Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2021-00227
Date Issued: 07/19/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S107AA16300
Jurisdiction: Tigard
Site address: 16589 SW TOWNSVILLE ST
Subdivision: ROSHAK RIDGE Lot: 163
Project: Polygon at Roshak Ridge, Lot 163
Project Description: New detached dwelling
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 5 First: 1238 sf Basement: 763 sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 4 Second: 1718 sf Garage: 486 sf Front: 8 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 3719 sf Value: $481,993.74 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals; 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
4 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Tubs/Showers: Garbage Disp:
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 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<10OK: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Fum>=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: 7 201-400 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 SF VB R-3 3719
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 Geo Tech Report Required
Prior To Pour
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $46,826.40
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work Is suspended for more
the 180 days. ATTENTION: Oregon I requires you to f w the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
Q69_nM_nnin fhrni,nh Q69 ni_n Yrn mm, fain nnv of fhn n,lne nr dirorf mmeflnne In(II!Nr h„Tallinn cm 9 9 1QR7r11 soon,119?Add
Issued By: Permittee Signature: !it .4... v ,94.°� �_
Call 503.639.4175 by 7:0D a.m.for the next available inspection date. �(�
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the lob site at the time of each inspection.
Mechanical Permit ApplicatioiRECEIVE ! FOR O>Ft l SE,ONLY
t'lReceived
City of Tigard
Date/By: PermitNo.:I�ST2021-002.2y
t _
° 13125 SW Hall Blvd.,Tigard,OR 97223 J U N 0 9 2021 Ptao Review //
— Phone: 503.718.2439 Fax: 503398.1960 Other Permit:
Inspection Line: 503.639.4175 DateJBy.
YIZrfJtl� CITY OF TIGARD Date Ready/By; Junin 21 See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISIO,Notified/Metlsod: Supplemental information
TYPE OF WORK �I COMMERCIAL FEE' SCHEDULE -USE CHECKLIST
Mechanical permit fees`arc based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$
. maw-nut.EQUIPMENT!SYSTEMS FEES'.
®I-and 2-family dwelling ❑Commercial/industrial El Accessory building For special information use checklist
I i Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 16589 SW TOWNSVILLE ST Furnace iog,o00 BTU(dnctswews) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(drrtdvents) 54.91
Heat pump 61.06
Suite/bldg./apt no.: Project name: Polygon at Roshak Ridge Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32 _
Subdivision: Polygon at Roshak Ridge Lot no.: 163 Odic 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/based 33.39
New SFU type constructionFlue vent for water heater or gas
fueplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 2332
Chimney/liner/flue/vent 23.32
EaPROPERTY 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/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32
APPLICANT ❑ CONTACT PERSON Other. 23.32
Business name:Polygon WLH,LLC Fuel piping:
S14.15 for first four;$4.03 for each additional
Contact name:Tonj a Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gera beat pump
Wall/suspendedhmlt beater
City/State/ZIP:Vancouver,WA 98660 Water beater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Range
E-mail:permitsubmittals(taylOrmorrison.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Pro Heating&Coaling Other
MECHANICAL PERMIT FEES'
Address: NW Alociek Dr,Ste.1104
Subtotal
City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee)
CCB lie.:209001 TOTAL PERMIT FEE
[` ( This permit application expires if a permit is not obtained within 180
/ A: 1\u�, J days after it has been accepted as complete.
Authorized signature: t.i LL .J • Fec methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date 10/30/20
r-1A,ilAn APnmircidUr D...,nn s.,,,rum I a Any
Electrical Permit Application c FOR OFFICE USE ONLY
City of Tigardater_fl LiLI V �r � Permit {STZ021-001.1
P3125 SWly .503 718,24 9 l Blvd.,Tigard,
FFM: 503.598.1960 J U N 0 9 2021 1 nit „W
v. Related Permit 4.
Inspection Line: 503.639.4175 Readynalaisy reels: Bl see Pare 2 for
Internet: ww-hg gov CITY OF I I G A R D Notifed/Idahod. Supplemental Information
TYPE OF w0JILD!NG DIVISION
PLAN'REVIEW
®New construction ❑Additionialteratiom/replacement Please cheek all Mai apply(submit a sets of plans whims ellerIced).
❑Demolition 0 Other: 0 Sassce or feeder 400 amps a more 0 Bedding over three stones.
whore CATEGORY OF CONSTRUCTION eaem&Ilse sun current 0 Marinas and boatyards
amps at IStI volts or 0 1'Yuating Mtiltlmpp
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building lei to mound,or exceeds 14.000 0 Commercial-ass agriaaltur,d
for❑Multi-family 0 Master builder ❑Otheramps Fire
other msmilit ens b liats.
Cl❑Fire poommp. 0 Inslatatlatinn of 150 KVA or
- JOB.SITE INFORMATION AND LOCATION Cl Emergency system larger separately dcaved
Job#: Job site address:16589 SW TOWNSVILLE ST ❑ 001Ta more. eor&adof swum
r00IIp of more. ❑"A"'E-"!2""I-3"
City/State/EX: Tigard,OR 97140 ❑Six or more residential routs occupancy
❑Healthcare facilities. ❑Recreational veh,cle parks.
Suite/bldglapt.#: Project name: Polygon at Roshak Ridge 0 rra&trdnn5 locatrnta 0 Supply voltage for more than
0 Service or feeder 600 maps or more 6010 volts nominal.
Crass sweet/directions to job site: FEE SCHEDULE
..m aarrbasa 1 Qt. I Each J We I -
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: 163 includes attached garage.
Tax rnap/parcel#: r,WO sq.f,or]ass 166.54 4
Ea,add'1500 sq.tt or cortex 33.92 I
�_. DESCRIPTION OF WORK Limited energy,resitkutia'
with above 75.00 2
New construction.Type SFU Limited sq.lt) •
enngy,multi-family 75.00 2
residential(with above sq.ft)
Renewable Energy 0 Sec Page 2
III PROPERTY OWNER ❑ TENANT Services or feeders installatIoa,alteration,and/or relocation
Name: Polygon Homes WLHLLC 200 amps or leas 100.70 2
Address: 703 Broadway St.,Ste 710 201 amps to 400 amps 13356 2
401 amps to 600 amps 200.34 2
City/Stale/ZIP! Vancouver,WA 98660
601 amps to 1,000 amps 301.04 2
Phone:(360 )946 8674 I Fax:( ) Over 1,000 amps or robs 55226 2
Temporary services or faders installation,alteration,and/or
Email: 0AlamiAbouhafs@taylormorrison.com-PamitSubmittais®taylormerrison.com relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps In 400 amps 125 08 2
Owner signature: Date: 401 alms to 599 amps 168 54 2
El
APPLICANT I 0 CONTACT FERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Polygon Homes W1.H LLC above service or fender fee, 7.42
circuit each branch circuit
Contact name: Omar Alami Abouhafa B.Fee for branch circuits without
service ar feeder fee,fast
Address: 703 Broadway St.,Ste 7 t0 56.18 2
branch circuit
City/Stale/ZIP:Vancouver,WA 98660 Each add'!branch cumin 7.42 1 2
Phone: 360 946 8674 Miscellaneous(service or feeder not included)
{ ) Fax ( ) Each manufactured or modular 67.84 2
Email:OAlamiAbouhafs lormorrison.com-PetmitSubmittal dwelling,service andJor fender
to
Y PermitSubmittals@taylormorrison.com Reconnect only 67 84 2
CONTRACTOR Pump or arigattton circle 67 84 2
Business name: Wear,.Electric Sign or outline lighting 67.81 2
Signal cirs-tints)or limited-campy
Address: 105 Dresden St panel,a ❑ ire Page 2 2alteration, cxt orrnsiw.
City/State/ZIP' Astoria OR 97103 ,Each additional inspection over allowable In any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(503 3►8 0563 Fax:( ) Investigation(I br min) 90.00/hr
Email'David@wallaccwires.com Industrial plant(1 hr min) 78.18/hr
CCB Lic.:224868 Inspections for which no fee is
specifically listed t'h br min 00.00/hr
FJecuicalLi - C1441 Su 'v. l: G3635 )
Suprv.Electrician signature,required: EI EC R[CAG PERtIff total- 9 `
_ '^ Subtom17
Print name:' 4p Date: tit//Z 1 0 Plan Review Required(25%of permit they:
/ State nacharge(12%of permit fee):.
Authorized signature TOTAL PERMIT ME:
This permit appliestien expires If a permit Is nut obtained within 1S0
Print name: e r aiv. y.rK Date: Lit/ f I days after It has been accepted as complete.
wV�*'a�- L z. f Number of taspeebmrs allowed per permit.
1ss.isths s'rnentac PmnaApp_an Virden her 06f17/2015 1151(1 IN5/COMMEn
- , •Plumbing Permit Application RECEIV
Building Fixtures FOR OFFICE USE ONLY
City of Tigard JUN 0 9 2021 Datc/B d Permit No.:MS 12021-0022_7
't 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Rev
Phone: 503.7182439 Fax: 503.598.1960CITY Plan Review
IA ® OF T(UARQ Date/By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISIOI Ready/By: furls: 10 Sec Paget for
Internet: www.tigard-or.gov otifted/Method: Supplemental Information
TYPE OF WORK FEE' SCHEDULE
®New construction ❑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 II.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
buildingSFR(3)bath 50032
❑Accessory II-Multi-family
Each additional bathllcitchen 25.02
❑Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16589 SW TOWNSVILLE ST Catch basin or area drain 18.76
City/State/Z1P:Tigard,OR 97224 Drywell,leach line,or trench drain18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:nashallatikaPolygon 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 R:-) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision:i Polygon at Roshak Ridge Lot no.: 163 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New SFU type construction
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:Polygon WLH,LLC Fixlure'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 lnterceptor/greasetrap 25.02
Business name:Polygon WLH,LLC Medical gas(value:S_) Page 2
Primer 12.51
Contact name:Tonja Morris •
Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
E-mail:permitsubmittals(ipolygonbomes.cam Urinal 25.02
CONTRACTOR Water closet 25,02
Water heater 37.52
Business name:G&B Plumbing&Sons Inc Waterpiping/DWV 56.29
Address:P.O.Box 92 Other 25.02
City/State/ZIP:SL Paul,OR 97137 Subtotal
Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: S72.50
CCB Lic.:184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: , ,tj�, TOTAL PERMIT FEE
Print name:Steve Fowler Date: 10/30/20 This penult application expires tie permit is not obtained within 150 days
after It has been accepted as complete.
'Fee methodology set by Tri-County Building industry Service Board.
IlBnildiog`PermicuiPLMU-PewtApp.doc 10/1/09 440.461611 IM2/COM/WEB)
City of Tigard
liCOMMUNITY DEVELOPMENT DEPARTMENT
C
IGARD Building Permit Review — Residential
Building Permit #: //15T2021-60227
Site Address: / rc 9 SW Townsville Street
Project Name: Polygon at Roshak Ridge Lot #: /&5
Planning Review
P6posal: New single detached house In /
Verify address/suite #active in Accela. River Te ace: ❑ No LyYes,River Terrace Review Addendum
S. - Plan Elements: r ion Control
opies of site plan on 8-1/2"x 11"or 11 x 17"paper ained trees with drip line and tree protection measures
awn to scale(standard architect or engineer scale) otprint of new structure(including decks)and FFE
N•rth arrow ty locations&easements(required for new and additions)
I'ite address,project or subdivision name and lot number • alk/driveway approach
1,pplicant information(name and phone number) c tion of wells/septic systems
A •t dimensions and building setback dimensions eet tree size,type and location
\I41.. are footage of buildings to be demolished eet names
I,..sting structures on site orner elevations (2'contours if more than 4'diffe -ntia
•t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replace.? MI, es o
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown �i t es o
0 Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑Yes,applicant was notified ❑ No Received: El Yes CI No
op El Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑Yes,applicant was notified ❑ No Received: 0 Yes ❑ No
0 rg
DC Exempti n for ADU applied for: ❑Yes CINo Received: ❑Y s 11 No
EePublic Facili Improvement(PFI)Permit:
equired: Yes,applicant was notified ❑Noit
1p ed For: Yes ❑ No,stop intake
i7( d Use Case#: SUB2015-00004 Zoning. `i c.-- e'3---
•uired Setbacks: Front: 8 Rear: 10 Side: 3 Street Side: Garage: 20
•uilding Height: Max. Height: N/A Actual H '•ht:
Landsca•e Area: 0 % Lot Coverage Max: ' •.
Entrance i - . ck no more than 8'from street-facing wall Parallel : eet or offset 45 degrees or less
Windows I Minimum ' . • area of all street-facing facades
Garage I Gara door is behin. " . street-facing wall 111 Yes ❑No,one of the following is met:
Door extends no more than .• wa • there is a covered porch extending beyond garage.
Door extends no more than 5' •. wa I . _ ere is a 12 sq ft.window above garage on 2°d floor.
0 Gara!- door width is I 1 ' .r ess ❑ 50%or less o : .•e I 60%or less and includes 7 of following:
i
I Covered pore 2 Recessed entrance ❑Wall offset I ' 'oof eave Roof offset
I Fire s• -yes I Lap Siding 0 Roof itch ❑ Gable,hi ,or •. . roof Dormer
I ccent siding I Window trim 11 Window recess U Window projecvo ❑ Balcony
II Visual Cle.ranee P. Urban Fores 1an
II ensitive Lands: ❑ Yes No Type:
Lid Co itions met prior to issuance of building permit
No s:
Approved By Planning: "' Date: .2
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
1:1Build ing\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: O(�o97oV
Site Plans: # 3
Building Plans: # 3
Building Permit#: Enter building pe [rmit#above. �y
Workflow Routing: Er-Planning 1. --Engineering Permit Coordinator Building
Workflow Sign-off: Er-Sign-off for Planning(include notes from planning review)
Route Application Documents: Q'Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Building: original permit application, site plans,building plans,engineer and
beam calculations and • st details,if applicable, etc.
Notes: // i
By Permit Technician: r ,/fff r' Date: 8I,//�,�Z011
Engineering Review
S5-2Sllope at building pad: /S
�'conditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 2� No
y
Assess Water Quantity Fee in-lieu: ❑ Yes L'7 No
LIDA Facility on lot: ❑ Yes 12-No
E�/
rinal Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: /Y,$ii f- ¢3 Date: 4,1/7/202/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Permit Coordinator Review
gConditions "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:
ti i DC Exemption: ❑ Received Does not a5 ly
VI SDC Fees Entered: Wash Co Trans Dev Tax: Yes J N/A
Tigard Trans SDC: es ❑ N/A
7 Parks SDC: ❑kl/A
0(7
Yes
LIDA ❑ Yes ki N/A
OK to Issue Permit
Approved by Permit Coordinator: ---"'" ;:``"v Date: ec/9/-2'r
1:1Bu ilding\Forms\BldgPermitRvw_RES_122419.docx