Permit ' aCEIVED
Plumbing Permit Application
Building Fixtures 3EP
I al
OF
y / ^n
CityOf Tigard _,I Y Of I Il7flrlD Received f// MST2021-00182
g RecDatetB -( Petmn No.:
l :-+ 13125 SW Hall Blvd.,Tigard,OR 972 r l&' DIVISION Plan Review
Phone: 503.718.2439 Fax 50359 l7 V I Date Brv9/4/A/ 4 G/, Other Permit No.
Inspection Line 503 639 4175
T'IGARU Date Rendy/By: 41/� ` luns ®See Page 2for
Internet www.ngard-or gov /^_i ,r?A
Nonfcdlhicthod: ' S Supplemental Information
TYPE OF WORK -- — ,ll dl. ,j•f'I ,412._. FEE* SCHEDULE ---_
E New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement E Other: I New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION ti I I I 1111 SFR(I)bath 312 70
■ I-anddwelling SFR(2)bath
❑ 2-family' _ ❑Commercial/industrial 437.78
❑Accessory building 0 Multi-family I SFR(3)bath I 500.32
I I Each additional bath/kitphen I 25 02
❑ Master builder 0 Other: I Fire sprinkler(2823 sq_ft.) Page 2
JOB SITE INFORMA"I'JON AND LOCATION I Site utilities:
Job site address:16712 SW Darwin Loop Catch basin or area drain 18.76
I 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 I Manufactured home utilities 50 03
Cross street/directions to job site: I Manholes 18.76
Rain drain connector I 18.76
Sanitary sewer(no.linear ft _) I Page 2
Storm sewer(no linear ft•_) I Page 2
Subdivision Water service(no linear ft.:_) I Page 2
Lot no.:186 I Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK (t It ''`" .,, � Backwater valve 1251
O1 Clothes washer 25.02
MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 2502
Drinking fountain I I 25,02 I
Ejectors/sump I 25.02
® PROPERTY..OWNER I 0 TENANT Expansion tank I 12 51
Name:Taylor Morrison
Fixture/sewer cap I 25 02
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
a r c -E- ,,f-- ':,FAI )J( 2i 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 I Fax:.( ) Tub/shower/shower pan 12.51
E-mail: gavin@allianceplumbing.net Urinal 25.02
:114 t Water closet 25 02
CONTRAC'FOR //
Water heater 37 52
Business name:Alliance Plumbing, LLC
Water piping/DWV 5629
Address:146 W Historic Columbia River Hwy Other: 25 02
City/State/ZIP:Troutdale,OR 97060 Subtotal
Phone:( 503 )492-3490 i Fax ( ) Minimum permit tee: $72 50
CCB Lic.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee)
/�► State surcharge(12%of permit fee)
signature: / -0 / TOTAL PERMIT FEE `. , 915-
Print name:Gavin Thomes I Date:8.25.2021 This permit application expires if a permit Is not obtained within Igo days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I\Building1Pernllls\PLMU-PerautApp doe 1()/111/119 440-451 ST1111/IRICOM/WFB)
■
Plumbing Permit Anolication - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities 11Qty. Fee(ea) Totar I Square Footage: Permit Fee: I
Footing dram-1"100' 50 03 I 0 to 2,000 $121 90
Footing drain-each additional 100' 37 52 12,001 to 3,600 $169.69
13,601 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' 6254 Medical Gas Systems:
Water Service-each additional 100' 3752 I - st ,
¢���t)� ��i� n a. ,i
Storm&Rain Drain-1st 100' 6254 I " 1
I $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
Ot °= i' ` Total ' each additional$100.00 or fraction thereof,to
and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000 00 $14850 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 includitla$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 includiis $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$100.00 or fraction thereof.
Subtotal:
•
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*. Plan Ree .$kit-H`
i Quante y by Fixtur's'type� I Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
I BaQtist y/Font ❑ Any new commercial building with water service 2"and
Bath Tub/Shower greater,except systems designed and stamped by licensed
engineer.
-Jacuzzi/Whirlpool I
ElCar Wash Each Stall New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918-780-0040.
I Cus idor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher -Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918-780-0040.
I Drinking Fountain
I 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 I
-Commercial food related I
-Industrial food related
Ice Mach/Refrig Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station I
Shower: -Gang
-Stall
Sink -Lav/Bar non-food related
-Bradley I
-Com/Serv/Util food related I
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDU5,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'
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2021-00182
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: O6/08/2021
TIGARD Parcel: 2S107AA18600
Jurisdiction: Tigard
Site address: 16712 SW DARWIN LOOP
Subdivision: ROSHAK RIDGE Lot: 186
Project: Polygon at Roshak Ridge, Lot 186 Primary Dwelling
Project Description: New primary dwelling with(1)attached ADU.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 82 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 24.5 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
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckfw 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: 6 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!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+ampNolt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: NI 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 Fire Rated Conditions
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $29,609.00
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 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: ficAly VadvDe/Wege Permittee Signature: O rt.,4ppltca.t& tt
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 Application REGF i: E D 2,-51(0121
Residential FOR OFFICE USE ONLY �f �h{�
City of Tigard MAY j 2021 Received
e r slip 202( PemutNo.:MSM02.1-Qvla2
III *I 13125 SW Hall Blvd.,Tigard,OR 97223 ^I -i r -,- Plan Review Ill,e,h1 /1/1, C W j- 00 2'
II • Phone: 503.718.2439 Fax: 503.598.196P-"I �� i''�a""` Date/By; :J ` rJr1 Other Permit:J W
1 ( 4 H i) Inspection Line: 503.639.4175 3 L11 I.D',N'--. DIVISION Date Read By: ® See Page 2 for
Internet: www.tigard-or.gov Notif..� ethod: 7,4 r�,4 ,�.• co, Supplemental Information
#ii.
TYPE OF WORK REQUIRED 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
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. , I
Valuation: $ r 6 WI-
® 1-and 2-family dwelling ❑Commercial/industrial
ElAccessory building ❑Multi-family Number of bedrooms: 4 •
El builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors:2 ^'� a�'19
Job site address: 16712 SW DARWIN LOOP New dwelling area: ysJ"c o10"'square feet \19
• City/State/ZIP:Sherwood,OR 97140 Garage/carport area: 456 square feet t6�
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridc Covered porch area: square feet
Cross street/directions to job site: Deck area: 116 square feet
er sir turemrea: `tlp square feet
V
RE D DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Polygon at Roshak Ridge 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.
SFU:New home construction Elevation:221100BR/221000BR Stacked Duplex Valuation: $
Type:Duplex(SFU&ADU)_Projected Start:July 2021 Existing building area: square feet
Ceriekt4ly ) 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 510 Occupancy groups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360 946 8674 Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON U9 BUILDING PERMIT FEES*
Business name:Polygon Homes WLH LLC (Pfeete refer mfee achedufe
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) 695-7700 Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Polygon Homes WLH LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:703 Broadway St., Ste 510 Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver, WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( )360 695-7700 Fax:( )360 693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247 //�� ,f/J t f /� Total fee due upon application: $201.60
Authorized signature: (/l4tllil..cY G�Li4ZG.ry eozzl.LLy, 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 Tr-County Building Industry
Service Board.
L\Building'Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(l 1/02/COM/WEB)
[echanical Permit A 11Catio � �� FOR OFFICE USE ONLY
S Received
City of Tigard i'� L�21 Dale/By: PermitNo.:
'I 13125 SW Hall Blvd.,Tigard,OR 97223 MAY r RAT S/to/21 i'�1S'f"2t021—P!J1.8 Z..
. J Plan Review „`n^��t`�Vn`
Phone:III 503.718.2439 Fax: 503.598.1960 DateBy Other Permit:0 l {e`
Y I{?A It 12 Inspection Line: 503.639.4175 CITY Or I I GARD Dale Ready/By: lure: See Page 2 for
Internet: Nww.tigard-or.gov BUILDING nivi yloa,i Notified/Method- Supplemental Information
TYPE OF WORK COMMERCIAL FEE*SCHEDULE USE CHECKLIST
Mechanical permit foes*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY,OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
®1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
I i Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling: 1,
Job site address: 16712 SW DARWIN LOOP
Furrnaacece I conditioning 46.75
Fuo0.000BTU(ducts/veots) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ductslvenu) 54.91
Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
1 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: Polygon at Roshak Ridge Lot no.: 186 Other: _._ 23.32
Other fuel appliances:
Tax map/parcel no.: Water beater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
New construction,new Single Family fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other 23.32
® PROPERTY OWNER • 0 T 'T •
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:( ) Articicrawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:Polygon L11,LLC Fuel piping:
W
S14.15 for first four;54.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
WalVsuspcnded/unit beater
City/State/ZIP: Vancouver,WA 98660 Water beater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Range
E-mail:permitsubmittalstaylormorrison.com t
Barbecue
rat CONTRACTOR Clothes dryer(gas)
I
Business name:Pro Heating Se Cooling Other:
MECHANICAL PERMIT FEES*
Address: NW Alociek Dr,Ste.1104 Subtotal
City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00)
Phone:(360)270-1590 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.:209001 TOTAL PERMIT FEE
This permit application expires 0a permit is not obtained within 180
e.i.,� days after it has been accepted as complete.
Authorized signature: '�' • Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date: 10/30/20
r.\Rr,il.inslDr,nri,slM5C Prow..Ann nMni I t An. nzn nz,n re•0,11 m•,mrcor
Electrical Permit Application 1 r r r, t t, , i t 1 I .I i i„I ,
City of Tigard Recented
Nr c/r o% Perm"a efi3'10-?-Co 1.8 2,
• 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.7182439 Fax: 503.598.1960 HDatels "°�Permit 4 •
10 2.2t 2x-Ub(7�
E,I) Inspection Line: 503.639.4175 ® Se
Ready Date/By- kris: e Ps e 2 ear
Internet: www.tigard-or.gov NmihediMahod. Supplemental ldormNio.
TYPE OF WORK ,_PLAN REVD9i:
®New construction ❑Addition/alteration/replacement Please chi alldne apply(skit a sou of plans w/4is checked):
0 Demolition 0 Other: ❑Service et fader 400 amps or mare ❑Building over three stones.
Were the available fault current ❑Merinos and bamyerde.
CATE(QRY-OF CONSTRUCTION exceeds 10,000 mope at 150 votes or ❑Floating buildings
El 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building lees to grand enunseen ❑Commmcid-see agricultural eaceeds
amps far n as other installations. tmildings-
❑Multi-family 0 Master builder 0 Other: ❑Fire pump. ❑lmtailatina of 150 KVA«
JOB SITE INFORMATION AND LOCATION °Emergency system lard separately demised
Job#: Job site address:16712 SW Darwin LoopCl of new mar load of system.
IDOI1PotMOM, 0"A`,"E-,"1-2^.~1-3-,
City/State/ZIP: Tigard,OR 97140 Clsix or mere residential,aoils Y
❑ltcahh-cnc facilities. ❑RmeaemW vehicle Paulo.
Suite/bldg apt.#: Project name: Polygon al Roshak Ridge ❑Bantams location 0 Supply voltage fa more than
Cross street/directions to job site: 0 Service or feeder 600 saps or more. 600 maks nominal
__ FBF SCULE
Downtime I Otr, I Each I. Teti 1.*,
New residential single-or moth-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: 186 Includes attached garage.
Tax map/parcel if: 1,000 eq.ft or less 168.54 4
Pa add'1500 sq.R.or portion 33.92 1
DESCIW''UOTl OF WORK Limited energy,residential
with above sq.ft) 75.00 2
New construction.Type SFU Limited energy,mtdti•famdy '
residential(with above sq.ft.) 73.00 2
® OWNER M1ER , El TENANT Renewable Energy CI See Page 2 -
Name: Polygon Homes O LLC Services or Rulers installation,alteration,and/or relocation
yg 200 amps or less 100.70 2
Address: 703 Broadway St.,Ste 710 201 amps to 40o amps 133.5E- 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Vancouver,WA 98660
601 amps to 1,000 amps 301.04 2
Phone:( 360 )946 8674 Fax:( ) Over 1,000 amps or volts 552.26 2
emporary E OAlamiAbouhafsgtaylormarrison.coar-PennitSubmittalsQtaylormorrrisott.com Trelocation lea or feeders iblwatton,alteration and/or
mail
Owner installation:This installation is being made on property that I own which is not 200 amps et less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125,08 2
Owner signature:_ _. Date: 401 amps to 599 amps 168-54 2
Branch circuits-new,alien' or extension,per Paso 0 APPLICANT I 0 CONTACT PERSON
Business name: Polygon Homes WI.H LLC A.Fee for above service
or feeder
wide
ce aler foe,
Contact name: Omar AIam1 Abouhafs each branch tweet 7.42 z
B.Fee for branch circuits without
' service or feeder
Address: 703 Broadway St.,Ste 710 brunch circuit fee,fast 56.18 2
City/State:/ZIP: Vancouver,WA 98660 Each add'l branch circuit a2 2
360 946 g6741H1soelanroas(service or feeder mot included)
Phone:
( ) Fax::( ) ._._ Each manufactured or modular 67.84 2
Email:OAlamiAbouhafs@taylormorrison.com-PermilSubmittals@taylormorrwhy
son.com dwelling,a °` ly"nd«feeder
Reconnewl 67.84 2
CONTRACTOR Pomp or erngitiem circle 67.84 2
Business name: Wallace Electric Sip or outline lighting 67.84 2
Address: 1 OS Dresden St Signed eittnit(s)or luailed energy In Set Page 2 2
panel,alteration,or extension_
City/SateJZIP: Astoria OR 97103 Each addit oral inspection over allowable In any of the above
Additional inspection(1 hrmin) 6625/hr
Phone:(503 3lia 0563 Fax:( ) Investigation(I hr min) 90.00/hr
Email: Davidgwallacewires.com Industrial plant(l lu min) 78.I8(ltr
Inspections for which no fee is
CCB Lic.;224868 i Electrical Li- C1441 Su rv.I ' 6363S specifically listed(S ter min)
.' ELECTRICAL PERMIT FEES :
Suprv.Electrician signature,required: — Subtotal-
Print name:•J /p [G Date: if lL/y i ❑Plan Review Required(2591,of permit foe):
Tr l State surcharge(12%of permit fee):
Authorized signature .• l��� c TOTAL PERMIT FlEL:
e This permit applicetieu expires If e remit is net Ataiacd within Igo
Print name: jp,141fL1rt 4 Date: zi / 7.f days after Ithasm a bees aepeed as complete.
•`sat" frl * thud=ofmopectioos allowed per permit.
imuita pramit6OE_PenmtApp}I.R ERE.doc pen 06117/1013 elL I ST(11/05/COif+a'EB
4umbing Permit Application
Building Fixtures R p rtserFh�g n,; FOR OFFICE USE ONLY
City of Tigard R"`i"`d Pen nit No.: (�t7?R O O
q 13125 SW Hall Blvd.,Tigard,OR 97223 P: Da a By: SI�D�Z �� MS
Plan Review Other Permit No.:
Mill
Phone 503.7182439 Fax: 503 598.1960 Da e/By 207i‘ WI
TICARD Inspection Line: 503.639.4175 C{j Y O� I i i: , 'i-) Date Ready/By: lulls: El Sec Page 2 for
Internet: www•tigard-or.gov =_7 r "1(' r?i?/Ir;!,,-. ; Notified/Method: Supplemental Information
TYPE OF WORK FEE' SCHEDULE
183 New construction ■ a Alition For special htformution use checklist.
Description I Qty. I Ea. I Total
■ - - ■ Other: New 1-I-family dwellings(jocludes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
��
1.7g 1-and 2-family dwelling IDCommercial/industrial SFR(2)bath 437.78
` SFR(3)bath 500.32
❑Accessory building 4E-Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16712 SW DARWIN LOOP Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:'Tigard,OR 97224
Footing drain(no.linear ft.: ) Page2
Suite.bldg./apt.no.: I Project name:_aahaieliirlpapolygon 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: 4 r' Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION a a•
Backwater valve 12.51
Clothes washer 25.02
New construction
• Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
_4 PROPERTYOVVNER ■ TENAmr Expansion tank 12.51
1 Fixture/sewer cap 25.02
Name:Polygon WLH,LLC
Floor drain/floor sink/hub 25.02
Address:703 Broadway
Garbage disposal 25.02
• t I Hose bib
t
IJ Ice maker 12.51
r_ APPLICANT ■ CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Tonja Morris
Roof drain(commercial) 12.51
• 703 Broadway St.,Ste 510
Sink/basin/lavatory 25.02
PVancouver, ..t Solar units(potable water) 62.54
• •i ,• l i I Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:permitsubmittals@polygonhomes.com
Water closet 25.02
CONTRACTOR
Water beater 37.52
Plumbing Sons IncWater piping/DWV 56.29
•• P.O. Other: 25.02
City/State/ZIP:St.Panl,OR 97137 Subtotal
Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:184372 Plumbing Lic.no.:pb634
State surcharge(12%of permit fee)
Authorized signature: �e t J `� TOTAL PERMIT FEE
Print name:Steve Fowler Date: 0/30/20 This permit application expires if a permit is not obtained within 180 days
after It has been accepted as complete.
'Fee methodology set by Tn•County Building Industry Service Board.
I:1BuildiegtPermits`FL$IU-PemdtApp.doe IO.OL09 4404616T(t0e1ICOM•WEB)
City of Tigard
p
ICOMMUNITY DEVELOPMENT DEPARTMENT
3 •
TIGARD Building Permit Review — Residential
Building Permit #: (1/IS-r.Q2l- co I g'2
Site Address: 16712 SW Darwin Loop, Sherwood, OR 97140
Project Name: Polygon at Roshak Ridge Lot #: 186
Planning Review
Proposal: New detached dwelling
0 Verify address/suite#active in Accela. 0 In River Terrace: ❑ No 0 Yes, River Terrace Review Addendum
Site Plan Elements: ' rosion Control
Di copies of site plan on 8-1/2"x 11"or 11 x 17"paper NiPr etained trees with drip line and tree protection measures
0 prawn to scale(standard architect or engineer scale) v ootprint of new structure(including decks)and FFE
0 orth arrow ° tility locations&easements(required for new and additions)
IS address,project or subdivision name and lot number 1 idewalk/driveway approach
ell pplicant information(name and phone number) wi ocation of wells/septic systems
Q .t dimensions and building setback dimensions ° treet tree size,type and location
aii, II..uare footage of buildings to be demolished 'treet names
V xisting structures on site ' orner elevations (2'contours if more than 4'differential�
12 .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 r o
ElClean Water Services-Service Provider Letter (lot platted prior to 9/10/1995):
Required: El Yes,applicant was notified El No Received: ❑Yes 0 No
El Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs
Required: El Yes,applicant was notified ❑No Received: H Yes ❑No
IDSDC Exemption for ADU applied for: ❑Yes 0 No Received: Yes ❑No
0 Public Facilities Improvement(PF1)Permit:
Required: El Yes,applicant was notified
❑ No Applied For: 0 Yes ❑No,stop intake
0 Land Use Case#: SVe>2-0tS—O000 0 Zoning: R"7
ElRequired Setbacks: Front: 8/12 Rear: 10 Side: 3 Street Side: N/A Garage: 20
El Building Height: Max.Height: N/A Actual Height: 24.5
0 Landsca se Area: 20 % El Lot Coverage Max: 80 %
Entrance 0 Set back no more than 8'from street-facing wall 0 Parallel to street or offset 45 degrees or less
Windows 0 Minimum 12%of area of all street-facing facades
Garage Q 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. dow above garage on 2"floor.
0 Gara door width is 112'or less ❑ 50%or less of facade � 60%or less and includes 7 of following:
Covered porch 0 Recessed entrance 0 Wall offset I:' 1'Roof eave ° Roof offset
Fire shingles 0 Lap Siding ❑Roof itch 0 Gable,hi ,or gambrel roof e Dormer
Accent siding Window trim Window recess Window projection El Balcony
0 Visual Clearance 0 Urban ForestrcPlan
ElSensitive Lands: ❑ Yes Ill No Type:
0 Conditions met prior to issuance of building permit
Notes:
El Approved By Planning: Date: s//o/Z/
Revisions (after Building Submittal o y) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Fomis1B Idg PermitRvw_RE S_1224 19.docx
A
Building Permit Submittal
Original Submittal Date:
Site Plans: #
Building Plans:
Building Permit#: ❑ Enter building]permit#above.
Workflow Routing: ❑ Planning LI Engineering ❑ Permit Coordinator ❑ 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.
ElBuilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date:
Engineering Review
lope at building pad: 2.21
E Conditions "Met"prior to issuance of building permit it,l/=
C7 Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes No
Assess Water Quantity Fee in-lieu: ❑ Yes o
�/ LIDA Facility on lot: ❑ Yes No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: S7U?2C=Zl
Revisions(after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
2'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:
gSDC Exemption: ❑ Received Does not ai ly
'SDC Fees Entered: Wash Co Trans Dev Tax: Yes J N/A
Tigard Trans SDC: jaCiies ❑ N/A
Parks SDC: 2.Yes ❑�- N/A y
LIDA ❑ Yes �I N/A
0 OK to Issue Permit
Approved by Permit Coordinator: Date: 5'u(2421
1:\Bui(ding\Forms\BldgPermitRvw_RES 122419.docx
A
City of Tigard
° COMMUNITY DEVELOPMENT DEPARTMENT
C
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: r O21-CO It 2
Site Address: 104l2 SWrDAP J1$1141 SBeep, tiP
Project Name: Polygon at Roshak Ridge Lot #: f 8(0
(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 QNo (Per MMD2020-00044)
• iculation: 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
■ 0 ❑ 0 ❑
2. Eyes on the s. - • : a minimum of 12%of each street facing facade must include windows • entrance doors.
Percentage Shown:
3. Entrances:At least one - ance must meet both of the following standards:
❑Parallel to street, . gle no more than 45°from street,
❑Max. 8 ft. setback from longes treet-facing wall
or open onto pot .
Entrance opens to a porch: ❑Yes II o
IfUes,all the following apply: ❑25 sq.ft.
One street facing entry ❑12 f ax.roof above floor of porch
❑5 ft. depth min. ❑3. /o min. e porch roof coverage
g
4.Detailed Design:All buildings shall include a min. o v- of the following elements on all street-facing facades:
O Covered porch min. 5 ft.wide x 5 ft. deep II Recessed entry area min. 5 ft.wide x 2 ft.deep
❑Wall offset min. 16 inches I P oomer min.4 ft.wide
0 Roof eave min. 12 inch projection ❑R. offset min.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
❑Accent siding min. 40%of street fa .e ❑Window trim • . . 2 '/a"wide by 5/8"deep
❑Window recess min. 3 inches for .l street facing ❑Bay window min. ft.wide by 2 ft. deep
❑Balcony min. 5 ft.wide x 3 ft. .eep with inside access ❑Attached garage is 3 'o or less of street facade
5. Garages and Carports: 'ay face the front or side lot line on a corner lot.
Setbacks:
No closer to front o ide lot line,than longest street-facing wall. ❑Yes ❑No. If No (Check o - :
0 May extend u. 0 5 ft.if there is a covered front porch and garage does not extend beyond the fro • .orch.
❑May eaten. p to 5 ft.where the garage is part of a two-story building and there is a window at the se • d story
above the age that faces the street with a min. area of 12 sq.ft.
Width• heck one)
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
I.\BuildingUForms\BldgPormitRvw_RES_RT_121417docx
Water Meter Fixture Unit Worksheet For New Buildings C:c (V E
Please complete the following information: MAY 0 j 2021
Contractor Name: Polygon Home,WLH LLC CITY Or i IGARD
BUILDING DIVISION
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 1
SFU ADUI Total
Bar sink x 1 =
Bidet x 1 _—
Clothes washer 1 1 2 x 4 = 8
Dishwasher 1 1 2 x 1.5 = 3
Hose bib, lgi one 1 1 2 x 2.5 = 5
Hose bib, each add'l 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:
1 to 30=5/8" 37.5 to 89 = 1"
30.5 to 37=3/4"
Meter Size: Meter Cost: $ 24,886.00
*************************************************************************************
FOR OFFICE USE ONLY
Fixture Units Points verified with
Building (Master)Permit or Plumbing ❑Yes ❑ No ❑ Other:
Meter#: Sale Date:
Receipt#: Meter Cost:
Employee Name:
1:/Building/Forrns/WaterMeters_010121_New.dOCX Page 2