Permit n CITY OF TIGARD MASTER PERMIT
111
1I s COMMUNITY DEVELOPMENT Permit#: MST2021-00302
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 r, _ �, Date Issued: 11/04/2021
.; Parcel: 2S107AA20200
I/ Jurisdiction: Tigard
Site address: 16552 SW DARWIN LOOP
Subdivision: ROSHAK RIDGE Lot: 202
Project: Polygon at Roshak Ridge, Lot 202
Project Description: New single detached house. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES PAID.
12/7/21: REPRINT to remove(1)hose bib.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1238 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 28 Bathrooms: 3 Second: 1718 sf Garage: 486 sf Front: 8 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2956 sf Value: $410,916.56 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 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: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp. 0 W/Svc or Fdr: 0
Ea addi 500 sf: 5 201-400 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 2956
Owner: Contractor:
POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE PHONE: 360-695-7700
FAX:
Total Fees: $37,265.30
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: /AZ/ Permittee Signature: lSe—C G%( ✓lle /h
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.
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
a ' Tra
nsmittal Letter
T 16/A k I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: A(I jc9v1 Amn5 2(On DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: L /fl'tckA AA
DEC 1 BM
COMPANY: \ouiloe MOW t&O v- \J 021-ht ) es-U C, CITY OF TIGARU
PHONE: 36 G f t 6 8644 3UILDING DIVISIO Y
EMAIL: OL& c oO(1/7o41- .gn>Y 0-.
RE: / .S"2 S c,U 'lam. aetku►n /1.�P 7 n2o� ( - Oct 3c�2
Site Address)LI � � (Permit Number)
(Projeq4Ine or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
'Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions: is
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: ee u i c i g'liv eqt.I eStep` Pen)t I u CI ) A(Ise
I ec \
10. m iNS:(7 ?1O ir►,,.b)Al . -' -a -�e-e-% ,
1-3
FOR FF CE USE ONLY
Routed to Permit Technic' .• Pate: VZ IiI 2( Initials: All—
Fees Due: ❑ Yes Nov Fee Descriptio : Amount Due:
Special
Instructions:
Reprint Permit(per PE): ❑ Yes No ` ❑ Done
Applicant Notified: Date: /2 1) f Initials:
I:\BuiIding\Forms\TransmittalLetter-Revisions 073120.doc
Plumbing Permit Applica i ECEIVED P1'112E1111
Building Fixtures DEC1 2021 FOR OFFICE USE ONLY
City of Tigard (+��/ Received Permit No.:
1114 II 13125 SW Hall Blvd.,Tigard,OR 974'2J t OF TIGARD Date/By:
I Phone: 503.718.2439 Fax: 503 Plan Revi®ING DIVISION �te1$Yew Other Permit No.:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: lam: 0 See Page 2 for
Internet: www.iigard-or.gov Notified/Method. Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. J 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
SFR(3)bath 500.32
❑Accessory building 0-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: 16552 SW DARWIN LOOP 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: 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
Water service(no.linear ft.:*) Page 2
Subdivision: Polygon at Roshak Ridge Lot no.: 202 Fixture or item: __
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New construction,type:SFU unit MST2021-00302
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
I PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: Taylor Morrison Northwest 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 1 25.02
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
-
toAPPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Taylor Morrison Northwest LLC. Medical gas(value:S ) Page 2
Primer 12.51
Contact name:'Omar Alami Abouhafs
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@taylormorrison.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:G&B Plumbing&Sons Inc Water piping/DW'V 56.24
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
k Plan review (25%of permit fee)
CCB Lic.:184372 Plumbing Lic.no.:pb634
State surcharge(12%of permit fee)
Authorized signature: ,. �t �. _ TOTAL PERMIT FEE
Print name:Steve Fowler Date: 10/30/20 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
t *Fee mcthodalogy set by Tri-County Building Industry Service Board.
1.1Bo0dm5'Pcrmits'PLMU-PermicApp-doe 10/01409 440.46I6TII0i02/COMv6B)
4
q CITY OF TIGARD MASTER PERMIT
11111 i COMMUNITY DEVELOPMENT Permit#: MST2021-00302
Date Issued: 11/04/2021
T1GARL) 13125 SW Hall Blvd,Tigard OR 97223 503.718,2439
Parcel: 2S107AA20200
Jurisdiction: Tigard
Site address: 16552 SW DARWIN LOOP
Subdivision: ROSHAK RIDGE Lot: 202
Project: Polygon at Roshak Ridge,Lot 202
Project Description: New single detached house. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1238 sf Basement: 0 sf Left: 3 Parking Spaces• 0
Height: 28 Bathrooms: 3 Second: 1718 sf Garage: 486 sf Front: 8 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2956 sf Value: $410,916.56 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 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
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
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'I 500 sf: 5 201-400 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 2956
Owner: Contractor:
POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $37,265.30
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: HoLLy VcU" Pe-Wey2 Permittee Signature: Ot'''Aj tAlt.cul-t o-w
Call 503.639.4175 by 7:00 a.m,for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application LmO1" Zo 2
Residential FOR OFFICE USE ONLY
City of Tigard RECEIVEDReceived 6j q� PermitNo.:
c, x�p Date/By: b ?j N\ NIJT�Gt-603C2
4 13125 SW Hall Blvd.,Tigard,OR 97223 Ai2 .7 Ltl + Plan Review -!Q L'
ilk _ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 9 e- der Permit: G02204V IN Z
T 1 G A R D In Line: 503.639.4175 CITY OF TIGA Date Ready/By: fur See Page 2 for
Internet: www.tigard-or.gov C� Notified/Method: p�Urz/ Supplementallnformation
BUll nu' Of
TYPE OF WORK REQUIRED ATA:1-AND 2-FAMILY DWELLING
0 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. 5tf 0 I-and 2-family dwelling 0 Commercial/industrial Valuation: $ LiO, I 11'
❑Accessory building ❑Multi-family Number of bedrooms: 5
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors:2 419 Z
Job site address: 16552 SW DARWIN LOOP New dwelling area: 2,956 square feet 11(8
City/State/ZIP:Sherwood, OR 97140 Garage/carport area: 486 square feet I?3416
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: 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 J Lot no.: 202 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New Construction/Type: SFU /Elevation plan: 222300D. Valuation: $
Projected start: February 2022 Existing building area: square feet
✓ Deferrals:deferral of payment of transportation&park SDCs to occupancy. New building area: square feet
0 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:
0 APPLICANT 0 CONTACT PERSON 619 BUILDING PERMIT FEES*
Business name:Polygon Homes WLH LLC (Please refer eo fee schedule)
Structural plan review fee(or deposit):
Contact name:Omar Alami Abouhafs
FLS plan review fee(if applicable):
Address:703 Broadway St., Ste 510
Total fees due upon application:
City/State/ZIP:Vancouver,WA 98660
Amount received:
Phone:(360)946-8674 Fax::( )360 693-4442
E-mail: perm its ubmittalsCtaylormorrison.com-OAlamiAbouhafs o taylormorrison.coin PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Polygon Homes WLH LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:703 Broadway St., Ste 510 Solar Installation Specialty Code checklist.
city/State/ZIP:Vancouver, WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( )360 695-7700 Fax:( )360 693-4442
State surcharge(12%of permit fee): $21.60
CCB lic.:207247 Total fee due upon application: $201.60
Authorized signature: OtN,GiL 4 .ry be, 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: 07/26/2021 *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 Applicat CEIVE FOR OFFICE USE ONLY
Cityof Tigard
Recei4ed
t ' JUL2 r. DateBy: g 2 .21 63{ Permit No.: Mkraczi- a0,30z
13125 SW Hall Blvd.,Tigard,OR 97223 UL tot' plan Review r1,\»
l { Phone: 503.718.2439 Fax: 503.598.1960 Date/By Other Permit: s V"K n,.2 I-�20
7F1A1'I7 Inspection Line: 503.639.4175 CITY OF IIGAR� Date Ready/By: torts El See Page(2 for
Internet: ctww.ttgard-or.gov Notified/Method: Supplemental Information
_ BUILDING DIVISION --
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
w. — 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
0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
®1-and 2-family dwelling ❑CommerciaUindustrial ❑Accessory building For special information use checklist
j Multi-family ❑Master builder ❑Other: Description _ Qty. Ea. 1 Total
JOB SITE LrFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75
Job site address: 16552 SW DARWIN LOOP Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000 I100,000 t BTU(ductsNvents) 54.91
Suite/bldg./apt.no.: J Project name: Polygon at Roshak Ridge Heat pump _ 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
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.: 202 Other 23.32
__ Other fuel appliances:
Tax map/parcel no.: Water heater 2
23.3_
DESCRIPTION OF WORK Gas fireplace/insert 33.39
New construction, detached SFU unit Flue vent for water heater or gas
Tye' fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0PROPERTY OWNER Other: 23.32
❑ TENANT
' Environmental exhaust and ventilation: _
Name:Polygon WLH,LLC Range hood/other kitchen
Address:703 Broadway St.,Ste.510 equipment F 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 I Fax:( ) Attic/crawlspace fans 23.32
—El APPLICANT � 0 CONTACT PERSON Other: 23.32 I
Business name:Polygon WLH,LLC Fuel piping:
__. S14.15 for first four;$4.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway Su,Ste 510 Gas heat pump
Wall/suspended/unit heater 1
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace
Ranee
E-mail:permitsubmittalst taylOrmorriSOfl.COM Barbecue
INt _W CONTRACTOR Clothes dryer(gas)
Business name:Pro Heating&Cooling Other:
MECHANICAL PERMIT FEES'
Address: NW Alociek Dr,Ste.1 104 •
Subtotal
City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00)
Plan review(25%u 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
p'- days after it has been accepted as complete.
Authorized signature: �u n.Q ' Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date: 10/30/20
I AAnikimotPrnnirt%wnr PP,,,,,,4n.,air1111.h,..
Electrical Permit ApplicationRECElVE I FOR OFFICE USE ONLY
City o xi Received
tY l` gand JUL �U1 Date/BY. A 2/2( m- _Pent MSTe2021-a)3O L-ate 13125 SW hail Blvd.,Tigard,OR 97223 Plan Review
• a'" Phone. 503.718 2439 Fax. 503 598 196 1yamAr Related Permit 6, Q f412 U'4-00 20
Inspection Line: 503 6394175 `CITY OF rIGARG Read Dateal funs. �"`"
R'tC;ARi] /'� n n Y Y' �see Page 2for
Internet: www.tigard-or SUIL.DING DIVISION-Nottficd,"tifcdrpd_ Supplementallnformation
TYPE OF WORK PLAN REVIEW
gi New construction ❑Addition/alteration/replacement Please check all that apply(submit j sets of plans whims checked)
0 Demolition ❑[)[}tom; 0 Same or feeder 400 amps a more ❑Budding over three stones
where the available fault current 0 Marinas and boatyard
_ CATEGORY OF C:ONSTRI CTION exc eds 10,000 amps at 150 volts or ❑Floating buildings
® t-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less w tnound,or exceeds 14.000 0 Commercial-use agricultural
amps fin all other installations budduu s
❑Multi-family ❑Master builder ❑Other: 0 Fire pump ❑Installation of 150 KVA or
JOB Silt INFORMATION .AND LOCATION 0 Emergency system larger separately derived
Job#: Job site address:16552 SW DARWIN LOOP El Addict m of new m°'°`lied of system.
10011P or Mara ❑"A"."E","1-2","1-3",
City/State/ZIP: Tigard,OR 97140 0 Six or more residential units occupancy
—. 0 Health-cart facilities. ❑Recreational vehicle paths.
Suitc/bldg_/apt.4: Project name: Polygon at Roshak Ridge ❑llasardons locations ❑Supply voleige for more than
❑Service or feeder 600 amps or more 640 volts nominal..
Cross street/directions to job site: FEE SCHEDULE
._ Asscripfioa i tTtr. l Each 1 'focal 1
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot 4: 202 Includes attached garage.
Tax map/parcel#: Loco sy ft or less 168 54 4
Ea.add'!500 sq ft or portion 33 92 1
. DESCRIPTION OF WORK Limited energy,residential .
Nl env construction.Type SFU
(with above sq.ft) 75.OQ 2
Limited energy,multi-faintly 75.00 2
residential(with above sq ft.)
Renewable Energy 0 Sec Page 2
El PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: Polygon Homes WLH LLC 200 amps or less 100.70 2_
Address: 703 Broadway St.,Ste 7I0 201 amps to 400 amps 133.56 ' 2
— 401 amlti to 600 amps 200 34 2
City/State/ZIP: Vancouver,WA 98660 601 amps to 1,000 amps 301 04 2
Phone:( 360 )946 8674 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or faders installation alteration,Email: OAlamiAbouhafs@taylormorrison.com-PenmitSubmittal to ylormorrison.com tin,and/or
y relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or kit 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447.449,670,and 701. 201 amps to 400 amps 125 08 2
Owner signature: Data: 401 amps to 509 amps 168 54 2
0 APPLICANT I ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
th
Business name: Polygon Homes WI.H LLC A.aboveFeo ft service or circuits>fce,
fcerkt foe, 7 42 a
- each branch circuit -
Contact name: Omar Alami Abouhafs B Fee for branch circuits without
Address: 703 Broadway St.,Ste 710 service or feeder fee,tint 56 I8 2
branch circuit
•
City/State/ZIP:Vancouver,WA 98660 Each add'!branch circuit 7.42 2
Phone: 364 946 8674Miscellaneous(service or feeder not included)
( ) Fax::( ) Each manufactured or modular 67 84 2
Email:OAlamiAbonhafs@tay lonnorrison.com-PerinitSubmittals@taylormolrison,com dwelling.service and/or feeder
Reconnect only 67 84 2
_ CONTRA("IOU Pump or in tgatiun circle 67.84 2
Business name: Wallace Electric Sign or outline lighting 67 84 2
I Address: 105 Dresden St Signal ceremt(s)or limited energy 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP: Astoria OR 97103 Each additional inspection over allowable in any o€the above
• Additional inspection(l hr min) 645 25/hr
I Phone:(503 308 0563 Furs:( ) Ins-mitigation(1 hr min) 00.110/hr
Email: llavidfwallacewires.com Industrial plant(1 hr min) 78 18/hr
-
Inspections for which no fee is
CCB tic.:224868 Electrical Li-- C1441 Su _I, 6363S specifically listed OShr min) 9000/hr
ELECTRICAL: PERMIT FEES
Suprv.Electrician signature,required:
b/' ''— Subtotal
Print name:'jam cep t Date: /tt Iz t _0 Plan Review Required(25%of permit fee):
t t" State surcharge(12%of permit fee)
Authorized signature T('ITAL PERMIT 1 I L
Print name: This permit application expires it permit is not obtained within 180
n 0,_��, Date: L f / flays aBer it has been accepted as complete.
— —.... 6 Z-I __ + Number of inspections allowed per permit.
1:\Bwl bn�8eructa'�f:LC,PenntApp_ELR ERF.dcc Rev 06/11/2015 4,0-46157(i 1J05/COM'WS9
RECEIVED
Plumbing Permit Application
Building Fixtures JUL 20V FOR OFFICE USE ONLY
City of Tigard CITY OF TIGARU Received 8 z 2t N MST26Lt-od3o2.
Permit No..
13125 SW Hall Blvd.,Tigard,OR 972p1�ILDING DIVISION y
s u Plan Review
' Phone: 503.718 2439 Fax: 503.598, Other Permit No
DatelBy S8J. "WZ 1-60282,
TIGARD Inspection Line: 503.b39.4175 Date Ready/By: Lids 21 See Page 2 fur
Internet: www.tigard-or.gov Nttifiedsiethod: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special in ornration use checklist. _
i Description Mil Ea. Total
❑Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
~
(�1-and 2-family.dwelling ID Commercial/industrial SFR(2)bath 437.78
!" SFR(3)bath 500.32
0 Accessory building -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: 16552 SW DARWIN LOOP Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
---- Footing drain(no linear ft ) Page 2
Suite/bldg./apt.no.: Project name:mlieeirwirFiidg+ePolygon 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.: 202 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
New construction,type:detached SFU unit Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 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:( ) Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Polygon W LH,LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Tonja Morris
Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 _ ( Sink/basinnavatory 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 Pm ip g 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: S7250
CCB Lic.: 184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized sigmature: .._ L TOTAL PERMIT FEE
Print name:Steve Fowler Date:
10/30/20 This permit application expires it a permit is not obtained within ISO days
after It has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board
1'tButldingtpetmits/PLMU-PermitApp_doe IQVI09 440.4616T(10fa21COM+WEB)
City of Tigard
III y COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 cA. Building Permit Review — Residential
Building Permit #: MSTio21- 00 62_
fr Site Address: 16552 SW Darwin Loop
Project Name: Polygon at Roshak Ridge Lot #: 202
Planning Review
1 Proposal: New house
I.I Verify address/suite#active in Accela. i] In River Terrace: ❑ No f7 Yes, River Terrace Review Addendum
Site Plan Elements: %]Erosion Control
6C13 copies of site plan on 8-1/2"x 11"or 11 x 17"paper f®Retained trees with drip line and tree protection measures
®Drawn to scale(standard architect or engineer scale) ill Footprint of new structure(including decks)and FFE
®North arrow klUtility locations&easements(required for new and additions)
It Site address,project or subdivision name and lot number X Sidewalk/driveway approach
®Applicant information(name and phone number) InLocation of wells/septic systems
1 ®Lot dimensions and building setback dimensions ®Street tree size,type and location
ISaSquare footage of buildings to be demolished J Street names
Existing structures on site CiCorner elevations(2'contours if more than 4'differential)
®Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? LfA ❑No
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes ENo
® Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ® No Received: ❑ Yes E No
IC Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified ® No Received: ❑ Yes E No
Il SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No
® Public Facilities Improvement(PFI) Permit
Required: ❑ Yes,applicant was notified a No Applied For: ❑ Yes ❑ No,stop intake
® Land Use Case#: SUB2015-00004 ® Zoning: R-7
1E Required Setbacks: Front: 8 Rear: 10 Side: 3 Street Side: N/A Garage: 20
Xl Building Height Max.Height: N/A Actual Height: 28
® Landscape Area: 20 % IRI Lot Coverage Max: 80
Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 de
Windows %of area of all street-facing facades
Garage ❑ Garage door is This section does not apply - o,one of the following is met:
❑ Door extends no mSee River Terrace Addendum h extending beyond garage.
❑ Door extends no . .. — .... . . -- . . . . .ow above garage on 2nd floor.
I
❑ Garage door widt . or less ❑ 50%or less of faca.- jO, or less and includes 7 of following:
• . porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roo -. ❑ Roof offset
• Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof me - -
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
® Visual Clearance ® Urban Forestry Plan
0 ❑Sensitive Lands:
Yes ® No Type:
❑ Conditions met prior to issuance of building permit
otes:
IN Approved By Planning: oetivtetn Date: 7/27/2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
I:\Building\Forms\BldgPermitRvwRES_122419.docx
Building Permit Submittal
Original Submittal Date: 6 .3 021
Site Plans: # 3 •
Building Plans: # 3
Building Permit#: nter building pee t#above.
Workflow Routing: Planning 2 Engineering Permit Coordinator 'lding I
Workflow Sign-off: Planning
for Planning(include notes from planning review)
Route Application Documents: Gil
'neering: (1) copy of permit application, (1) site plan, (1) building plan and
ginal plan review routing form.
Building: original permit application,site plans,building plans,engineer and
beam calcula ' and trust details,if applicable,etc.
Notes:
By Permit Technician: --- Date: y 2 213e1
Engineering Review
Lid Slope at building pad: di,
[Conditions"Met"prior to issuance of building permit
Ild' ,asements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: El Yes P".No
Assess Water Quantity Fee in-lieu: El Yes tr No
LIDA Facility on lot ❑ Yes VNo
inal Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: efr �21
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
zie 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: El Received X Does not apply
7(SDC Fees Entered: Wash Co Trans Dev Tax: /Yes ❑ N/A spGs p„Q
Tigard Trans SDC: /Yes ❑ N/A •
Parks SDC: /Yes ❑ N/A
LIDA ❑ Yes X N/A
IZ. OK to Issue Permit
Approved by Permit Coordinator: 11-\ \i‘-Q
Date: S112 E2021
t
I:\Building\Forms\BldgPermitRvw_RES_I22419.docx
City of Tigard
III r COMMUNITY DEVELOPMENT DEPARTMENT
■
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: Mc('toik oc>30'L
Site Address: 16552 SW Darwin Loop
Project Name: Polygon at Roshak Ridge Lot #: 202
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
1
Planning-Review of.liver ?Terrace Plan.District Desika Standards (18 G40.070.I.):
Is the project subject to the plan district design standards? ® Yes ❑ No
1.Articulation: a minimum of 1 element per each street-facing façade that has 30-60 ft. of frontage. An additional
element 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 min. 5 ft. deep ft. deep min. 2ft., 5 ft.wide min.2 ft.,Eft.wide Gabled dormer
ii ❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: 17%
14
3. Entrances:At least one entrance must meet both of the following standards:
facing wall ® Parallel to street,angle no more than 45° from street,
$7 Max. 8 ft. setback from longest street-
or open onto porch
Entrance opens to a porch: X Yes ❑ No
If yes,all the following apply: ® 25 sq.ft. min.
] One street facing entry ® 12 ft. max. roof above floor of porch
GCC 5 ft. depth min. GC 30%min.porch roof coverage
4. Detailed Design:All buildings shall include a min. of five 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 ❑ Dormer min. 4 ft.wide
❑ Roof eave min. 12 inch projection ❑ Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood $7 Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min.40%of street facade N Window trim min. 2 1/2"wide by 5/8" deep
❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft.deep
❑ Balcony min. 5 ft.wide x 3 ft.deep with inside access ❑ Attached garage is 35% or less of street facade
5. Garages and Carports:Mayface the front or side lot line on a corner lot.
� �
Setbacks:
No closer to front or side lot line, than longest street-facing wall. ® Yes ❑ No. If No (Check one):
❑ May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
above the garage that faces the street with a min. area of 12 sq.ft. l
Width: (Check one)
❑ 12-foot-wide garage door ® 40%max. of street façade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: Date: 7/27/2021
1:\Bui l ding\Form s\BldgPermitRvw_RES_RT_121417.docx
City of Tigard
: Transportation System Development Charge (SDC)
T1GARD Notification of Fee and Payment Options
ANNUM
This advises you that the total TSDC for this project is as shown below and outlines the payment options that may be
available to you. This total includes charges for TSDC-Improvement,TSDC-Reimbursement, and TSDC-River
Terrace,if relevant.
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).
City of Tigard
Date: Site Address:
8/4/2021 16552 SW Darwin Loop
Project Polygon at Roshak Ridge - Land Use Case or
Name: Lot 202 Building Permit #: MST2021-00302
Tax Total TSDC
2S107AA20200 $10,348
Lot#: Amount*:
*The total TSDC amount shown above is the sum of$6,690 for TSDC-Improvement, $386 for
TSDC-Reimbursement,plus $ 3,272 for TSDC-River Terrace,if relevant.
This constitutes my request to use the TSDC payment option or combination of options I have selected below. [This
selection can be changed up to the time a building permit is issued.] I realize that TSDC charges are due and payable at the time
a building permit is issued unless those charges are Deferred or are financed through Installment Payments.
❑ Cash, Check, or Credit Card, payment due at building permit issuance.
0 Deferral until Occupancy,payment due before issuance of an occupancy permit.
Payment of the TSDC may be deferred until issuance of the occupancy permit. In requesting this option,I understand
that any deferred TSDC must be paid prior to issuance of a Certificate of Occupancy or final inspection. For a deferral
request to be accepted both the Property Owner and the Developer must sign this request.
❑ Credit Voucher for developer-built required public improvements, subject to approval, completion,and
acceptance of creditable improvements
NOTE: TSDC Credits must be redeemed at the time TSDC Payment is due,either at the time the building permit
is issued or,if payment is deferred,prior to issuance of an occupancy permit. If you expect to claim TSDC Credits be
sure the improvements, any creditable payments,and your Request for Credits is complete either before your building
permit is to be issued or,if payment is deferred,before you request an occupancy permit. No refund of TSDC Payments
will be made if Credits are submitted more than 30 days after issuance of the relevant building or occupancy permit.
❑ "Bancroft" or Installment Payments (separate application required.)
Dn -,e gafrpa eeu Dom,.A gzolti
PROPERTY OWNER DEVELOPER
DATE: 08/04/2021 DATE: 08/04/2021
I:ACommunity Development\Permit Coordinator\SDC Forms\TSDC Combination Payment Option Form 112718 AMS
City of Tigard
Parks SDC Charge (Parks)
TIGARD Notification of Fee and Payment Options
Please sign and return prior to building permit issuance.
This advises you that the total Parks SDC charge for this project is as shown below and outlines the payment
options that may be available to you. This total includes Parks SDC-Improvement,Parks SDC-Reimbursement,
and either Parks-Neighborhood or Parks-Neighborhood River Terrace charges as relevant. This form is to be
signed and submitted prior to issuance of a building permit.
City of Tigard
Date: 8/4/2021 Site Address: 16552 SW Darwin Loop
Project Polygon at Roshak Ridge - Land Use Case
Name: Lot 202 or Permit #: MST2021-00302
Tax Total Parks
2S107AA20200 $10,903
Lot#: SDC Amount*:
*The total Parks SDC amount shown above is the sum of$ 6,278 for Parks-Improvement,$1,739 for Parks-
Reimbursement,and either$ N/A for Parks-Neighborhood or$2,886 for Parks-Neighborhood River Terrace.
This constitutes my request to use the Parks SDC payment option or combination of options I have selected below.
[This selection can be changed up to the time a building permit is issued.] I realize that SDC charges are due and payable at the
time a building permit is issued unless those charges are Deferred or are financed through Installment Payments.
❑ Cash, Check,or Credit Card,payment due at building permit issuance.
® Deferral until Occupancy,payment due before issuance of an occupancy permit.
Payment of the Parks SDC may be deferred until issuance of the occupancy permit. In requesting this option,I
understand that any deferred Parks SDC must be paid prior to issuance of a Certificate of Occupancy. For a deferral
request to be accepted both the Property Owner and the Developer must sign this request.
❑ Credit Voucher (for developer-built required public improvements, subject to approval, completion,and acceptance of
creditable improvements.)
PLEASE NOTE: Parks SDC Credits must be redeemed at the time Parks SDC Payment is due, either at the time
the building permit is issued or,if payment is deferred,prior to issuance of an occupancy permit. If you expect to claim
Parks SDC Credits be sure the improvements,any creditable payments,and your Request for Credits is complete either
before your building permit is to be issued or,if payment is deferred,before you request an occupancy permit. No
refund of Parks SDC Payments will be made if Credits are submitted more than 30 days after issuance of the relevant
building or occupancy permit.
❑ "Bancroft" or Installment Payments (separate application required.)
Onca.4, &or"; eezdazie. Ontaa,.Reahu'.R6elidadd.
PROPERTY OWNER DEVELOPER
DATE: 08/04/2021 DATE: 08/04/2021
I:\Community Development\Permit Coordinator\SDC Forms\Payment Option Forms
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
11le
4 Transmittal Letter
r I,,,\R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: AAi i)Y1 �tmts to. DATE RECEIVED:
DEPT: BUILDING DIVISION
RECEIVED
FROM: 4Jrn4,c& kik1h,: Ab0ullo\Vs SEP 2 2021
COMPANY: CITY OF TIGARD
I (c 2 �4R �n BUILDING DIVISION
PHONE: .-6o %9 ( 86 44 By:
EMAIL: '9 :ti'lO()11 1 LQ'nlo(r' • t -,
RE: / taki 1 11 ST..2.c ( — 003 0CL
(Site Address) (Permit Number)
O o .d f— _ 02
(Pro t ame or subdivision name and lot number) d
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Descriiptiont
Additional set(s) of plans. #2, Revisions: ckfctite4 c.,oti.A14191.4
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other (explain):
REMARKS: ?e,otlst Seep cevi,s, c1,, laj adLu/ and ,e2nj 4
r,�r?a d F .. . x '"E..,o:.x „,r,r� ',Far u'4r MI nflM.1' '.t,M 'A°'''4,
Fro OFFICE �O L, 0 r
Routed to Permit Techni ian: te: 21 Initials:
Fees Due: ❑ Yes �Descrip ion:,,x Amount Due:
$
6 $ RS,_
Special
Instructions:
Reprint Permit(per PE : ❑ Yes No E Done
Applicant Notified: Date: 7712 f Initials:
1:\Building\Forms\TransmittalLetter-Revisions_073120.doc