Permit CITY OF TIGARD MASTER PERMIT
Ill 1 _ COMMUNITY DEVELOPMENT Permit#: MST2021-00316
Date Issued: 11/04/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107AA19600
Jurisdiction: Tigard
Site address: 16649 SW BOTANY BAY LN
Subdivision: ROSHAK RIDGE Lot: 196
Project: Polygon at Roshak Ridge Lot 196
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
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 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 2 One Hour Fire Rated Eaves
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: Ha{,(,cj Va.w Pe- Wege Permittee Signature: Ow Apri-tiza,lio-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 lob site at the time of each inspection.
.Building Permit Application RECEIVE
DECEIVE I Zare12-1
Residential nq FOR OFFIC1 USE ONLY
t J 0 r. 2021 Received (X� �y/�`
City of Tigard Date/By: 410 �� G PermitNo.: mg-201,1-003 b
a II ° 13125 SW Hall Blvd.,Tigard,OR 97223 (•ITV OF TIGARD Plan Review * . n 1 /I 50Q�VV,VV)
Phone: 503.718.2439 Fax: 503.598.19 Date/By: 2,) AA Other Permit: 2151
TIGARD
Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: /�G i Jur s: See Page 2 for
Internet: www.tigard-or.gov .0 Notified/Met,•+: Supplemental
upplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrialValuation: $ r Lit❑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 3f 33
Job site address: 16649 SW BOTANY BAY LN New dwelling area: 2,947 square feet )7a,7
City/State/ZIP:Sherwood, OR 97140 Garage/carport area: 486 square feet I ?,.a(
Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge Covered porch area: square feet
Cross street/directions to job site: Deck area: D4S square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Polygon at Roshak Ridge Lot no.: 196 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: 222300ER Valuation: $
Deferrals: YES/deferral of payment of transportation&park SDCs to occupancy. Existing building area: square feet
Projected start: April 2022 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 0 CONTACT PERSON CIO BUILDING PERMIT FEES*
Business name:Polygon Homes WLH LLC (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Omar Alami Abouhafs
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@taylormorrison.com-OAlamiAbouhafs@taylormotrison.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
a
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 /� �1 �/`C� Total fee due upon application: $201.60
On.Authorized signature: a/L .cy ,cy9L4/ 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(1 l/02/COM/WEB)
RECEIVED.
Mechanical Permit Application MG
(} q q9 ,. . FOR OFFICE
City of Tigard M 7 0 5 2021 Recetlea -»y f . . Permit , {1—��//� 1� r ,,.r�1.
Reeive QQi( MS1 i3O .
't 13125 SW Hall Bhd.,Tigazd,OR 97223 T/ C �q
t Phone: 503.718.2439 Fax: 503.598.1960%A 1 I OF TIGARD Blau Review /�/� y�
Date/By: Other Penult %,10t t/,,-ob
Tlt'rA u.) Inspection Line: 503.639.4175 BUILDING DIVISION DateRcady/By: curls B See Page 2for
Internet: tvww.tigard-or.gov Notified/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-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
1 j Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATIO\ AND LOCATION Heating/cooling,:
Air conditioning 1 46.75
lob site address: 16649 SW Botany Bay Lane 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.: 196 Other. 23.32
- Other fuel appliances:
Tax map/parcel no,: Water heater 23.32
,_.._
DESCRIPTION OF WORK Gas fireplace/insert 33.39
- Flue vent for water heater or gas
New construction,type:SFU fireplace 23.32
Log liebter(gas) _ 23.32
._ _.____.._.. - Wood/pellet stove 33.39
Wood fireplacelinsert 23.32
Chimneyliner/flue/vent 23.32
® PROPERTY OWNERTENANTOffer 23.32
❑ 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 Fax:( ) Attic/crawlspace fans_ 23.32
® APPLICANT 0 CONTACT PERSON Other 23.32
Fuel piping:
Business name:Polygon WLH,LLC S14.15 for first four,S4.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St, 510 -- Gas heat pump
— - Wallisuspendedlunit heater
City/State/ZIP:Vancouver,WA 98660 Water heater �—
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Range
E-mail:permitsubmittalsgtaylormorrison.corn Barbecue _
CONTRACTOR Clothes dryer(gas) v I
Business name:Pro Heating&Coming 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)270-1590 Fax:( ) State surcharge(12%of permit fee) _
CCB lic.:209001 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Q� �1 � � „ days after it has been accepted as complete.
Authorized signature: ""�' �w'r�t t�V • Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date: 10/30/20
r,o,,;I4,.,,APr,,,,,eMer P..,ne an.,rum li Anr aan,-,T"r„m�wvrermrco.
Electrical PermitRECEIVED
Application FOR OFFI(I.USE Oy1,1
t, Cityo Ti and .:�7 0 t L Received
f r Rene y t. ._9/0 Peront k 11,t Gut.i Vp'.3 t'Cj
-' 13125 SW Hall Blvd.,Tigard,OR 97223p,I n/OC TIG p cjD !Inn Review
Phone: 5U3.713 2439 Fax: SU3.59 3.If t f Lll1f1 Related Permit*: SwQao2t /�'JJ
74
1)atc•Ry `cis: I
Inspection Line: 503 639 4175 I heady t)atem r 0runs: See Pao for
TtGARU BUILDING DIVISION.
x Internet: www.ligard-orgov Notified/Method. Supplemental Information
TYPE OF WORK PLAN REVIEW
, ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wit erns checked)
❑5a vice or feeder 400 amps a inure 0 Building over three stones
0 Demolition ❑Other: where the available fault current
❑Manna and boatyard,
CATEGORY OF CONSTRUCTION excncds 10,000 amps at 15o volts or 0 Floating bwldmgs
gi I-and 2-family dwelling 0 Commercial/industrial ElAccessory building lei to ground,or exceeds ta,ot o ❑[on menial-use agricultural
❑ ltlftl-family El Master builder amps fen all other installation, building
❑Other: ❑Fire pump 0 Installation of 150 KVA or
JOB SITE INFOR'NATION AND LOCATION 01':mergcncy system larger scparntely denied
ew
Job#: Job site address:16649 SW Botany lOollP o or more.BayLane ❑Addihn of re.motor h>rd of system.
❑"A'"."k;`""'1-Z" "1-3",
City/State/ZIP: Tigard,OR 97140 ❑Six of Marc residential units oecupanoii
.._ — ❑Health-care facilities ❑Recreational vehicle parks..
Suite/bldg./apt#: Project name: Polygon at Roshak Ridge ❑tinzardous locations 0 Supply voltage for more than
❑Service or feedm 600 amps or more 600 volts nominal
Cross street/directions to job site: FEE SCUEI)LJI Is
Description I Otr. I Each 1 Total I
New residential single.or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: 196 Includes attached garage.
Tax map/parcel#: 1,000 sq R.or less 168 54 4
Fa.add'!500 sq It or portion 33 92 1
DESCRIPTION OF WORK Limited energy,n:sidtulial
(with aboveft..) 75.Op 7
New construction.Type SFU sq.
Limited oovltey,muhi-family 75.00 ?
residential(with above sq.ft.)
El PROPERTY OWNERRenewable Energy 0 Scr Page 2
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 amp;to 600 amps 200 34 2
City/State/ZIP: Vancouver,WA 98660 601 amps to 1,000 amps 301 04 2
!'hone:(360 )946 8674 Fax:( ) Over 1,000 amps or volts 552.26 2
Entail: OAlamiAbouhafs@taylormnrrison,cam-PerrnitSubmittals@taylormorrison.com relocation services or feeders installation,alteration,and/or
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 Owner signature: Date: 401 amps to 599 amps 168 54 2
0 APPLICANT _ I 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch cucuits with
Business name: Polygon Homes WI.H LLC above service or feakr foe,
each branch circuit 7 42 _
Contact name: Omar Alami Abouhafs 13 Fee for branch circuits waking
Address: 703 Broadway St.,Ste 710 service or feeder fee,inert 56.18 2
branch circuit
City/State/ZIP: Vancouver,WA 98660 Each add'!branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360 )946 8674 Fax::
( ) Each manufactured or modular 67 84 2
Email:OAlamiAbotlhafsi taytormotrison.com-PcrmitSubmittals@taylormorrison.com dwelling,
Rccomuti only iservicenland/or feeder
67 64 2
_ CO VTR:\(TUB Ptunp or inigatiun circle 67 84 2
Business name: Wallace Electric Sign or outline lighting 67.84 2
Address: 105 Dresden St si ai cucutt(s)or twined—energy~❑ yen)'age 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 hr mitt) 66 25/hr
I Phone:(503 301$0563 Fax:( ) Investigation(1 hr min) 90.OXu hr
Email: llavid@wallacest'ires.com Industrial plant(I hr min) 78 l8/hr ,
-
Inspections for which no tee is
calLie.:224868 Electrical Li.• C1441 Su v_I: 6363S specifically listed('f hr min) 9000i hr
Suprv.Electrician signature,required:
ELECTRICAL. PERMIT FEES
Subtotal
Print name:7) t, , _ Date: it /4 /z f 0 Plan Review Required(25%of permit fcc):
` ( (ii
State surcharge(12%of permit fee)
Authorized signature Tfl`TAL PEILIvfI`f Fla,
This permit application expires If a permit is not obtained within 180
Print name: �t ati y, I)ate: [t r4 /y tI days after It has been accepted as complete.
rcL��s�! 7i// l/ • Number of inspections allowed per permit.
l.'dfmlding\i'emuti'LLCpermrtApp_FIR L•RB'dcc Rev 06'1712015 1 e-1615r(i V05rCOM1WEB
' Plumbint; Permit ApplicatiRECEI V Er
. Building Fixtures fa 0 5 1021 FOR OFFICE USE ONLY
City of Tigard Received 4, permit No.:
1 13125 SW Han Blvd.,Tigard,OR 9722C1TY OF TIGARU Date/By: 9 ZI m ST2D 21-Op3�to
,71 Plan Review
Phone: 503.718.2439 Fax: 503.59g..�8�p Other Permit No:Su/a -00acl
Inspection Line: 503.639.4175 DUILD(NG DIVISIQ� Dater _
TIGARD Date Ready/By: )uric: EI See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
►Z/ New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
. l-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessorybuilding SFR(3)bath 500.32
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: 16649 SW Botany Bay Lane 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:°ii irPolygon at Roshak Ridge Manufact red 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
on at Roshak 196 Water service(no.linear ft.:�) Page 2
Subdivision: Polygon RidgeLot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater vaive 12.51
New construction,type:SFU 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 Fixmrclsewer cap 25.02
Address:703 Broadway Si,Ste 510 Floor drain'flaor 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 Interceptor/grease trap 25.02
Business name:Polygon\N'LH,EECv Medical gas(value:5 ) 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:permitsubmittals@polygonhomes.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:G&B Plumbing&Sons Inc
Water pipingiDWV 56.29
Address:P.U.Box 92 Other: 25,02
City/State/ZIP:St.Paul,OR 97137 Subtotal
Phone:(503)868-1417 Fax:(971)727-8170 _ Minimum permit fee: 572.50
Plan review (25%of permit fee)
CCB Lic.:184372 Plumbing Lic.no.:pb634 State surcharge(12%of permit fee)
Authorized signature: >� � V- i".'',. - - TOTAL PERMIT FEE
Print name:Steve Fowler Date: 10/30/20 This permit application expires if a permit is not obtained within 130 days
after it has been accepted as complete,
*Fee methodology set by Tri-County Building Industry Service Board.
1.\Buiiding\PerrnitstPLMU-PermitApp.doc 10/OIR74 440.4616T(I0.002COMAWEB)
.
City of Tigard
IN44 COMMUNITY DEVELOPMENT DEPARTMENT
Tl cARD Building Permit Review — Residential
Building Permit #: fkr9a- OQ,Stto
Site Address: /(p&y"! sr, ric inv.)y eAV £A&
Project Name: 'PQLV&CD J Af jZO Ak ` Aoc C Lot #: 1 q
Planning Review
Pro sal: t f+c M5
Verifyaddress/suite#active in Accela. In River Terrace:
� ❑ No River Terrace ReviewAddendujm
Sit lan Elements: Erosion Control
3 •.pies of site plan on 8-1/2"x 11"or 11 x 17"paper M tfi&etained trees with drip line and tree protection measures
/, It awn to scale(standard architect or engineer scale) dal FF Itprint of new structure(including decks) and FFE
• o th arrow L/J ty locations&easements(required for new and additions)
e ddress,project or subdivision name and lot number Sidewalk/driveway approach
plicant information(name and phone number) 11/41it [lL ation of wells/septic systems
Lot dimensions and building setback dimensions 1�15 eet tree size,type and location
E Square footage of buildings to be demolished eet names
OtfiExisting structures on site Z Comer elevations (2'contours if more than 4'dif�ferceenti 1)
Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ii,�es No OC
zIfimpervious area(applicable if R-7,R-12,R-25&R-40)
yes,is a storm water quality facility shown? ❑Yes No
Clea Water Services—Service Provider Lette of platted prior to 9/10/1995):
quired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
Water Meter Fixture Unit Worksheet—Additio , emodels and ADUs
Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
C Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No
Public Facilities Improvement (PFI)Permit:
quired: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No, stop intake
nd Use Case#: sUf' occ-CSujbLI Zoning; 12 y • S
' -•uired Setbacks: Front: 12-- Rear: 10 Side: 3 Street Side:' Garage:-
• ilding Height: Max. Height: 1.,J A- Actual Height: 28•S-'
2 Landscape Area: NA- % ❑ Lot Coverage Max: al-
ntrance ❑ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Window • um 12%of area of all street-facing facades
Garage ❑ Garage o . d widest street-facing wall ❑ Y o,one of the following is met:
¢,( ❑ Door extends no more a wall e is a covered porch extending beyond garage.
Sy „9m/1 ❑ Door extends no more th ' om wall an ' a 12 sq ft.window above garage on 2nd floor.
RQQ ❑ Garage door wid . 12'or less ❑ 50%or less of faca e 0%or less and includes 7 of following:
vered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roo ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roo Dormer
❑ Accent siding �tndow trim ❑ Window recess ❑ Window projection ony
Y� V al Clearance 111 Urban Forestry Pl a
,nsitive Lands: ElLJ Yes No Type:
onditions met prior to issuance of building per 't
Now
Approved By Planning: Date: J Z/
Revisions (after Building Submittal on ) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\B1dgPeimitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: O /S /Z
Site Plans: # 3
Building Plans: # .3
Building Permit#: a-Enter building permit#above.
Workflow Routing: a-Planning v Engineering e Permit Coordinator es-"Er Building
Workflow Sign-off: e i -Sign-off for Planning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
'1:I—Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: j'f i k i' Tit 4,,S e H h )21e— Date: ' c/,s`/2
Engineering Review
Slope at building pad: __3,
Q�Conditions "Met"prior to issuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
[Id Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes CNo
Assess Water Quantity Fee in-lieu: ❑ Yes CIA o
LIDA Facility on lot: ❑ Yes No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
pproved by Engineering: - Date: _'
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
SDC Exemption: ❑ Received Does not apply
SDC Fees Entered: Wash Co Trans Dev_ Tax: Yes ❑ N/A
igard Trans SDC: 7 Yes ❑ N/A So(s
Parks SDC: Z. Yes ❑ N/A
L P ' ❑ Yes N/A
OK to Issue Permit
Approved by Permit Coordinator: ( Date: 5 ii4t261.4
I:\Building\Fonns\B1dgPennitRvw_RES_122419.docx
City of Tigard
11,,,, N COMMUNITY DEVELOPMENT DEPARTMENT
2
TIGARD River Terrace Building Permit Review Addendum
,b.
Building Permit #: Ly(1vp'4\-V6\i‘Q
Site Address: )(p(pyq CA) `ge:T IOY ?Ay (,,WO
Project Name: ppWWis.t_Ar 21i'Ak 4t466. Lot #: (el ,
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Distric Design Standards (18.640.070.1.):
Is the project subject to the plan district design standards? es ❑ 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.
Porch min. 5 dee Balcony w/ access 2 Window Projection Vertical Wall Offset a
P
ft. deep min.2ft.,5 ft.wide min. 2 ft.,6ft.wide
Gabled dormer
❑ ❑ ❑ ❑
2.Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: > ) .
3.EEnntr noes:At least one entrance must meet both of the followi standards:
is Max. 8 ft. setback from longest street- facing wall 0 'ara1lel to street,angle no more than 45° from street,
� or open onto porch
Entrance opens to a porch: IQ Yes ❑ No
If es,all the following apply: 625 sq.ft.min.
ne street facing entry i12 ft.max. roof above floor of porch
i?! 5 ft.depth min. 0%min.porch roof coverage
4.Detailed Design:All buildings shall include a min. of five of to following elements on all street-facing facades:
r Bred 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
1r Roof eave min. 12 inch projection ❑ Roof offset min.of 2 ft.
^
❑ Roof shingles either tile or wood li/able,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 ❑ Window trim min.2 t/z"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: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 40%max. of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: �1. Date: k
I:\Building\Fonns\BldgPeimitRvw_RES_RT_121417.docx
City of Tigard
Parks SDC Charge (Parks)
T1GARI Notification of Fee and Payment Options
ems;;.. :A*ray;: . �„ s ass IWW eaW n , a ,° s,�.: A444 0,4 as
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: 16649 SW Botany Bay Ln
Project Polygon at Roshak Ridge - Land Use Case MST2021-00316
Name: Lot 196 or Permit #:
Tax Total Parks
2S107AA19600 $10,903
Lot#: SDC Amount*:
*The total Parks SDC amount shown above is the sum of$ 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.)
Ong.A/'.A6eua, Om ..A '.A6au
PROPERTY OWNER DEVELOPER
DATE: 08/10/21 DATE: 08/10/21
I:\Community Development\Permit Coordinator\SDC Forms\Payment Option Forms
City of Tigard
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:
8/10/2021 16649 SW Botany Bay Ln
Project Polygon at Roshak Ridge - Land Use Case or
Name: Lot 196 Building Permit #: MST2021-00316
Tax Total TSDC
2S107AA19600 $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.)
D 4 une-'.A6eu/a D .Aiahu. An
PROPERTY OWNER DEVELOPER
DATE: 08/10/21 DATE: 08/10/21
I:\Community Development\Permit Coordinator\SDC Forms\TSDC Combination Payment Option Form 112718 AMS
TayIorMorrison,
RECEI r ED
Polygon at Roshak Ridge, Lot 196 s J
New submittal CITYOF iIUNnu
BUILDING DIVISION
Subject: New residential construction — SFU.
Address: 16649 SW BOTANY BAY LANE.
Elevation: 222300ER.
Total R3 occupancy: 2,947 SF.
Attached to this packet, please find the following documents:
• 1x Building application.
• 1x Mechanical, Electrical and Plumbing applications.
• 3x Site plan (size: 11"x 17").
• 2x Structural calculations.
• 2 x Main floor layout (size: 11"x 17").
• 2 x Main floor Calculations.
• 2 x Upper floor layout (size: 11"x 17").
• 2 x Upper floor Calculations.
• 2x Roof truss Layout (size: 11"x 17").
• 2x Roof truss Calculations.
• 3x Architectural plans (full size).
Thank you
tor TaylorMorrison..
moay lrrison.
1'ornea rnsp,FSA Gy Y(7, COMMUNITIES 'ram Li'
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
111 2 " Transmittal Letter
T I k i A It r) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Ailr aR�p Onb DATE RECEIVED:
DEPT: BUI�ING DIVISION RECEIVED
FROM: Drnuo& 1\ SEP 2 202/
,.,..G CITY OF TIGARD
COMPANY: j 1,02 V lo(tif Ss BUILDING DIVISION , ._
PHONE: 0 63 .4 Qt� I By: 1 �.
`
EMAIL: D peer. Y�;f, t O € W IfltlQt�" BL, C 8
d
RE: 16649 SW R i*ar16 ga,ci �v r1sT .2,0. 1- Qo31
(Site Address) (Permit Number)
co gC OL 10#-- .9 6
(Pr name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions: 5'ffvctlr Cae[c
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: //4r�C r', -Q r�((��- /I J O PaL4& iCt� (ev,'ej t L l io ceso(ve
4h.L ChC (. )frCc/
FOR OF ICE USE ONLY
Routed to Permit Techni ian: Date: Z' Initials: A—A
Fees Due: [' Yes Nd" Fee Descri io : Amount Due:
$$ 75-
--V.6 6"--- 1-...---- $
Special
Instructions:
Reprint Permit(per PE) ❑ Yes / Jr' ❑ Done
Applicant Notified: Date: /Z7 ( � I Initials•
l:\Building\Forms\Transmittal Letter-Revisions_073120.doc