ft.,Eft.wide Gable. .ormer ■ El ❑ El 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: CIParallel to street, . gle no more than 45° from street, ❑Max. 8 ft. setback from longes treet-facing wall or open onto pot Entrance opens to a porch: El Yes II o IE es,all the following apply: 025 sq.ft. ' [One street facing entry El 12 f ax.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 D ormer min.4 ft.wide ❑Roof eave min. 12 inch projection ❑R..- offset stun.of 2 ft. 0 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 O Accent siding min. 40%of street fa "de ❑Window trim • ' . 2 I/2"wide by 5/8"deep ❑Window recess min.3 inches for .1 street facing ❑Bay window min. ft.wide by 2 ft.deep O 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. 0 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. O 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 they.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 I 50%max. of street façade with 7 detailed design elements Notes: Approved By Planning: e"— Date: 3/1/21 I:\BuildmgWorms\BldgPermaRvw_RES_RT_121417.docz 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 s Transmittal Letter i c,~. E: n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DI,, ? ,4VIISION ��1l// • RECEIVED FROM: Si ,4 p? ,1., oiha, MAR 2 9 front COMPANY: `� ££ (Oegszvl CITY OF TIGARCD �. BUILDING DiVISIQ�N �T PHONE: (49 t 914(0 b ZSEMAIL: a A AbvliZ Q 1 07w/s 'l.ceN., RE: 7 .5_ // 1. ,self sui,S A14( I -(Si ddress) (Permit Num er _ (Prof a or subdivision name and lot num er) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s)of plans. 3 Revisions: Al A ci_Q 5 9•0,00t 03 Cross section(s) and details. Wall bracing and/or lateral analysis ' Floor/roof framing. Basement and retaining walls. Beam calculations. E gineer's cal lations. L 41 Other(explain): fir�oni64 ay . ,,, en.t U, o REMARKS:jt� tA A l 51. 0 ll/� 0? t pl Pal S . e ,rev,S� � a�dRf cS �Jloy! C'9� Atif �` 1 �` If, S � 6. sZ ar 'J <<af alp' R [���/- 9a gtt/�4�vn1P/: FOR OF ICE USE ONLY Routed to Permit Technicianate: y fU/Z j Initials: li- Fees Due: ,Yes / Fee Description: Amount Due: / N N) e `/ $ pi:v.-J.-- $ $ Special Instructions: Reprint Permit(per PE : ID Yes No' ❑ Done Applicant Notified: Date: Li i.L/.L. Initials: I.\Building\Forms\TransmittalLetter-Revisions 073120.doc