Permit CITY OF TIGARD MASTER PERMIT
I COMMUNITY DEVELOPMENTN , :r,:.Itl
Permit#: MST2021 00318
x l ' Date Issued: 11/04/2021
TIGARD 13125 SW Hat Blvd.,Tigard OR 97223 503.718.2439 , Parcel: 2S107AA20500
I Jurisdiction: Tigard
Site address: 16584 SW DARWIN LOOP
Subdivision: ROSHAK RIDGE Lot: 205
Project: Polygon at Roshak Ridge, Lot 205
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: 1220 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 28.5 Bathrooms: 3 Second: 1727 sf Garage: 486 sf Front: 12
Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2947 sf Value: $409,741.34 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 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: 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 2947
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: $37,228.63
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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By: /..i."‘:
Permittee /i •�Issued Signature: ,(.Lf���C�
6�
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.
IlliCity of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
le
TTransmittal Letter
T I c A 12 n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
ii
TO: A I1 l)y f Rlii15hg61CJ DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: 97)22.\ \_ A DEC 12021
COMPANY: T (o,2 /7 Ac), t Bit es1 Li( t;ITY OF TIGARD
PHONE: BUILDING DIVISION By: -.
EMAIL: 9 0/1/A °LionUhit9 C P I /A JYi vg, Sv .cJa -�
RE: SW Th i i7 L/ V\ST Io ( — 003 ( 7
' Addr s) (Permit Number)
D 0 OS
(Pro'e a or subdivision name and lot number
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Cos $ ' t a .. t R ,pt : �i
Additional set(s) of plans. 1 Revisions: tow,l-t t hose 646,
Cross section(s) and details. Wall bracing and/or latera analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain): �
REMARKS: cev,S re Ralik P-sl e)-- - -eYI>\004 0 (1) .A os e b ��.,
( RpcHz„...
t �,\(:). m -. b):\64`` 6 .
FOR FF CE USE ONLY
Routed to Permit Technici Date: 1 . (, z-i Initials: iht-
Fees Due: El Yes [] Fee Descrip ion: Amount Due:
0 N -E t..,-- $ 721------
Special
Instructions:
Reprint Permit(per PE): ❑ Yes R 11 o ✓/ ❑ Done
Applicant Notified: Date: J,,2,17/2/ Initials:
I:\Building\Forms\TransmittalLetter-Revisions 073120.doc
Plumbing Permit Application' D n. iii
Building Fixtures DEC 1 2021. FOR OFFICE USE ONLY
City of Tigard CITY OF TIGAHIJ Received
III
Permit No.:
it 13125 SW Hall Blvd.,Tigard,OR 972 3 tt Plan Rev
s Phone: 503.718.2439 Fax: 503.598. u.DING DIVISION Plan Rtview Other Permit No.:
Inspection Line: 503.639.4175 t)atetRe
TIGARD Internet: www.ti,ard-or. pv Date Ready By: Inns: H See Page 2 for
g g Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist.
Description I Qv. 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(1)bath 312.70
l-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 _
❑Accessory building SFR(3)bath 500.32
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: 16584 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.: 205 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New single-family unit construction. (MST2021-00318) Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump _ 25.02
® PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: Taylor Morrison Northwest LLC. Fixturcrsewer 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
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Taylor Morrison Northwest LLC. Medical gas(vatic:S ) Page 2
Primer 12.51
Contact name:'Omar Amami 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 P tPing I)WV 56.29
Address:P.O.Box 92 Other: 25.02
City/State/ZIP:St.Paul,OR 97137 Subtotal
Phone:(503)868-1417 Fax:(971)727-8 1 70 Minimum permit fee: S72.50
Plan review (25%of permit fee)
CCB Lie.:184372 Plumbing Lie.no.:pb634
State surcharge(12%of permit fee)
Authorized signature: ��' 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.
*Fee methodology set by TO-County Building Industry Service Board
I.dtaiidangPermits'PLMti-l'amsApp.doe I0!91419 440-06167(10,02/COM'WEB)
® CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2021-00318
Date Issued: 11/04/2021
T 1 C.;A R D 13125 SW Hall Blvd,Tigard OR 97223 503.718.2439 Parcel: 2S107AA20500
Jurisdiction: Tigard
Site address: 16584 SW DARWIN LOOP
Subdivision: ROSHAK RIDGE Lot: 205
Project: Polygon at Roshak Ridge,Lot 205
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: 1220 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 28.5 Bathrooms: 3 Second: 1727 sf Garage: 486 sf Front: 12 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2947 sf Value: $409,741.34 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 2947
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: $37,228.63
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: Ho-tLaj Va.w De,WE-gE- Permittee Signature: 01A,Ato-p-Liza4-ia-vu
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 ApplicationLorirAOS°RECEIVED2
5
Residential FOR OFFICE USE ONLY
Cityof Tigard Received .,,,..—///���
il - g Date/By: Z �r Permit No.: 1 . /OZt'�2's
a '" 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review / 1 _ l
T I G A R n Phone: 503.718.2439 Fax: 503.598 l OF ,OF TIGARD Date/By: 10 J Other Permit: V+ 1 a �— J
Inspection Line: 503.639.4175 TDate Ready/By: �� J ghee Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION' ..Ified/Method: , A) ,•�� Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction ❑Demolition Pen-nit 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. ,l
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ LI p�`1 9 j 3
❑Accessory building 0 Multi-family Number of bedrooms: 5
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors:2 3433
Job site address: 16584 SW DARWIN LOOP New dwelling area: 2,947 square feet 1 7 7
City/State/ZIP:Sherwood,OR 97140 Garage/carport area: 486 square feet 1.D.D.O
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 I Lot no.: 205 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
ew Construction/Type: SFU /Elevation plan: 222300E Valuation: $
Deferrals: YES-deferral of payment of transportation&park SDCs to occupancy. Existing building area: square feet
Projected start: March 2022 New building area: square feet
El PROPERTY OWNER 0 TENANT uter 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 0 CONTACT PERSON Ui9 BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Polygon Homes WLH LLC 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: permitsubmittals a,taylormorrison.com-OAlamiAbouhafs@taylormorrison.com 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: Gilt LL 41a.4te .cy 66.1.zitid. 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: 08/02/2021 *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 ApplicatinliE EIV ! �FOR OFFICE USE ONLY '
City of Tigard ; Ziri` Received '- eve/0���l
AUGi r-
L' Datc/Byc Permit No.
• "` 13125 SW Hall Blvd.,Tigard,OR 97223
v Plan Review
5142? Zl—cx�2 II
Phone: 503.7I8.2439 Fax: 503.598.I960CI�/OF 1 IGARG Dated>' Pernik:
Other Per : p
7F GAltl7 Inspection Line: 503.639.4175 BUILDING 1' A Date Ready/By: tans: @ See Pale 2 for
Internet: www.tigard-or.gov DIVISION' NotiScd-Method 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 I SYSTEMS FEES*
(I I-and 2-family dwelling ❑Commercial/industrial ❑ Accessory building For special information use checklist.
j Multi-family ❑Master builder ❑Other: Description
_ Qty. Ea. I Total
JOB SrrE LNFORATION AND LOCATION Heatinrlconling:
Ibl
Air conditioning I I 46.75
Job site address: 16584 SW Darwin Loop
Furnace 100.000 BTU(ducts/vents) 46.75
City/State/ZIP.Tigard,OR 97224 Furnace 100,000i BTU(ducts/vents) 54.91
Suite/bldg./apt.no. 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.: 205 Other: 23.32
---- Other fuel appliances: _
Tax trap/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert_ 33.39
New Single Family Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39 _
Wood fireplace/insert _ 23.32
Chimney,°liner/fue/v_ent ry 23.32
"4 PROPERTY OWNER Other: _ 23.32
❑ TENANT' -
Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen I --
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 N __ Fax:( ) Attickrawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: _._ 23.32
Business name:Polygon WLI1,LLC Fuel piping:
S14.15 for first_fottri$4.03 for cacti additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
— Wall/suspended/unit heater I
City/State/ZIP:Vancouver,WA 98660 `Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Ranee
E-mail:permitsubmittalsttaylOrmorfiSOn.COM Barbecue
iNk CONTRACTOR Clothes dryer(gas)
Business name.Pro Heating St Cooling Other I I
MECHANICAL PERMIT FEES*
Address: Ns'Alociek Dr,Ste.1104
Subtotal
City/State/ZIP:Hillsboro,OR Minimum permit fee(S90.00)
Plan review(25i.of permit fee)
Phone:(360)270-1590 Fax:( ) State surcharge(12°ia of permit fee)
CCB lie.:209001 TOTAL PERMIT FEE
� ( This permit application expires if a permit is not obtained within 1s0
I\/` ,t ^ s., days after it has been accepted as complete.
Authorized signature: t� JJJt�'vtc-f t • Fee methodology set by Tn-County Building Industry Service Board
Print name:Elia Duran Date: 10/30/20
rwe.ilelm•tv,rrn:rat4F^Pormit 411,1 runt ix,4,,
ii
Electrical Permit Applicatio -..,- - t - FOR OFFI( F I Sr t)N 1 ti
City of Tigard Received 4 I-
Permit b ApC Tnn,� r'� > �(
III
13125 SW Ball Blvd.,Tigard,OR 97223 IhiteDy M31 /)+�` 31�
` pp r, flan Review
I —
!r ' Phone: 503.718 2439 Fax: 503.598.I9JIT i/OF TIGARL _ Related Permit it- . 2D2,' 2 Y
ISatuTiv. It
Inspection Line: 503.639 4175 Readyoatc/R Juns:
I I.c3A1.1, BUILDING DIVISION _ Y Suppl10 emental
Pene2Inr
Internet: wyvw.11gard-Or,gOV Nocificd,'Mcttad. Supplementallafotvaation
`
TYPE OF WORK PLAN REVIEW
IX1New construction ❑Addition/alteratiou/repl'Scement Please check all that apply(submit a sets of plans w/itams checked)
0 Service or feeder Ono am rn inure
❑Demolition ❑Other: 1b ❑BuddingManna,over three stories
.._- where the available fault current ❑Manna,and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or D Floating buildings
® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building kin to mound,or exceeds 14.01.10 0 Commercial-use agricultural
0 Multi-family ❑Master builder amps for all ether,nstatt tion; buildings
Other: ❑Fire pump 0 Installation of 150 KVA or
JOB Slit INFORMATION AM) LOCATION ❑lunergcncy system larger separately derived
Job it: Job site address:16584 SW Darwin Loo CI Addition of new motor toad of %ystan-
p 10011P or more.
City/State/ZIP: Tigard,OR 97140 0 six or more residential units occupancy
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldgJapt.#: [ Project name: Polygon at Roshak Ridge [hazardous lccattons 0 Supply voletge for more heart
0 Service or feeder 600 amps or more 600 volts nominal..
Cross street/directions to job site: FEE SCHEDULE
.._ -- -- Gmcripuan 1 Oty. I Each 1 'Total 1 '
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: 205 Includes attached garage.
Tax map/parcel#: 1,000 sy ft.or less 16$54 4
Ea.add'l 500 sq tt or portion 33 92 1
DESCRIPTION OF WORK Limited enemy,resideuuat
(with above 75.00 2
New construction.Type SFU �I R1
Limited
fider,t (ssith tsq fi)ily
75.00 2
® PROPERTY OWNER Renewable Energy 0 Sec Page 2
❑ TENANT l Services or feeders installation,alteration,and/or relocation
Name: Polygon Homes WLH LLC 200 amps or less 100.70 2
Address: 703 Broadway Si,Ste 714 201 mops to 400 amps 133.56 2
• 401 amps to 600 amps 200 34 2
City/State/ZIP: Vancouver,WA 98660 _ 601 amps to 1,000 amps Sot 04 2
Phone:(360 )946 8674 Fax:( ) over 1,000 amps or volts 552.26 2
Email: OA.iamiAbouhafs�taylormorrison.corn-PermitSubmittal to lormorrison.com Temporary services or feeders installation,alteration,and/or
Y relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
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: I.)ate: 401 amps to 509 amps 168 54 2
❑ APPLICANT _I I ❑ C:ONTAC! PERSON Branch circuits--new,alteration,or extension,per panel
A Fee for branch circuits with
Business name: Polygon Homes WT.H LLC above service or feeder fee,
each branch circuit 42 _
Contact name: Omar Alami Abouhafs B Fee for branch circuits without
Address: 703 Broadway St.,Ste 710 service or(ecdcx fee,first 56.I8 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Each add'l brunch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360 )946 8674 Pam..
( ) Each manufactured or modular 67 84 2
Email:OAlamtAbOtlhafSTd' dwelling,service and/or feeder
tay lormomson-corn-PermitSubmittals(a1taylormorrison-con Reconne t only
67 84 2
�._ ,
•
CO.YTR:\('l'OR Pump or in'gation circle 67 84 2
Business name: Wallace Electric Sign or outline lighting 67.84 `2
Address: 105 Dresden St Signal circutt(s)or limited energy 0 See Page 2 2
panel,alteration,ix extension.
•
City/State/ZIP: Astoria,OR 97103 Each additional inspection over allowable in any of the above
Additional inspection(1 hr mitt) 66 25/hr
Phone:(503 308 0563 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: Darid@wallaccwires.com wallaccwires.com Industrial plant(1 hr min) 7$l8/In
Inspections for which nu tee is
CCl3_ie.:224868 I Electrical Li-' C 1441 Su 1; .: 6363S specifically listed(15 hr min) 40 MY 6r
Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES
Subtotal
Print name:Ditiv a2 Date: it/4 _❑Plain Review Required(25%of permit foe):
t //z I
State surcharge(12%of permit fee)
Authorized signature TOTAL PERMIT iI:E,
This permit application etpirta if a permit is not obtained within l80
Print nam i4�V , Date: q / days after it has been accepted as complete.
�6 7 `r 4 t . Number of Inspections allowed per permit.
1.'dsuddin1H'trtaits'LLC.PennnApp_ELg ERE.doc Rev 06'1712011 4.U.l615T(1I/05fC0hiNVER
Plumbing Permit ApplicatRECEIVED
Building Fixtures FOR OFFICE USE ONLY
f. City of Tigard Received
r' Date/By: 61 4 k kir Permit No.: M3 Z k`�3
. .t 13125 SW Hall Blvd.,Tigard,OR 97�o� 1��AI�L S �R
t YgZ ) Plan Review
• Phase: 503.718.2439 Fax: SU3.598. Other Permit No.: �e1.'��21 t
Date.By: `�_
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: taro: !3 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. 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(1)bath 312.70
XI-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 4E-Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
___ ___...___.__....__a Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
^Job site address: 16584 SW Darwin Loop Catch basin or area dram 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:fl,.JMl.fUJ,.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.: 205 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New Single Family
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:Polygon WLH,LLC Fixture/sewercap _ 25.02
Address:703 Broadway St.,Ste 510 Floor drain/floor sink hub 25.02
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 Interceptorigrease trap 25.02
Business name:Polygon WLH,LLC Medical gas(value:S ) Page 2
Contact name:Tonja Morris Primer 12.51
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:pernritsubmittals ::poiygonhomes.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:C&B Plumbing&Sons Inc Water piping/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
- Plan review (25%of permit fee)
CCB Lie.:184372 Plumbing Lic.no.:pb634
State surcharge(12%of permit fee)
Authorized signature: ty^-,-, TOTAL PERMIT FEE
Print name:Steve Fowler 1 0/30/20 This permit application expires if a permit is not obtained within 180 days
Date; after it has been accepted as complete.
*Fee methodology set by Tri-County Building Induces Service Board
tlBuiiding%PermitslPLMU-PemtitAno.doe 10,01M05 440-4616T(I0'02.1cOM,weB)
City of Tigard
v COMMUNITY DEVELOPMENT DEPARTMENT
111111
rIGARD Building Permit Review - Residential
Building Permit #: MST SoIA-OU3I &
Site Address: I ( iS2 l Sul 17A2W\ N lam'
Project Name: ry c,01i Ar 12c5'i4i z. .1; .,J t6E Lot #: '7A.
Planning Review
Propo l: N(-�l) t ,E -
erify address/suite#active in Accela. ,In River Terrace: ❑ No L Yes,RiverTerrace Review Addendum
Site lan Elements: 2<osion Control
3 •.pies of site plan on 8-1/2"x 11"or 11 x 17"paper n1i4 [\1R ed trees with drip line and tree protection measures
G II awn to scale(standard architect or engineer scale) mpt o stint of new structure (including decks) and FFE
rA>orth arrow s "ty locations&easements(required for new and additions)
IrriSite address,project or subdivision name and lot number 14 Sidewalk/driveway approach
Elaipplicant information(name and phone number) j L 1Lo ation of wells/septic systems
I Lot dimensions and building setback dimensions et tree size,type and location
tip, 0Square footage of buildings to be demolished IOSet names
rl ❑Existing structures on site ACorner elevations (2'contours if more than 4'differenti/l)
❑Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes ❑Nc 1
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes lNo
Ia Clean Water Services—Service Provider Lette of platted prior to 9/10/1995):
quired: ❑ Yes,applicant was notified I�1 No Received: ❑ Yes CI No
Y1W Water Meter Fixture Unit Worksheet—Additio s,Remodels and ADUs
equired: ❑ Yes,applicant was notified L�J No Received: ❑ Yes ❑ NoDC Exemption for ADU applied for: ❑ Yes 'CJ No Received: ❑ Yes ❑ No
IJ Public Facilities Improvement (PFI)Permit
^ quired: ❑ Yes,applicant was notified LQ No A plied For: ❑ Yes ❑ No,stop intake
,YJ nd Use Case#: r�, Ug��s'0Zoning: Q.y • s
uired Setbacks: Front: J L. Rear: i 0 Side: '3 Street Side: NA Garage: Z.0
B /�Q uilding Height: Max. Height: (U Actual Height: 2 S•s
L Landscape Area: NA % .I Lot Coverage Max: JPI
- ..nce ❑ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows Zi. ► " 'mum 12%of area of all street-facing facades
Garage ❑ Garage •:• is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
of i\ ❑ Door exten. -• ore than 5'from wall and there is a covered porch extending beyond garage.
`�' c9, ❑ Door extends no more .- 'from wall and there is a 12 sq ft.window above garage on 2nd floor.
cj ❑ Garage door width is ❑ 12'or less ill -II°o or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance • • • set ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ .. - hip,or gambrel roof ❑ Dormer
❑ Accent siding '-Window trim ❑ Window recess ❑ 1•'.-•ow projection ❑ Balcony
, isual Clearance IQ Urban Forestry P an
ensitive Lands: ❑ Yes Forestry
Type:
I Conditions met prior to issuance of building permit
Not _
LJ Approved By Planning: _ - Date: g 2/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
l:\Building\Forms\B1dgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: Q !ci. 1
Site Plans: # J
Building Plans: # 3
Building Permit#: ea—Enter building permit#above.
Workflow Routing: n—Planning - Engineering ea—Permit Coordinator Building
Workflow Sign-off: pa—Sign-off for Planning(include notes from planning review)
Route Application Documents: ,B"Engineering: (1) copy of permit application, (1) site plan, (1)building plan and
original plan review routing form.
Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: 44 tcki Tbte.S40t4 44,_M Date: ��,�/l l
Engineering Review
,,_/Slope at building pad:
► I Conditions "Met"prior to issuance of uilding permit /e/1/1
[Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes VNo
Assess Water Quantity Fee in-lieu: ❑ Yes ,, No
LIDA Facility on lot: El Yes ILi( No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
LSYApproved by Engineering: Date: 1 !Z Z/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: Approved ❑ Not Approved
Permit Coordinator Review
Z 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 zr Does not apply
/SDC Fees Entered: _Wash Co Trans Dev Tax: Yes CIN/A
Tigard Trans SDC: Ye S DCs
Parks SDC: . Yes ❑ N/A
LIDA D 'Yes N/A
OK to Issue Permit
Approved by Permit Coordinator: stryv-,&_
Date: S(l(,Q (UZI
1:\Building\Forms\B]dgPermitRvw_RES_122419.docx
City of Tigard
~ COMMUNITY DEVELOPMENT DEPARTMENT
T1GARD River Terrace Building Permit Review Addendum
Building Permit #: WISI-Sera-1j Rg
Site Address: i(L'S$4 S1A3 eDjttPiJi 13 1,CCP
Project Name: t,YesCX) 4r , pK 'Q(Q Lot #: 2O —
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Distr tt Design Standards (18.640.0701):
Is the project subject to the plan district design standards? al Yes ❑ No
1.Articulation: a minimum of 1 element per each street-facing facade 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 mindeep Gabled dormer
ft.deep min.2ft., 5 ft.wide min.2 ft.,6ft.wide
❑ ❑ ❑ ❑
2.Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: 7 1 Z'/'
3.Entrances:At least one entrance must meet both of the follow g standards:
Ia Max. 8 ft. setback from longest street-facing wall 'J L arallel to street,angle no more than 45° from street,
/ or open onto porch
Entrance opens to a porch: Jc Yes ❑ No
If yes,all the following apply: [ 5 sq.ft.min.
YJ e street facing entry2 ft.max. roof above floor of porch
5 ft. depth min. 121.0%0 min.porch roof coverage
4.Detailed Design:All buildings shall include a min. of five oft ollowing elements on all street-facing facades:
vered porch min. 5 ft.wide x 5 ft. deep Recessed entry area min. 5 ft.wide x 2 ft.deep
all offset min. 16 inches ❑ Dormer min.4 ft.wide
Eil Roof eave min. 12 inch projection ❑ f offset min.of 2 ft.
❑ Roof shingles either tile or wood ZGable,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 façade ❑ Window trim min. 2 '/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
Ii
5. Garages and Carports:May face 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.
Width: (Check one)
❑ 12-foot-wide garage door YJ 40%max.of street facade
❑ 50%max.of street facade with 7 detailed design elements
Notes:
Approved By Planning: - Date: 2
I:\Building\Forms\B1dgPeimitRvw_REs_RT_121417.docx
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: 8/10/2021 Site Address:
16584 SW Darwin Loop
Project Polygon at Roshak Ridge - Land Use Case MST2021-00318
Name: Lot 205 or Permit #:
Tax Total Parks
2S107AA20500 $10,903
Lot#: SDC Amount*:
*The total Parks SDC amount shown above is the sum of$ 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.
El 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.)
Dom,.A6.4 .4eoul - Dom,.A .AAn
PROPERTY OWNER DEVELOPER
DATE: 08/10/21 DATE: 08/10/21
I:\Community Development\Permit Coordinator\SDC Forms\Payment Option Forms
City of Tigard
le
III : Transportation System Development Charge (SDC)
TIGARD Notification of Fee and Payment Options
a astaaiitiffateattavaasaOIMSaars11 ssarrlcOW311ns1/a 444NOWittlitifilnkiilliMallfnftt$MWM.MatiMSMIMMO .US00444VMOC41114a4604111141611
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:
8/10/2021 16584 SW Darwin Loop
Project Polygon at Roshak Ridge - Land Use Case or
Name: Lot 205 Building Permit #: MST2021-00318
Tax Total TSDC
2S107AA20500 $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.
❑ 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.)
Omem-4 ux':.46eu OmaA,
PROPERTY OWNER DEVELOPER
DATE:08/10/21 DATE08/10/21
I:ACommunity Development\Permit Coordinator\SDC Forms\TSDC Combination Payment Option Form 112718 AMS
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
r 11 m Transmittal Letter
T 1(.J A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: AllU(�son ARrr► ona DATE RECEIVED:
DEPT: BUILDir_NG DIVISION RECEIVED
FROM: bflfflag A-671 . Abovha -S SEP 2 2021
COMPANY: 1� CBS fi�0�1'��or� CITY OF TIGARD
BUILDING DIVISION
PHONE: 'O 94-6 S6 -Lt By it
EMAIL: �-}0.LAYmt t7t7 > ��XY7�1 O/ h.
RE: 6n Si-i. U A RUM h C IST � l�2.I — 003`a
(Site Address) (Permit Number)
P4C l — eit4 02Os
(Pr name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description,!0 '
Additional set(s) of plans. Revisions: STri/'v0 C,q,Ic‘
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): I
REMARKS: Sf r,,c Cy�r2j C nn lsed 1 beeV) c-2v -0 peso(ve
fifu_ h 1 t` u o 2eAp`&- rAinnrn14d .
FOR FFt E USE ONL
Routed to Permit Techni ian: Date: 9co Z j7
Initials:
Fees Due: [I] Yes Noiz Fee Description: Amount Due:
t • 'L $
(2(
Special
Instructions:
Reprint Permit (per PE): ❑ Yes No ❑ Done
,#\Applicant Notified: V — Date: 7/7�24 Initials:
I:\Building\Forms\TransmittalLetter-Rev isions_073120.doc