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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 your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT g Transmittal Letter i c;ikfl.ti 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: '-6 CU* b E2--- DATE RECEIVED: DEPT: BUILDIN IVISION RECEIVED FROM: "pis JUN 2 2 ?Ti7 1-tejak CITY OF TIGARD COMPANY: � r BUILDING DIVISION ((�� PHONE: `D13 u / EMAIL: (iCO A 1 Qe(14,40f a\50A, CPVA RE: it t�k 9, SV \(_A 100 )4 )3SV7J)21n ✓ (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: 6-g, 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 Ro to Permit Technician: Date: 6-a,3- Z'- Initials: �(Jr Fees Du Yes 0 No Fee Description: Amount Due: 0 s t r ply, ("AAA ,./ $ 93 $ $ $ Special Instructions: Reprint Permit(per PE): El Yes No D Done Applicant Notified: Date: /i,3/a Initials: I:\Building\Forms\TransmittalLetter-Rev sif ors" U731)doc Plumbing Permit Application // q// e Building Fixtures rcoit torrid. t'sE ()Ni.1 Cityof Tigard R Ili g EL IVE Received 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie Date/By: ll30lly""" Permit No.: MST2021-00193 a Phone: 503.718.2439 Fax: 503.598.1960 NOV zQ i Date/By: 1 pZ/Jail nn '466, Other Permit No.. -1 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: Juos: H See Page 2 for Internet www.tigard-or.gov r' Notified/Method: Supplemental Information TYPE OF WORK CITY Y (,)1. ,--.i 11 FEE* of�EDFI E ❑ r t at o DIVISION , . ■ Nev,New construction For special information use checklist. Description i Qty. I Ea. I 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 1-and 2-family d SFR(2)bath 437.78 ❑ ywellin g ❑Commercial/industrial IDAccessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 0 Master builder T 4iu. 1729 4_ , Fire sprinkler( sq.ft.) Page 2 JOB SITE.INFO�TIO IIY . t I t Site utilities: Job site address:14402 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.: 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 2 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 ® PROPERTY OWNER 1 0 TENANT Expansion 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 ® 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 CONTRACTOR Water closet 25.02 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 CCB Lic.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee) /� State surcharge(12%of permit fee) Authorized signature: / 7-----• `( ' TOTAL PERMIT FEE Date: 8�2021 This permit application expires if a permit is not obtained within 180 days Print name:Gavin Thomes after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:ABuildingA Permits VPLMU-PermilApp.doc 10/01/09 440-4616T(IO/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. i teas Total Square Footage: 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 Valuation: Permit , Fee: Storm&Rain Drain-1st 100' 62.54 $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 tl each additional$100.00 or fraction thereof,to Other Inspectionsobi 'Fees } Total and including$10,000.00. Inspection of existing plumbing or for $10,001.00 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) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000`00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) 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-I/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 Replace/ Please check all that apply. Work Performed: Capped Added Relocate ❑ 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 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator Dishwasher: Commercial 0 Any multipurpose fire sprinkler system. 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 that meet the qualifications above. Garbage -Domestic non-food 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: -Lav/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 fees assessed for.the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal • Other Fixtures: l:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 III CITY OF TIGARD MASTER PERMIT II COMMUNITY DEVELOPMENT Permit#: MST2021-00193 T f G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/01/2021 Parcel: 2S107AA17500 Jurisdiction: Tigard Site address: 14402 SW 165TH AVE Subdivision: ROSHAK RIDGE Lot: 175 Project: Polygon at Roshak Ridge, Lot 175 ADU (2 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: 720 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 25.5 Bathrooms: 3 Second: 1009 sf Garage: 398 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 1729 sf Value: $230,956.74 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: 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: 3 201-400 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 8 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 1729 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 Fire Rated Conditions VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 Ersn Cntrl 503-639-4175 PHONE PHONE: 360-695-7700 FAX: Total Fees: $18,238.98 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 oF9-nM-nnin Thrniinh HAIR oc9_nn1-anon vn$$may nhf,in n onnw of fho r,Joe nr rfironf ni,cefinne fn(It ejc-by rnllinn cn1 919 10R7 nr 1 ann 1'29 94AA H Va.wDe,W e Issued By: Permittee Signature: �w 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 Ap licatio ECE VE Residential FOR OFFICE USE ONLY MAY o G 2021 Received City of Tigard Date/By:Ik,n 1 1 T 121 Permit No.: MST Zo21-OCAOLS 1111 a 13125 SW Hall Blvd.,Tigard,OR 9722(DITY OF TIGARD Plan Review Q,(� Z Phone: 503.718.2439 Fax: 503.59t8 D IG DIVISION Date/By: I( ooiluot-I /7l I Other Permit: a,20Z'_Ob12, T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: / / t Y+ ® See Page 2 for Internet: www.tigard-or.gov No Tied/Method: ' /� /' j--�. Supplemental Information frr TYPE OF WORK REQUIRE I DATA:1-AND 2-FAMILY DWELLING ®New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 6—toll ❑ 1-and 2-family dwelling 0 Commercial/industrialValuation: $ �3O�� ❑Accessory building El Multi-familyNumber of bedrooms: ❑Master builder 'Other: Ac u 2. Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 0L, If /I p:-.1 Job site address: 14402 SW 165th Ave. New dwelling area: 2144-t` square feet 1 of City/State/ZIP:Sherwood,OR 97140 Garage/carport area: 3-I$ square feet f 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 1 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. ,tl LNew home construction: Triplex standard ( SFU,ADU1, ADU2) Valuation: $ Elevation: 221200AR/221300AR/221400AR 7^Existing building area: square feet Projected Start: September 2021 50,E ns ► 17 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: D APPLICANT 0 CONTACT PERSON U9 BUILDING PERMIT FEES* Business name:Polygon Homes WLH LLC (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name:Omar Alami Abouhafs 703 Broadway St., Ste 710 FLS plan review fee(if applicable): Address: 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 PhotoVoltaic 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: $201.60 Authorized signature: D> ,.ry 1akn ,cy C59 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Omar Alami Abouhafs Date: 05/04/2021 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) . Mechanical Permit Applicatior> ECEIVE:' FOR OFFICE USE ONLY City Of Tigard MAY 0 2021 Received 1� 21 Permit No, 'r 13125 SW Hall Blvd.,Tigard,OR 97223 Datc/By. ' 11 '�021-�1q3 '111 Plan Review Phone: 503.718. 439 Fax: 503.59$.I960 ,�-t� pate/By: OtherPennit:QA� 1_ I MAKI) Inspection Line: 503.639.4175 Lit 1 Y LW I IUMl�i. Aare Rcad+/B : luris Internet: www.tigard-or.gov t '..ih.17 nl�(1S!C nn,,,, See Pent l Information - Not[fiedlMetho Supplemental upplementanformation TYPE OF WORK COMMERCIAL FEE* SCHEDULE- USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction 0 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/SYSTEMS FEES* 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heatingiconling: Air conditioning I 46.75 Job site address: 14402 SW 165th Ave. Furnace 100.000 BTU(ductsfveats) 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 23.3232 Cross street/directions to job site: Hydronic hot waters stein 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.: 175 Other 23.32 ---- Other fuel appliances: Tax map/parcel no.: Water beater 23.32 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 23.32 Chimney/liner/flue/vent 23.32 ® PROPERTY OWNER ❑ TENANT Other. 23.32 Environmental exhaust and ventilation: Name:Polygon WLH,LLC Range hood/other kitchen .-.-.. - equipment 33.39 Address:703 Broadway St.,Ste.510 _ Clothes dryer exhaust 33.39 City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms, -------- toilet compartments,utility rooms) 23.32 Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32 - ® APPLICANT 0 CONTACT PERSON Other: 23.32 Business name:Polygon WLH,LLC Fuel piping: $I4.15 for first four;$4.03 for each additional Contact name:Tonja Morris Furnace,etc. Address:703 Broadway St.,Ste 510 Gas heat pump Wal1/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace ~E-mail:permitsubmittalsaylormorrison.COm Range a,t Barbecue iNt CONTRACTOR Clothes dryer(gas) A _ Business name:Pro Heating&Cooling Other: ___ MECHANICAL PERMIT FEES* Address: NW Alociek Dr,Ste.1104 Subtotal City/State/ZIP:Hillsboro,OR _ Minimum permit fee(S90.00) _ Plan review(23%of permit fee) Phone:(360)270-1590 l Fax:( ) State surcharge(12%of permit fee) CCB lic.:20900I TOTAL PERMIT FEE ( This permit application expires if a permit is not obtained within 180 .e.i I\u days after it has been accepted as complete. Authorized signature: `�" t4 JJ • Fee methodology set by Tri-County Building industry Service Board Print name:Elia Duran [ ate: 10/30/20 r.tAuilAinn\Pnrmlr.414.4'Pnrn+ir on.,tr,,fl 11 rine ,,nn d.r'rY'.++rnnu^�itrnlrt:o. R CEIVED Electrical Permit Application ► (►►:(►ii le I ► ,i e1\1 , City of Tigard MAY el 0?1 it met Fernald 11r1cr'2(�1►-co(g3 13125 SW Hall Blvd.,Tigard,OR 97223 Dian Review s . Phone: 503.718.2439 Fax: 503.598.196{f;i1"e(OF Ti aARD 1)atrinyIN Related Permit iiJ Inspection Line: 503.639 4175 V`+`20-6-for 1 i G A R D •R�$� i�'Pcl t^ r1►..ice►(} :1 Ready l>etc By Jruis: ®See Page E for Internet: www.tigard-or.gov Notified/Method. Sappkaseatal Information TYPE OF WORK PLAN REVIEW - ®New construction ❑Addition/alteration/replacement Ply dark all that apply(submit a sets of plans wtsemi checked).. El Set sire or feedern 400 amps or more ❑Building ever three stories El Demolition ❑other where the available faun commit ❑Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 16,000 amps at 150 volts or ©Floating buildings ❑ I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building its.to ground,cc exceed&:14.000 D Commmercral-use agricultural ❑Multi-family 0 Master builder 0 Fin other: ADU 2for all° installations buildings. pomp 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system larger separately derived Job#: Job site address: 14402 SW 165th Ave 0 Addition of new motor load of ty l0011P or snore. ❑"A",`E","12"."1-3", City/State/ZIP: Tigard,OR 97140 0 Six or mom residential units occupancy 0 licalth.carc facilities 0 Recreational vehicle parks. Suite/bldg./apt#: Project name: Polygon at Roshak Ridge ❑llasardotts locations 0 Supply voltage Mr more than ❑service or feeder 600 amps or more. 600 toles nominal Cross street/directions to job site: FF,F. SCHEDULE Description 1 tier, I each ,1 rotas 1 • New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: 175 Includes attached garage. Tax map/parcel#: 1,000 aq-fl or less 168 54 4 Ea.add'1500 sq.ft.or portion 33.92 1 —. DESCRIPTION OF WORKI invited energy,residential New construction. Type: ADU 2 (with above sq.ft) 75.00 2 _. Limited energy.multifamily residential(with above sq.ft.) 75.00 2 ® PROPERTY OWNER Renewable Energy 0 Ste Page 2 ❑ TI s A]\.l Services or feeders installation,alteration,and/or relocation Name: Polygon Homes WLH LLC 200 amps or less 100.70 2 Address: 703 Broadway St.,Ste 710 201 amps to 400 amps 133.56 2 600 City/State/ZIP: Vancouver,WA 98660 401 ' amps 200 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; Te OAlamiAbouhafsgtaymorrison.corm-PermitSubmittals@taylonnorrison.com ���n vices or feeders installation,alteration and/or lor 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 to400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168 54 2 El APPLICANT _ ❑ CONTACT PERSON Branch circuits—new,Alteration,or extension,per panel A.Fee for branch cucwts with Business name: Polygon Homes WLH LLC above service or feeder foe, each branch circuit 7.42 2 Contact name: Omar Alami Abonhafs B.Fee for branch circuits without Address: 703 Broadway St.,Ste 710 service or feeder fee,first 56.(8 2 branch circuit City/State/ZIP: Vancouver,WA 98660 Each add'l branch circuit I 7.42 2 Phone 360 945 8b74 Miscellaneous(service or feeder not included) ( ) Fax::( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email:OAlamiAbouhafs@taylormorrison.com-PermitSubmittals@taylnrmorrison.com Reconnect only 67 84 2 CONTRACTOR Pump or inrgation circle 67.84 2 Business name: Wallace Electric Sign or outline lighting 67.84 2 Address: 105 Dresden St Signal circurt(s)or limited r nergy Page 2 2 panel,alteration,or extension. 0 See City/StatelZlP: p a OR 97103 Each additional inspection over allowable in any of the above Additional inspection(1 err min) 66 2 5/hr Phone:(503 3)8 0563 Pax:( ) Investigation(I hr min) 90.00/hr " Email: David`rt)wallacewires.com Industrial plant(1 hr min) 78.18/hr CCB Lie,:224868 Electrical Li C1441 Su is 6363S InspectionsY l seed(/i hr man) r which no lee rS 90.00/hr + specifically Su rv_Electrician si ELECTRICAL PERMIT FEES P gnature,required: r --"'"•^_ subtotal Print name:DAys f, GE_ Date: l jL /�i 0 Plan Review Required(25%of permit fee): / State surcharge(12%of permit fee) Authorized signature TOTAL PERMIT FEE: Print nitrtle: iti permit application expires If permit is not obtained within MOyjr Date: I days atter It has bees seeepted as complete. • Number of inspections allowed per permit. 1.'addinePeruntiVI C RermuAnn FIR PDF•l.,n�•MC/In,nnru Plumbing Permit Applicatio I VE , Building Fixtures FOR OFFICE USE ONLY 13125Sf"Tigard " y 2.021 Received II 21 �g�Ze>21-CaUia3 arRe e ive Permit No.: Mill .t 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598 19 ` �(OF TIGARD Dafeigy. Other Permit No.:S /�Z1-t�e..'La, TIGARD Inspection Line: 503.639,4175 E27�:!i 1f-`.n!A11 10 DateReady/By: ru s E7 See Page 2for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction 0 Demolition For special information�use checklist. Description l u9' l Ea. Total 0 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 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 El Accessory 'Iviulti-family SFR(3)baW _ 500.32 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: 14402 SW 165th Ave 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.: ) I Page 2 Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge R 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 tic 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 ® PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixture sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:703 Broadway St.,Ste 510 Garbage disposal 25.02 City/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:S ) Page 2 Primer 12.51 Contact name:Tonja Morris Roof drain(commercial) 12.51 Address:703 Broadway St.,Ste 510 Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 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 piping 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: S72.50 CCB Lic.: 184372 Plumbing Lic.no.:pb634 Plan review (2540 of permit fee) State surcharge(12%of permit fee) Authorized signature: ` TOTAL PERMIT FEE Print name:Steve Fowler I Date: 1 0/30/20 This permit application expires if a permit is not obtained within I80 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. taBuitdinvPemits:PLMU-PermitApp.doc 10!01r09 440-4616T(IO'02/CUM'WEB) t ri+w City of Tigard IIII w COMMUNITY DEVELOPMENT DEPARTMENT T1GARD Building Permit Review — Residential Building Permit #: W\q-2\ -oO 1 a3 Site Address: 14402 SW 165th Ave Project Name: Polygon at Roshak Ridge Lot #: 175 Planning Reviewgibt 9 (2EV. 1- mVtse>Sr1E ft-PiN 1%asoweomeraAssys. Proposal: New detached dwelling (ADU 2) ElVerify address/suite# active in Accela. El In River Terrace: ❑ No El Yes,River Terrace Review Addendum Site Plan Elements: erosion Control Cli copies of site plan on 8-1/2"x 11"or 11 x 17"paper detained trees with drip line and tree protection measures Drawn to scale(standard architect or engineer scale) Footprint of new structure(including decks)and FFE 0 orth arrow Litility locations&easements(required for new and additions) Fite address,project or subdivision name and lot number 'Sidewalk/driveway approach ISkpplicant information(name and phone number) ri k ,;,ocation of wells/septic systems II ot dimensions and building setback dimensions ,treet tree size,type and location O' P II'quare footage of buildings to be demolished Street names IIxisting structures on site Corner 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 O Clean Water Services-Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑Yes,applicant was notified 0 No Received: ❑Yes El No ElWater Meter Fixture Unit Worksheet-Additions,Remodels and ADUs Required: El Yes,applicant was notified 0 No Received: El Yes ❑No ❑ SDC Exemption for ADU applied for: ❑Yes ❑ No Received: ❑Yes 0 No 0 Public Facilities Improvement (PFI)Permit: Required: El Yes,applicant was notified ❑ No Applied For: 0 Yes ❑ No,stop intake 0 Land Use Case#: ADU2020-00017 El Zoning: R-4.5 El Required Setbacks: Front: IZI Rear: 10 Side: 3 Street Side: NSA Garage: 3 O Building Height: Max.Height: 30 Actual Height: 25.5 0 Landsca.e Area: 20 % El Lot Coverage Max: 80 % Entrance I2 Set back no more than 8'from street-facing wall 0 Parallel to street or offset 45 degrees or less Windows 0 Minimum 12%of area of all street-facing facades Garage 0 Gara e door is behind widest street-facing wall 0 Yes ❑ No,one of the following is met: ❑gDoor extends no more than 5' from wall and there is a covered porch extending beyond garage. Iuul Door extends no more than 5' from wall and there is a 12 sq ft.window above garage on 2"d floor. ifr drape—auvidrh i_`„ 12'or less ❑ 50%or less of facade 6 Je a ss, f iners 7 oYfollowing: 0Covered porch Recessed entrance 1'Roof eave Roof offset Fire shingles Roof itch ❑ Gable,Ao,or gam f El Dormer g _Window trim U Window recess Window projection loony ElVisual Clearance 0 Urban Forestry Plan 0 Sensitive Lands: ❑ Yes LI No Type: O Conditions met prior to issuance of building permit Notes: 0 Approved By Plannin;> - -� - Date: /f Revisions (after Building Submittal only) Review to Revision 1: ,❑'Approved ❑ Not ApprovedAO" ID NI 24 vl Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_122419.docx �. 4. Building Permit Submittal Original Submittal Date: 5.4/2, Site Plans: # Building Plans: # 3 Building Permit#: Enter buildingAerrmmit# above. Workflow Routing: Planninglei Engineering 2 P rmit Coordinator 12 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 ,yiginal plan review routing form. • Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: //i7/?) Engineering Review I'Slope at building pad: _-_/ Conditions "Met"prior to issuance of building permit Easements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes rNo Assess Water Quantity Fee in-lieu: ❑ Yes [ No eLIDA Facility on lot: ❑ Yes F No yial Plat Recorded: NOT Approved by Engineering: Date: —S7-701/2_4:5 Notes: /" '' "eel-- .S -- ? 'c ��i i� . "ter- 3 v4-44 Approved by Engineering: Date: /(i/7_ 7 / Revisions (after Bit' ing Submittal only) viewer Date Revision 1: L/J Approved ❑ Not Approved 4/ll��2S��f Revision 2: ❑ Approved ❑ Not Approved C Permit Coordinator Review ,Conditions "Met"prior to issuance of building permit Approved,NOT Released: Sc Car+,,n,riwt-„„, _At. 517)1 Li Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: SDC Exemption:if ❑ Received Does not an ly SDC Fees Entered: Wash Co Trans Dev Tax: EYes N/A Seems Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA Yes yr N/A e2VOK to Issue Permit Approved by Permit Coordinator: .fr7r Date: 1OI2(2a?i( 1 I:\Building\Forms\BldgPermitRvw_RES_1224I 9.docx -�" City of Tigard 11111 COMMUNITY DEVELOPMENT DEPARTMENT T 1 G A RD River Terrace Building Permit Review Addendum Building Permit #: AG12021-DDICIS Site Address: ILP 12 S UU i(S-4' ArV Project Name: Polygon at Roshak Ridge Lot #: IDS (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 0No (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. Balcony w/ access 2 Window Projection Vertical Wall Offset a Porch ;.. 5 ft. deep ft.deep min. 2ft.,5 ft.wide min. 2 ft.,Eft.wide Gable. .ormer U ❑ ❑ ❑ ❑ 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 longes trees-facing wall or open onto por Entrance opens to a porch: ❑Yes II o If es,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: 0 Covered porch min. 5 ft.wide x 5 ft. deep II Recessed entry area min. 5 ft.wide x 2 ft. deep ❑Wall offset min. 16 inches I ormer min. 4 ft.wide ❑Roof eave min. 12 inch projection DR.., offset min.of 2 ft. ❑Roof shingles either tile or wood ❑Gable, .'p or gambrel roof design ❑Roof pitch oriented south min. 500 sq. . ❑Horizont, ap siding min. 3-7 inches wide ❑Accent siding min. 40%of street fa de ❑Window trim • . 2 1/2"wide by 5/8"deep ❑Window recess min. 3 inches for I street facing ❑Bay window min. ft.wide by 2 ft. deep ['Balcony min. 5 ft.wide x 3 ft. .eep with inside access 0 Attached garage is 3 'o or less of street facade 5. Garages and Carports: •1 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 0 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 t. age that faces the street with a min. area of 12 sq.ft. Width- heck one) ❑ -foot-wide garage door ❑40%max. of street facade II 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: U ir, - Date: S J]'hi I:\Building Worms\BldgPermitRvw_RES_RT_I2I417.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 I G A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Agnes Lindor DATE RECEIVED: DEPT: BUILDING DIVISION . CEIVED FROM: Omar Alami Abouhafs COMPANY: Taylor Morrison iv3 ' }.1 Y OF TIGA 0,. i PHONE: (360)946 8674 'WING DIVISION EMAIL: OAIamiAbouhafs@taylormorrison.com RE: 14398/14400/14402 SW 165th Ave MST2021.00491/...00192/...00193 (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. FO FFICE USE ONLY Routed to Permit Technici Date: L( 2I Initials: Fees Due: ❑Yes No Fee De rip ion: Amount ue: \• b P e $ ,e- Special Instructions: Reprint Permit(per PE): ❑Yes No ❑ Done Applicant Notified: Date: Initials: City of Tigard C Deferral Until Occupancy Request TIGARD Washington County Transportation Development Tax (TDT),Transportation and Parks System Development Charges (SDCs) 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: 14402 SW 165th Ave Project Polygon at Roshak Ridge Land Use Case or MST2021-00193 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: Om.a4 llU 46ea Date: 10/26/21 Developer: notaA,. ifutt .46Bu Date: 10/26/21 Permit Coordinator: ATM Oeitfrtetrb Date: 10/26/2021