Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2021-00335
Date Issued: 11/04/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107AA22300
Jurisdiction: Tigard
Site address: 16627 SW DARWIN LOOP
Subdivision: ROSHAK RIDGE Lot: 223
Project: Polygon at Roshak Ridge, Lot 223
•
Project Description: New detached dwelling. NO FINAL INSP UNTIL DEFERRED SDCs PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 5 First: 1211 sf Basement: 763 sf Left: 3 Parking Spaces: 0
Height: 28 Bathrooms: 4 Second: 1715 sf Garage: 485 sf Front: 8 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 3689 sf Value: $509,862.34 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 6 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
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 6 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 addl 500 sf: 7 201-400 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
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 3689
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 Geo Tech Report Required
Prior To Pour
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $27,547.98
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
oc2 nnl nnln thrnnnh CUP oc9-nnl-nnon Vnn may,nhtnin a rnnv of tha r i nr riirart l«tinne to( i INf'by raiiinn Fn'i 9Q9 1QR7 nr 1 Ann'Az?9-Add
Issued By: Hc{Ly Vaw De-We-ge, Permittee Signature: Ow Ap-pUe_.64i,01,),
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.
23
Building Permit Application ic' a-s
ll 2
Residential RECEIVED Q J FOR/ OFFICE USE ONLY
(�T /��( 2 C
Date/By:eivedOU / 'L �/ ,_ISTZ [� [�O/3✓
Cityof -ii
Tigard . Penni[No.:
II ° 13125 SW Hall Blvd.,Tigard,OR 97223 A U G 1 0 2021 Plan Review
_ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: ,A ! .erPern" R2 / 2/4
T n R D Inspection Line: 503.639.4175 ���/ "�C7/ Date Ready/By: Ij) ® See Page 2 for
Internet: www.tigard-or.gov �U������ DIVISION i6edMethod: Supplemental Information
C7 1
TYPE OF WORK RE I UIRED DA A: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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling Elm Comercial/industrial Valuation: $ Q�, $ Z
0 Accessory building El Multi-familyNumber of bedrooms: 5 ✓✓✓
❑Master builder ❑Other: Number of bathrooms: 4
JOB SITE INFORMATION AND LOCATION Total number of floors:3 L 1 1
Job site address: 16627 SW DARWIN LOOP New dwelling area: 3,689 square feet\-1 l c
City/State/ZIP:Sherwood, OR 97140 Garage/carport area: 485 square feet I a 1 1
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: square feet 7
Cross street/directions to job site: Deck area: 12e?) square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Polygon at Roshak Ridge I Lot no.: 223 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: 222803B. Valuation: $
Deferrals:YES(deferral of TSDC fees&park SDCs until occupancy.) Existing building area: square feet
Projected start: 2022 New building area: square feet
® PROPERTY OWNER ❑ 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 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
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: c)ht VL WeLdlte .c etYl Adel, 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: 08/09/2021 *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 Application ECEIVE
City of Tigard CCt1Yed Date/Byeview
Permit No.:t,{sr20Z I'Cb33 5
tl 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 A U G ® 2021 Plan Rev Date/By other Permit:
',MA I'I7 Inspection Line: 503.639.4175 Date Ready/By: luris 0 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method• Supplemental Information
BUILDING DI'JISIO...
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*
® 1-and 2-family dwelling ❑Commercial/industrial [I]Accessory building For special information use checklist
( j Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total_
JOB SITE LNFORItL&TION AND LOCATION Heating/cooling:
conditioning 1 46.75
Job site address: 16627 SW Darwin Loop Furnace 100,000 BTU(ductslvenn)_ 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+•BTU(ductstvents) 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 bot watertent 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.: 223 Other: 23.32 -1
—__ 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:Single-Family Units fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
_Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
- Other.
® PROPERTY OWNER ❑ TENAIV'I' 23.32
- ' Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
Address:703 Broadway St.,Ste.510 equipment 33.39
�. Clothes dryer exhaust 33.39
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
— toilet compartments,utility rooms) 23.32
Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other: _ _ 23.32
Business name:Polygon WLH,LLC Fuel piping:
S1415 for first four;$4.03 for cach additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
Wall/suspended/unit beater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace
Range
E-mail:permitsubmittalsatayIOrmOrriSOn.COM Barbecue
iNt r 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)270-1590 Fax:( ) State surcharge(12%of permit fee)
CCB lie.:209001 TOTAL PERMIT FEE
.�� This permit application expires if a permit is not obtained within 180
C.�GtiQ. f) Aa days after it has been accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date: 10/30/20
t-iti,4i1.4me1Prrm.raMrk- p.”44me aAa113 A..r
Electrical Permit Application RECEIVE I i-oR OFFICE 1'sE tr i 1
City of Tigard Received Petard h H3Y202I-c0335
• 13125 SW Ilan Blvd.,Tigard,OR 97223 AUG i 0 2021 13i1aa Rcvi
aRBv
cw 1
' !' Phone: 503.718 2439 Fax. 503.5981960 1)ateru y-
Related Permit t1:
Inspection Line: 503 6394175 CITY OF i IUARL stead Data( Iurir:
`I'1GART] } Y SecPa!e2for
Internet: www.ugard-or,gov 3U11 DING nIVIi'ilft.. NotiticdfMedrod. Supplemental Information
i TYPE OF WORK PLAN REVIEW
®New construction 0 Addition/alteration/replacement Please cheek an dun apply(submit 1 sets of plans writ-ins checked)
0 Demolition Other: El or feeder 400 amps in murr 0 Budding over three stones
where the available fault currmi. 0 Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Homing buildings
® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building km to ground,or exceeds 14,000 Cl Commercial-rise agricultural
amps for all other installations buildirv .
0 Multi-family ❑Master builder ❑Other: ❑Fire pum
p p 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system larger separately denied
D Ad4itisi of new motor kind of `y&t.m_
Job#: Job site address: 16627 SW Darwin Loop 10013P or more.
City/State/ZIP: Tigard,OR 97140 0 So:or more residential"pits occupancy
—.... _ _. 0 Health-carc facilities. 0 Recreational vehicle parks.
Suite/bldg_/apt.ti: l Project name: Polygon at Roshak Ridge ❑hazardous locations 0 Supply voltage for more than
0 Service or feeds,600 amps or more 600 valets nominal.
Cross street/directions to job site: FEE SCHEDULE
neacriptioe —1 Qtr. I each I 't ial I .
New residential single-or multi-family dwelling unit
Subdivision:Polygon at Roshak Ridge Lot#: 223 Includes attached garage.
1,000 sq fl or less 168 54 4
Tax map/parcel#:
Fa add'1500 sq.ft,or portion 33 92 1
_.y DESCRIPTION OF WORK Limited , ivy,residential
(with above sq.ft) 75.00 2
New construction.Type SFU Limited en
ergy,multi-family 75.00 2
residential(with above sq ft.)
Renewable Energy ❑ Sec Page 2
® PROPERTY OWNER 0 TF\A�"I 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 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 2
Phone:(360 )946 8674 Fax:( ) Over 1,000 amps or volts 552.26 2
m-PermltSubmittal a'lurmorrison.com Temporary services or feeders installation,alteration,and/sirEmail: OAlamiAbouhafs@taylormorrison.co
y relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange.according to ORS 447,449,670,and 701. 201 amps to 400 amps 125 08 2
Owner signature: Date: 401 amps to 509 amps 168 54 2
❑ APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for hntnch cuewts with
Business name: Polygon Homes WI.H LLC above service or feeder fee, 7 42
" each branch circuit _
Contact name: Omar Alami Abouhafs B Fee for branch circuits without
service or feeder fee,lirst
Address: 703 Broadway St.,Ste 710 branch circuit 56 l s 2
City/State/ZIP:Vancouver,WA 98660 Each add'l brunch circuit 7.42 2
Phone: 360 946 8674Miscellaneous(service or feeder not included)
Fax::( ) Each manufactured or modular 67 84 2
lli
Email:OAlamiAbouhafs�ataylormorrison.com-PermitSubmittals@taylnrrnorrison.coin Reconng'service and/or feeder _
Reconnect only 67 84 2
CONTRACTOR Pump or inigatiun circle 67.134 2
Business name: Wallace Electric Sign or outline belting 67.84 2
Si riai circuit(s)or 3rmited-energy
Address: 105 Dresden St panel,alteration,iw extension. 0 See Page 2 2
City/State/ZIP: Astoria OR 97103 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66 251 hr
Phone:(S03 37y8 0563 tax:( ) Investigation(1 hr min) 90.00/to
Email: David@wallacewires.com
wallacewires.com Industrial plant(1 hr min) 78 181 hr
Inspections for which no tee is
CCII lie.:224868 Electrical Li'• C1441 Su v. I; .: 6363S specifically listed(h hr min) 90 A0f hr
ELECIRICAI, PERINIT FEES
Suprv.Electrician signature,required: Subtotal
Print name:D •p Date: Jr/4 JZ f __ElPtsn Review Required(25%of permit fee):
/
State surcharge(12%of permit fee)
Authorized st ature TOTAL PERMIT FEE:
Thu permit application expires if a permit is not obtained within 184
Print name: Date: days after it hex been accepted as complete.
--,4 f 0-44f ' � &I 7-t • Number of tnspecirons allowed per permit.
I.4lial ing+Permiti'1iLC,PcrnrtApp_E.R ERG.dcc Rev 06111,2011 46 4615f(1 II651C0M1Wf9
Plumbing Permit ApplicationE I e
Building Fixtures II�� FOR OFFICE USE ONLY
City of Tigard AUG 1 Q 2021 Received Deceive; Permit No.:/-i$T2('fu-Q0335
.t 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
Phone: 503.7182439 Fax: 503.598.146111Y OF f Il Af i€� Date/By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 BUJLOIN( D!VIS!OItN,I Date Ready/By: runs; Ea Sue Page 2 for
Internet: www.tigard-or.gov NotifedtMethod: Supplemental information
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special in ormation use checklist.
--- - Description J ty. Ea. 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
Xl-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437,78
SFR(3)bath 500.32
0 Accessory building AZ-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: 16627 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:‘liptioisolrlilitigoPolygon 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.: 223 Fixture or item:
Tax map/parcel no.: Back-flow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New construction,type.Single-Family Units
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
. ® PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:Polygon WLH,1.LC Fixtunlsewercap 25.02
Floor drain/floor sink/hub 25.02
Address:703 Broadway St.,Ste 510
Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptodgrease trap 25.02
Business name:Polygon WLH,LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Tonja Morris -
--- Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 Sink/basin/avatory 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®cpolygonhomes.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:G&B Plumbing&Sons Inc Water Pin iF g/DWV 56.29
Address:P.O.Box 92 Other: 25.02
City/State/ZIP:St.Paul,OR 97137 Subtotal j
Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: 572.50
IPlan review (25%of permit fee)
CCB Lic.:184372 Plumbing Lic.no.:pb634
State surcharge(12%of permit fee)
Authorized signature: J'..•.� TOTAL PERMIT FEE
Print name:Steve Fowler Date: 1 0/30/20 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tn-County Building Industry Service Board.
t'.\B itkdintWermitsiPLMU.PermitApp.doe IOft01/04 440-4616T(IO'O2'COM'WEB)
City of Tigard
111 COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
..
Building Permit #: HST 202(-00?3 5
Site Address: 16627 SW Darwin Loop
Project Name: Polygon at Roshak Ridge Lot #: 223
Planning Review
Proposal: New house
Verify address/suite# active in Accela. f=1 In River Terrace: ❑ No ® Yes, River Terrace Review Addendum
Site Plan Elements: See comments below
Erosion Control
®3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper nCl Retained trees with drip line and tree protection measures
XJDrawn to scale (standard architect or engineer scale) XIIFootprint of new structure(including decks)and FFE
®North arrow XiUtility locations&easements (required for new and additions)
®Site address,project or subdivision name and lot number KJSidewalk/driveway approach
®Applicant information(name and phone number) UDLocation of wells/septic systems
/CLot dimensions and building setback dimensions Street tree size,type and location
square footage of buildings to be demolished Street names
InExisting structures on site ®Corner 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? `'1Y/lx ❑No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? EYes ENo
[] Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
® Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
a SDC Exemption for ADU applied for: LI Yes ❑ No Received: ❑ Yes ❑ No
E7 Public Facilities Improvement (PFI) Permit
Required: ❑ Yes,applicant was notified ® No Applied For: ❑ Yes ❑ No,stop intake
® Land Use Case#: SUB2015-00004 ® Zoning:
® Required Setbacks: Front: 8 Rear: 10 Side: 3 Street Side: na Garage: 20
El Building Height Max.Height: N/A Actual Height: 28
• Landscape Area: 20 % 'ti Lot Coverage Max: 80
Entrance ® Set back no more than 8'from street-facing wall IK1 Parallel to street or offset 45 degrees or less
Windows $] Minimum 12%of area of all street-facing facades F: 19% R: 20%
Garage El Garage door is behind widest street-facing wall ® Yes ❑ No,one of the following is met:
❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
Q Garage door width is ❑ 12'or less PE 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
® Visual Clearance ® Urban Forestry Plan
❑x Sensitive Lands: ❑ Yes ® No Type:
Conditions met prior to issuance of building permit
Notes: MMD2020-00045 to only apply standards in 18.290
• Approved By Planning: Ara &t4J4ti Date: 8/17/2021
Revisions (after Building Submittal only) Reviewer llate
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 000/21/2I
Site Plans: # 3
Building Plans: # 3
Building Permit#: GVEnter building permit# above.
Workflow Routing: Y Planning [ ngineering O'Permit Coordinator LLYf3uilding
Workflow Sign-off: ,Ifr/Sign-off for Planning(include notes from planning review)
Route Application Documents: I� 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 .la trust details,if applicable,etc.
Notes:
By Permit Technician: ,17 eff. , Date: df/Ig�z421
Engineering Review o
I!d Slope at building pad:
eConditions"Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat
V/Water Quality/Quantity Facility ,� //
Assess Water Quality Fee in-lieu: ❑ Yes L1YNo
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes CNo
VFinal Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: I/3/7/
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 ��,�,,,,,(
Tigard Trans SDC: �'Yes ❑ N/A SIX,. - "-"1
Parks SDC: JZi Yes ❑ N/A
LIDA ❑ Yes N/A
OK to Issue Permit
Approved by Permit Coordinator: 4\1O\r"-P\r--\--
Date: (2 5 (204
1:\Building\Forms\BldgPermitRvw_RES_122419.docx
City of Tigard
p 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: 8/24/2021 Site Address: 16627 SW Darwin Loop
Project Polygon at Roshak Ridge - Land Use Case
Name: Lot 223 or Permit#: MST2021-00335
Tax Total Parks
Lot#: 2S107AA22300 SDC Amount*: $10,903
*The total Parks SDC amount shown above is the sum of$ 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.
El "Bancroft" or Installment Payments (separate application required.)
Dom-,A ',A6ou Okrt4A,.A 4619ul
PROPERTY OWNER DEVELOPER
DATE: 08/24/21 DATE: 08/24/21
I:\Community Development\Permit Coordinator\SDC Forms\Payment Option Forms
City of Tigard
Transportation System ortation stem Development Charge (SDC)
y
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:
8/24/2021 16627 SW Darwin Loop
} Project Polygon at Roshak Ridge- Land Use Case or MST2021-00335
Name: Lot 223 Building Permit#:
Tax Total TSDC
2S107AA22300 $10,348
Lot#: Amount*:
*The total TSDC amount shown above is the sum of$6,690 for TSDC-Improvement, $386 for
TSDC-Reimbursement,plus $ 3,272 for TSDC-River Terrace,if relevant.
This constitutes my request to use the TSDC payment option or combination of options I have selected below. [This
selection can be changed up to the time a building permit is issued.] I realize that TSDC charges are due and payable at the time
a building permit is issued unless those charges are Deferred or are financed through Installment Payments.
❑ Cash, Check, or Credit Card,payment due at building permit issuance.
0 Deferral until Occupancy,payment due before issuance of an occupancy permit.
Payment of the TSDC may be deferred until issuance of the occupancy permit. In requesting this option,I understand
that any deferred TSDC must be paid prior to issuance of a Certificate of Occupancy or final inspection. For a deferral
request to be accepted both the Property Owner and the Developer must sign this request.
❑ Credit Voucher for developer-built required public improvements, subject to approval, completion,and
acceptance of creditable improvements.)
NOTE: TSDC Credits must be redeemed at the time TSDC Payment is due,either at the time the building permit
is issued or,if payment is deferred,prior to issuance of an occupancy permit. If you expect to claim TSDC Credits be
sure the improvements,any creditable payments,and your Request for Credits is complete either before your building
permit is to be issued or,if payment is deferred,before you request an occupancy permit. No refund of TSDC Payments
will be made if Credits are submitted more than 30 days after issuance of the relevant building or occupancy permit.
❑ "Bancroft" or Installment Payments (separate application required.)
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PROPERTY OWNER DEVELOPER
DATE: 08/24/21 DATE: 08/24/21
I:\Community Development\Permit Coordinator\SDC Forms\TSDC Combination Payment Option Form 112718 AMS