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Permit
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 yourproject. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT It = Transmittal Letter i (; R 1) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: 11/A '4-°C)*& ' E71-- DATE RECEIVED: DEPT: BUILDIN - DIVISION RECEIVED Y , ,� JUN 2 2 2i)?r FROM: S I t CITY OF T COMPANY: < HPak. Dr CITY OF TIGARD IIVISION 2Oyu .,. A I By. _PHONE: co5 013 / Lj EMAIL: (O \-64 C)`&40"ivttOr?‘SOA CPAA �t \ SSW.( n`l4 ✓ QQ Skie (off RE: t "re Permit Number) Address) ( (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: I Description: I Copies: I Description: Additional set(s) of plans. Revisions: ecx;I,c` 5 AGILE tWd1'0 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: FOR OFFICE USE ONLY y Initials: li Ro to Permit Technician: Date: 6-al- Z Fees Du Yes ❑No Fee Description: Amount Due: 0 s rlr p/Q feAmp./ $ 43 $ $ $ Special Instructions: Reprint Permit(per PE): I ElYes \c]No 1 ❑Done Applicant Notified: Date: r //�g ar. Initials: pp 6 I:\Building\Forms\TransmittalLetter-Rev lions_ 31).doc Plumbing Permit Application Building Fixtures - 1-1C,,,ULi V trn i- 1=11.211121EIMIlliiiiill- Cit of Tigard Received MST2021-00192 Y g Date/By: + �/„),,... Permit No r qn q Y `/ 6//J 13125 SW Hall Blvd.,Tigard,OR 97223 Env 9 LUGl ' _ Plan Review Phone: 503.718.2439 Fax: 503.598.196 DateOther Permit No.: I l ci A It D Inspection Line: 503.639.4175 �7-�/ MARL Date Ready/By: Saris. H See Page 2 for Internet: www.tigard-or.gov l.J 1 1 l� rlU Notified/Method: Supplemental Information TYPE OF WOR3UILDING DIVISION- FEE* SCHEDULE ■ New construction For special in ormation use checklist. ❑ ❑Demolition P l 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(I)bath 312.70 1-and 2-family SFR(2)bath 437.78 ❑ wellin g ❑Commercial/industrial buildingSFR(3)bath 500.32 ❑Accessory Li Each additional bath/kitchen 25.02 ❑Master builder ❑Other: • Fire sprinkler(1625sq.ft.) Page 2 JOB SITE INFORMATION' � �i "-, „ ►e3l 4'',� � Site utilities: Job site address:14400 SW 165th Ave. t ''' ��� 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.: I Project name: Polygon at Roshak Ridge Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: I Lot no.:175-ADU 1 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF'WORK Backwater valve 12.51 Clothes washer 25.02 MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 IA'PROPERTY OWNER } EA TENANT tank 12.51 Fixture/sewer cap 25.02 Name:Taylor Morrison Floor drain/floor sink/hub 25.02 Address:703 Broadway Street Suite 710 Garbage disposal 25.02 City/State/ZIP: Vancouver,WA 98660 Hose bib 25.02 Phone:( 360 ) 695-7700 Fax:( ) Ice maker 12.51 © APPLICANT ill CONTACT PERSON Interceptor/grease trap 25.02 Business name:Alliance Plumbing, LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Gavin Thomes Roof drain(commercial) 12.51 Address:146 W Historic Columbia River Hwy Sink/basin/lavatory 25.02 City/State/ZIP:Troutdale,OR 97060 Solar units(potable water) 62.54 Phone:( 503)577-6535 Fax::( ) Tub/shower/shower pan 12.51 E-mail: gavin@allianceplumbing.net Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:Alliance Plumbing, LLC Water piping/DWV 56.29 Address:146 W Historic Columbia River Hwy Other: 25.02 City/State/ZIP:Troutdale,OR 97060 Subtotal Phone:( 503 )492-3490 Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.:184601 Plumbing Lic.no.:PB732 1.--..--, Zl State surcharge(12%of permit fee) Authorized signature: y TOTAL PERMIT FEE Print name:Gavin Thomes Date:It(9 2021 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. i:ABuildingA Permits VPLMU-PermitApp.doc 10/01/00 440-4616T(I 0/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site utilities Qty. fee test Total SquareFootage: Permit Fee Footing drain-1"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 62.54 : Permit Fee: $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Fees � Qt.), Fie{gay Totat Inspectionseach additional$100.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or for S10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) 3 '' t and including$25,000.00. Inspections outside of normal business 90.00/hr ..$.2Shc 1.00 to$50,000,J0 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) �»-...�r each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for,Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replaee/ Please check all that apply. Work Performed, Capped Added Relocate 0 Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool ❑ Car Wash: -Each Stall New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. ❑ Any multipurpose fire sprinkler system. Dishwasher: -Commercial Domestic El Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lay/Bar non-food related -Bradley Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet plumbing permit can be issued. Urinal • Other Fixtures: I:ABuilding\Permits\PLMF PermitApp.doc 08/04/2011 2 III nCITY OF TIGARD MASTER PERMIT � aCOMMUNITY DEVELOPMENT Permit#: MST2021-00192 Date Issued: 12/01/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107AA17500 Jurisdiction: Tigard Site address: 14400 SW 165TH AVE Subdivision: ROSHAK RIDGE Lot: 175 Project: Polygon at Roshak Ridge, Lot 175 ADU (1 of 2) Project Description: New attached ADU. NO FINAL INSPECTION UNTIL SDC FEES ARE PAID. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 672 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 25.5 Bathrooms: 3 Second: 953 sf Garage: 287 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 1625 sf Value: $212,859.60 Rear: 10 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer. 100 Tubs/Showers: 2 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: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 2 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: 2 201-400 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 ADU VB R-3 1625 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 Fire Rated Conditions PHONE: PHONE: 360-695-7700 FAX: Total Fees: $17,892.61 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 Oc9-nni nnln thrni trill nAP oc9-nM-Anon vni t mov nhrnin a nnnv of tho rnlee nr riirenf n,ieerinne In ell IAIr by n,Ilinn sn1 919 1QR7 nr 1 Ann 449 ) 44 Issued By: HaUA VO 'De'W69e- Permittee Signature: °K'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 iob site at the time of each inspection. •Building Permit Application I VED Residential FOR OFFICE USE ONLY City of Tigard MAY 0 �' 2021 Rd or 5 s^ -CO �y Date/By:eceive '�' k Permit No.: MS` ZOZ1- (-l2_ 13125 SW Hall Blvd.,Tigard,OR 97223 p. eview Phone: 503.718.2439 Fax: 503.598.19t�(itTY OF 1IGARD Plan Date/BRy `I�a•/74 W Other Permit:S Uyna2'^00 1 42 i t_ IL f Inspectionterne: Line: 503.639.4175d-or.g BUILDINGDIVISION Not�ady/B l t See Pent 2 for Internet: www.tigard-or.gov Noti d/Method: 4L/ �I � Supplemental Information TYPE OF WORK UIRED DAT,: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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. r-O 0 1-and 2-family dwelling ElCommerciaFindustrial Valuation: $ ),t�' v�l V ❑Accessory building 0 Multi-family Number of bedrooms: 3 ❑Master builder ®Other: AS u 'L Number of bathrooms 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 ,,nnn( 1�1 Job site address: 14400 SW 165th Ave. New dwelling area: 444 square feet CT S.3 City/State/ZIP:Sherwood, OR 97140 Garage/carport area: 2 P7 square feet ict 72, 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.: 175 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. AOktNew home construction: Triplex standard (SFU, ADU1, ADU2) Valuation: $ Elevation: 221200AR/221300AR/ 400AR Existing building area: square feet Projected Start: September 202 .�j2e5 /6„/ i ree mir 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 710 Occupancy groups: city/state/ZIP:Vancouver,WA 98660 Existing: Phone:(360)946 8674 Fax:( ) New: ® APPLICANT 0 CONTACT PERSON et9 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 710 Total fees due upon application: City/State/ZIP:Vancouver,WA 98660 Phone:( 360) 946 8674 Fax::( ) Amount received: E-mail: PermitSubmittals@taylormorrison.com,OAlamiAbouhafs@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 710 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: $201.60 Authorized signature: 71/244 sty 192G.(geN.1. ,:a611- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Omar Alami Abouhafs Date: 05/04/2021 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Applicati �CEIVED City of Tigard Rece,ved c/ice r2' Msr y%-CC)(012 b Datc/F3y t/ PcrmitNo,; l 13125 SW Hall Blvd.,Tigard,OR 97223 MAY r► 2021Plan Review;, Phone: 503.718.2439 Fax: 503.598.1960 Other Permit: C uiQ �Zt_to 1 Date/By: Jf+14 tltiAl.I) Inspection Line: 503.639.4175 CITY OF fiGARD Date Ready/By: 1°ris @ See Page 2 for Internet: www.tigard-or.cov BLit!DING S y Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work 0New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* '^ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building _ For special information use checklist Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total JOB armINFORMATION AND LOCATION Heating/cooling,: i Air conditioning 1 46.75 Job site address: 14400 SW 165th Ave. Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+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-duet,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Pol on at Roshak Ride Other 23.32 y9 9 Lot no.: 175 Other fuel appliances: Tax map/parcel no.: Water heater 2 23.3� DESCRIPTION OF WORK Gas fireplace/insert 33.39 - — — Flue vent for water heater or gas New home construction- fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 2332 Chimney/liner/flue/vent 23.32 ® PROPERTY OWNER 0 TENANT Other 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/crawispace fans 23.32 IE3 APPLICANT El CONTACT PERSON Other: _ 23.32 Business name:Polygon WLH,LLC F°eipina' 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 ----- Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace Ranee E-mail:permitsubmittals ataylOrMOITISon.COm Barbecue ,.t CONTRACTOR Clothes dryer(Ras) Business name:Pro Heating&Cooling Other: MECHANICAL PERMIT FEES* Address: NW Alociek Dr,Ste.1104 Subtotal City/State/ZIP:Hillsboro,OR ___-_____ Minimum permit fee($90.00) _ 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 Gela, f)u� days after it has been accepted as complete. Authorized signature: e.v J • Fee methodology set by Tri-County Building Industry Service Board Print name:Elia Duran Date: 10/30/20 r iss.e,4,nest.rmir.ivtir e..,naa,..adnf l3rin. n..n..cr Yr. .m,,.-',..,ntco• Electrical Permit Applicatiol,ECEIVED i sll; t11 i•it I I •i i01 l City of Tigard MAY 0 5 2021 lamed S- 1_1-/z l NT-- l mt A MSr -00(`i Z- it 13125 SW flail Blvd.,Tigard,OR 97223 -- -- .-_._Plan . ew II Phone: 503..718,2439 Fax 503.598.1t9TY OF TIGARD wB Related Permit 4: .Z(-a 4 I 4.. Inspection Lim 503.639 4175 r I C.; h I) BUILDING DIVISION Ready Oniony rtrrir ® see Page a for Internet: www.tigard-or,gov Notilied/Mcthod. Supplemental Information TYPE OF WORK PLAN REVIEW ®New construction 0 Addition/alteration/replacement Please cheek all that apply(submit a sets of plans w/items checked) ['Same or feeder 400 amps or more ❑Budding over three stones 0 Demolition ❑Other: Where the available fault current 0 Marinas and boatyard, CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 bloating bwldmgv 0 I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14.000 0 Commercial-use agricultural ®Older ADU 1amps(on an other installations buildings ❑Multi-family 0 Master builder 0 Fire pump. 0 Installation of 150 KVA or JOB sfrE INFORMATION AND IAR'ATIOiN ❑Emergency system larger separately derived Sob#: Job site address: 14400 SW 165th Ave ❑A tion of new motor load of system. 10911P or more. ❑..A"."E..,..1-2•,,"I-3", City/State/ZIP: Tigard,OR 97140 0 Six or more residential units occupancy u CI Health-cartfacilities_ 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Polygon at Roshak Ridge 0 Hazardous locations 0 Supply voltage for more than ❑Service or fccder 600 amps or more 600 rubs nominal.. Cross street/directions to job site: FEE SC NEDLTI E 1lottrigtroa I Ott. I Earl 1 Total I • New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot is 175 Includes attached garage. fax map/parcel 4: 1,000 s s1 ft less 168 54 4 Ea.add'l 500 aq.It.or portion 33.92 1 IWSCRti'TIOt1T OF WORK Limited energy,residential New construction_ Type: ADU 1 (with above sq.tE) 75.00 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 PROPERTY OWNER Renewable Energy 0 See Page 2 ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: Polygon Homes WLH LLC 200 amps or less 100.70 2 Address: 703 Broadway SE,Ste 710 201 amps to 400 amps 133.56 2 City/State/L1P: Vancouver,WA 98660 — 401 to 600 amps 204 34 2 601 amps to 1,000 amps 301 04 2 Phone:( 360 )946 8674 Fax:( ) Over 1,000 amps or volts 552.26 2 Email: 0AlamiAbouhafs@taylonnorrison.com-PermitSubmittal to lotmorrison_com Temporary services or feeders installation,alteration,and/or sQ Y relocation ` Owner installation:This installation is being made on property that I own which is not 200 amps or less I 59.36 1 1 intended for sale,lea. ten or lease, t, exchange,accordingto ORS S 447,449,570,and 701. 201 amps at 400 amps 125,08 z Owner signature: Date: 401 amps to 599 amps 168.54 2 0 APPLICANT - i ❑ CONTACT PERSON Branch circuits-new lttcration,or extension,per panel A.Fee for branch circuits with Business name: Polygon Homes Wi.H LLC above service or fouler fee, each branch circuit -42 Contact name: Omar Alatni Abouhafs B Fee for branch circuits without Address: 703 Broadway St.,Ste 710 service or feeder fee,fist 18 2 - - branch circuit City/State/ZIP: Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Phone: 360 94b 8b74 Miscellaneous(service or feeder not included) ( ) Fax::( ) Each manufactured or modular dwelling,service and/or feeder 67 84 2 Email:OAlamiAbouhafs@taylormorrison.con-PermitSubmittals@taylormorrison.com Reconnect only 67 84 2 CONTRACTOR �— Pump or tntigatiun circle 67 84 2 Business name: Wallace Electric Sign or outline lighting 67.84 2 i Address: 105 Dresden St Signal circuits)or limited energy panel,alteration,or extension. 0 See Page 2 2 _ Each additional inspection over allowable in anyof the above i City/State/ZIP: Astoria OR 97103 Additional nspection(1 hr min) 66 25/hr Phone:(503 3.8 0563 Lax:( ) Investigatum(1 hr min) 90.019 hr Email: llavid(awallacewires.com industrial plant(1 hr min) 78 IS/hr Inspections for which nu lee is Electrical Li • CI441 Su?rv.1 ' 6363S specifically listed eh hr min) 90.00J hr CCB[An.:.:224868 Suprv-Electrician signature,required: ELECTRICAL. PERMIT FEES . Print name;' Subtotal fp . j z, Date: ///� )�i 0 Plan Review Required(25%of permit foes [/ �r State surcharge(12%of permit fee) Authorized signature /� TOTAL PERMIT FEE: Print name: tl This prnatt application expires if a permit is not obtained within 180 __ i a,.4t, Date: i ` /Z t days after It has been steepled as complete. • Number of inspections allowed per permit tl'e�aV frn 7T nirAras FI R PISS,,G.c r' R wu tK.•f9hnvr . .. ._.._.__.__-_____—_ Plumbing Permit Application Building Fixtures m. a _ FOR OFFICE USE ONLY City of Tigard Received [� g MAY Date/By: NI, J I /Z I Permit No.: .�-2�771' 00 I q 2,- 'I 13125 SW Hall Blvd.,Tigard,OR 97223 ',, 061 2021 ,• S'I Plan Review n Phone: 503.718.2439 Fax: 503.598.l9 DatefBy Other Permit No.:s'WK 2t'fL\-�\f�-, 71GARD Inspection Line: 503.639.4175 �Y OF Ti br' Dale ReadyBy: Jura Id See Page 2 for Internet: www.tigard-or.gov :3UlLDiNG DIVISION Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE A New construction 0 Demolition For special information use checklist Description Qty. ---ET.--1 Total ❑Addition/alteration/replacement 0 Other. New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building • Multi-family Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) _ Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 14400 SW 165th Ave 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: Polygon at Roshak Ridge Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Lot nc 175 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 i2 PROPERTY OWNER , ❑ TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixture/sewer cap 25.02 Floor drain/floor sinkfiub 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 ^ ElAPPLICANT IDCONTACT 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-mailPermitSubmittals@taylormorrison.com,OAlamiAbouhafs@taylormorrison.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:G&B Plumbing&Sons Inc Water PP i m DWV 56.29 Address:P.O.Box 92 Other 25.02 City/State/ZIP:St.Paul,OR 97137 _ Subtotal Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: $72.50 CCB Lie.:184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: _ ,vim TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days Print name:Steve Fowler Date: 1 O/3O/2O after it has been accepted as complete. "Fee methodology set by Tn-County Building Industry Service Board. l:iBmtdingtPertnits\PLMti-Pemilt App doe 10/01 59 440-4616T(10,02COMAWEB) City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT II T 1 , D Building Permit Review — Residential Building Permit #: M Si .o2i- DO 1 t2 Site Address: 1111100 SW 165th Ave Project Name: Polygon at Roshak Ridge Lot #: 175 Planning Reviewat ( c i 1 —�v S(FE-''PIX{3� SOWE►v Kit Proposal: New detached dwelling (ADU 1) CIVerify address/suite# active in Accela. ❑.• In River Terrace: ❑ No 0 Yes, River Terrace Review Addendum Site Plan Elements: ,rosion Control DI copies of site plan on 8-1/2"x 11"or 11 x 17"paper detained trees with drip line and tree protection measures CI rawn to scale(standard architect or engineer scale) v-ootprint of new structure(including decks)and FFE 'o r t h arrow :,,Jtility locations&easements(required for new and additions) Q'ite address,project or subdivision name and lot number °sidewalk/driveway approach D-pplicant information(name and phone number) O/k ocation of wells/septic systems 0 ot dimensions and building setback dimensions a treet tree size,type and location 11'quare footage of buildings to be demolished e>treet names NIPII xisting structures on site 1;orner elevations (2'contours if more than 4'differential IIot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ° es o impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es o 0 Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑Yes,applicant was notified ❑No Received: ❑Yes ❑r No 0 Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: ❑Yes,applicant was notified ❑No Received: ❑o Yes ❑No ❑ SDC Exemption for ADU applied for: ❑Yes ❑No Received: 0 Yes ❑ No ❑s Public Facilities Improvement (PFI)Permit: Required: ❑r Yes,applicant was notified 0 No Applied For: ❑r Yes ❑No,stop intake ❑r Land Use Case#: ADU2020-00017 ❑ Zoning: R-4.5 Required Setbacks: Front: al. . Rear: 10 Side: 3 Street Side: NSA Garage: 3 0 Building Height: Max. Height: 30 Actual Height: 25.5 0 Landscape Area: 20 % 0 Lot Coverage Max: 80 Entrance e Set back no more than 8'from street-facing wall ❑r Parallel to street or offset 45 degrees or less Windows e Minimum 12%of area of all street-facing facades Garage ! Gara e door is behind widest street-facing wall ❑o Yes CINo,one of the following is met: ❑gDoor extends no more than 5' from wall and there is a covered porch extending beyond garage. ❑u Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2"d floor. ara 12'or less ❑50%or less of facade = 60%or less and• ow ng: (� A - Covered porch Recesse entra all of _ oof eave Roof offset �"` Fire shingles La Si ' oo itch a mbrel roof Dormer si g _ Window trim L.1 Window recess Window prolec Balcony ❑o Visual learance ❑r Urban Forestry Plan 0 Sensitive Lands: ❑ Yes ill No Type: QConditions met prior to issuance of building permit Notes: QApproved By Planning: ����:..en..► Date:4 1' Revisions (after Building Submittal only Review x D to Revision 1: .Approved ❑ Not Approved 101141 2.674 Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPerm itRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: 5-/CO/2 1 Site Plans: # ?s Building Plans: # 3 Building Permit#: ErEnter building ermit# above. Workflow Routing: Planning Engineering [J Permit Coordinator ❑ Building Workflow Sign-off: ign-off for Planning(include notes from planning review) Route Application Documents: Engineering: (1)copy of permit application, (1) site plan, (1) building plan and al plan review routing form. R ' ' ' ` ; Buildin : origirial permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: 1 Date: c"--43/2/ En neering Review LE Slope at building pad: ,-3/P Conditions "Met"prior to issuance of building permit ix, asements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes I 'No Assess Water Quantity Fee in-lieu: ❑ Yes Lr No LIDA Facility on lot: ❑ Yes EKTo Er Final Plat Recorded: E NOT Approved by Engineering:ng _ �� Date: s7.�2/ Notes: Nev le//e it S:e..rt,l �� 4 ►t Of4'1 pproved by Engineering: Date: Revisions (after Buuii 'ng Submittal only) `----Reviewer Date Revision 1: L7 Approved ❑ Not Approved idl2-,S� / Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review ,Er Conditions"Met"prior to issuance of building permit Approved,NOT Released: Sze Gywt,. Glhv- -fp_ g124 r2✓yl 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 amply SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes 11 N/A Tigard Trans SDC: Zr Yes ❑ N/A See- 1) 4D Parks SDC: , Yes ❑ N/A YY‘'1 LIDA ❑ Yes Z N/A jai OK to Issue Permit /Approved by Permit Coordinator: Q Date: IDJ2(0 12621 I:\Building\Forms\BldgPermitRvw_RES_122419.docx • City of Tigard 1111 COMMUNITY DEVELOPMENT DEPARTMENT ■ T C G A R D River Terrace Building Permit Review Addendum Building Permit #: mW2021- QO 1°I2- Site Address: MOO ( (pS41n Av Project Name: Polygon at Roshak Ridge Lot.#: 11,c- (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of River Terrace Plan District Design Standards (18.640.070.1); Is the project subject to the plan district design standards? ❑Yes CI No (Per MMD2020-00044) Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additio ele -nt required for lots with over 60 ft. of street frontage shall be provided every 30 ft. Porch 5 ft.deep Balcony w/access 2 Window Projection Vertical Wall Offset a Gable• .ormer ft.deep min. 2ft.,5 ft.wide min. 2 ft.,6ft.wide 0 ❑ ❑ 0 2.Eyes on the str- : a minimum of 12%of each street facing facade must include windows • entrance doors. Percentage Shown: 3. Entrances:At least one e ance must meet both of the following standards: ❑Parallel to street, . gle no more than 45° from street, ❑Max. 8 ft. setback from longer trees-facing wall or open onto por Entrance opens to a porch: ❑Yes o IfLes,all the following apply: ❑25 sq.ft. One street facing entry ❑12 f ax.roof above floor of porch ❑5 ft.depth min. ❑3./o min. porch roof coverage 4.Detailed Design:All buildings shall include a min.o v of the following elements on all street-facing facades: ❑Covered porch min. 5 ft.wide x 5 ft. deep I Recessed entry area min. 5 ft.wide x 2 ft. deep ❑Wall offset min. 16 inches ormer min.4 ft.wide ❑Roof eave min. 12 inch projection ❑R•. offset min.of 2 ft. ❑Roof shingles either tile or wood ❑Gable, .13 or gambrel roof design ❑Roof pitch oriented south min. 500 sq. . ❑Horizont. .p siding min. 3-7 inches wide ❑Accent siding min. 40%of street fa .e ❑Window trim • ' . 2 1/2"wide by 5/8"deep ❑Window recess min.3 inches for .1 street facing ❑Bay window min. ft.wide by 2 ft. deep ❑Balcony min. 5 ft.wide x 3 ft. eep with inside access ❑Attached garage is 3 'o or less of street facade 5. Garages and Carports: 'ay face the front or side lot line on a corner lot. Setbacks: No closer to front o ide lot line,than longest street-facing wall. ❑Yes ❑No. If No (Check o - : ❑May extend u. o 5 ft.if there is a covered front porch and garage does not extend beyond the fro •orch. ❑May exten• p to 5 ft.where the garage is part of a two-story building and there is a window at the se d story above the :,..age that faces the street with a min. area of 12 sq.ft. Width• heck one) ❑ -foot-wide garage door Cl 40%max. of street facade I 50%max.of street façade with 7 detailed design elements Notes: Approved By Planning: / 4‘'VDate: ---CM 21 I:\Building\Forms\BldgPermitRvw RES_RT_121417.docx 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 _'PI Transmittal Letter T l c A It rD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov TO: Agnes Lindor DATE RECEIVED:/ DEPT: BUILDING DIVISION RECEIVED Y ED FROM: Omar Alami Abouhafs OCT 1 3 2021 COMPANY:Taylor Morrison i✓I1Y OF TIGARU PHONE: (360)946 8674 BUILDING DIVISION): 4. EMAIL: OAIamiAbouhafs@taylormorrison.com RE: 14398/14400/14402 SW 165th Ave MST2021.99491/...00192/...9$49.3• (Site Address) (Permit Number) Polygon at Roshak Ridge, lots 175 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s)of plans. 3 Revisions: site plan+ Details 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: Additional documents were provided with the site plan to resolve the waterline issue in the driveway. For O�FICE USE ONLY Routed to Permit Technici , tlZ 2-1 Initials: Fees Due: ❑Yes Nd/ Fee Description: Amount Due: pb itE $ /21_____— $ Special Instructions: Reprint Permit(per P ): ❑Yes0 Done Ar Applicant Notified: k/.0.7.______ Date: t/7 p/?1(10--- ( Initials: City of Tigard gi Deferral Until Occupancy Request Ti G A R D Washington County Transportation Development Tax (TDT),Transportation and Parks System ' Development Charges (SDCs) x"+ishetA E#ar;e'. 944 i5k# f%'sae. ,"k&""a - 8a5 P!art,NOWk52€".00 qtan4W9M,Adv4' 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). Date: 10/26/2021 Site Address: 14400 SW 165th Ave Project Polygon at Roshak Ridge Land Use Case or MST2021-00192 Name: Building Permit#: Tax Lot Total Parks 2S107AA17500 #: Lot 175 Amount*: $5,652 TDT Total TSDC Amount: N/A Amount*: $211 *The total TSDC amount shown above is the sum of$ 0 for TSDC-Improvement,$211 for TSDC- Reimbursement,and$ 0 for TSDC-River Terrace,if applicable.. *The total Parks SDC amount shown above is the sum of$4,576 for Parks-Improvement,$ 1,076 for Parks- Reimbursement, and either$ N/A for Parks-Neighborhood or$ 0 for Parks-Neighborhood River Terrace. This constitutes my request to defer payment of the TDT,TSDC, and Parks SDCs, as provided above, until occupancy. Payment of the TDT,TSDC, and Parks SDCs may be deferred until issuance of the occupancy permit. In requesting this option, I understand that any deferred TDT,TSDC, and Parks SDCs must be paid prior to final inspection or issuance of an occupancy permit. TDT may only be deferred if the TDT is greater than the amount for a single-family residence. I further understand that the amount of TDT due on deferred obligations shall be the amount in effect at the time of issuance of the building permit. For a deferral request to be accepted both the Property Owner and the Developer must sign this request. Property Owner: I -4kul.e-'.A4aa Date: 10/26/21 Developer: D/ta i 4ga-0a 46etdaod- Date: 10/26/21 Permit Coordinator: OetArtek Date: 10/26/2021