Permit .rt,
Plumbing Permit Application /f / g
Building Fixtures t 1 OR OI f1( 1 1 l ONE)
City of Tigard Received Received / MST2021 00425
y # f Pennil No.:
ligI. 13125 SW Ball Blvd.,Tigard,OR 97223 Date/By:: ,��'
g' nq9Plan Review
Phone: 503.718.2439 Fax: 503.598.1960I10 ' 2UL 7 y /i3/21 A Other Permit No.:
Inspection Line: 503 639.4175
Il Date/By.: �/
f I C A R D Date Ready/By: Juns ® See Page 2 for
Internet www ti'lyd ro o - Notified'V1eito I Supplemental Information
TYPE OE WORK L E 1. SCIIF DIII
❑■ Nev, construction I.❑DoiIflon For special infornmhon use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
❑ 1-and 2-family dwellingSFR(2)bath 437.78
❑Commercial/industrial
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other
Fire sprinkler(2023 sq.ft.) Page 2
JOB SITE INFORMATION, �° . st Site utilities:
Job site address:16644 SW Townsville St. 1 4
Catch basin or area drain 18.76
i,�II 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.: 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
i
Water service(no.linear ft.:_) Page 2
Subdivision: 1 Lot no.:216-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
I Dishwasher 25.02
I Drinking fountain 25.02
Ejectors/sump 25.02
' ifPROPERTY OWNER 1 0 TENANT Expansion tank 12.51
Name:Taylor Morrison
Fixture/sewer cap 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
0 APPLICANT Q 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 1 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 Lic.:184601 Plumbing Lic.no.:PB732
�-�7► State surcharge(12%of permit fee)
�
Authorized signature: �� -- TOTAL PERMIT FEE
Print name:Gavin Thomes Date:L I/a/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.
1:ABuildingAPermitsVPLMU-PermiiApp.doc I0/tl I/O') 440-46I 6T(I 0/02/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-1'100' 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!00' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Storm&Rain Drain-1st 100' 62.54 Valuation. ermit Fee,
$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
Other Ins ections or Fees' Qty. Fee(ea) 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 $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 of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
Cuspidor Water Aspirator _ ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic 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"
Isometric or Riser Diagram
❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
1:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
litaffiaNNOMeaMfaiiiiitinititqi
ii CITY OF TIGARD MASTER PERMIT
�1II/ COMMUNITY DEVELOPMENT Permit MASTER
MST2021-00425
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/03/2021
Parcel: 2S107AA21600
Jurisdiction: Tigard
Site address: 16644 SW TOWNSVILLE ST
Subdivision: ROSHAK RIDGE Lot: 216
Project: Polygon at Roshak Ridge,Lot 216-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
Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2023 sf Value: $293,700.62 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 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: $24,815.85
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
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Issued By: HoLL.ct Va.w De Wege- Permittee Signature: Ow Ap-p-Lizzl,lion.
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.
, , 1-0-r- 0 /
Building Permit Application s . i
Residential RECEIVE I Q 'fj� FoR OFFICE l SE ONLY7�J/�
City of Tigard Received OQ �f/ 7/ if 5 2 �/to 25
2 I. / Permit No. f./W
13125h SW Hall Blvd.,Tigard,OR 97223 �j F f 2021 Plan Review ' �'!I� w/�_ e�` �'/2
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: b
vY f Yt'i Other Penni 4f~ JJ
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Read B : T See Pa e2 for
Internet: www.tigard-or.gov BUILDING D!'JIS!O I No' ethoi f� ii1 Supplementalforormation
TYPE OF WORK B�Li J REQUIRED DATA:I`-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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: S a 1�' CO
�2
❑Accessory building El Multi-familyNumber of bedrooms: 4
0 Master builder 0 Other: Number of bathrooms: 3 `
JOB SITE INFORMATION AND LOCATION Total number of floors:2 D.`19
Job site address: 16644 SW TOWNSVILLE ST New dwelling area: 2,023 square feet 'q N 1
City/State/ZIP:Sherwood, OR 97140 Garage/carport area:'4 (p square feet (2,02,....
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: square feet
Cross street/directions to job site: Deck area: lqz square feet
OtlifyetkiLaievsquare feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Polygon at Roshak Ridge Lot no.: 216 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: ��j rj/j��L Indicate the value(rounded to the nearest dollar)of all
y equipment,materials,labor,overhead,and the profit for the
1
DESCRIPTION OF ORK work indicated on this application.
SFU:New home construction Elevation:221100A/221000A Duplex Valuation: $
Type:Duplex_Projected Start:November 2021 Existing building area: square feet
1t40„yt c1Ce. S pc ito t- L1 9-CCtar11I New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Polygon Homes WLH LLC Type of construction:
Address:703 Broadway St., Ste 510 Occupancy groups:
1 City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360 946 8674 Fax:( ) New:
® APPLICANT 0 CONTACT PERSON U49 BUILDING PERMIT FEES*
Business name:Polygon Homes WLH LLC (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Omar Alami Abouhafs
Address:703 Broadway St., Ste 710 FLS plan review fee(if applicable):
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*
Commercial and residential prescriptive installation of
CONTRACTOR 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.
Permit Fee(includes plan review
City/State/ZIP:Vancouver, WA 98660 $180.00
and administrative fees):
Phone:( )360 695-7700 Fax:( )360 693-4442
State surcharge(12%of permit fee): $21.60
CCB lic.:207247 Total fee due upon application: $201.60
Authorized signature: (ri htaA.,4 Trite ,ry6dG4/;Cl,G4d. This permit application expires if a permit is not obtained
�J within 180 days after it has been accepted as complete.
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 Applicati jC �! tall c11 Ilr.E USE ONLY
r City of Tigard rlG�l IU Received PertnitNo,: r y2i2I.pd ZC
'r 13125 SW Hall Blvd.,Tigard,OR 97223 r, -g i Plan Review
i Phone: 503.718.2439 Fax: 503.598.1960 .r G er LU 1 Other Permit:
lr i t'rA R 111 Inspection Line: 503.b39.4175 Date Ready/By: kris ElSee Page 2 for
Internet: www.tigard-or.gov CITY Y OF i IGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK _ COMMERCIAL FEE* SCHEDULE —USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling 0 Commercial/industrial ❑ Accessory building For special information use checklist
1 j Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling: —
Job site address: 16644 SW TOWNSVILLE ST Air conditioning 46.75
Furnace 100,000 BTU(ducm'vents) 46.75
City/State/ZIP:Tigard,OR 97224 ,Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge Heat pump 61.06
Duct work 23.32
r
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.: 216 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
ri
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
23.32
Ili PROPERTY OWNER ❑ TENANT Other: 23.32
• Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
equipment 33.39
Address:703 Broadway St.,Ste.510
_ Clothes dryer exhaust 33.39
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
- u,--- toilet compartments,utility rooms) 23.32
Phone:(360)695-7700 Fax:( ) Anic/crawlspace fans 23.32 I
® APPLICANT 0 CONTACT PERSON Other: 2332
Fuel piping:
Business name:Polygon WLH,LLC
814.15 for first four;S4.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
--•--- Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water beater
Phone:(360)695-7700 Fax: :(360)693-4442 Fireplace
Range
E-mail:permitsubmittals(tayIOrmOrrlSOfl.COm Barbecue
"Ak 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 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
Jr .- a bum -nJ days after it has been accepted as complete.
Authorized signature (�C� * Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date: 10/30/20
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Electrical Permit Application RECE IV
City of Tigard p C� ? Reeeved TZr2O2ft2c
13125 SW Hal)Blvd.,Tigard,OR 97223 C E` 2 _ 2 0..t 1,,A0v Prom t a
!' Phone. 503.71$2439 Fax SO i.59$1960 t'lan Review 1Ja>G•Av Related Permit 4
i ice;\ n lnspc lion Line 503.639..4175 CITY OF TI GAh''.: Ready Date ty luin. to See Page 2 for
Internet: www,tlg&d-or.gov S�1 f�l!�P�' nii Jlr;?';.. N°ttLccUMcdtod. Supplemental Information
TYPE,OF WORK E 'l PLAN REVIEW
®New construction CI Addition/alteration/replacement Please check all that apply(submit j sets of plans w(,tms checked).
❑Sava or fttdcr 4(8)amps is more []Budding over three stones
Q Demolition 0 Other: where tie available fault moron 0 Mations and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volt,or 0 Floating handing,
®1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building kesv to ground,or exceeds 14,000 ❑Coeamerctal-ore agricultural
amps roc as other installations buildings
0 Multi-family ❑Master builder 0 Other:
❑ Lam
Fire pump D Lamination of 150 KVA or
JOB SITE INFORMATION AND LOCATION OEnicrecocy system largo separately derived
lob#: Job site address:16644 SW BOTANY BAY LN padailiae°f clew motor lea°°f system
100IIP or more. ❑"A":'E "1 2 "I-3".
City/State/ZIP: Tigard,OR 97140 O Sin of more methanol oohs occupancy
❑Health-care facilities. 0 Woaeatioeal vetucte parka_
Suite/bldg./apt#: Project name: Polygon at Roshak Ridge ❑Hazardous location, 0 Supply voltage for more than
CI Service or feeder 600 amps or more 600 wits mm+nal-
Cross street/directions to job site: FEE SCItEDULE
uaer;ati.. 1 Otr. I Each L rail I •
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge I Lot#: 195 Includes attached garage.
1,000 sq ft or less 168 54 4
Tax map/parcel#: Ea.add'I 500 sq.R.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
75.00 2
New construction.Type U (with above sit.tt)
SF
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
- Renewable Energy 0 See Page 2
®PROPERTY OWNER ❑ TENANT Services or feeders iBMa atIonralteration,aad/ar relocation
Name: Polygon Homes WLH LLC 200 amps or less 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 mope to 1,000 amps 301.04 2
Phone:(360 )946 8674 Fax:( ) Over Loon amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: OAlamiAbouhafs@taylormorrison.cam-PermitSubmittals@taylormorrison,co r relocation
Owner installation:This installation is being made on property that 1 own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amp.to 400 amps 125 08 2
Owner signature: Date: 401 amps to 599 amps 168 54 2
— Branch circuits-new,alteration,or extension, r panel
❑ APPLICANT f CI CONTACT PERSON
Business name: PolygonA Fee for branch circuits with
Homes WI.H LLC above service or feeder fee,
each branch circuit 7.42 2
Contact name: Omar Alarm Abouhafs I3 Fee for branch circuits without
Address: 703 Broadway St.,Ste 710 service or feeda fee,first branch 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Eaoh add't branch circuit 7.42 2
Phone: 360 94b 8674Miscellaneous(service or feeder not included)
( ) Fax::( ) ... .__ Each manufactured or modular 67.84 2
Email:OAlamiAbouhafsegta lofanorrisott.com-PermitSub mittal. dwelling,service ar,dr°r feeder
Y S(QflaylOTmOlrlson.C/Nrt Reconnect only 67 84 2
CONTRACTOR Pump or irrigation circle 67 84 2
Business name: Wallace Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 105 Dresden St panel,ahcnuon,or extension. D See Page 2 2
City/State/ZIP: Astoria,OR 97103 Each additional inspection over allowable In any of the above
.._._ Additional inspection(1 hr min) 66.25/hr_
Phone:(503 3118 0563 Fax:( ) investigation(1 hr min) 90.(X)!hr
Fmail:David(Jwallaccwires.com Industrial plant(1 hr min) 78.18/hr
inspections for which nu for is 90.00/m
CCB Lie.:224868 Flectrieal Li-- C1441 St .I: .- 6363S specifically listed(15 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: „_,,."^' Subtotal
Print name:D).tf w. Date: at/z Jy i i_p Plan Review Required(25%of permit fox) ..
Slate surchar a(12%of _
8 permit fee)
Authorized si�attnrez5.,
TOTAL PERMIT FT;E:
This penult application expires if■permit is ask obtained eri/hin IbU
Prot name$ `. l i t Date: days after II has bran accepted m comptetr.
.--.._.-...__ -.- ".s',-_�' f N�of mspecbtms allosscd per permit.
I.wuiktagWeom0H:te_PnertApp EI.R FRE.doc Sev06'1712015 __..._ 4�/a5/C014/WEB
Plumbing Permit Applicatio
Building Fixtures 1RECEIVED FOR OFFICE USE ONLY
City of Tigard SEP 2 I 2021 Received �� w� .Z5
Date/By: Perot No.:�(, r�r/
,.q 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �
Phone: 503.718.2439 Fax: 503.598.1cm OF TIGARD Date/By: Other Permit o.:
TIGARD Inspection Line: 503.639.4175 �3Of f OWC7( I\PS!ON Date Ready/By: lw s ZSec Page 2 for
Internet: www.tigard-or.gov Notiliied!Meihod: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
Z New construction ❑Demolition For special information use checklist.
Description j Qty. I Ea. J 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
(,I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building VI-Multi-family
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: 16644 SW TOWNSVILLE ST 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.: Project name: oePoiygon 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.: 216 Fixture or item:
_
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New construction SFU
Dishwasher 25.02
J Drinking fountain 25.02
Ejectomsump 25.02
® PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:Polygon WLH,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:703 Broadway`St.,Ste 510
Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02
Phone:(360)695-7700 Fax:( ) lee maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptorigrease trap 25.02
Business name:Polygon WLH,LLC., Medical gas(value:S ) Paget
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:permitsubmittalsCpolygonhomes.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:G&B Plumbing&Sons Inc
Water piping/DWV I 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: S72.50
Plan review (25%of permit fee)
CCB Lie.: 184372 Plumbing Lic.no.:pb634 State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE I
Print name:Steve Fowler Date: 1 O/3O/2O j 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
1:+Guiidtng Perin iisTLMr-PermitApp.eec 10,01/09 440-46167(I0'02'cOM'wEB)
City of Tigard
.1,4 r COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c A It D Building Permit Review — Residential
(4,
Building Permit #: tr2o21--coi{2.5Site Address: 16644Townsville St.
Project Name: Polygon at Roshak Ridge Lot #: 216
Planning Revie�z�/� /�
Proposal: New dwelling w t 7 (I) 4 ek r-( �Gf
ElVerify address/suite#active in Accela. 0 In River Terrace: ❑ No 0 Yes,River Terrace Review Addendum
{ Site Plan Elements: ° rosion Control
111: copies of site plan on 8-1/2"x 11"or 11 x 17"paper etained trees with drip line and tree protection measures
12 D rawn to scale(standard architect or engineer scale) .footprint of new structure(including decks)and FFE
1 orth arrow ,:,Jtility locations&easements(required for new and additions)
(bite address,project or subdivision name and lot number ,,Sidewalk/driveway approach
11'pplicant information(name and phone number) ..)Location of wells/septic systems
0 ot dimensions and building setback dimensions ,street tree size,type and location
I.quare footage of buildings to be demolished , treet names
II 4xisting structures on site °,.omorner elevations(2'contours if more than 4'differential
0 ot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? lJYes o
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es o
QClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑Yes,applicant was notified CI No Received: ❑Yes ❑r No
0 Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑Yes,applicant was notified ❑No Received: Yes ❑No
❑ SDC Exemption for ADU applied for: ❑Yes ❑o No Received: ❑Yes El No
CI Public Facilities Improvement(PFI) Permit:
Required: ❑Yes,applicant was notified ❑No Applied For: ❑Yes ❑ No,stop intake
0 Land Use Case#: SUB2015-00004 Q Zoning: R-7
❑r Required Setbacks: Front: 8/12 Rear: 10 Side: 3 Street Side: NSA Garage: 20
ElBuilding Height: Max.Height: N/A Actual Height: 24
ElLandscape Area: 20 °/„ 0 Lot Coverage Max: 80
Entrance ., Set back no more than 8'from street-facing wall ❑Parallel to street or offset 45 degrees or less
Windows ,, Minimum 12%of area of all street-facing facades
Garage ° Gara e 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.
CIGarage door width is I 12'or less ❑ 50%or less of facade ° 60%or less and includes 7 of following:
Covered porch 13 Recessed entrance ❑r Wall offset e 1'Roof cave Roof offset
Fire shingles I Lap Siding ❑Roof itch ❑ Gable,hi ,or gambrel roof ❑ Dormer
_ Accent siding I Window trim U Window recess U Window projection 0 Balcony
❑ Visual Clearance El Urban Forest Plan
CISensitive Lands: ❑ Yes LI No Type:
ElConditions met prior to issuance of building pe it
Notes:
0 Approved By Planning: Date: 94s
4/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
l:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: .1( )d2
Site Plans: #
Building Plans: # 3
Building Permit#: Enter buildingpermit#above. y�
Workflow Routing: Planning . 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.
Mr Building: original permit application,site plans,building plans,engineer and
beam calculations an,. rust details,if applicable,etc.
Notes:
By Permit Technician: ,'�/�-t it Date: 71.2 _
Engineering Review
gySlope at building pad: eh
Lr 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: ❑ Yes Lk1 No
Assess Water Quantity Fee in-lieu: ❑ Yes 'No
,�,/ LIDA Facility on lot: ❑ Yes lWNo
EJ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
�pproved by Engineering: � Date: __g 3
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
pr Conditions "Met"prior to issuance of building permit
El Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
SDC Exemption: ❑ Received Does not a2 ly
igSDC Fees Entered: Wash Co Trans Dev Tax: yes N/A
Tigard Trans SDC: ,Yes ❑ N/ASee Ttirryl
���
Parks SDC: 0 Yes ❑ N/A
LIDA ❑ Yes Yr N/A
OK to Issue Permit
Approved by Permit Coordinator: Ar(PIR—
Date: 1 Dt 5(2YLi\
I:\BuildinglForms\BldgPermitRvw RES_122419.docx
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
r I A R D River Terrace Building Permit Review Addendum
Building Permit #: 512O ZI-d 04L6-
Site Address: 16644 SW ownsville St
Project Name: Polygon at Roshak Ridge Lot #: 216
(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 [7No (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 ft. deep min. 2ft., 5 ft.wide min. 2 ft.,6ft.wide Gable• .ormer
• ❑ ❑ ❑ ❑
2. Eyes on the str- •t: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: ❑Yes 1 o
IfL�es,all the following apply: El25 sq.ft. in.
One street facing entry ❑12 f ax.roof above floor of porch
❑5 ft.depth min. ❑3►/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 II Recessed entry area min. 5 ft.wide x 2 ft. deep
❑Wall offset min. 16 inches ormer min. 4 ft.wide
❑Roof eave min. 12 inch projection ❑R•• offset min. of 2 ft.
❑Roof shingles either tile or wood ❑Gable, .ip 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 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 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 - .
❑May extend u. o 5 ft.if there is a covered front porch and garage does not extend beyond the fro .orch.
❑May extenrn, 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)
❑ -foot-wide garage door ❑40%max. of street facade
50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: Date: 9/23/21
1:\Building\Forms\BldgPennitRvw_RES_RT_121417.docx
RECEIVED
Water Meter Fixture Unit Worksheet For New Buildings SEP 2 ? 2021
CITY OF' IGARD
Please complete the following information: BUILDING DIVISION
Contractor Name: Polygon Home, WLH LLC
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: 16644 SW TOWNSVILLE ST /ADU : 16646 SW TOWNSVILLE ST
Subdivision Name: Polygon at Roshak Ridge Lot#: 216
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'] 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:
1 to30= 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:
I:/Bui]ding/Forms/WaterMeters_010121 New.docx Page 2
City of Tigard
111 Deferral Until Occupancy Request
T I G A R D 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: 16644 SW TOWNSVILLE ST
Project Land Use Case or
Polygon at Roshak Ridge MST2021-00425
Name: Building Permit#:
Tax Lot Total Parks
25107AA21600 $5,839.00
#: Lot 216 Amount*:
TDT Total TSDC $1,354.55
Amount: N/A Amount*:
*The total TSDC amount shown above is the sum of$ 0 for TSDC-Improvement,$ 225.00 for TSDC-
Reimbursement,and $1,129.55 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: ()mail.Wanc;.c46ey. Date: 11/3/2021
Developer: DaA-Wa /969U146 Date: 11/3/2021
Permit Coordinator: 1611VA Oetfrtek Date: 11/3/2021
FOR OFFICE USE ONLY-SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
1 ~114
Transmittal Letter
T it A R Ia 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: f\l lg.)v\ }p(nl� ofl DATE RECEIVED:
DEPT: BUDDING DIVISION
) FIECEIVED
FROM: grMak ARSY YY\ _AbOd 10t,-S OCT 21 2021
COMPANY: 1(p{Z cm*COIA k!oawed- Ll_C G1TY OF TIGAPIti
PHONE: G® 9 4 6 g 644 3UILDING DIVIS O* 4
R
EMAIL: 9 o�. ,„,,v a 100014 s @ fa,,,,toe invo egiso., (4,„„
RE: MO L L__ 16_611.1C1 ' i i,Jcjj N�v(i,LC- ST- MST 0004.1 —( ()4.ZS
Site Address) (Permit Number)
0 ea/ �0.choie df1-• i.2-i6 /t eo40 6
(Pr �ame or subdivision name and lot number
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. 3 Revisions: Rf1 F
details. Wall bracingam 1 te�anal analysis!
Cross section(s) and Y
Floor/roof framing. Basement and retaining walls.
Beam calculations. .2 Engineer's calculations.
Other(explain):
REMARKS: ► / e (I _ C — ► o _s. . % • I. ' 41 i,M.
i 4•: : •a I go .r . • ." e, /12"74-J of/o ' fed-Z-A Pi_
, A t FO OFFI E USE ONLY.
Routed to Pe ec an: Date: o 2 Initials:
Fees Due: Yes�o Fee Descr ption: Amount Due:
ti l f Ld i Sit` ` - $ �b
4 G,,../
l P , -
Special P`'c
Instructions:
Reprint Permit (per PE): ❑ Yes [ o ❑ Done
4 Applicant Notified: � Date: 4e. ll // 7,2_/ Initials:
I\Building\Forms\TransmittalLetter-Revisions_073120.doc