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Permit ;,, u . - , CITY OF TIGARD MASTER PERMIT 111 • a COMMUNITY DEVELOPMENT Permit#: MST2021-00301 Date Issued: 11/04/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 107AA20100 Jurisdiction: Tigard Site address: 16540 SW DARWIN LOOP Subdivision: ROSHAK RIDGE Lot: 201 Project: Polygon at Roshak Ridge Lot 201 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: 1050 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1461 sf Garage: 400 sf Front: 8 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 2511 sf Value: $348,398.38 Rear: 10 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 4 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 Other Fixtures: 0 Drywell-Trench Drain: 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: 4 201-400 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 2511 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: $22,508 12 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 oc nni-nn1n rhrni inh OCR oc9-nnl-anon Vnn ma"nht in.rnrw of tha ridge nr rlirert nii<ctinnc to(11 mu-by rmilinn cr s 919 1027 nr 1 Ann 111 91dd Issued By: FIoU y Vav�DE-Wege Permittee Signature: Oh/App-Lixa,fio-v', 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. • t/t Building Permit Application `ECEIVED 1 ''/° :- '!w z Residential FOR OFFICE USE ONLY City of Ti and JUL 2 7 2021 Received 6, Permit No.: = °J g Date/By: D ' 1' r""a ,'"�301 II • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review u Phone: 503.718.2439 Fax: 503.598.196CI�OF TIGARD Date/By: Zl Z' Other Permit:5(}592r'(J] --oo2o Inspection Line: 503.639.4175 Date Ready/By: la See Page 2 for 1 TIGARD iCARD Internet: www.tigard-or.gov BUILDING DIVISION >stifled/Method: .2 5�( /,/ - k • Supplemental Information TYPE OF WORK REQUIRED :1-AND 2-FAMILY DWELLING El New construction 0 Demolition Permit fees*are based on the value of the work performed. --- Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION 3� 0 Valuation: $ �� ���� ® 1-and 2-familydwellingCommercial/industrial ❑Accessory building 0 Multi-family Number of bedrooms: 5 ❑Master builder 0 Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors:2 2 ) l 1 Job site address: 16540 SW DARWIN LOOP New dwelling area: 2,511 square feet t l.(w City/State/ZIP:Sherwood, OR 97140 Garage/carport area: 400 square feet I o 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.: 201 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: 222200FR. 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 ® 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 Vi9 BUILDING PERMIT FEES* Business name:Polygon Homes WLH LLC (Please refer tojee schedule) Structural plan review fee(or deposit): Contact name:Omar Alami Abouhafs FLS plan review fee(if applicable): Address:703 Broadway St., Ste 510 City/State/ZIP:Vancouver,WA 98660 Total fees due upon application: Phone:(360)946-8674 Fax::( )360 693-4442 Amount received: E-mail:permitsubmittals@taylormorrison.com-OAIamiAbouhafs@taylormorrison.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name:Polygon Homes WLH LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:703 Broadway St., Ste 510 Solar Installation Specialty Code checklist. 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: 002422. 4619a/ This permit application expires if a permit is not obtained r/ 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\Petmits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Applicatit:> ECEIVE FOR OFFICE USE,ONLY City Of Tigard(� Received Q Zi(�t .1`a, t4J 1 /J�/u-G0301 IN y O Permit No.: r 13125 5W Hall Blvd.,Tigard,OR 97223 JULry �au Rrviesv t Phone: 503.71 S.2434 Fax: 503.598.1960 Other Permit:Q UAXIA,.cow` Inspection Line: 503.639A175 t�ITYOFTIGHHL Date Re J 1 712?Aitl) DatcRtadylty: earls RI See Page 2 for Internet: nnvw.tigard-or.gov BUILDING DIVISIO Notified'Method_ Supplemental Infortuadan 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 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:S CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES' ®1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. j Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total Heating/cooling: JOB 51TE INFORMATION AND LOCATION Air conditioning 1 46.75 Job site address: 16540 SW DARWIN LOOP Furnace 100.000 BTU U(ducu!vents) 46.75 _ City/State/ZIP:Tigard,OR 97224 Furnace 100,000)BTU(ducts/vents) 54.91 y Suitetbldg./apt.no.: Project name: Polygon at Roshak Ridge Heat pump 61.06 Duct work _ 23.32 Cross street/directions to job site: Hydronic hot waterstem 23.32 Residential boiler(radiator or bydronic) 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.: 201 Other. 23.32_ �� __ Other fuel appliances: Tax map/parcel no.: Water hearer 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 — Flue vent for water heater or gas New construction-Type SFU 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 ❑ TENANT Other. 23.32 _-_ Environmental exhaust and ventilation: Name:Polygon WLH,LLC Range hood/other kitchen equipment _ 33.39 Address:703 Broadway St.,Ste.510 Clothes dryer exhaust 33.39 City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms, —•-.--- -- toilet compartments,utility rooms) 23.32 Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32 ® APPLICANT 0 CONTACT PERSON Other: 23.32 , Fuel piping: Business name:Polygon R LEI,LLC _ $14.15 for first four;$4.03 for each additional Contact name:Tonja Morris Furnace,etc. _____~______ Address:703 Broadway 54,Ste 510 Gas beat pump - WalUsuspended/unit heater City/State./ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace Range E-mail'permitsubmittais(taylOrmOrrlSOf.COM Barbecue CONTRACTOR Clothes dryer(gas) Business name:Pro Heating&Cooling Other: MECHANICAL PERMIT FEES* Address: NW Alociek Dr,Ste.1104 Subtotal City/State/ZIP:Hillsboro,OR Minimum permit fee(S90.00) Plan review(25%of permit fee) Phone:(360)270-1540 Fax.( ) State surcharge(12%of permit fee) CCB lic.:209001 TOTAL PERMIT FEE This permit application expires if a permit is not ohtained within 180 e- days after it has been accepted as complete. Authorized signature: Q'' • Fee methodology set by Tri-Counry Building Industry Service Board . Print name:Elia Duran I Date: 10/30/20 I lrinilrt;n..\Pnrmn,tMif'P,.rmil son r1An 117 AA, ,Electrical Permit Application RECEIVE FOR OFFI('F LSE ONLY City of Tigard JULReceived • n peruiitn -r• 13125 SW Ball Blvd.,Tigard,OR 97223 U 2 "� 2021 l�xrlBv 2 �' �� Mau � , flan Review ' t t, Phone: 503.718.2439 Fax. 503.5981960 Related Permit tl t>a�.tiy Sll,'�?�sl ouu)k T'1 rt R n Inspection Line: 503.639 4175 CITY OF TI GAR D y t)atcmy runs: fa See Page 2 for Internet: www.ugard-or.gov Notified/Method. Supplemental Information BUILDING DIVISION' TYPE OF WORK PLAN! REVIEW ®New construction ❑Additionlalteration/replacement w Please check all that apply(submit I sets of plans whtmns checked): 0 Demolition ❑()[sera 0 Smoke or feeder 430 amps of more ❑Building over three stones where the mailable fault current ❑Marinas and boatyard CATEGORY OF CONSTRUCTION exceed..,10,000 amps at 150 volts or ❑Floating buildings 1-and 2-familydwellingCommercialfindustrial h.gs to ground,or exceeds 14,000 ❑Commercial-use agricultural � 0 ❑Accessory building amps for all other installations buildings ❑Multi-family ❑Master builder ❑Other: Li Fire pump 0 Installation Of 154 KVA or JOB SITE INFORMATION AND l,Ot"A`l'1ON 0 Emergency system larger separately derived Job#: Job site address:16540 SW DARWIN LOOP ❑AdIIPoion ofore.new motortoadof system. 100IIP or more. ❑"A","E","1-2"."I-3", City/State/ZIP: Tigard,OR 97140 0 Six or more residential units occupancy 0 Health-care facilities. ❑Recreational vehicle parks. Suite/bldgJapL#: Project name: Polygon at Roshak Ridge ['Hazardous locations ()Supply voltage for more than 0 Service or tecdn 600 amps or more 600 volts nominal. Cross street/directions to joh site: FEE SCHEDULE Description I rrir• I Earb,�' 'ratal I New residential single.or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: 201 Includes attached garage. Tax map/parcel#: 1,000 sq n.or less 168 54 4 Es.add'I 500 sq ft.or portion 33 92 1 DESC'R.IPTION OF WORK Limited i.ircigy,residential 75.00 2 New construction.Type SFU (with above sq.ft} Limited energy,must-family 75.00 residential(with above sq.ft) Renewable Energy ❑ See Page 2 ® 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 710 201 amps 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 301 04 z Phone:(360 )946 8674 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: OAlatniAboullafs@taylormorrison.com-PermitSubmittals@taylormorrison.com 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: Date: 401 amps to 599 amps 168 54 2 Branch circuits-new,alteration,or extension,per panel 0 APPLICANT I ❑ CONTACT PERSON A Fee for[ranch cue-oils with Business name: Polygon Homes W I-I LLC above service or feeder fee, 7 42 each branch circus Coutac-t name: Omar Alami Abouhafs B.Fee for stanch circuits without Address: 703 Broadway St.,Ste 710 service t feet fee,first branch eircuit 56.18 2 City/State/ZIP: Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Phone: 360 946 8674 Miscellaneous(service or feeder not included) ( ) Fax::( ) Each manufactured or modular dwelling,sennee and/or feeder 67 84 2 Entail:OAlamiAbouhafsAtaylormorrison.com-PcrmitSubmittals@taylormorrison_com Reconnect ouiy 67 sn 2 CONTRACTOR Pump or irrigation circle 67 84 2 Business name: Wallace Electric Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: 105 Dresden St 0 See Page 2 2 panel,alteration,or extension. City/State/ZIP: Astoria OR 97103 Each additional inspection over allowable In any of the above Additional inspection(1 lir min) 66 25/hr Phone:(St13 308 0563 Pax:( ) Investigation(1 hr min) 90.00/hr Email: David@wallaccwires.com Industrial plant(1 semen) Its 1>t/hr Inspections for w•tuch nu tee is CCB Lie.:224868 Electrical Li • C 1441 Su -l. .: 6363S specifically listed OS hr min) 90.001 br ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal Print name:DAQ•f, Date: t /4 lz t 0Plan Review Required(25%of permit fcc): I• State surcharge(12%of permit fee). Authorized signature �f TOTAL PERMIT FEE: This permit application expires it a permit is not obtained wind-WHO Print nflftlC: j��',�� � Date: L[/// / I days atter It has been accepted as complete. ----fi t _f) f z ..'.'— . Number of inspections allowed per permit. 1:41loilebngtemdeLLC_PernutApp_ELR ERF.tlrc Rey 06;17f1011 4 t;-4615r(i I/051COM+WEB Plumbing Permit Applica CEI V ED Building Fixtures l FOR OFFICE USE ONLY 9tj,. '' Received _ City of Tigard { Permit Nu.: -.t 13125 SW Hall Blvd.,Tigard.OR 9 f OF TIGARD Date/By: 21 �1U2� (� t Plan Review Phone: 503.71$2439 Fax: 503.59 Other Permit No.: Saga-DM\ p Date/By: TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: lots: El See Page 2 for Internet: www.tigard-or.gov Noticed vlethod: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist. Description I Qty. j Ea. 1 Total 0 Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 XI-and 2-family dwelling ❑CommerciaUindustrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑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: 16540 SW DARWIN LOOP Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Dryweli,leach line,or trench drain 18.76 -_. Footing drain(no.linear ft. ) Page 2 Suite/bldg./apt.no.: Project name:446610404kiisligiePolygon 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.: 201 Fixture or item: Tax map/parcel no.: Back-flow preventer 3L27 DESCRIPTION OF WORK Backwater valve (2.51 -- Clothes washer 25.02 New construction-Type SFU 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/Slate/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:Polygon WLH,LLC Medical gas(value:S ) Page 2 Primer 12.51 Contact name:Tonja Morris Roof drain(commercial) 12.51 Address:703 Broadway St.,Ste 510 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 M E-mail:permitsubmittalsEpolygonhomes.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater I 37.52 Business name:C&B Plumbing&Sons Inc Water pipingrDWV 56.29 Address:P.O.Box 92 Other: 25.02 City/State/ZIP:St.Paul,OR 97137 rn 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: ?> ...> y1,� TOTAL PERMIT FEE Print name:Steve Fowler Date: 10/30/2 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 11 tlnildmg+PermitstPl.Mt1-PermitApp doe 107014)9 440-4616Tt10Y62/COM'weat City of Tigard 111 _ Transportation System Development Charge (SDC) TIGARD Notification of Fee and Payment Options 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 16540 SW Darwin Loop Project Polygon at Roshak Ridge- Land Use Case or MST2021-00301 Name: Lot 201 Building Permit#: Tax Total TSDC 2S107AA20100 $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. X❑ 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.) Ong,.A ' Sewluzzfr Dm.QiL.A '46eui PROPERTY OWNER DEVELOPER DATE: 08/04/2021 DATE: 08/04/2021 1:ACommunity Development\Permit Coordinator\SDC Forms\TSDC Combination Payment Option Form 112718 MIS 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: 16540 SW Darwin Loop Project Polygon at Roshak Ridge - Land Use Case Name: Lot 201 or Permit #: MST2021-00301 Tax Total Parks 10 903 Lot#: 2S107AA20100 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. LiCredit 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. El "Bancroft" or Installment Payments (separate application required.) Dom.4 un. '.46efru 01114.2 4Eam ,A6au PROPERTY OWNER DEVELOPER DATE: 08/04/2021 DATE: 08/04/2021 I:\Community Development\Permit Coordinator\SDC Forms\Payment Option Forms City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT T 1 G A RD Building Permit Review — Residential Building Permit #: Ms:0020" SO k Site Address: 16540 SW Darwin Loop Project Name: Polygon at Roshak Ridge Lot #: 201 Planning Review Proposal: New house C7 Verify address/suite#active in Accela. g7 In River Terrace: ❑ No $7 Yes, River Terrace Review Addendum Site Plan Elements: %]Erosion Control 5i13 copies of site plan on 8-1/2"x 11"or 11 x 17"paper ITaRetained trees with drip line and tree protection measures ®Drawn to scale(standard architect or engineer scale) XFootprint of new structure(including decks)and FFr. ®North arrow7Utility locations&easements (required for new and additions) GC Site address,project or subdivision name and lot number X Sidewalk/driveway approach ®Applicant information(name and phone number) Inliocation of wells/septic systems ®Lot dimensions and building setback dimensions ®Street tree size,type and location ITaSquare footage of buildings to be demolished 1E Street names tiaExisting structures on site 1iCorner 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? WiA❑No impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes El No i Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified X No Received: ❑ Yes ❑ No id 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 ❑ 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-4.5 la Required Setbacks: Front: 8 Rear: 10 Side: 3 Street Side: 8 Garage: 20 k l Building Height: Max.Height: N/A Actual Height: 28 ▪ Landscape Area: 20 % © Lot Coverage Max: 80 cyo 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 m —.stow above garage on 2nd floor. ❑ Garage door widt " or less ❑ 50%or less of faca ° or less and includes 7 of following: orch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roo ❑ Roof offset Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony ® Visual Clearance IX Urban Forestry Plan E Sensitive Lands: ❑ Yes ® No Type: ® Conditions met prior to issuance of building permit Notes: ® Approved By Planning: ADate: 7/27/2021 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: Site Plans: # Building Plans: # „3 Building Permit#: Er Enter building pet4 above. � Workflow Routing: Planning leering ❑ rnit Coordinator -0 uilding Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: 4 Engineering: (1) copy of permit application, (1) site plan, (1)building plan and 7ginal plan review routing form. uilding: original permit application,site plans,building plans, engineer and beam calculations d trust details,if applicable,etc. Notes: By Permit Technician: Date: 8/Z/0 Engineering Review Slope at building pad: _3A 1r Conditions "Met"prior to issuance of building permit PPEasements (encroachments)per engineering conditions of approval and plat X7ater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: El Yes �No Assess Water Quantity Fee in-lieu: ❑ Yes 1No LIDA Facility on lot: ❑ Yes !trNo Y.Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes:� Itte Approved by Engineering: Date: ' /2 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review f 2r 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 // Does not apply r ❑ SDC Fees Entered: Wash Co Trans Dev Tax: /Yes ❑ N/A "FCeS .C:i n".C4 Tigard Trans SDC: Yes ❑ N/A Parks SDC: /Yes ❑ N/A LIDA ❑ Yes y" N/A / OK to Issue Permit Approved by Permit Coordinator: GPe . Date: 91121 2D24 I:\Building\Fonns\B1dgPermitRvw_RES_122419.docx City of Tigard ■ COMMUNITY DEVELOPMENT DEPARTMENT T 1 a It D River Terrace Building Permit Review Addendum Building Permit #: 111\5"(' - CD 47(71 Site Address: 16540 SW Darwin Loop Project Name: Polygon at Roshak Ridge Lot #: 201 j (New dwelling=subdivision name;Addition or Alteration=last name of owner) Plannitik_Review of.W vet ?Terrace Plan District Design Standards (18.640.070.1): Is the project subject to the plan district design standards? ® Yes 0 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 min. 5 ft. deep Gabled dormer ft. deep min.2ft., 5 ft.wide min. 2 ft.,6ft.wide ® Front/Side ❑ ❑ ❑ ® Side- two provided 2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors. Percentage Shown: Front: 14% /Side: 12% 3. Entrances:At least one entrance must meet both of the following standards: ® Max. 8 ft. setback from longest street facing wall ® Parallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porch: ® Yes 0 No If yes,all the following apply. ® 25 sq.ft. min. ® One street facing entry ® 12 ft. max. roof above floor of porch ® 5 ft.depth min. ® 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: g Covered porch min. 5 ft.wide x 5 ft. deep F ] Recessed entry area min. 5 ft.wide x 2 ft. deep F Wall offset min. 16 inches F ❑ Dormer min. 4 ft.wide 5a Roof eave min. 12 inch projectionF/S ® Roof offset min. of 2 ft.F 0 Roof shingles either tile or wood ® Gable,hip or gambrel roof design F/S O Roof pitch oriented south min. 500 sq. ft. 0 Horizontal lap siding min. 3-7 inches wide O Accent siding min. 40%of street facade K) Window trim min. 2 1/2"wide by 5/8" deep F/S O Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep 0 Balcony min. 5 ft.wide x 3 ft. deep with inside access 0 Attached garage is 35% or less of street facade 5. Garages and Carports: face the front or side lot line on a corner lot. Ca o May � ts.M Setbacks: No closer to front or side lot line, than longest street-facing wall. ® Yes 0 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. O 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) O 12-foot-wide garage door 0 40%max. of street facade ® 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: ArA ifitAMbib Date: 7/27/2021 I:\Building\Forms\BldgPermitRvw_RES_RT_121417.docx