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Permit Plumbing Permit Application iiimi===riitly Building Fixtures City of TigardRECEIVE Received �/ Permit NoMST2021-00426Date/By: � iI/yt • 13125 SW Hall Blvd.,Tigard,OR 97223QV9 �� '111 Date/By: (� i 3,1 Plan Review IIPhone: 503.718.2439 Fax: 503.598.1960 g �y) A Other Permit No.: Inspection Line: 503.639.4175 (� Ready/By: H See Page 2 for l IGARD g g (iITV OF MARL; DateRead/B 7uns. Internet www.li and or. ov I 1 1 V l�f trll Notified/Method: Supplemental Information I 1 TYPE OF WO UILD NC olvisiONk FEE* SCHEDULE ❑■ New construction Q 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 ft for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ❑■ I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ID Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 0 Master builder 0 Other Fire sprinkler(1228 sq.ft.) Page 2 Jos SITE INFORMATION ..-.t,.Yfr r. Site utilities: ° .=' i• Catch basin or area drain 18.76 Job site address:16646 SW Townsville St. , - 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 I Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Lot no.:216-ADD Fixture or item: fax 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 ON PROPERTY OWNER ❑ 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 1.-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 offee) Authorized signature: TOTAL PERMIT FEE Print name:Gavin Thomes Date tl/8/2021 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'.ABuildingVPermitsVPLMU-Permit App.doe 1(1/(11/(19 440-4616T(I0/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-I'100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum 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 Inspections 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 tor 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 ❑ Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 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" -3" Isometric or Riser Diagram 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food 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 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 08/04/201I 2 CITY OF TIGARD MASTER PERMIT Ili I COMMUNITY DEVELOPMENT Permit#: MST2021-00426 Date Issued: 11/03/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107AA21600 Jurisdiction: Tigard Site address: 16646 SW TOWNSVILLE ST Subdivision: ROSHAK RIDGE Lot: 216 Project: Polygon at Roshak Ridge, Lot 216-ADU Project Description: New attached ADU. NO FINAL INSP UNTIL DEFERRED SDCs PAID. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms. 3 First: 1228 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 24 Bathrooms: 2 Second: 0 sf Garage: 275 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 1228 sf Value: $174,454.24 Rear: 10 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 3 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 add9 500 sf: 2 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW ADU VB R-3 1228 Owner: Contractor: 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: $21,027.66 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 oc2nn1-nnln lhrn„nh nap oc9-nnl-noon vnn may nht,in a rnnv of}ha nine nr r irart roe oeti.nc fn mi if iC by ra iiinn cry;919 1o1,17 nr 1 Rnn'Y39 94dd Issued By: Ho-U.y VcU''De,We9e Permittee Signature: Ow App-blza,tio-Pt 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 lob site at the time of each inspection. Euilding Permit Application `` 0 7--,4/ Residential RECEIV : FOR OFFICE l!si?ONLY . City of Tigard Received Di 21477 111 " 13125 SW Hall Blvd.,Tigard,OR 97223 S E P 2 1 2021 Date/By: r Permit No.: 520 �� Plan Review ( 4 ^1 /1 N �//e2/2 .e 2 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: t b (�. f.r/f Other Permit:`e�0" "r I C.A R D Inspection Line: 503.639.4175 CITY OF TI GARL.)Date Ready/By: ` / ee Page 2 for Internet: www.tigard-or.gov BUILDING DIVISIONtifie ethod: f va .1—� Al�� Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING Q 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 ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Lisl .a ❑1-and 2-family dwelling ElCommercial/industrial Valuation: $ ',y( ElAccessory building 0 Multi-family Number of bedrooms: 3 ❑Master builder ®Other: ADU Number of bathrooms:2 JOB SITE INFORMATION AND LOCATION Total number of floors:1 \ SO!Tj Job site address: 16646 SW TOWNSVILLE ST New dwelling area: 1,228 square feet `L�iv City/State/ZIP:Sherwood,OR 97140 Garage/carport area:)6(a'7Ssquare feet Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area:›E‹ square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Polygon at Roshak Ridge I Lot no.: 216 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Algiq 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:221100A/221000A Duplex Valuation: $ Type:Duplex_Projected Start:November 2021 Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:Polygon Homes WLH LLC Type of construction: Address:703 Broadway St., Ste 510 Occupancy groups: City/State/ZIP:Vancouver,WA 98660 Existing: Phone:(360 946 8674 Fax:( ) New: ®APPLICANT ❑ CONTACT PERSON 09 BUILDING PERMIT FEES* Business name:Polygon Homes WLH LLC (Please refer ro fee schedute) 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: :( ) E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of 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 Total fee due upon application: $201.60 Authorized signature: QhteiA,4 (21/a 4166Yd 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: 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 A.pplicatio ECEI V E FOR OFFICE USE ONLY City of Tigard Datc1B Received Sr202l�o Permit No. '! 'u 13t25 SW Hail Blvd.,Tigard,OR 97223 SEP 2 1 2021 `l"�a Phone: 503_718.2439 Fax: 503.398.1960 DatcRevietiv Other Permit: CITY OF TIGARD Dater By: 1tih1;1? InspectionLinc: 503.639.4175 DatcRcad}'r13y rails E}See Page 2for Internet: www.tigard-or.gov BUILDING DIVISIONNouficd/meihod: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction ❑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* 0 1-and 2-family dwelling ❑Commerciallindustrial ❑Accessory building For special information use checklist I j Multi family ❑Master builder El Other: ADU Description Qty. Ea, Total JOB SITE LNFORNLATION AND LOCATION Heating/cooling: Job site address: 16646 SW TOWNSVILLE ST Air conditioning i 46.75 Furnace 100,000 BTU(ducts/vents) { 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,0001°BTU(ducts/vents) 54.91 SuitePoldg./apt.no.: Project name: Polygon at Roshak Ridge Heat pump 61.06 Duct work 2332 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hvdronic) 2332 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Fluelvent 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 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ® PROPERTY OWNER ❑ TENAN 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 I APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name:Polygon WLH,LLC Fuel piping: 514.15 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 heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace Ranee E-mail:permitsubmittals(taylormorrison.eom 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($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 I A� This permit application expires if a permit is not obtained within 180 I days after it has been accepted as complete. Authorized signature: Fee methodology set by TrnCounty Building tndusts Service Board IPrint name:Elia Duran Date: 10/30/20 r.lAnildirwlPr.mireUvfPr P.rmn*nr 1110111,e. Electrical Permit Application RECEIVE S fUR ot.lit t t sl (ICI 1 City of Tigard SEP 2 1 2021 Date/By. Permit* .i, ' D .. -10 24 13125 SW llan Blvd.,Tigard,OR 97223 ---- Phone: 503,718 2439 Fax 503 598 1960CITY OF TIGARD- o Plan Review Rdo[cd Permit d l:. I Inspection line 503.6394175 BUILDING DIV1SIOt 0atrtR runs j retezfar Internet: www.tigard-or.gov WScd/Mcttod. Supplementalleformabon IN TYPE OF WORK PLAN REVIEEW. IN New construction ElAddition/alteration/replacement Please Brack all that apply(sutmnt a sets of plans wins-ins checked) 0 Demolition ❑Other: ❑So vice or feeder 400 amps«more 0 Building over three stones. where the avatlabk fault current ❑Marinas and bootyaniv CATEGORY OF CONSTRUCTION records 10,000 amps at ISo,»Its Of 0 1-10atm8 buildings ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building lesv to ground,or exceeds 14,000 ❑cammexcial-roe agricultural Other: ADU amps for all other mstatlattars budding ❑Multi-family ❑Master builder ID ❑Fire pump 0 Installation of 150 KVA or JOB ShIE INFORMATION AND LOCATION 0 hmentency system. larger separately derived Job#: Job site address: 16646 SW BOTANY BAY LN O taxis of new minor load of system. 1oa1TP or more. ❑"A"."E","1-2"."1-3", City/State/ZIPP: Tigard,OR 97140 O Stx«mare residential units o it panty ❑Heaitb-e-are facilities. ❑Recreational vehicle parks. Suite/bldg.apt.#: Project name: Polygon at Rttshak Ridge ❑l1.-trardous lotions 0 Supply voltage f«more dam ❑Service or feed,,600 amps OF more 640 volts nominal. Cross street/directions to job site: y FEESCllEDI7LE . • osacnptioa . I tky. I r,rh j Taal I • New residential single or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lai#: 195 Includes attached garage. Tax map/parcel#: I,tx10 aq it or fees 168 54 4 Fa.add'l 500 sq.(t or portion 33 92 1 DESCRIPTION OF WORK Limited energy,resdrinbal (math above 75.00 2 New construction.-Type SFU ( sq.R) Limited energy,multi-family 75.00 residential(with above sq.R.) 2 al PROPERTY OWNER Renewable Enemy 0 See Page 2 ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: Polygon Homes WLH LLC 200 amps or lea 100.70 2 Address: 703 Broadway St.,Ste 710 201 amps to 400 amps 133.56 2 401 ampe to 600 amps 200 34 2 City/State/ZIP Vancouver,WA 98660 601 amps to 1,000 amps 301 oa ' 2 Phone:(360 )946 8674 Fax ( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Entail: 0AlamiAboubafs@blylortnorrison.com-PermitSuhmittals@taylormorrison.com 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 amps to 400 amps 123,08 2 Owner signature: llatc: 401 amps to 599 amps 168 54 2 0 APPI.ICAN T 0 CONTACT PERSON Branch circuits-new,alteration,or extension,Rer panel �-'-` A.Fee for branch circuits with Business name: Polygon Homes WI.H LIC above service or Ironer tee, 7 42 Contact name: Omar Alarm Abouhafs each branch comma B Fee for branch circuits without Address: 703 Broadway St.,Ste 710 service or feeder fee,(teat 56 18 2 brands circuit City/State/ZIP:Vancouver,WA 98660 Each add'I branch circuit 7.42 2 1 Phone: 360 946 8674Fax: Miscellaneous(service or feeder not included) ( ) :( ) Each manufactured or modular 67 84 2 Email:OAiamiAbouhafs@(aylormorrison.cotn-PermitSubmittals@taylormorrison_con dwelling,i curly and/or render 'xno 67 84 2 CONTRACTOR Olt Pump or irrigation circle 67 84 2 Business name: Wallace Electric Sign or outline liehtias 67 84 2 Address: 105 Dresden St Signal circuit(s)at limited-energy panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP: Astoria OR 97103 Each additional inspection over allowable In any of the above ( Addttirmal Inspection(1 hr min) 66 25/hit Phone:(503 308 0563 1'ax:( ) Investigation(I hr min) 90.00/far Finail:David@wallaccwires.com Industrial plans(1 far mini 78 l tt/far ---, Inspections for which no tine is CCB I.ic.:224868 Electrical Li ' C1441 Su .I: 6363S specifically listed(tt'lumin) 0000/hr Suprv.Electrician signature,required: ',w ELECTRICAL;PERMIT FEES Nv"'" Subtotal - Print name:D> sp ,. Date: Jr fL Ai _O_ Plan Review Requital(25%of permit fee): _ — t i State surcharge(12%of permit fee)- Authorized sig fixture �/r� TOTAL PERMIT FEE: tt 1 This permit application expires if a permit a net obtained within tern [Print name: 1„ _ Date: `/X days after It has been accepted as complete- _—____ .-..... r i I - ` Number of Lest/moons allow ... per permit. EiHutkdagY'cmutt'iEt.(:_1'a'mitADP FI.R ERf..doc Rev061112015 4 0.t61ST(t1/05lCOMM1LFB Plumbing Permit APplicatio fIECEIVE Buitdling Fixtures FOR OFFICE USE ONLY City of Tigard SEP 2 1 2021 Received r Date/By �jl��Z��O G v 13125 SW Hall Blvd.,Tigard,OR 97 TY OF TIGARD Plan Review Phone: 503.718.2439 Fax: 503.59 Other Permit Nc.- Date/By Permit No. TIGARD Inspection Line: 503.639.4175 DING DIVISION Date Ready/By: Jmis: H See Page 2 for Internet: www.tigard-or.gov Notified/Method, Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist. - Description I Qty. 1 Ea. I Total ❑Addition/alteration/replacement 0 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 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building SFR(3)bath 500.32 -Multi-family Each additional bath/kitchen 25.02 ❑Master builder ®Other: ADU Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 16646 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:ArmiliaiJullitriptiPolygon 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 _____ Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name:Polygon WLH,I.LC Fixture-sewcrcap 25.02 Floor drain/floor sink/hub 25.02 Address:703 Broadway St.,Ste 510 t-- -.- -- 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 WLI1,1.1.0 Medical gas(value.$ ) Page 2 Primer 12,51 Contact name:Tonja Morris Roof drain(commercial) 12.51 Address:703 Broadway St.,Ste 510 Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:permitsubmittals@polygonhomes.com Urinal 25.02 Water closet 25.02 CONTRACTOR - Water heater 37.52 Business name:G&B Plumbing&Sons Inc Water P tPing DWV 56.29 Address:P.O.Box 92 Other: 25.02 City/State/ZIP:St.Paul,OR 97137 Subtotal Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: S72.50 I Plan review (25%of permit fee) CCB Lic.:184372 Plumbing Lic.no.:pb634 State surcharge(12%of permit fee) Authorized signature: 7y�-_ TOTAL PERMIT FEE Print name:Steve Fowler Date: 1 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 Tri.County Building industry Service Board. 1',auiidmg/Permits\PL?IU-PermitApp.doe IOR)IN5 4404616T(IO,a2tCOM+WEB) City of Tigard v!piCOMMUNITY DEVELOPMENT DEPARTMENT ■ T l G A R n Building Permit Review — Residential 0 Building Permit #: 4SrD2l-ff42(, Site Address: 1664 Townsville St. Project Name: Polygon at Roshak Ridge Lot #: 216 Planning Review , Proposal: New dwelling ❑ Verify address/suite#active in Accela. El In River Terrace: ❑ No El Yes,River Terrace Review Addendum Site Plan Elements: ✓Erosion Control 0: copies of site plan on 8-1/2"x 11"or 11 x 17"paper ..F6tetained trees with drip line and tree protection measures Obrawn to scale(standard architect or engineer scale) ,Footprint of new structure(including decks)and FFE 0 orth arrow ,Utility locations&easements(required for new and additions) rite address,project or subdivision name and lot number Ljidewalk/driveway approach 0•pplicant information(name and phone number) _:,ocation of wells/septic systems 0 ot dimensions and building setback dimensions Street tree size,type and location l .quare footage of buildings to be demolished ,Street names II xisting structures on site v 2omer 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? °❑i 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 ❑o Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑Yes,applicant was notified ❑✓ No Received: 0 Yes El No ❑r 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 ❑e No Received: ❑Yes ° No CI Public Facilities Improvement(PFI)Permit: Required: El Yes,applicant was notified ❑o No Applied For: ❑Yes ❑ No,stop intake El Land Use Case#: ADU2021-00012 Q Zoning: R-7 ❑° Required Setbacks: Front: 8/12 Rear: 10 Side: 3 Street Side: NSA Garage: 20 0 Building Height: Max.Height: NSA Actual Height: 24 CILandsca.e Area: 20 % CI Lot Coverage Max: 80 0/0 Entrance 0 Set back no more than 8'from street-facing wall El Parallel to street or offset 45 degrees or less Windows 0 Minimum 12%of area of all street-facing facades Garage 0 Garage door is behind widest street-facing wall ❑Yes ❑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 0 12'or less ❑ 50%or less of facade ° 60%or less and includes 7 of following: Covered porch 0 Recessed entrance ❑° Wall offset 8 1'Roof cave Roof offset Fire shingles 0 Lap Siding ❑ Roof itch El Gable,hi ,or gambrel roof ❑Dormer Accent siding I Window trim Window recess Window projection ❑° Balcony ❑ Visual Clearance ❑° Urban Foresu Plan ❑ Sensitive Lands: ❑ Yes 1_J No Type: 0 Conditions met prior to issuance of building per it Notes: ❑ Approved By Planning: Date: Of Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw RES_122419.docx Building Permit Submittal Original Submittal Date: OAOa/ Site Plans: # . ' Building Plans: # 3 Building Permit#: Enter building p'er/mit#above. Workflow Routing: Planning L�Engineering PrPermit Coordinator ErBuilding Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: a ngineering: (1) copy of permit application, (1) site plan, (1) building plan and /original plan review routing form. 12 tuilding: original permit application, site plans,building plans,engineer and beam calculations and itt details,if applicable,etc. Notes: / By Permit Technician: j//4/7w Date: 09/30-02/ Engineering Review Slope at building pad: !d2 EfConditions "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 rtkZ o Assess Water Quantity Fee in-lieu: ❑ Yes o LIDA Facility on lot: ❑ Yes No Ei Final Plat Recorded: ❑ NOT Approved by Engineering: Date: ,N�ottes: L� Approved by Engineering: Date: 9 2 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: SDC Exemption: ❑ Received g Does not a ly „ SDC Fees Entered: Wash Co Trans Dev Tax: 4/Yes U N/A �n Tigard Trans SDC: ,"Yes El N/A 5 S P�CX�',,' `C Parks SDC: ,'Yes ❑ N/A LIDA ❑ Yes /ZN/A 0 OK to Issue Permit Approved by Permit Coordinator: Date: 101I SI202I I:\Building\Forms\BldgPermitRvw RES_122419.docx City of Tigard .1114 COMMUNITY DEVELOPMENT DEPARTMENT T i G A R D River Terrace Building Permit Review Addendum Building Permit #: H5r202/-00([2-(0 Site Address: 16646 SW Townsville 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 CI No (Per MMD2020-00044) 'culation: 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: CIMax. 8 ft. setback from longer trees-facing wall CI Parallel to street, . gle no more than 45° from street, or open onto por Entrance opens to a porch: 0 Yes 1 o IfLes,all the following apply: CI25 sq.ft. in. One street facing entry Cl 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 Recessed entry area min. 5 ft.wide x 2 ft.deep ❑Wall offset min. 16 inches I 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 0 Accent siding min.40%of street fa .e ❑Window trim , ' .2 1/"wide by 5/8"deep ClWindow 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 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. 0 5 ft.if there is a covered front porch and garage does not extend beyond the fro .orch. ❑May exten. p to 5 ft.where the garage is part of a two-story building and there is a window at the se d story above the 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 I:\Building\Forms\BldgPermitRvw_RES_RT_121417.docx City of Tigard 'Pi q Deferral Until Occupancy Request TIGARD 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: 16646 SW TOWNSVILLE ST Project Land Use Case or Polygon at Roshak Ridge MST2021-00426 Name: Building Permit#: Tax Lot Total Parks 2S107AA21600 $5,839.00 #: Lot 216 Amount*: TDT Total TSDC $2,134.00 Amount: N/A Amount*: *The total TSDC amount shown above is the sum of$ 0 for TSDC-Improvement,$ 225.00 for TSDC- Reimbursement,and$1,909.00 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: 0mxa.d-.Agim.i.R6eako Date: 11/3/2021 Developer: Oma.L.41a4la.A6ali4a6a. Date: 11/3/2021 Permit Coordinator: Date: 11/3/2021