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Permit
Plumbing Permit Application Building Fixtures RECEIVE City of Tigard Received 13125 SW Hall Blvd.,Tigard,OR 97223 NOVy q Date/By: /r/-{ -- Permit No.: MST2021-00423 Phone: 503.718.2439 Fax: 503.598.1960 Y 9 2021 Plan Review /- Date/By: L' f/ 42) �- Other Permit Ni.: T It,A R D Inspection Line: 503.639.4175 Date Ready/By: luris: H See Page 2 for Internet. www.tigard-or goy CITY OF TIGARC Notified/Method: Supplemental Information TYPE;OF '° BUILDING DIVISION FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist. 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(1)bath 312.70 Q 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler(2023sq.ft.) Page 2 " ' JOB SITE INFORMATION AND, LOCA O Site utilities: Job site address:16658 SW Townsville St. ,1a Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard,OR 97224 ) ,ffi, Page drain(no.linear ft.:_) Pa e 2 Suite/bldg./apt.no.: ( Project name: P. r..n 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: Lot no.:217-SFU Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER 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 ) 695-7700 Fax:( ) Ice maker 12.51 0 APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02 Business name:Alliance Plumbing, LLC Medical gas(value.$ ) Page 2 Primer 12.51 Contact name:Gavin Thomes Roof drain(commercial) 12.51 Address:146 W Historic Columbia River Hwy Sink/basin/lavatory 25.02 City/State/ZIP:Troutdale,OR 97060 Solar units(potable water) 62.54 Phone:( 503)577-6535 Fax: :( ) Tub/shower/shower pan 12.51 E-mail: gavin@allianceplumbing.net Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business 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 - Plan review (25%of permit fee) CCB Lie.:184601 Plumbing Lic.no.:PB732 { State surcharge(12%of permit fee) Authorized signature: �j� ��( TOTAL PERMIT FEE Print name:Gavin Thomes Date:tt/Si 2021 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:V Building A Permits VPLMU-PermitApp.doc 10/01/009 440-4616T(I 0/112/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee tea} Total Square Footage:. Permit Fee: Footing drain-l"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 Vatluati©tt. Permit Fees Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for aneeti+�111s; o F, Qty. Fee{e } 'llYrtal each additional$100.00 or fraction thereof,to In and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000,00 and$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 Pllumbin Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate 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 Car DCar Wash: -Each Stall New exterior plumbing site utilities for any complex structure Drive Thru as defined in OAR918-780-0040. Cuspidor/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. 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: -Lay/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: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 _ CITY OF TIGARD MASTER PERMIT `' I COMMUNITY DEVELOPMENT Permit#: MST2021-00423 TIGARD 13125 SW Hall Blvd,Tigard OR 97223 503.718.2439 Date Issued: 11/10/2021 Parcel: 2S 107AA21700 Jurisdiction: Tigard Site address: 16658 SW TOWNSVILLE ST Subdivision: ROSHAK RIDGE Lot: 217 Project: Polygon at Roshak Ridge, Lot 217-Primary Project Description: New primary dwelling with(1)attached ADU. NO FINAL INSP UNTIL DEFERRED SDCs ARE PAID BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 82 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 24 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: $293,700.62 Rear: 10 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 LaundryTrays: 0 Y Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Bckflw Prevntr: 0 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+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 2023 Owner: Contractor: TAYLOR MORRISON NORTHWEST 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: $22,861.85 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 Qc9-not-nnin thrni inh nAP oc9-nn1_nngn Vnu mw nhfnin=rnnv of fha ndac nr rlirart ni iacfinne 1n ni iMC by rollinn 5n'l 9Z9 11,00"R,77�nr 1 Ann 717 9744 Issued By: HOUAJim V '1 t We9e- Permittee Signature: 0t'�'App-1.,^c" -fi-0- t 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 Applicationor- f.Zi • Ll2- Residential RECEIVED FOR OFFICE (SE ONEI City of Tigard Received V 2021 �(ST2021—U(423 .14 Date/By: Permit No.: • 13125 SW Hall Blvd.,Tigard,OR 97223 iew f n �a� 2 i tJ )2&i Phone: 503.718.2439 Fax: 503.598.1960 S E P 2 2021 Plan DateBRevy: 0 1 Other Pe l'1CiAKU Inspection Line: 503.639.4175 CITY OF TIUA D DateReady/By: *m�" 0 SeePage2for Internet: www.tigard-or.gov otifiedmtethod / ( Supplemental Information BUILDING DIVISION TYPE OF WORK REQUIRED TA:1-AND 2-FAMILY DWELLING ®New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® 1-and 2-family dwelling ElCommercial/industrial Valuation: $ a�3'� �� ❑Accessory building 0 Multi-family Number of bedrooms: 4 ❑Master builder El Other: Number of bathrooms:3 JOB SITE INFORMATION AND LOCATION Total number of floors:2 7((_7 1 Job site address: 16658 SW TOWNSVILLE ST New dwelling area: 2,023 square feet 1 City/State/ZIP:Sherwood, OR 97140 Garage/carport area Ll square feet (62 Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: square feet Cross street/directions to job site: Deck area: 1(N square feet Otln Mks ""v\Qt L 4 square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Polygon at Roshak Ridge I Lot no.: 217 Permit fees*are based on the value of the work performed. Tax map/parcel no.: PO t,/` � Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF RK work indicated on this application. $FU:New home construction Elevation:221100A/221000A Duplex Valuation: $ Type:Duplex_Projected Start:November 2021 Existing building area: square feet ?feost d4eA. C PC Poo on 0 BCfupvltL 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: El APPLICANT 0 CONTACT PERSON CIO BUILDING PERMIT FEES* Business name:Polygon Homes WLH LLC (Please refer to feeschedula) 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 Phone:(360) 695-7700 Fax::( ) Amount received: E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic 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 D �/` /_ Total fee due upon application: $201.60 Authorized signature: £2ht44 41a.hto,rY p'tgz�/►azie- This permit application expires if a permit is not obtaine �� within 180 days after it has been accepted as comple+ Print name:Omar Alami Abouhafs Date: 09/17/2021 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit kpplicai. F■ � � ' FOR OFFICE USE ONLY City of TigardLIVED Received ST ZI -604,23 q Date/By: Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503.r S 18.2439 Fax: 503.598.I960 2021 flee Review E P 2 IJafc(By: Other Permit: tltrhhl} Inspection Line: 503.639.4175 Date ftcady,By maxis Internet: uww.tigard ar.gov H See Page 2 for CITY OF Y IGAtRD Notified/Method Supplemental Information BUILDING fMSION TYPE OF WORK COhIri1ERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction 0 Additiotvalteration/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:S RESIDENTIAL EQUIPMENT/SYSTEMS FEES* • 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building _ For special information use checklist I j Multi-family ❑Master builder ❑Other: Description Qty. Ea.--I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: 16658 SW TOWNSVILLE ST Air conditional46.75 Furnace 100,000 BTU(duce/vents 46,75 Furnace 100 000+BTU(ducts/vents) 54.91 City/State/UP:Tigard,OR 97224 Suite/bldg./apt,no.: Project name: Polygon at Roshak Ridge Heat puma 61.06 Duct work 23.32 Cross street/directions to job site: Hydronic hot water system _ 23.32 Residential boiler(radiator or hvdronic) 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.: 217 Other 23.32___ Other fuel appliances: Tax map/parcel no.: Water heater 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 2332 Chimney/liner/flue/vent 23.32 ® PROPERTYOWNER ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name:Polygon FVLH,LLC Range hood/other kitchen _.._..._—.. equipment Address:703 Broadway St.,Ste.510 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/crawlsnace fans 23,32 ® APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name:Polygon W'LH,LLC !Bel piping: S14.15 for first four:54.03 for each additional Contact name:Tonja Morris Furnace,etc. Address:703 Broadway SL,Ste 510 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace Range E-mail:permitsubmittalsg.taylorfilorriSon.com Barbecue 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(590.00) Plan review(25%of permit fee)Phone:(360)270-1590 Fax:( ) CCB lie.:209001 State surcharge(12%of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within ISO .�(L 1(.t- 1 days after it has been accepted as complete. Authorized signature Fee methodology set by Tri-County Building Indnscy Service Board Print name:Elia Duran � °ate: 10/30/20 f\Roilrimo1Perrnir6Mri POrm:r Ann!Wall;Anr Electrical Permit Applica i^ Li V I(Ill(11'I U I I ,1 t,,, , City of III • 13125 SW Hall Blvd.,Tigard,OR 972 E Dart By Permit N. Sf 1 2-3 y Phone: 503.718.2439 Fax 503-59$.1 Plan Review J .. OF 1 IGARD D.,Ready haea.d *. hispedian Iarte iO3-639.4175 k.£.# _. . . I;t.,.•.h.U Internet: www.tig[rd.ar.gov BUILDING DIVISION . '"" ranee meal for Supplemental Irronr.Aor TYPE OF WORK ®New construction ❑Addition/alteration/replacement Please check all that apply submit2�f plans whams checked): El or feeder 400 amps a mete ❑Building over three stones. ❑Demolition ❑Other: where ttt;a.ailebk fault current a Mariam and boatyards CATEGORY OF CONSTRUCTION rowed"10,000 amps at ISO wen or ❑Flo.tirg buildings ®I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building lei to ground,or exceeds 14,000 ❑Cemaserciai-sae agnvul ural ❑Multi-family ❑Master builder ❑Other: ❑amps for all other installations mammas Fire pomp ❑Installation of 150KVA m JOB SITE INFORMATION AND LOCATION ['Emergency system larger separately d derived Job#: 1 Job site address:16658 SW TOWNSVILLE St ❑Additinnor new motor load nf system worm or more. O"A',-6","1-2"."1-3", City/State/ZIP: Tigard,OR 97140 ❑six at mom resuienual,ants occupancy Suite/bltigJapt#: Pro ect name: Polygon ❑1lesah-care facilities. ❑Supply tonal.ebick parks. J at Roshak Ridge ❑hazardous letanra,r 0 Supply voltage for more din Cross street/directions to job site: ❑Service or tee-,ore amps or more 6410 volts sonunal. FEE SCHEDULE owariseim 1 on I YAM 1 Total I r Subdivision:Polygon at Roshak Ridge New residential single-or multi-fnmuy dwelling anti. Lot#: 217 laelydes attached garage. Tax map/parcel#: 1,000 sq.ft cams 168 54 4 DESCRIPTION OF WORK Ea. 500 sq.ft or portion 33.92 1 Limited energy,residential 75.00 2 New construction.Type SFU (wide above sq.ft) ... Limited energy,multifamily residential(with above sq.ft.) 75.00 2 DI PROPERTY OWNER i 0 TENANT Renewable Energy 0 See Page 2 Name: Polygon Homes WLH LLC Servic200 am or faders installation,alteration,and/or relocation 200 amps or leas 100.70 2 Address: 703 Broadway St Ste 710 201 amps to 400 amps 133.56 2 City/State/ZIP: Vancouver,WA 98660 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:(360 )946 8674 I Fax:( ) Over 1,000 amps or volts 552.26 2 Email: OAhmliAbotrhafs(t�taylormorrisoncnm-PelmitSu Itxmorri�n Qom Temporary writes or feeders installation,alteration,and/or Y relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less intended for sale,lease,rent,or exchange,according to OILS 447,449,670,and 701. 201 amps to 400 amps 125 08 2 Owner signature: Date: 401 amps to 599 amps 168-54 w (2 - 1 El APPLICANT tCANT I ❑ CONTACT PERSON Branch its-new,alteration,or extension,per paw Business name: PolygonA.Fee for branch c(ocel s with Homes WEB LLC above service Of feeder tee, 7.42 2 Contact name: Omar Alami Itbotthafa each branch circuit B.Fee for branch circuits wrthoui Address: 703 Broadway St,Ste 710 service or feeder fee first branch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98660 Each edd'l branch circuit 7.42 2 Phone:(360 )946 8674 I Fax::( ) Miscellaneous(service or feeder not included) lath manufactured or modular - Email:0AltuniAbouhafs@taylormonistm.com-PermitSubmittals( taylnrmorrison.cotn `wait,servia and/or Icudet 67 sex 2 CONTRACTOR Rcoonnoor only 67 84 2 Pump or hmgatiun circle 67.84 2 Business name: Wallace Electric Sign or outline lighting 67.84 2 Address: 105 Dresden St Signal mrcud(s)or ignited-energy 0 See Page 2 2 panel,slterarton,or extension. City/State/ZIP: Astoria OR 97103 Each additional inspection over allowable in any of the above Phone:(503 308 0563 Additional inspection(1 hr Mel) 66 25/ter Fax:( ) Investigation(I ter min) 90.00/hr Email:llavid@svallaccwires.txrm Industrial plant(1 ter min) 78 18/hr inspections for which no tee is — l Electrical Li C 1441 Su rv.1: 6363 S specifically listed(K ter min) 90 ten/ter CCA Lie.:224868 Suprv-Electrician signature,required: ELECTRICAL PERMIT FEES ' Print name: v Subs 4 c Date: y fL 1 ❑Plan Review Required(25%of permit sec): t f F/� State surcharge(12%of permit roc) • 1 Authorized sign permit signature TOTAL PERMIT FIB: 1 Print name: This per applicable,expires it a pins*Mast ant stained waddle ISO. t . _...-_ . Date. /1/4 /Z t.._ drys after b has hem accepted as complete. • Number of inspections allowed per permit 1.1Builduir 4rutnALLC Per,roApp aR ERFdcs Rev06'17/2015 41d/G/JG`15111LBSCOM/WFB Plumbing Permit Application Building Fixtures RECEIVED FOR OFFICE USE ONLY City of Tigard SEP 2 - 2021 MaI Received D HST ��0423Date/By:; Permit Na.: v 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718 2439 Fax .1 503.59$ 96q Inspection Line: 503.639. 7:5 lilt I Y OF I CARD Date/By. her Permit N . 41 TIGARb pate RcadyrBy: luris: lZ See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION NDate Ready/By.: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist. — — Description I Qty. 1 Ea. 1 Total 0 Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath I 312.70 Xl-and 2-family dwelling * ❑Commercial/industrial SFR(2)bath _ _ 437.78 ❑Accessory building 44-Multi-family SFR(3)bath 500.32 Each additional bath/kitchen ` 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 16658 SW TOWNSVILLE ST Catch basin or area drain 18.76 Dryvell,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:aiiiiioir.nigpolygon 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: Polygon at Roshak Ridge Lot no.: 217 Fixture or item: Tax map/parcel no.: Backflow preventer 3 L27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 New construction SFU Dishwasher 25.02 Drinking fountain Ejectors/sump ® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixturelsewercap 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%VLH,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 Sinkibasin lavatory 25,02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan E-mail:permitsubmittals®polygonhomes.com Urinal t CONTRACTOR Water closet Water heater Business name:G&B Plumbing&Sons Inc Water piping/DWV 56 Address:P.O.Box 92 Other: t, City/State/ZIP:St.Paul,OR 97137 Subtotal Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee. S72.50 CCB Lie.: 184372 � �Plluumbing Lic.no.:pb634 Plan review (25%of permit fee) cl70v"l"` State surcharge(12%of permit fee) Authorized e silMatur 1 ` TOTAL PERMIT FEE Print name:Steve Fowler Date: 1 O/3O/2O l This permit application expires if a permit is not obtained:within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I'+BuitdmrgPcrmiis\PLMU•Permiospp.die I a5UId514 440-4616T(10102iCOM+tvEB) City of Tigard q COMMUNITY DEVELOPMENT DEPARTMENT I/ T.l AEz�.� Building Permit Review — Residential Building Permit #: f2O2t �O425 Site Address: 16658 S Townsville St. Project Name: Polygon at Roshak Ridge Lot #: 217 Planning Review Proposal: New detached dwelling ElVerify address/suite#active in Accela. 0 In River Terrace: ❑ No El Yes,River Terrace Review Addendum Site Plan Elements: Erosion Control II copies of site plan on 8-1/2"x 11"or 11 x 17"paper ,ftetained trees with drip line and tree protection measures CD rawn to scale(standard architect or engineer scale) , Footprint of new structure(including decks)and FFE 0 orth arrow .JJtility locations&easements(required for new and additions) 12.ite address,project or subdivision name and lot number Sidewalk/driveway approach 113'pplicant information(name and phone number) ..Location of wells/septic systems 0 ot dimensions and building setback dimensions :Street tree size,type and location II.quare footage of buildings to be demolished street names I xisting structures on site °Corner elevations(2'contours if more than 4'differential� 13 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 ElClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑Yes,applicant was notified El No Received: ❑Yes 0 No ElWater Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: El Yes,applicant was notified ° No Received: ❑Yes El No ❑ SDC Exemption for ADU applied for: Yes 0 No Received: ❑Yes No 0 Public Facilities Improvement(PFI) Permit: Required: El Yes,applicant was notified El No Applied For: pp El Yes ❑ No,stop intake 0 Land Use Case#: SUB2015-00005 0 Zoning: R-7 0 Required Setbacks: Front: 8/12 Rear: 10 Side: 3 Street Side: NSA Garage: 20 0 Building Height: Max. Height: N/A Actual Height: 24 0 Landsca.e Area: 20 % 0 Lot Coverage Max: 80 0/0 Entrance Q 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 Gaffe door is behind widest street-facing wall ❑Yes ❑r No,one of the following is met: Door extends no more than 5'from wall and there is a covered porch extending beyond garage. Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor. 0 Gara e door width is 12'or less ❑ 50%or less of facade r 60%or less and includes 7 of following: Covered porch Q Recessed entrance ❑r Wall offset e 1'Roof cave Roof offset Fire shingles 0 Lap Siding ❑ Roof itch 0 Gable,hi ,or gambrel roof ❑Dormer Accent siding Window trim Window recess Window projection 0 Balcony ❑ Visual Clearance 0 Urban Forest Plan ❑ Sensitive Lands: 0 Yes U No Type: 0 Conditions met prior to issuance of building per Notes: _ El �Approved By Planning: , - Date: 2 _14_ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved El Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: a00-0.2./ Site Plans: # 3 Building Plans: # 3 Building Permit#: Enter buildin permit#above. n ^ Workflow Routing: Planning ngineering ermit Coordinator 0—Building Workflow Sign-off: a-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 riginal plan review routing form. Building: original permit application,site plans,building plans,engineer and beam calculations an. rust details,if applicable,etc. Notes: By Permit Technician: ��//// Date: i ?49/<0.21 Engineering Review �, "Slope at building pad: `e9 Conditions"Met"prior to issuance of building permit 11 Easements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Assess Water Quantity Fee in-lieu: ❑ Yes f1 NNo ULIDA Facility on lot: ❑ Yes ICJ No inal Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: PrApproved by Engineering: Date: 9 3e:774/ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ 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: �7. SDC Exemption: ❑ Received ,�I Does not a7�jly SDC Fees Entered: Wash Co Trans Dev Tax: Yes N/A f rw1J Tigard Trans SDC: 2 Yes ❑J S cG N/A Parks SDC: .EYes ❑ N/A LIDA ❑ Yes ZN/A OK to Issue Permit Approved by Permit Coordinator: A °' j� Date: t015 I 202( I:\Building\Forms\B1dgPermitRvw RES_122419.docx City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT 111111 Tic;n u t, River Terrace Building Permit Review Addendum Building Permit #: 672-02!-0m 42 3 Site Address: 16658 W Townsville St Project Name: Polygon at Roshak Ridge Lot #: 217 (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 ElNo (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. Porch :,. 5 ft. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a ft.deep min.2ft., 5ft.wide min.2 ft.,Eft.wide ❑ ❑ Gable. .oomer ❑ ❑ 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: facing wall El Parallelto street, . gle no more than 45° from street, ❑Max. 8 ft. setback from longes treet- or open onto por Entrance opens to a porch: ❑Yes o If es,all the following apply: ❑25 sq.ft. in. UOne street facing entry ❑12 f ax.roof above floor of porch ❑5 ft.depth min. ❑30/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 III Recessed entry area min. 5 ft.wide x 2 ft.deep ❑Wall offset min. 16 inches g ormer min.4 ft.wide 0 Roof eave min. 12 inch projection ❑R. • offset min.of 2 ft. ❑Roof shingles either tile or wood ❑Gable, sip or gambrel roof design ❑Roof pitch oriented south min. 500 sq. s. 0 Horizont.. ap siding min. 3-7 inches wide ❑Accent siding min.40%of street fa .e 0 Window trim , ' .2 1/2"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 'o or less of street façade 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. o 5 ft.if there is a covered front porch and garage does not extend beyond the fro .orch. 0 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 s age that faces the street with a min. area of 12 sq.ft. Width• heck one) 0 -foot-wide garage door 0 40%max.of street façade rd 50%max.of street facade with 7 detailed design elements Notes: Approved By Planning: Date: 9/23/21 I:\Building\Fonns\BldgPtrmitRvw_RES_RT_121417.docx ED Water Meter Fixture Unit Worksheet For New Buildings�EC I SEP 2 1 20?1 Please complete the following information: CITY OF iatr tiO Contractor Name: Polygon Home, WLH LLC 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: 116658 SW TOWNSVILLE ST /ADU : 16660 SW TOWNSVILLE ST Subdivision Name: Polygon at Roshak Ridge Lot#: 217 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 ADU 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, 1st 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 3 4 7 x 1 = 7 Water closet, 1.6 GPF 2 3 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" 30.5to37=3/4" Meter Size: Meter Cost: $ 24,886.00 ************************************************************************************* FOR OFFICE USE ONLY Fixture Units Points verified with Building(Master)Permit or Plumbing 0 Yes ❑ No ❑ Other: Meter#: Sale Date: Receipt#: Meter Cost: Employee Name: ......__...._.. ._........ ...... _ _. .._ _...... . . .. _ .___.__...._. . ..... . .... l:/Building/Forms/WaterMeters_010121 New.dOCX Page 2 City of Tigard .11 . q Deferral Until Occupancy Request TI GARD Washington County Transportation Development Tax (TDT),Transportation and Parks System Development Charges (SDCs) This form is to be signed and submitted prior building permit issuance or, if no building permit is required,then upon land use approval(TMC 3.24, as amended by Ordinance No.21-09). Date: 11/3/2021 Site Address: 16658 SW TOWNSVILLE ST Project Polygon at Roshak Ridge Land Use Case or MST2021-00423 Name: Building Permit#: Tax Lot 2S107AA21700 Total Parks #: Lot 217 Amount*: $5,839.00 TDT Total TSDC Amount: N/A Amount*: $2,134.00 *The total TSDC amount shown above is the sum of$ 0 for TSDC-Improvement,$ 225.00 for TSDC- Reimbursement,and$ 1.909.00 for TSDC-River Terrace,if applicable.. *The total Parks SDC amount shown above is the sum of$4,727.00 for Parks-Improvement,$ 1,112.00 for Parks- Reimbursement,and either$ N/A for Parks-Neighborhood or$ 0 for Parks-Neighborhood River Terrace. This constitutes my request to defer payment of the TDT, TSDC, and Parks SDCs, as provided above, until occupancy. Payment of the TDT,TSDC, and Parks SDCs may be deferred until issuance of the occupancy permit. In requesting this option, I understand that any deferred TDT,TSDC, and Parks SDCs must be paid prior to final inspection or issuance of an occupancy permit. TDT may only be deferred if the TDT is greater than the amount for a single-family residence. I further understand that the amount of TDT due on deferred obligations shall be the amount in effect at the time of issuance of the building permit. For a deferral request to be accepted both the Property Owner and the Developer must sign this request. Property Owner: Ohta4..A&uno'.A6oaUEa Date: 11/3/2021 Developer: nota.L.A&pa.A6ead Date: 11/3/2021 Permit Coordinator: AIWA Oeiftleirti Date: 11/3/2021