Permit „ CITY OF TIGARD MASTER PERMIT
1111
COMMUNITY DEVELOPMENT Permit#: MST2021-00317
Date Issued: 11/04/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503 718.2439 Parcel: 2S107AA19900
Jurisdiction: Tigard
Site address: 16579 SW BOTANY BAY LN
Subdivision: ROSHAK RIDGE Lot: 199
Project: Polygon at Roshak Ridge,Lot 199
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: 1211 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1715 sf Garage: 485 sf Front: 12 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2926 sf Value: $406,947.88 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 2926
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: $24,296.75
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
QS7_M1_nMn fhrrcinh nap oc7-nnl-noon Vn,,may nhtain a rnr,,of rho rnioe nr rlirorf nemefinnc fn ni isir by roiiinn Sn4 719 1027 nr 1 Ann z'29 94d11
Issued By: F o-U,y Vaw De'1n/e y2 Permittee Signature: Dw A
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
....
Building Permit Application tt:'I" / g
. ‘ RECEIVE t 13_ 81512
Residential FOR OFFICE USE ONLY
) i)bL / Sl ?' Received 1 f 1 N I (i'��0�� Y
City of Tigard Permit No.:
;� • 13125 SW Hall Blvd.,Tigard,OR 97223�rITY OF TIGARD Date/By: 2�
g Plan Review/
R Phone: 503.718.2439 Fax: 503.598.196 Date/By: • / Other Permit: � I oo 0
1- �.1 R t) Inspection Line: 503.639.4175 BUILDING DIVISION to Ready/By: Jut• ® See Page 2 for
Internet: www.tigard-or.govtified Meth ` � Supplemental Information
TYPE OF WORK QUIRED DATA: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.
El1-and 2-family dwelling ❑Commercial/industrial Valuation: $ a l 1 7r
❑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 / 11
Job site address: 16579 SW BOTANY BAY LN New dwelling area: 2,926 square feet 171 c-
City/State/ZIP:Sherwood,OR 97140 Garage/carport area: 485 square feet /a//
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.: 199 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: 222300BR. Valuation: $
Projected start: mid 2022 Existing building area: square feet
Deferrals:deferral of payment of transportation&park SDCs to occupancy. New building area: square feet
El 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:
El 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
Amount received:
Phone:(360)946-8674 Fax::( )360 693-4442
E-mail:permitsubmittals@taylormorrison.com-OAlamiAbouhafs taylormorrison.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 Total fee due upon application: $201.60
Authorized signature: nitail.,ty a.412G 469G2/:CG .41. 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
Print name:Omar Alami Abouhafs Date: 07/26/2021 Service Board.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
CE. Mechanical Permit Applic r:•1 a IVED FOR OFFICE USE ONLY
Cityof Tigard Received
Date/By: 6 E2 "' PeamitNo,: MOW'603(7
" 13125 SW Hall Blvd.,Tigard,OR 97223 v"v __
Plan Review
4 7 Phone: 503.718.2439 Fax: 503,598.19 Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGARU Date/By: S�IQ?pZx-OOZ'
tl{ih1:17 Dall R
e Ready/By; Juris" 0 See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION NotifiedtMethud
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.
Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION _Heating/cooling:
Air conditioning 1 46.75
Job site address: 16579 SW Botany Bay LN Furnace 100.000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000 t-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.: 199 `Other. 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.3..2
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
Chico ley liner/tlue/vent 23.32
0 PROPERTY OWNER Other. 23.32
❑ TENANT
Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range bood/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 0 CONTACT PERSON Other: 23.32
Business name:Polygon WLH,LLC Fuel piping:
S14.15 for first four;$4.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
WalUsuspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater__
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Ranee
E-mail:permitsubmittaisgtaylormorrison.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)270-1590 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
0J- 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 tgeiklmali+rtrnudh,lfir.V...nn one UM 11 Anr AM.I I fl/ M�Nv4 rm+CD
Electrical Permit Application ���� FOR OFFICE 1.tiE ONLY
City of Tigard -R-EcReC l 1-Oc3t
»,telv Prrm,t ,'W oZ
IIII a 13125 SW Hall Blvd.,Tigard,OR 97223
!_ .g Plan Review
Phone: 503.7182439 Fax. 503.598I960,'.�=i ,) Z021 Dawns Relied PermitIJ. (�jjD2c 7I'a(Yl I
Illspc tloa Line: 503 639 4175 Read DatclFl furls:
'1Lii\hD `' Y y QI SeePascZfor
Internet www.11gard-or.gov �IT i OF TIGARC� Notified/Method. Supplemental Information
TYPE OF N.'CITY
tLT t PLAN REVIEW
El New construction ❑Additionialter )l acealeftt Please check all Mai apply(subnnt/sets of plans wlitams checked).
ElDemolition Other: IDSame or feeder 400 ampo si inure El Budding over three stones
l _ where the alwilablc fault current 0 Marinas and boatyards
CATEGOR'i OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 floating buildings
Q 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building le.to ground,or exceeds 14,0110 El Coatmacial-use agricultural
amps for all other mstallattcars buildings
(3 Multi-family ❑Master builder El Other: 0 Fri
PAP 0 Installation,of I50 KVA or
JOB SITE INFORMATION AND 1A)CA lOi1 0 Einerpeney system larger separately derived
Bay 0 Addition of new motor load of system.
Job it: Job site address:16579 SW Botany B y LN 10011P or more.
City/Slate/ZIP: Tigard;OR 97140 ❑sox or more residential units occupancy
-• .. _ Oilcan-care facilities. ❑Recreational vehick parks..
Suite/bldg./apt.#: I Project name: Polygon at Roshak Ridge ❑Hazardous locations 0 Supply voltage for more than
0 Servue or feeder 600 amps or more 441`-Otis nominal.
Cross street/directions to job Site: FEE SCHEDULE
Description —I 4tr• I Each l •labs[ I °
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge 1 Lot#: 199 Includes attached garage.
Tax map/parcel#: Loco sq ft.or less 168 54 4
Ea.add'l 500 sq ft.or portion 33 92 1
DESCRIPTION OF WORK Limited maw,resident:at
en(with above sq.R) 75.00 2
New construction.Type SFU .Limited energy,multi-family
residential(with above sq.ft.)
7500 2
Renewable Energy 0 Sec Page 2
® PROPERTY OWNER ❑ TENANT Services or feeders installation alteration,and/or relocation
Name: Polygon Homes WLH LLC 200 amps or less t T 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 2
Phone:( 360 )946 8674 Fax:( ) Over 1,000 amps or volts 552.26 2
Entail: OAMamiAbouhafs toy ylormorrison.com-PermitSubmittal a'lormorrison.corn Temporary services or feeders installation,alteration,and/or
� } 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
❑ APPIIC tNI` I ❑ CONTACT PERSON Branch circuits--new Alteration,or extension,per panel
A Fee for branch circuits with
Business name: Polygon Homes WI.FI LLC above service or feedsx lee, 7 a2
each branch circuit -
Contact name: Omar Aland Abouhafs B Fee for branch circuits without
Address: 703 Broadway St.,Ste 710 service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Each add't branch circuit 7 42 1 2
Phone: 360 )946 8674Miscellaneous(service or feeder not included)
( Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67 84 2
Email:OAlamiAbouhafsfaytay'lotmotrison.com-PcrmitSubmittals@taylnrmorrison.coin Reconnect only - 67 84 2
CONTRAI7T012 .._ Pump or anp,atiun circle 67 84 2
Business name: Wallace Electric Sign or outline lighting 67.84 2
Address: 105 Dresden St Sinai cnrcut(s)or limited-energy 0 See Page 2 2
panel,alteration,or extension.
City/StateIZ1P: Astoria OR 97103 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 64;25/hr
Phone:(501 3)8 0563 lax:( ) Investigation(1 hr min) 91(X)/hr
Email David@waIlaccwires.com Industrial plant(1 hr mint? 78 18/hr
Inspections for which no tee is 90 04/hr
co;Lie.:224868 Electrical Li'' C1441 Su '.1.' .: 6363S specifically listed('/:hr min)
ELECTRICAL PERMIT FEES
Suprv_Electrician signature,required: — Subtotal
Print name:D tQ, LE_645,, Date: it/4/Iz t ,_0 Plan Review Required(25%of permit feet:
17L . State surcharge(12°/n of permit fee).
Authorized signature' TOTAL PERMIT FEE:
This permit application expires if a permit is out obtained within 18U
Print narll0: s T Date: days after it has been accepted as complete.
1.1Bunlding&'crntits'�C'Lc_PennrtApp_ELR ERE.dcc Rev 06117120t5 1'di-I615'r(I I/05•'COMt4V'FB * Number of inspections allowed per permit.
Plumbing; Permit AppIicati
RtFr-
OVFD
Building Fixtures
b FOR OFFICE USE ONLY
City of Tigard Received M(( q��
Date/B; 0 ' 2 0� ( Permit No. IIUgial- 7
�t 13125 SW Hall Blvd.,Tigard.OR 9722 y `�"�
• y- Plan Review _
Phone: 503.718.2439 Fax. 503.593. OF 1 IGARG Date/By Other Permit No. z-c `0
TIGARD inspection Line: 503.639.4175 3UILDING DIVISIOI` Date Ready/By: JunN El See Page 2 for ^
Internet: www.tigard-or.gov NotifiedJMethod: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist.
--- - -- Description I Qty. 1 Ea. J Total
0 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
❑Accessory buildingSFR(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: 16579 SW Botany Bay LN Catch basin or area drain 18.76
-
-- -
--- Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
----- - -- - Footing dram(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:ii.LMiriiii,ePolygon at Roshak Ridge Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Polygon at Roshak Ridge Lot no.: 199 Fixture or item:
Tax map/parcel no.: Backflow preventer 3 L27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02 J
New construction,type:Single-Family Units
--- Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:Polygon WLH,LLC Fixturclsewercap 25.02
Floor drain/floor sink/hub 25.02
Address:703 Broadway St.,Ste 510
Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Polygon 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/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:C&B Plumbing&Sons Inc Water piping+DWV 56.24
Address:P.O.Box 92 Other: 25.02
City/State/ZIP:St.Paul,OR 97137 Subtotal
Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: $72.50
CCB Lie.: 184372 Plumbing Lic.no.:pb634
Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: � 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.
*Pee methodology set by Tri-County Building Industry Service Board
I\Building/Pc nits\Pl.hn..I.PemutApo tine IWOIil5i 440-461611 10t02/COM+'WEB)
City of Tigard
IIIII DEVELOPMENT DEPARTMENT
TICARD` Building Permit Review — Residential
e aW BTU _'.�`. .. sift Pik:#. S:`4n5 S. liMeiMdA ,'n1VNLI "TOWN S".SI i I. MWMO AM°rx ..V:AIIMM ,. .''t
Building Permit #: msra021-003 Slit)1
Site Address: I(LTc `o t•J)I sv-/ Lm •
Project Name: {�oL /C CE K era(Cro E Lot #: 1 cm
Planning Review
Prop al: id tV`i _'{-jp1"‘
Verify address/suite# active in Accela. „.2rIn River Terrace: ❑ No Yes, River Terrace Review Addendum
Site lan Elements: LlErosion Control
pies of site plan on 8-1/2"x 11"or 11 x 17"paper [t] etained trees with drip line and tree protection measures
D .wn to scale(standard architect or engineer scale) Footprint of new structure(including decks) and FFE
.rth arrow ,�f'Otility locations&easements (required for new and additions)
IA S address,project or subdivision name and lot number VJSidewalk/driveway approach
Applicant information(name and phone number) `t- cation of wells/septic systems
[Lot dimensions and building setback dimensionseet tree size,type and location
Square footage of buildings to be demolished L�JS_t t names
NA I Existing structures on site I, Corner elevations (2'contours if more than 4'differenti 1)
❑Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes No )P
im ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes No
12pClean Water Services—Service Provider Letter �t platted prior to 9/10/1995):
wired: ❑ Yes,applicant was notified CJ No Received: ❑ Yes E No
Water Meter Fixture Unit Worksheet—Addi • s,Remodels and ADUs
quired: ❑ Yes,applicant was notified 1'J No Received: ❑ Yes E No
19 S Exemption for ADU applied for: El Yes LJ"No Received: ❑ Yes E No
Public Facilities Improvement (PFI)Permit:
R • ed: ❑ Yes,applicant was notified No Applied For: ❑ Yes E No,stop intake
Land Use Case#: S COIe. � Zoning: g`{ •S—
quired Setbacks: Front: 12- Rear: 10 Side: 3 Street Side: NA Garage: ZO
t
B ilding Height: Max. Height: N Actual Height: 27
Landscape Area: N A % Lot Coverage Max: m4 %
ntrance ❑ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Win. . ❑ Minimum 12%of area of all street-facing facades
Garage li ,rage door is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
��d ❑ D•c -xtends no more than 5'from wall and there is a covered porch extending beyond garage.
�� ❑ Door exten. •• more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
' ❑ Garage door width is ■ _' .r less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following:
IN ❑ Covered porch ❑ Recesses -• .nce ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ■ • •if pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ indow trim ❑ vt''. -.w recess ❑ Window projection ❑ Balcony
Zual Clearance Jan Forestry Pl
sitive Lands: ; " Yes No Type:
Conditions met prior to issuance of building permit
No M tit 9io2v-00044 &Tip$ Neu1 St-s orL f nif_c s- TD rKecr id• `: to oAQOS
Z1 Approved By Planning: Date: g S/2(
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
1:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: �/2/
Site Plans: # 3
Building Plans: #
Building Permit#: Z.-Enter building pe9it#above.
Workflow Routing: ErPlanning 7.Engineering Permit Coordinator uilding
Workflow Sign-off: ign-off for Planning(include notes from planning review)
Route Application Documents: r Engineering: (1) copy of permit application, (1) site plan, (1)building plan and
cyiginal plan review routing form.
IVIBuilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Date: g/312
Engineering Review
Slope at building pad:
Vi Conditions "Met"prior to issuance of building permit
['Easements (encroachments)per engineering conditions of approval and CC/Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes A/No
Assess Water Quantity Fee in-lieu: ❑ Yes L' No
LIDA Facility on lot: ❑ Yes ["No
te Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
ErApproved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
(u 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 g Does not apply
7 SDC Fees Entered: Was Cn Tran Dev Tax: je Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A Sp(h aQ trlrc,4
Parks SDC: fe Yes ❑ N/A
LIDA ❑ Yes / N/A
OK to Issue Permit
Approved by Permit Coordinator: 1 (p L/►
Date: D �
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
City of Tigard
" COMMUNITY DEVELOPMENT DEPARTMENT
p
T c A RD River Terrace Building Permit Review Addendum
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Building Permit #: NI5T'I,oi1 -co311-
Site Address: 1((S'}Ci Si 'oTh\I 3/4`/ .
Project Name: 1701Y6-or1/4-) A.r ROStt P.I0&e Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
' arming Review of River Terrace Plan District Design Standards (18.640.070.1):
Is - project subject to the plan district design standards? ❑ Yes Cif/No Per2, *MAD2O2o- 0 00114
1.Attic ion: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An addi '.nal
element req -d for lots with over 60 ft.of street frontage shall be provided every 30 ft.
Porch min. 5 ft. .. Balcony w/ access 2 Window Projection Vertical Wall Offset a Gay ed dormer
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
❑ ❑ ❑ ❑ ❑
2.Eyes on the street:a mini m of 12%of each street facing facade must include windo •s or entrance doors.
Percentage Shown:
3.Entrances:At least one entrance mu meet both of the following standards:
❑ Max. 8 ft, setback from longest street fac wall CI Parallel to str-- ,angle no more than 45° from street,
or open onto ..rch
Entrance opens to a porch: ❑ Yes ❑ No
If yes,all the following apply: ❑ 25 s• t.min.
❑ One street facing entry ❑ 1 t.max. roof above floor of porch
❑ 5 ft. depth min. 30%min. porch roof coverage
4.Detailed Design:All buildings shall include a min. o . ve of the • owing elements on all street-facing facades:
❑ Covered porch min. 5 ft.wide x 5 ft.deep ❑ Recess-. entry area min. 5 ft.wide x 2 ft.deep
❑ Wall offset min. 16 inches ❑ Dormer mi 4 ft.wide
❑ Roof eave min. 12 inch projection ❑ Roof offset mi •f 2 ft.
❑ Roof shingles either tile or wood ❑ Gable,hip or gam: -1 roof design
❑ Roof pitch oriented south min. 500 s•. ft. ❑ Horizontal lap siding 's. 3-7 inches wide
❑ Accent siding min. 40%of street .cade ❑ Window trim min.2 1/2"w - by 5/8"deep
❑ Window recess min. 3 inches all street facing ❑ Bay window min. 5 ft.wide b • ft. deep
❑ Balcony min. 5 ft.wide x 3 . deep with inside access ❑ Attached garage is 35%or less o eet facade
5. Garages and Carpor ..May face the front or side lot line on a corner lot.
Setbacks:
No closer to fron .r side lot line,than longest street-facing wall. ❑ Yes ❑ No. If No (Check one):
❑ May exten a .p to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
❑ May ex : d up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
above t garage that faces the street with a min. area of 12 sq.ft.
Wid : (Check one)
I. 12-foot-wide garage door ❑ 40%max.of street facade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: - _ Date: O.s 2 f
1:\Building\Pons\BldgPei mitRvw_RES_RT_121417.docx
City of Tigard
Parks Sly C Charge (Parks)
TIGARD Notification of Fee and Payment Options
Please sign and return prior to building permit issuance.
This advises you that the total Parks SDC charge for this project is as shown below and outlines the payment
options that may be available to you. This total includes Parks SDC-Improvement, Parks SDC-Reimbursement,
and either Parks-Neighborhood or Parks-Neighborhood River Terrace charges as relevant. This form is to be
signed and submitted prior to issuance of a building permit.
City of Tigard
Date: 8/10/2021 Site Address: 16579 SW Botany Bay Ln
Project Polygon at Roshak Ridge - Land Use Case
Name: Lot 199 or Permit #: MST2021-00317
Tax Total Parks
2S107AA19900 $10,903
Lot#: SDC Amount*:
*The total Parks SDC amount shown above is the sum of$ 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.)
D 4 .4eouA Dom, ,46eu
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
WAX
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 16579 SW Botany Bay Ln
Project Polygon at Roshak Ridge - Land Use Case or
Name: Lot 199 Building Permit #: MST2021-00317
Tax Total TSDC
2S107AA19900 $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.)
Dom,.4 k7Mt ebwiazfr Oman,.AEviti/16aadia6d.
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