Permit Plumbing Permit ApplicaCEIVED
Building Fixtures SEP 1Z,, FOR OFFICE USE ONLY
Received �a
City of Tigard Date/By. (/I/ T� Permit No.: MST2021-00183
IN13125 SW Hall Blvd.,Tigard,OR 991T(OF TIGARD Plan Review
_ Phone: 503.718.2439 Fax: 503.59 19J 74`07 Other Permit No.:
Inspection Line: 503.639.4175 3UIL-L1ING DIVISION Date/By: 9-g-
T I G A R D Date Ready/By �+ 1,+ ( i 1 him ® See Page 2 for
Internet: www.tigard-or.gov Notifie�dt�/Method'. Supplemental Information
TYPI- OF WORK Pi*T' L IL1,..1e tA s4 f- FEE* ISChTDULE
❑� New construction D I)enrol it ion For special in'arniation else checA6.W.
-- - ----- ---- Description I Qty. I Ea. 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
E 1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78
El Accessory buildingSFR(3)bath 500.32
❑Multi-family
Each additional bath/Itc en 25.02
❑Master builder ❑Other: _ Fire sprinkler(1228 sq.ft.) Page 2
JOB SITE INFORMATION AND IL(1C 1111 1 nr7i i 11 j([1 Site utilities:
Catch basin or area drain 18.76
Joh site address:16710 SW Darwin Loop
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: I Lot no.:1186 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12-51
il - - Clothes washer 25.02
MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:Taylor Morrison
Floor drain/floor sink/hub 25.02
Address:703 Broadway Street Suite 710 Garbage disposal 25.02
City/State/ZIP: Vancouver,WA 98660 Hose bib 25.02
Phone:(360 ) 695-7700 Fax:( ) Ice maker 12.51
i1t 1 ti �, .'',
art �t �''�i� ;t�i) I(li�' Interceptor/grease trap25.02
Medical gas(value:$ ) Page 2
Business name:Alliance Plumbing, LLC
Primer 12.51
Contact name:Gavin Thames 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
Urinal 25.02
F-mail: gavin@allianceplumbing.net
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: $7250
CCB Lie.:184601 Plumbing Lie.no.:PB732 Plan review (25%of permit fee)
/� State surcharge(12%of permit fee)
Authorized signature: / -� / ) TOTAL PERMIT FEE 136,e 53
Print name:Gavin Thomes Date:8.25.2021 This permit application expires if a permit is not obtained within ISO days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:1Building\PermitstPLMU-PernuiApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit 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-1st 100' 62.54
$1.00 to$5,000,00 Minimum tee$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
p and including$10,000.00.
Inspection olexisting 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 oldie following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate PP y
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
IDCar Wash: Each Stall New exterior plumbing site utilities for any complex structure
-Drive Thu as defined in OAR918-780-0040.
El Aspirator --' Medical gas and vacuum systems for health care facilities.
Cr El Any multipurpose fire sprinkler system.
Dishwasher: ommercial- ome El Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
-3" - -- Isometric or Riser Diagram
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/liar 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:
1:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2021-00183
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 2S107AA18600Date Issued: 2021
TIGARD Parcel: S 107
Jurisdiction: Tigard
Site address: 16710 SW DARWIN LOOP
Subdivision: ROSHAK RIDGE Lot: 186
Project: Polygon at Roshak Ridge, Lot 186 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: 24.5 Bathrooms: 2 Second: 0 sf Garage: 275 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 1228 sf Value: $163,663.38 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
Drains: 0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel TYPOS Air Conditioning: Y Vent Fans: 3 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<l00K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 2
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvcIFeeders 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: 2 201-400 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 Y
Other: N Other Description: Ecompasing.
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 Fire Rated Conditions
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 Ersn Cntrl 503-639-4175
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $24,384.58
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 'K vA v1 Ve,We� Permittee Signature: 0 IV AppliCarLOYI
Call 503.630.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application,F C F I\®E D
Residential !! FOR OFFICE USE ONLY
City of Tigard MAY e 1 2021 n teBy: ) IV 21 jv'T PermitNo.: NIST'2o21-Opt d�3
y
1111 • 13125 SW Hall Blvd.,Tigard,OR 97223 , P�Rev'
I ' y: 4 fal ' q2,,/, other Permit: JvvRZC rg-00(2I
Phone: Hall Blvd. Fax: 5 9819i�B' Lt- I ft7 t'1LI Date/a
flCL1Rl) Inspection Line: 503.639.4175 ]LI!I_R !f DIVIS!0�,i Date Ready/By: 'urn ® Sec Page 2 for
Internet: www.tigard-or.gov Not_:4, ethod:'2 b.1 ` Supplemental Information
/01L✓r
TYPE OF WORK REQUIRE 1 DATA:1-AND 2-FAMILY DWELLING
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. 2$
Valuation: $ \43 (D(23w
O I-and 2-family dwelling ElCommercial/industrial I
❑Accessory building El Multi-familyNumber of bedrooms: 3
❑Master builder ®Other: ADU I Number of bathrooms: 2
JOB SITE INFORMATION AND LOCATION Total number of floors: 1 15o3
lob site address: 16710 SW Darwin Loop New dwelling area: If<1/ - square feet
City/State/ZIP:Sherwood, OR 97140 Garage/carport area: 'k,27Ssquarefeet
Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Polygon at Roshak Ridge I Lot no.: 186 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.
ADU 1:New home construction/Elevation: 221100BR/221000BR Valuation: $
Type:ADU/Projected Start: July 2021 Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 'TENANT Number of stories:
Name:Polygon Homes WLH LLC Type of construction:
Address:703 Broadway St., Ste 710 Occupancy groups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360)946 8674 Fax:( ) New:
® APPLICANT 0 CONTACT PERSON U,9 BUILDING PERMIT FEES*
Business name:Polygon Homes WLH LLC (Please refer ro fee schedule)
Structural plan review fee(or deposit):
Contact name:Omar Alami Abouhafs
FLS plan review fee(if applicable):
Address:703 Broadway St., Ste 710
Total fees due upon application:
City/State/ZIP:Vancouver,WA 98660
Amount received:
Phone:( 360) 946 8674 Fax::( )
E-mail: PermitSubmittals taylormorrison.com, AlamiAbouha s taylormorrison.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 710 Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver, WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:( )360 693-4442 State surcharge(12%of permit fee): $21.60
CCB Iic.:207247 // _ Total fee due upon application: $201.60
Authorized signature: OhLQi1. ,C�}&ILL AlIe0'' 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: 05/04/2021 *Fee methodology set by Tn-County Building Industry
Service Board.
I:\Building\Petmits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
t Mechanical Permit Applicatioilp FC F is
City of Tigard
Ry
g oate/evy S(Q/2i Imo' Permit No.: MS 0Z,-co1g?)
III '! 13125 SW Hall Blvd.,Tigard,OR 97223 I/,t q ,r. 2 Pion Review �,t
-- �''/i�'i� ^ fftlq Date/By: Omer Penult: SW e207,-0=4 t
Phone: 503.718.2439 Fax: 503.598.1960 t' w c.JG�
t I t i.h G I i Inspection Line: 503.639.4175 CITY
I_ I I�ARCI Dare Ready/By. hris- 0 See Page 2 for
Internet: wvw.ligard-or.gov 'I Inlf, NotiGedlMUbod: Supplemental Information
31A._.D.. ,, DIVISIO\I
TYPE OF WORK COMMERCIAL FEE* SCHEDULE USE CHECKLIST
El New construction ❑Addition/alteration/replacement lacement Mechanical permit fees*are based on the value of the work
P performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION
RESTDENTIAL EQUIPMENT I SYSTEMS FEES*
1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist
Multi-family ❑Master builder ®Other: ADU 1 Description Qty. Ea. Total _
JOB SITE INFORMATION AND LOCATION Heating/cooling:
... Air conditioning 1 46.75
Job site address: 16710 SW Darwin Loop Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU Onus/vents) 54.91
pump
Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge Heat
Duct work work 61.06
23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
bydronicl 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: Polygon at Roshak Ridge Lot no.: 186 Other 23.32
- Other fuel appliances:
Tax mapIparcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
— Flue vent for water heater or gas
New home construction-RIM fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/Yent 2332
ElPROPERTY OWNER 0 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/ZJP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(360)695-7700 Fax:( ) Attic/crawispace fans 23.32
El APPLICANT 0 CONTACT PERSON Other 23.32
Business name:Polygon WLH,LLC Fuel piping:
S14.15 for first four,S4.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 heat pump .
Wallsuspended/unitheater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace ,
E-mail:perrnitsubrnittals€taylormorrison.corn Range
Barbecue
4t 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($90.00)
Plan review(25%of permit fee)
Phone:(360)270-1590 I Fax:( ) State surcharge(12%of permit fee)
CCB lic.:209001 TOTAL PERMIT FEE
�` ( This permit application expires if a permit Is not obtained within ISO
/ A: a- I\� days after it has bees accepted as complete.
Authorized signature: (.�G(� J * Fec methodology set by Tri-Counry Building Industry Service Board
Print name:Elia Duran Date: 10/30/20
1.111.014tinalPrtrnirall.[Fr Pn.Til Ann Mn111 Ain.. ,..oft Aee 1 T.,,Mn re,”.•41TDi
1 _ '
• C
Electrical Permit Application 9LCEIVEJ 1OR 014111 I SI 0\I 1
City of Tigard MAy II i, 2a -
Received
1 i Detell3 . S- 0 ? ( N1-- P'111- PA&1-2,2:121-CO ta3
•1 13125 SW Hall Blvd.,Tigard,OR 97'223 Ran Review
S1422.6
- • Phone: 503.718.2439 Fax: 501598.1960 cl Ty oF' --i Related Permit 4: 21 00121!GAF:0 nmkg0Y.
, 1:Boeotian Line: 503439.4175 furis: el See Page 2 for
P." Internet: www.taliard-or.liov • NotifiediMetbad. Supplemental haematite
• TYPE OF WORK ' r PIAN-BEYIEW - • ._ '' '•' •','-''::
13I New construction CI Addition/alteration/replacement Please cheek all that apply(submit 1 sets of plans w/items checked):
['Satire or feeder 400 amps te more El Building mar three norms.
El Demolition El Other:
where the awsllable fault mama Elblarinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10.000 limps at 150 volts or °Floating buildings
ls or cee 0 1-and 2-family dwelling 0 Commerciakindustrial 0 Accessory building es to ground, exds 14.000 0 Conaceercial-use agricultural
amps fin all other installations buildings_
El Multi-family 0 Master builder Q other-. ADU 1 ['Fire pump, 0 Installation of 150 KVA a-
JOB SITE INFORMATION AND_LOCATION ,.. 0 Emergency system larger separately*dyed
°Addition of DeVi motor load of system.
Job II: Job site address:16710 SW Darwin Loop 100I1P or morn 0"A",13;1/P,"1-r,
0 sot or more residential ands City/State/ZIP: Tigard,OR 97140
Olicahh-earc facilities 0 Recreational seluele parks.
Suite' /bIdgJapt.If: Project name: Polygon at Roshak Ridge 0 Ileradous locations 0 Supply vohage for MOIC Men
0 Service or feeder 600 amps or mom. 600',ohs rtamlaal-
Cross street/directions to job site: FF,E SCHEME 'orsorpriss I om I Farb .1 Tsui I .
New residendal single-or inultl-temily dwelling unit.
Subdivision:Polygon at Rosbak Ridge Lot*: 186 Includes attached garage.
Tax map/parcel if: 1,000 sq.11..Or kss 168.54 4
Ea.add'1500 sq.ft=portion 33.92 I
'. ... . . DESCRIPTION OF WORK Limited=Orgy.residential
75.00 2
.
New construction. Type: ADU 1 (with above fitlft-)
Limited energy,multi-family
75.00
residential(with above sq.tt.)
Renewable EmergY 0 See rage 2
II titOrEwrir.owrout I 13 TENANT Services or feeders installation,alteration,cud/or rdoealioa
Name: Polygon Homes WLH LLC 200 amps or km 100.70 2
--
,
Address: 703 Broadway St.,Ste 710 201 amps to 400 amps 133_56 2
401 amps to 600 amps 200,34 2
City/State/ZIP: Vancouver,WA 98660
601 amps to 1,000 amps 301.04 2
Phone:(360 )946 8674 Fax:( ) Ova 1,00D amps or volts 552.26 2
Temporary services or feeder'installation,situation,and/or
Email: 0A1sm1Abouhafs@Mylormorrison.com-PermitSubmittals@taylormorrison.com eammakie
Owner installation:This installation is being made on property that I own which is not 200 amps or less 5936 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 snips 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
Branch circuits—new,alter-alio%or extension,per panel
- ' 13 drrLICArrr I - 0 C°14TACr PERS°N A.Fee tar branch circuits with
Business name: Polygon Homes WIII LLC above service or feeder Dm,
7.42 /
each branch circuot Contact name: Omar Aunt Aboubak
B.Fee for branch circuits without
service or feeder fee,first
Address: 703 Broadway St,Ste 710 56,18 2
Munch circuit
City/Stale/ZIP:Vancouver,WA 98660 Bach addi branch circuit 742 2
Miscellaneous(service or feeder eot included)phone:(360 )946 8674 Fax::( ) Each manufactured or modular
67.84 2
dwelling.service and/or feeder
'
Email:0AlanriAboubafs@itaylorraorrison.com-PemitSubmittals@taylormorrison.com ..,obly —
67.64 2
CONTRACTOR Pump or irrigation circle 67 64 2
Business name: Wallace Electric Sian or outline lighting 67.84 2
Simnel circuit(s)or limited-energy
Arkint88: 105 Dresden St 1] See Page 2 2
panel,alteration,or=tension_
CiiY/Siaitan: Aston OR 97103 Each add'noaal iespemson over allowable la any of the above
a,
Additional inspection(1 lir min) 6625/ht
Phone:(503 308 0563 Fax:( ) Investigation(1 hr min) 90.00/hr
Ern a
Industrial plain a hr min) 78.18/hr
dg Industrial plain
for which no fee is
hr
CCB Lie.:224868 Electrical LihC1441j A6363S specifically listed(6 lir mon 90)
ELECTRICAL PERMIT FEES .
Suprz Electrician signature,required:
g a 6 4"--------_ •
Subtotal:
Prim name:DAt,• a. Date: trig drz t Cl Plan Review Required(25%of permit foe):
Authorized simmture
lillit4e4Z" State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Thin puede application mares if a pest is ant.bloomed within 180
Print name: ,41,14,0 i."444.44e.. Date: days&few ti lue been&steeped as ecuipletr-
• Number of inspections allowed par permit.
tilliailmecima6=_Pciont/iPP ELR ERE doe RN 06/112015 151111105/C5ISPRES
Plumbing Permit Application r
Building Fixtures REC.', g FOR OFFICE USE ONLY
Cityof Ti and Received Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 D'I�Y_ S`//On : NrMSt" .O21-C)I�3
11 aPhone: 503.718.2439 Fax: 503.598.1960 Plan Review Date/By: Other Permit No.:9Q24n(-6O1Z1
Inspection Line: 503.639.4175 CITY (.`'_. Date Read curls: ® See Page 2 for
TIG��P.Q Ready/By:
Internet: wWw.tigerd-0LgOv i3U11.r` NotiliedlMethod: Supplemental Inform anon
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist.
Description I Qty. 1 Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes I00 ft for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building • -Multi-family
Each additional bath/kitchen 25.02
❑Master builder DI Other. ADU 1 Fire sprinkler(__sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16710 SW Darwin loop 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
Suite/bldg/apt.no.: 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: 1 Lot nc 186 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 ❑ TENANT Expansion lank 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/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-mailPermitSubmittals taylorrnorrison.com, AlamiAbouha s taylormorrison.corn 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 Lic.: 184372 Plumbing Lic.no.:pb634
State surcharge(12%of permit fee)
Authorized signature: }� fa / TOTAL PERMIT FEE
Print name:Steve Fowler Date: 10/30/20 This permit application expires If a permit is not obtained within 180 days
after II has been accepted as complete.
'Fee methodology set by Tri-Couny Building Industry Service Board
t:\Ba ng\PersrePLMU-PermirApp.dor 10/01/09 440-4616T(I0/02CO61/w®)
t , ,
City of Tigard
III
III
' COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Residential
TIGARD
Building Permit #: MSTQp2\- OO °
Site Address: I(o110 SW Vp6211431N/ t„o(. ' SHe04=0i OR, GPI 40
Project Name: Polygon at Roshak Ridge Lot #: 186
Planning Review
Proposal: N Crk'QO j° )U
❑r Verify address/suite#active in Accela. El In River Terrace: El No El Yes,River Terrace Review Addendum
Site Plan Elements: ° rosion Control
Os copies of site plan on 8-1/2"x 11"or 11 x 17"paper kw, etained trees with drip line and tree protection measures
0 Drawn to scale(standard architect or engineer scale) " ootprint of new structure(including decks)and FFE
0 orth arrow v tility locations&easements(required for new and additions)
a.ite address,project or subdivision name and lot number r idewalk/driveway approach
0 pplicant information(name and phone number) rla ation of wells/septic systems
0 ot dimensions and building setback dimensions treet tree size,type and location
OlP I1.quare footage of buildings to be demolished ° trees names
� xisting structures on site orner elevations(2'contours if more than 4'differential
Ell ot 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
❑r Clean Water Services-Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑Yes,applicant was notified ❑r No Received: ❑Yes El No
❑' Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs
Required: ❑r Yes,applicant was notified El No Received: Yes ❑No
❑ SDC Exemption for ADU applied for: ❑Yes ❑r No Received: Yes ❑No
El Public Facilities Improvement(PFI)Permit:
Required: El Yes,applicant was notified ❑No Applied For: El Yes ❑No,stop intake
❑' Land Use Case#: A+00702t—O4 ElZoning: R"7
❑o Required Setbacks: Front: 8/12 Rear: 10 Side: 3 Street Side: NSA Garage: 20
❑. Building Height: Max.Height: N/A Actual Height: 24.5
❑r Landsca.e Area: 20 % ❑a Lot Coverage Max: 80
Entrance 13 Set back no more than 8'from street-facing wall El Parallel to street or offset 45 degrees or less
Windows Minimum 12%of area of all street-facing facades
Garage 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.
ElGarage door width is 1 12'or less ❑ 50%or less of facade ° 60°/u or less and includes 7 of following:
Covered porch 12 Recessed entrance ❑r Wall offset 1'Roof eave ° Roof offset
Fire shingles ellLap Siding ❑ Ro f,itch El Gable,hi ,or gambrel roof Dormer
_Accent siding IWindow trim L Window recess U Window projection El Balcony
❑r Visual Clearance ❑r Urban Foresta Plan
❑r Sensitive Lands: ❑ Yes El No Type:
❑✓ Conditions met prior to issuance of building permit
Notes:
El Approved By Planning: Date: S//O/Z I
Revisions(after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
f w ,
Building Permit Submittal
Original Submittal Date: S/(Q/2021
Site Plans: # 3
Building Plans: # 3
Building Permit#: Enter buildingbuildingrge9ait#above. �/
Workflow Routing: Planning Engineering Permit Coordinator ' Building
Workflow Sign-off: ign-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: ,S/D�/
Engineering Review
ffi Slope at building pad: ,47%
ErConditions"Met"prior to issuance of building permit M/04.
Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes [ o
Assess Water Quantity Fee in-lieu: ❑ Yes �L_'I�7�-N No
�-�/ LIDA Facility on lot: ElLI Yes No
J Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: .Srm2/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: 0 Approved 0 Not Approved
Permit Coordinator Review
Conditions "Met"prior to issuance of building permit
0 Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
4SDC Exemption: 0 Received Does not a2 ly
DC Fees Entered: Wash Co Trans Dev Tax: Yes N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes ,a'N/A
%OK to Issue Permit
Approved by Permit Coordinator: fT,Oe\--... Date: (11I 200 I
I:\Bui(ding\Forms\BIdgPermitRvw_RES_122419.docx
. . ''
City of Tigard
N .
a COMMUNITY DEVELOPMENT DEPARTMENT
River Terrace Building Permit Review Addendum
TIGARD
Building Permit #: MS"r2c2.1 od/S 3
Site Address: /010 SI&1 )A42..w1kl w= / SF1eekrc0Q, 02 Q-Iy0
Project Name: Polygon at Roshak Ridge Lot #: / C&(p
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.07O.4
Is the project subject to the plan district design standards? ❑Yes CINo (Per MMD2020-00044)
Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additio
ele -nt required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch .. 5 ft. deep Gable. .oorner
ft. deep min. 2ft.,5 ft.wide min. 2 ft.,6ft.wide
I 0 ❑ ❑ 0
2. Eyes on the str- - :a minimum of 12%of each street facing facade must include windows .. entrance doors.
Percentage Shown:
3. Entrances:At least one e ance must meet both of the following standards:
❑Parallel to street, . gle no more than 45° from street,
❑Max. 8 ft. setback from longes treet- facing wall
or open onto por
Entrance opens to a porch: El Yes I o
If yes,all the following apply: El25 sq.ft. .
UOne street facing entry ❑12 f ax.roof above floor of porch
❑5 ft.depth min. ❑3 P/°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 mil. 4 ft.wide
❑Roof eave min. 12 inch projection DR. , 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
0 Accent siding min. 40%of street fa .e ❑Window trim , ' . 2 1/"wide by 5/8"deep
❑Window recess min.3 inches for 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 - :
❑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 r.•age that faces the street with a min. area of 12 sq.ft.
Width- heck one)
I -foot-wide garage door ❑40%max. of street facade
I 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: Date: 3/1/21
1\Building\Farms\BIdgPermiIRvw_RES_RI_121417.docx
Water Meter Fixture Unit Worksheet For New Buildinii ECAVED
Please complete the following information: MAY (' ^ MI
Contractor Name: Polygon Home,WLH LLC Ci Y v
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: 16712 SW Darwin Loop /ADU 1: 16710 SW Darwin Loop
Subdivision Name: Polygon at Roshak Ridge
Lot#: 186
Building Permit#:
Please fill in the number of each fixture as detailed on the plans. Multiply the quantity by the point value
to arrive at the point total. Add all point totals together for total fixture unit points.
Fixture Unit Quantity Point Value Point Total
SFU ADU1 Total
Bar sink x 1 =
Bidet x 1 --
Clothes washer 1 1 2 x 4 = 8
Dishwasher 1 1 2 x 1.5
Hose bib, 1&one 1 3
1 2 =x 2.5 5
Hose bib, each add'i 1 1 2 x 1 = 2
Kitchen sink 1 1 2 x 1.5 = 3
Laundry sink x 1.5 =
Lavatory 4 3 7 x 1 = 7
Water closet, 1.6 GPF 3 2 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:
1to30=5/8" 37.5to89= 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:
liBuilding/Forms/waterMeters_010121 New.dOCX Page 2