Permit Plumbing Permit ApplicarCEIVED
Building Fixtures SEP 1 FOR OFFICE USE ONLY
1. Ji�'. FOR
- City of Tigard Daze/By y/j/"f J Permit No.: MST2021-00080
• 13125 SW Hall Blvd.,Tigard,OR 972i�V OF TIGARD Plan Review/p /
Phone: 503.718.2439 Fax: 503.59$ Date/By: 1/g//I Lf�7 Other Permit No.. •
Inspection Line. 503.639.4175 ; ill nIMG DIVISIONli?I DJARD Interact: www.li ard-or.go� - Y Y 7 ��, 2 lads See Page 2 for
g NotfleNMeho /� r, �-� Supplemental Information
TYPE OF WORK i r + LLri1 t .2 ---- FEE" SCHEID LE
❑Q New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea 1 Total
❑Addition/alteralion/replacenent ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑� I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family .
Each additional bath/kit en 25.02
❑Master builder III Other. Fire sprinkler(2023 sq.ft) Paget
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:16680 SW Sunshine Coast Catch basin or area drain 8.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:SFU 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.:152 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
11HIy wit Backwater valve 1251
DESCRIPTION OF- WORK i1lill.',1
Clothes washer 25.02
MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I 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 1 695-7700 Fax:( ) Ice maker 12.51
0 .APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical (gas value:$_) e 2
Page
Business name:Alliance Plumbing, LLC 1
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
CCB Lie.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: ►Z--7� TOTAL PERMIT FEE ipf,qS
This permit application expires if a permit is not obtained within 180 days
Print name:Gavin Thomes Date:8.25.2021 after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
IABuilding\Permits\PI-MU-PermnApp.doc IS/01 NW 4411-46i6T(1 a/V11COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Sq
uare Footage: Permit Fee:
Footing drain- I"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 st 100' 62.54
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.522 $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(en) Total each additional$100.00 or fraction thereof,to
pand including$10,000.00.
Inspection of existing plumbing ur for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no tee 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 Ibllowing.
Fixture Type for Replace/ Please check all that a
Work Performed: Calmed Added Relocate apply.
Baptistry/Font ❑ Any new commercial building with water service 2"and
P greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool - engineer.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918-780-0040.
ElCuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities.
Dishwasher Commercial ❑ Any multipurpose fire sprinkler system.
Domestic 0 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 fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
:1Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
CITY OF TIGARD MASTER PERMIT
IIa COMMUNITY DEVELOPMENT Permit#: MST2021-00080
T(GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date issued: 05/12/2021
Parcel: 2S107AA15200
Jurisdiction: Tigard
Site address: 16680 SW SUNSHINE COAST ST
Subdivision: ROSHAK RIDGE Lot: 152
Project: Polygon at Roshak Ridge, Lot 152-Primary Dwelling
Project Description: New primary dwelling with (1)attached ADU,on separate permit, and 116 sf deck and deck cover.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 82 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1941 sf Garage: 456 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2023 sf Value: $275,389.70 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
0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckfiw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 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
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 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: $29,581.88
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: i .. cp'Q'L r Permittee Signature: O11 o IICSa-t iU 4Nt
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Applicati.r A I V
l.._. I.... .- 1/ 2l
Residential FOR OFFICE USE ONLY
=EEC •i_ ' 102` Received 3/f/Z D
City of Tigard natersy: O21 Air Permit No.:MST lL - oco I
111 13125 SW Hall Blvd.,Tigard,OR 97223 ••= Plan Review
II Phone: 503.718.2439 Fax: 503.598.196f�I I Y OF i iutirit; uateBy:
t 7 — l } Other Pen t:swRZo�t oc�fo2
li(. ,ttn Inspection Line: 503.639.4175 BUILDING DIVISION oareReaay/By / t ///��� ® See Page z for
Internet: www.tigard-or.gov Noti ethod: / �� (.,. Supplemental Information
AND OF WORK REQUIRED DATA:1-A- `D 2-FAMILY DWELLING
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of al
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit fo e
CATEGORY OF CONSTRUCTION work indicated on this application.
0 I-and 2-family dwelling ❑Commercial/industrial Valuation: $ a-7 1 389 70
0 Accessory building ❑Multi-family Number of bedrooms: 4
0 Master builder ❑Other: Number of bathrooms: 3 ``
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 24 ,9
Job site address: 16680 SW Sunshine Coast St New dwelling area: 2023 square feet 1 1 11
City/State/ZIP:Sherwood, OR 97140 Garage/carportarea: 456 square feet 662.,..
Suite/bldg./apt.no.: Project name C?i"e' T�rr'r'� Rlnrtha�ct Covered porch area: square feet
Cross street/directions to job site: pel 6/7 ,�� eL/�� �/ Deck area: 116 square feet
`� Oth�- • �,, V 4--` �{t t`esquare feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: 152 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New Single Family Valuation: $
` Existing building area: square feet
1
New building area: square feet
C‘'\Z ® PROPERTY OWNER 0 TENANT Number of stories:
LI4Name:Polygon Homes WLH LLC Type of construction:
Address:703 Broadway St., Ste 510 Occupancy groups:
city/State/ZIP:Vancouver,WA 98660 Existing:
"�J Phone:( )360 695-7700 Fax:( )360 693-4442 New:
APPLICANT CONTACT PERSON v
El APPLICANT BUILDING PERMIT FEES*
Business name:Polygon Homes WLH LLC (Please refer to feesehedu7e)
Structural plan review fee(or deposit):
Contact name:Omar Alami Abouhafs
FLS plan review fee(if applicable):
Address:703 Broadway St., Ste 510
Total fees due upon application:
City/State/ZIP:Vancouver,WA 98660
Phone:( )360 695-7700 Fax: :( )360 693-4442 Amount received:
E-mail: permitsubmittals@taylormorrison.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
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 Perm t Fee(includes plan review $180.00
and administrative fees):
Phone:( )360 695-7700 Fax:( )360 693-4442 0
State surcharge(12%of permit fee): $21.60
CCB lie.:207247 //yy /��J �1 / �" Total fee due upon application: $201.60
Authorized signature: (/.i/ta ,cy icani. / G6'LL/LGer,[r2 This permit application expires if a permit is not obtained
(� within 180 days after it has been accepted as complete.
Print name:Omar Alami Abouhafs Date: 02/12/2021 *Fee methodology set by Tri-County Building Industry
Service Board.
1:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
. Alecn:�ndeal Permit Application A
City of Tigard ECEIVE� LT, �mm Oi.� I-:
J 6CSW lia1 RM,Ts Ord,_R9 .__
t xxRer ew
F. Phone 50+718.2439 FaX 503.595.I960 r Other Perunzi;
{ p girl1)YiC1r34
Trttpec,lon Liner5G3.ba9 4175 BAR 2 2UL 1 llase flicady,* • lua- g See Page E far
t rnGC www.tieard-or goy Not dieddVehgd: - Supplements/Informed on
CITY OF TIGARI) _ _._
j TYPE OF w�1ILDING DIVISION M conIaIERCIn.L.FEE* SCREl)U ; - USECHFCKLIs"3'
Mechartteai puma fats*are basal on the value of the work —
New construction 0 Ad ditinnialteratianh°epl performed.tndic tothevalue(sounded to the nearest_dollas)of all
0 DDetnolition El Other. mechanical mntut e4aiprngClt,la5or,overhetn,anti ofli
Value:5
CATEGORY OF CONSTRUCT _ RESU)F TIALEQiTf]lstpNT/SYSTEMsFLES
I-anF"--t!2-family dwelling Ij Commercial/industrial ial 0 Accessory building j roap8r7attn n v an urerreci3kv
j ] j Multi family0 Master builder i�Other; :Uescrrptron (fit} Fa. _ :__ Total_
JOB SITE INFORMATION AND LOCATION-- fleatmalcooline-
I---•-
I_Air condrionine 4575 ( --
Job site addr
ess- 16680 SW Sunshine Coast St '—
rumace 00,000 BTU(ductd,verus) d5.75
y'Smte1Zt Irnard,OR 9T74 € Furn I ace °00,0001 BTU(ducShe-its? 54.92
_I r
Stuterbidg tap no.. Project et name. River Terrace Northeast heat»ugnp 51't6
.._. i Duet work _____ I 23.32 i
Crossstreettdirentiaosto job sin' I drunk.lost yarn'SWUM 23.32 -_i
Residential boiler(radiator or
hadronic) 23 32 1
f Unit heaters{sueۥtype,not electric), I
1 in-wall.induct,sus sanded.etc. 4b_75
L Fin&vent for any of above 23.32 I .
Subdivision: riot no.: 152
I Other, 23.32 I
_, . ....m.._._. ._ ._.. ___._ ; Other fuel appliances
1 Tax map/parcel no.: _m_
Wan-heater - ' 23.32
I DESCRIPTION OF WORK Gas fire iacelinsert 33.39
/_� L. - • i/1 �M , Flue vent for water heater or gas
11111
I lve.1�/) 3.].(UCI,i !l at Pew fire tact
/ /,I�� �// ho Itchier{sax} _
23,32. __ ......
l bV v f rr / '101 . Wood,' elle stoveM 33.39
Wood fireplace/insert .__. 1111.1. 23.32 J
I Chnleyilinerlfiuu'vcnt 1111123.32
i_.__ I i
( PROPERTY OWNER
..... ._ 0 TENANT I Other 23.32 �-
(.._-.. ._._. _.._.._. __..._ _______.. _._.__ _�..M.._I r Environmental exhaust and venniat runt _
Name:Polygon WLH,IAA:- t Ranee lrcand/other kiichen
- _.__.-.__ -..W urlC.n=_.... 33.39
Address:703 Broadway S�Ste. 10 t
_._...--_._y C€otknr�derrxlsauaC ......__ 3.39 1 __.�
City/Statei7IP:Vancouver,WA 98660 m Single-duet lgt cam arImhaust(bathrooms.
. eits.unlit,rooms) 23.32 a
Phone;(360)695-7i0iI Fax:( ) Atha/crawls ace fans _ 23.32 i
APPLICANT 0 CONTACT PE,RSO/si Other: 2.3.32
•
i Business name Polygon WLH,LLC Fuel piping:
Contact name:Tar a Morris _ 3 roc each additional
4ddr ss 703 Broadway St,Ste SW ushe
3 Furnace,
....�.�_ Gus heal rr„ _
I Waflisssii mil d'i m at r I €
CityriS;ateiZIP,Vanconser,WA9R6b0 V'a.erncater I
Phone:(360)695-7704 Fax: -(360)693-4442 F„«p1 ;
-, i P.tie
' ..� I �� r��! E naiF pernisubmituts{ aylOn1Orrison.conl ..rarbe ' •CONTRACTOR ',lathes dryer(Ras) .• _...
Business name:Pro Heating roc Cooling x
Address; NWAlociek Dr,Ste 1104 1 MECHANICAL PERMIT PEES'` _7
Subtotal
Cry/State/LIP:Ilillsbara,OR Minimum penult fee(S90.00)
_. _..............._,....__ _.. ..... _..._........._ I Plan review(25%of penult fee)
IPhone:(3601270-1590 Fax:( i I I State sareharge(12%of permir fee) 1
CCB",ic.:209001 • TOTAL PERMIT FEE
____ .�_
.. This,...._.._.__ .._,...._v.._ _.q__ ..�..__�_ --..-_.. ks permit xppYk if expires a permit is not obtained within MOZC{ 3('� days after it has beta scrupled as complete,
Authorized.signature: - Fee' methodology red by Tri-Comny Bcrhlicg industry Senses Board
LPrint name.El€a Doran ( Date: 10/30/20 i
I
TUS,,ilAin.11,,,m4WR.i lln.rytit Ann aigil i-,,r, ...h mitt r,,;2,u^r,.o,,,,,,, _
r
Electrical Permit Application ) e s FOR OFFICE USE ON I.\
• Received r�c 7s�
City Of Tigard • Date/B : Z Permit#: '2O2I—bW B r/
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503 639 4175 Ready Date/By: tuns: H See Page 2 for
Tlt3:\RU Internet. wwwtigard-or.gov 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 ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
O Multi-family ['Master builder 0 Other: 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: 16680 SW Sunshine Coast 100HP or more. ❑"A","E","l-2","1-3",
❑Six or more residential units. occupancy.
City/State/ZIP: Tigard OR 97224 ❑Health-care facilities. 0 Recreational vehicle parks,
Suite/bldg' p Project t.#: Pro ect 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#:152 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
(with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
$] PROPERTY OWNER ❑ 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
1 401 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
In APPLICANT ❑ 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 )816-78t)0 Fax: : ( ) Each manufactured or modular 67.84 2
to lormorrison.com dwelling,service and/or feeder
Email: permitsubmittals
@ y 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 0 See Page 2 2
Address: 1915 E 5th St., Ste D panel,alteration,or extension
City/Slate/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
ail ortlandelectric.biz Industrial plant(I hr min) 78.18/hr
Email:
p @p Inspections for which no fee is
CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lie.: 4920ys specifically listed 04 hr min) 90.00/hr
/� CX�� ELECTRICAL PERMIT FEES
�,JI,
Suprv.Electrician signature,required: „'1✓ Subtotal:
Print name: Alex Shalya Da e:10/30/20 ❑Plan Review Required(25%of permit fee):
State surcharge 2a of permit fee):
Authorized signature: TOTTALL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Serqev Mishchuk Date:10/30/20 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1.1Building\PemdtslELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440'615T(I I/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
combined: $75.00 Description I Qty. I Each I carat I
Fee for all residential systems
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 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:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
❑
Garage Door Opener* 50.01 to 100 kva 552.26 2 g p >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: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('G hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 a Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
El Boiler Controls
El Clock Systems
El Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
El Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
LlBuildnglPerndtstELC_PemulApp_ELR_ERE_doc Rev 06/17/2015
. • •Plumbing Permit Application . °` .
Building Fixtures FOR OFFICE USE ONLY
IEH 1_
{ '? a Received
City of Tigard Permit No::
.1 13125 SW Hall Blvd.,Tigard,OR 97223 PleeRev 3 g 2oZT Ni' (hSt'2o2t 0�$�
r Paan Review Other Permit No.:
Phone: 503.718.2439 Fax: 503.59LJ tj'('(' (Jr I liy;;-ii{L/ Dale/By;
bispection Line: 503.639.4175 1 pate Ready/By: curls: H See Page 2 for
TIGARD Internet: www.tigard-or.gov `'='�i---:�U DIVISION
Nat Read/Br _ Supplemental 2 f 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 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
Xl-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 50032
❑Accessory building %-Multi-family •
Each additional bath/kitchen 25.02
❑Master builder 0 Other. Fire sprinkler(_sq.fc) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Jab site address: 16680 SW Sunshine Coast St Catch basin or area drain 18.76
-- ------ --- ----- Drywall,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.: ) Page 2
Suite/bldg.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: Lot nc 152 Fixture or item:
Tax map/parcel no.: Bacleflow 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 Fixture/sewer 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
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Polygon WLH,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/hasin/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/DW 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 Mmimwn pemit fee: 572.50
CCB Lie.:184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: . 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.
fa3aildiag',Permics/PLMU-PermitApp.doc 10,01`t9 4404616T(too'_/CowWES)
Plan# r'ywk S ( DJ9t (g) 14
Floors 2. Large Ar S
Bed rooms y Small g( /( HoElia '_
we 3 v ` c
Tub 3 Basement n
Vent 5j 1st Floor T�Z-
Water Heater 1 2nd Floor k 9 ( I
AC y11...5- P 3rd Floor
School Ic`s,q�" R-3 Total 2..O2?
tov r V2.f..� I I(p Garage Li 5�
O t C1 �
1 t I� Total iy1 G�
s--Q. \o: 6 #forElec 3 f
Wb ; ra- qVoLog-
1
x
Ilq City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T i G A R D Building Permit Review — Residential
Building Permit #: MST202.1 - 0OoS 0
Site Address: 16680 SW Sunshine Coast St
Project Name: Polygon at Roshak Ridge Lot #: 152
Planning Review
Proposal: New single detached house `P lz. t M A.2�/
❑r Verify address/suite#active in Accela. El In River Terrace: ❑ No ❑r Yes,River Terrace Review Addendum
Site Plan Elements: erosion Control
0: copies of site plan on 8-1/2"x 11"or 11 x 17"paper detained trees with drip line and tree protection measures
I'prawn to scale (standard architect or engineer scale) footprint of new structure(including decks)and FFE
0 'orth arrow •LJtility locations&easements (required for new and additions)
Mite address,project or subdivision name and lot number •'idewalk/driveway approach
0 pplicant information(name and phone number) 14111%. ocation of wells/septic systems
Ol0 of dimensions and building setback dimensions Jitreet tree size,type and location
t), II'quare footage of buildings to be demolished •Street names
II xisting structures on site _ orner elevations (2'contours if more than 4'differential
I9 .t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? LIYes o
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es •Vo
❑ Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑Yes,applicant was notified ❑r No Received: ❑Yes ❑r No
ClWater Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: 0 Yes,applicant was notified No Received: A Yes ✓ No
❑ SDC Exemption for ADU applied for: LJ Yes ❑No Received: Yes No
❑r Public Facilities Improvement(PFI)Permit:
Required: El Yes,applicant was notified ❑No Applied For: El Yes ❑No,stop intake
❑o Land Use Case#: SUB2015-00004 ❑ Zoning. R-12
ElRequired Setbacks: Front: 8/12 Rear: 10 Side: 3 Street Side: N/A Garage: 20
El Building Height Max.Height: N/A Actual Height: 25
ElLandsca.e Area: 20 % 0 Lot Coverage Max: 80 %
Entrance 12 Set back no more than 8' from street-facing wall El Parallel to street or offset 45 degrees or less
Windows 0 Minimum 12%of area of all street-facing facades
Garage 0 Gara door is behind widest street-facing wall ❑Yes El 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.
❑r Garadoor width is III 12'or less 0 50%or less of facade 60%ox less and includes 7 of following:
Ilge
Covered porch CI Recessed entrance ❑r Wall offset ' 1'Roof eave Roof offset
Fire shingles Lap Siding ❑ Roof itch ElGable,hi ,or gambrel roof Dormer
Accent siding Window trimU Window recess LJ Window projection El Balcony
OIp R
Visual Clearance ❑° Urban ForestrvPlan
ElSensitive Lands: Yes No Type:
ElConditions met prior to issuance of building p t
Notes:
El Approved By Planning: r Date: 3/8/2021
Revisions(after Building Submittal only) Reviewer Date
Revision 1: El Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
I:1Building\Forms181dgPermitRvw_RES_I224I9.docx
Building Permit Submittal
Original Submittal Date: ./i 7/21
Site Plans: # 7
Building Plans: #,....,, ,
Building Permit#: E ter buildin ermit#above. �y ��/
Workflow Routing: AZ-Planning "-ngineering 'R 1 ermit Coordinator �J 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
o ' al 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: Sf��z
EngineeringReview
Slope at building pad: 2 /d
conditions"Met"prior to issuance of building permit 141'
sements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes Er No
CJy
Assess Water Quantity Fee in-lieu: ❑ Yes o
LIDA Facility on lot: II Yes NU No
Final Plat Recorded:
0 NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 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 ao-jIy
SDC Fees Entered: Wash Co Trans Dev Tax: Yes J N/A
Tigard Trans SDC: JT Yes ❑ N/A
Parks SDC: ,-Yes ❑ N/A
LIDA ❑ Yes gN/A
Q OK to Issue Permit
Approved by Permit Coordinator: ;L)n ,,, P sd`- - Date: 3 l0110324
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
K .
lipq
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: Ms -toz t . ooA.Q'o
Site Address: 16682 SW Sunshine Coast St
Project Name: Polygon at Roshak Ridge Lot #: 152
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.64O.070.I.):
Is the project subject to the plan district design standards? ❑Yes 0 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.
Porch 5 ft. deepBalcony w/access 2 Window Projection Vertical Wall Offset a
ft deep min.2ft., 5 ft. wide min. 2 ft.,6ft.wide Gable. ormer
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 ance must meet both of the following standards:
0 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 I o
I� (
f-ves,all the following apply: ❑25 sq.ft. .
ElOne street facing entry ❑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 Dormer min.4 ft.wide
❑Roof cave 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. .. 0 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
0 Window recess min.3 inches for .1 street facing ❑Bay window min. ft.wide by 2 ft. deep
❑Balcony min. 5 ft.wide x 3 ft. .eep with inside access ❑Attached garage is 3 'o or less of street facade
5. Garages and Carports: ',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 0 No. If No (Check o :
0 May extend u. o 5 ft.if there is a covered front porch and garage does not extend beyond the fro . .orch.
❑May exten. p to 5 ft.where the garage is part of a two-story building and there is a window at the se : d story
above the v..age that faces the street with a min. area of 12 sq.ft.
Width: heck one)
❑ -foot-wide garage door ❑40%max. of street facade
50%max. of street facade with 7 detailed design elements
Notes: /
Approved By Planning: igaie-2-----____—, Date: 3/8/21
I:Ruildmg\For.nslBldgPamitRvw RES_RT_121417.docz