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Permit 7 Plumbing Permit Applicat l; r,Y, Building Fixtures FOR OI F1( 1.1 I SIF: ()Nil City of Tigard FEB 2 2022 Received 24 2122 MST2021-00411 Date/By: Permit No.: III • 13125 SW Hall Blvd.,Tigard,OR 97223 y„ 1 Plan Review ■ Phone: 503.718.2439 Fax: 503.5''':I1V6 1' I IGARD Date/By: o/%//2 ,4f4 Other Permit No.: Inspection Line: 503.639.4175 (t JI�..I IN(3 DIVISION Date Read/B Juris. ® See Page 2 for i tt� t) Internet: www.ti and-or. ov y y3 g g g Nohfied/MethoQ' Supplemental Information ik OF'WOR ` ' ' , ' , z it �y ew construction El Demolition For special information use checklist. Description I Qty. I Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) , 11 ` .f A E OIL ,STRt ai,:i �� ' ,,, SFR(I)bath 312.70 and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78 ❑Accessorybuilding ' SFR(3)bath 500.32 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( 1228sq.ft.) V Page 2 s £ INFORMATION _ ION " Site utilities: Job site address: 16576 SW Darwin Loop Catch basin or area drain 18.76 City/State/ZIP:/State/ZIP: Drywell,leach line,or trench drain 18.76 ri Tigard,OR 97223 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: Lot no.:1204(ADU) Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 £ Backwater valve 12.51 y� I Clothes washer 25.02 MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 x� �x r`~2 ° ,PR �iit t TE rvi v )'� Expansion tank 12.51 Name: Taylor Morison Fixture/sewer cap 25.02 Address: 703 Broadway St.Suite 710 Floor drain floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Vancouver,WA 98660 Hose bib 25.02 Phone: 816 7805( 360) Fax ( ) Ice maker 12.51 r. 41 :: uy: 4''5147,. _ iF � ��V s., ,'e € PEA Interceptor/grease trap 25.02 2. :. . -� ens, ,�w�,��� � �'r�� �. . . Business name: Alliance Plumbing, LLC Medical gas(value:$ ) Page 2 Contact name: Gavin Thomas Primer 12.51 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 )492-3490 Fax::(503 )912-6438 Tub/shower/shower pan 12.51 E-mail: gavin@alliartceplumbing.net Urinal 25.02 Water closet 25.02 "' i . - �, { ���.: r tit r.,.."A' a3 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:( 503)912-6438 Minimum permit fee: $72.50 CCB Lic.: 184601 Plumbing Lic.no.: PB732 Plan review (25%of permit fee) Digitally si9netl by HanmftlM1omas 1 State surcharge(12%of permit fee) Authorized signature:Hannah Thomas :=.:ah�a1101aKe 2::;.9.rcpcd8 TOTAL PERMIT FEE Date:MU 011710,219 08•00' Print name: Hannah Thomas Date:1/27/2022 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. 1:11uilding\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) i 711 CITY OF TIGARD MASTER PERMIT 1 • COMMUNITY DEVELOPMENT Permit#: MST2021-00411 T I.t.-;A R 17 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/11/2022 Parcel: 2S 107AA20400 Jurisdiction: Tigard Site address: 16576 SW DARWIN LOOP Subdivision: ROSHAK RIDGE Lot: 204 Project: Polygon at Roshak Ridge, Lot 204-ADU Project Description: New attached ADU. NO FINAL INSP UNTIL DEFERRED SDCs PAID. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 1228 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 25 Bathrooms: 2 Second: 0 sf Garage: 275 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 1228 sf Value: $174,454.24 Rear: 10 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 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 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 3 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 1228 Owner: Contractor: TAYLOR MORRISON NORTHWEST 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: 360-946-8674 PHONE: 360-695-7700 FAX: Total Fees: $17,374.12 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 ac7-nn1-nnln fhrn,,nh nAR o7-nn1-noon vnii mw nhthin a nnrnr of fhc r,dcc nr rfircnf ni tceffnnc fn nr INC by nnllinn FnZ 919 10R7 nr I Rnn 1'27 9111d Issued By: HAM V De We'9ez 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 Application 'Residential RECEIV 1 FOR OFFICE 1'SE oNLY Received ( A //gyp I . City of Tigard ry Date/By: �� )%/ S� Permit No.. J i1J II • 13125 SW Hall Blvd.,Tigard,OR 97223 SEP 1 20 i Plan Review Phone: 503.718.2439 Fax: 503.598.1960 P.teBy: lb IS i .) Other Permit:c5(/1)�QZpZ4 Q' - T I C A R D Inspection Line: 503.639.4175 ^,.�OF'T*G`' ?1 e Ready/By: / la See Page 2 for Internet: www.tigard-or.gov V, ENGIN hod ! 1 Supplemental Information NING( TYPE OF WORK REQUIRED 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. r_.' ®1-and 2-family dwelling 0 Commercial/industrial Valuation: $ J J�� ElAccessory building 0 Multi-family Number of bedrooms: 4 ❑Master builder 0 Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors:2 ,(4--/C3, Job site address: 16574 SW DARWIN LOOP New dwelling area: 2,023 square feet 94 1 City/State/ZIP:Sherwood,OR 97140 Garage/carport area: T4147 square feet `q2 Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area square feet Cross street/directions to job site: Deck area: 1.7„.4) square feet Ofh eltc�ytte top." 110 square feet REQUIRED DATA:� COMMERCIAL-USE CHECKLIST Subdivision: Polygon at Roshak Ridge Lot no.: 204 Permit fees*are based on the value of the work performed. Tax map/parcel no.: P1 �� 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. SFU:New home construction Elevation:221100B/221000B Duplex Valuation: $ Type:Duplex_Projected Start:November l 2021a Existing building area: square feet cLe�Pr� CPC weft c9(Gu U New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:Polygon Homes WLH LLC Type of construction: Address:703 Broadway St., Ste 510 Occupancy groups: City/State/ZIP:Vancouver,WA 98660 Existing: Phone:(360 946 8674 Fax:( ) New: ® APPLICANT 0 CONTACT PERSON U9 BUILDING PERMIT FEES* Business name:Polygon Homes WLH LLC (Please referto fee schedule) Contact name:Omar Alami Abouhafs Structural plan review fee(or deposit): FLS plan review fee(if applicable): Address:703 Broadway St., Ste 710 Total fees due upon application: City/State/ZIP:Vancouver,WA 98660 Amount received: Phone:(360) 695-7700 Fax::( ) E-mail: 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 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: $201.60 Authorized signature: £7in- 1,,eQk.e.4111.4-4,A69Likod..- This permit application expires if a permit is not obtained �� within 180 days after it has been accepted as complete. Print name:Omar Alami Abouhafs Date: 09/17/2021 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(l 1/02/COM/WEB) . , Mechanical PCI'IIIit Application ' . FOR OFFICE USE ONLY �V "'. Received • . City of Tigard 'i, Datc/By: Permit No.: /IV 20 GI—00tf 0 " 13125 SW Hall Blvd.,Tigard,OR 97223 — i 1 Plan Review S -'^ ZOZ,1 — _ Phone: 503.7 t$.2439 Fax: 503.598.1960 i Other Permit: W'e �� Date.: : 1 Tlt'rAhl) Inspection Line: 503.639.4175 S �� r G tugs Internee www.tigard-or.gov o. Supplemental See Page 2 for a o 0' a Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCRFDULE - 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 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:S CATEGORY OF CONSTRUCTION— _ RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. j Multi-family ❑ Master builder ❑Other: _Description Qty. Ea. Total JOB SITE LNFORMATION AND LOCATION — _Heating/cooling: Air conditionin, 1 46.75 Job site address: 16574 SW DARWIN LOOP Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,0001 BTU(ducts/vents) 54.91 Heat pump 61.06` Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge — 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.: 204 Other: 23.32 -- --- Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 — Flue vent for water heater or gas New construction,new Single Family 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 Outer. 23.32 ' Environmental exhaust and ventilation: Name:Polygon WLH,I.LC Range hood/other kitchen Address:703 Broadway St.,Ste.510 equipment - 33.39 Clothes dryer exhaust 33.39 III City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms, —------------ toilet compartments,utility rooms) 23.32 Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32 APPLICANT ❑ CONTACT PERSON Other: y 23.32 Business name:Polygon WLH,LLC Fuel piping: I S14.15 for first four;S4.03 for each additional Contact name:Tonja Morris Furnace,etc. Address:703 Broadway St.,Ste 510 Gas heatrp_unp Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 I Fax: :(360)693-4442 Fireplace Range E-mail:permitsubmittalsCtaylofmOffiSOn.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) C CCB tic.:209001 TOTAL PERMIT FEE t This permit application expires if a permit is not obtained within 180 PJ' I\G� days after it has been accepted as complete. Authorized Signature. �' JJ ' Fee methodology set by Tn-County Building industry Service Board Print name:Elia Duran Date: 10/30/20 111AnilAinalPermir,,ia,1P: Pnlmit*nn.5.451 11 An, , .. VrraYYraaYY.1i•. RECEIVED Electrical Permit Application City of Tigard S E P 1 !!! ver, Due/BY Perm,t it 1(4512p 2 f- co go • 13125 SW Hall Blvd.,Tigard,OR 97223 A Phone. 503.7182439 Fax: 503598.I960 CITY OF TIGiarew Related Permits S t,„J 12747.I—cap.. h t? won Line: 503 639 4175 Zuni, �' I ki....ad,i.1i ,, S SeePge2tw Internet: www.ngnrd-or.gov KING/ENGI Sup ,al Infor,natioa p� TYPE OF WORK PLAN'REVIEW' IN New construction ❑Addition/alteration/replacement Pkasc check all that apply(submit j sets of plans w/itmrs checked). 0 DGRloIitlAlt Other: Set wee or feeder 400 amps tie more 0 Building over three stones where tire available fault cu cent Cl Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings IK] I-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to mound,or eaceed::14,000 ❑Commerc ai.ase agricultural ❑Multi-family ❑Master builder ❑Other: amps for all other installations buildings Eire pump ❑Installation of 150 KVA or JOB SfiE INFORMATION AND LOCATION 0 Emergency system larger tltr separately dented Additi Job#: Job site address:16574 SW DARWIN LOOP D °of new motor teed rr system.r4011E011P or more. ❑"A"T',"1-1",`I-3", City/State/DJ': Tigard,OR 97140 0 six or more resuktit l Dells Occupancy ❑Health-ewe Lacibhes ❑Rotxcanonal vehicle parks. Suite/bldg./apt#: Project name: Polygon at Roshak p���e 0 Hazardous locate.. 0 Supply voltage for more than �.`- ""'b 0 Service or feed!.600 amps or more 600 wits nominal. Cross street/directions to job site: FEE SCHEDULE arcs«pti,. I Ott I C.d. 1 Total 1 • New residential sidle-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: 204 includes attached garage. Tax map/parcel#: 1,000 sq.It or less 168.54 4 Ea.add'l 500 sq.It or portion _ 33 92 1 DESCRIPTION OF WORK Limited energy,residential with above 75.00 2 New construction.Type SFU ( ft) Limited energy,multi-family 75.00 2 residential(with above sq ft.) Renewable Energy ❑See Page 2 ® PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: Polygon Homes WLH LLC 200 amps or leas 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 55126 2 Temporary services or feeders installation,alteration,and/or Entail: OAlamiAbotihafs@tayloxmorrison.com-PennitSubmittals@taylormorrison.com relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 r 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 0 APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension, r panel Business name: Polygon Homes WI.H LL.0 - A Fbo fo branch c feed with _ above service or feedtx tea, 7.42 eat Contact name: Omar Alan!Abonhafs branch c circuits Fee for branch circuits withmil Address: 703 Broadway St.,Ste 710 service or feeder fee,first 56 18 2 branch circuit City/State/ZIP: Vancouver,WA 98660 Each add'/branch circuit 7 42 2 Phone: 360 446 8674Miscellaneous(service or feeder not included) ( ) Fax::( ) Each manufactured or modular 67 84 2 Entail:0AlamiAbouhafs@taylormorrison.com-PermmitSubmittal dwelling, maker reeler COY s�taylorntomson.Com Roo onnact only 67 84 2 CONTRACTOR Pump or unrgation circle 67 84 2 Business name: Wallace Electric Sign or outline lightmµ 67.84 2 ._- -- Signal cutouts)or hmitcd-energy Address: 105 Dresden Si _panel,aheru.on,or extension. See Page 2 2 City/StatelZlP: Astoria OR 97103 Each additional inspection over allowable in any of the above Addihtxual inspection(1 ter min) 66 25/br Phone:(503 3118 0563 Fax:( ) investigation(1 hr min) 90.00/hr Email:David@wallaccwires.com Industrial plant(I hr nut) 78 18f hr inspections for which no fee is CCB I.ic.:224868 Electrical Li :C1441 S .1: .• 6363S spetxficany listed OShr min) 90.00J hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: - Subtotal Print name:" heriler,q,e_. Date: K// /�f _❑Plan Review Required(25%of permit fox) ~ I / State surcharge(12%of permit foe): Authorized signature T'(ytAL PERMIT Fi:1: This penult application expires If a permit is sal obtained within 180 Print name: -4401.3401 Date: (j / days alter It � bus been accepted as wpaete. ■ /Z`'1---- a Number of mspo tams allowed per peravt. t.'taurldur 'e,i s c_Penan R Mike ELs Rev06'179015 ....._ 4 '4615T(r1/OSICOWWFB I I Plumbing Permit Application RECEI s Building Fixtures FOR OFFICE USE ONLY t Cityof Tigard SEP 1 7 ved g ; .ate,B Permit No. M5�Zoll-add • 13125 SW Hall Blvd.,Tigard,OR 97223 }.. 1 a Phone: 503.718 2439 Fax: 503.598.1960 CITY OF TIagliriew Other Permit No.:s412.7.4u""aQZO# TIGARD Inspection Line: 503.639,417E •W»YING/ENGi 7uris: EJ See Page 2 far Internet: www.tigard-Or.gov ,t Supplemental Information TYPE OF WORK FEE* SCHEDULE For special El New construction ❑Demolition 1 information use checklist. Description I Qty. I Ea. { 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 dwelling i 0 Commercial/industrial SFR(2)bath 437.78 9(.1 " SFR(3)bath 500.32 0 Accessory building 41-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: 16574 SW DARWIN LOOP Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Dryweli,leach line,or trench drain 18.76 -•-- - Footing drain(no.linear ft.:_) Page 2 i Suite:bldg./apt.no.: Project name:.iiiiiigtai:)ZirllyePolygon 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.:i) Page 2 Subdivision: Polygon at Roshak Ridge Lot no.: 204 Fixture or item: _ Tax map/parcel no.: v Back-flow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 New construction SFU Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixture/sewercap 25.02 I - - - Floor dtainrfloor sinklhub 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 I ® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Polygon W LII,LLC Medical gas(value:S I Page 2 Primer 12.51 Contact name:Tonja Morris Roof drain(commercial) 12.51 Address:703 Broadway St.,Ste 510 Sink/basin/lavatoty 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:permitsubmittalsCpolygonhomes.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 Plan review (25%of permit fee) CCB Lie.: 184372 Plumbing Lic.no.:pb634 _�� State surcharge(12%of permit feel I Authorized signature �C _._...._. TOTAL PERMIT FEE I I Print name:Steve Fowler Date: 1 0/30/20 This permit application expires if a permit is not obtained within 180 days L after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board 1:\Buiiding\Perm its\PLMU-Permit App.doe IQ/WAN 444-4616T(1o'a2/COM4VER} " City of Tigard RECEIVED INq COMMUNITY DEVELOPMENT DEPARTMENT i SEP 1 7 2021 TIGARD Building Permit Review — Residential CITY OF TIGARD Building Permit #: 43, {'V Site Address: 16 5 T t Stir PaPkt?I'l two(' el Project Name: Pcity0 avt L.J"_ Ras k k.. Aver" Lot #: 0414 Planning Review // A _ O Proposal: )U€,(AI' # t (pet i Verify address/suite# active in Accela. In River Terrace: ❑ No VOYes,River Terrace Review Addendum Site Plan Elements: lilETOSlori Control [3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper ARetained trees with drip line and tree protection measures ®Drawn to scale(standard architect or engineer scale) ®Footprint of new structure(including decks)and FEE [North arrow IllUtility locations&easements(required for new and additions) glSite address,project or subdivision name and lot number IiiSidewalk/driveway approach 4Applicant information(name and phone number) PLot dimensions and building setback dimensions [15treet tree size,type and location ®Street names r1r s [Corner elevations (2'contours if more than 4'differential) ©Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ®Yes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes MNo a Clean Water Services—Service Provider ---• ,. .latted prior to 9/10/1995): Required: • Yes,applicant was notifies . ► . Receives •z *Yes ❑ No ® Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: 0 Yes,applicant was notified ❑ No Received: CAP Yes ❑ No . Reoai-_od: n ter- 5 A Public Facilities Improvement(PH) Permit: Required: ❑ Yes,applicant was notified ® No Applied For: 2 Yes fl No,stop intake [iil Land Use Case#: SUBZO(S —CO y fa Zoning: �` T E J Required Setbacks: Front: t Z Rear: ,O Side: 3 Street Side: 0, 1 Garage: ZO 1 [ 1 Building Height: Max. Height: �� 251 �r A' Actual H ' ht: �/ Landscape Area: v(/ % IA Lot Coverage Max: Entrance Set back no more than 8'from street-facing wall Aiii Parallel to street or offset 45 degrees or less Windows [V Minimum 12%of area of all street-facing facades Garage rGarage door is behind widest street-facing wall ❑ Yes Xl No,one of the following is met: Lk Door extends no more than 5'from wall and there is a covered porch extending beyond garage. ❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor. Ip Garage door width is ❑ 12'or less ❑ 50%or less of facade IV 60%or less and includes 7 of following: [;i1 Covered porch jitl Recessed entrance ❑ Wall offset 1 1'Roof eave X Roof offset ❑ Fire shingles ❑ Lap Siding IRI Roof pitch [,!� Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection g Balcony A Visual Clearance GeI Urban Forestry Plan 5- Sensitive Lands: ❑ Yes fl No Type: M Conditions met prior to issuance of building permit Notes: Ly Approved By Planning: Date: a Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Fonns\B1dgPermitRvw_RES_122419.docx Building Permit Submittal of Original Submittal Date: /11_17-I Site Plans: # �j Building Plans: # Building Permit#: ® Enfer building permit# above. Workflow Routing: a Planning g Engineering Permit Coordinator Building Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1)building plan and original plan review routing form. ABuilding: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: � By Permit Technician: /(/lil i� Date: 4 Z'�6/ En ineering Review 1116 Slope at building pad: 3 Conditions "Met"prior to issuance of building permit tea Easements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes [11/1\lo Assess Water Quantity Fee in-lieu: ❑ Yes Y No LIDA Facility on lot: ❑ Yes Lf No ❑ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: LIYApproved by Engineering: .� Date: 9'/29/2/ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: SDC Exemption: ❑ Received lie Does not apply "�� SDC Fees Entered: Wash Co Trans Dev Tax: / Yes ❑ N/A Sec -ter r'c--P rms Tigard Trans SDC: Yes ❑ N/A Parks SDC: /I Yes ❑ N/A LIDA ❑ Yes % N/A OK to Issue Permit Approved by Permit Coordinator: Date: 10I521)2( 1:\Building\Forms\BldgPennitRvw_RES_122419.docx RECEIVED City of Tigard I COMMUNITY DEVELOPMENT DEPARTMENT S E P 1 7 2021 . ■ T 1 c lz n River Terrace Building Permit Review .1 : �j�] jGINEENEERIIVQ Building Permit #: /Sr28 at -co-Lit Q Site Address: 1651-1 SW Da.,r iA i n Loop Project Name: Polygon at Roshak Ridge Lot #: Zo (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 ❑. 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.,6❑ft.wide 0 I 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 1 0 If es,all the following apply: El25 sq.ft. in. UOne 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 111 Recessed entry area min. 5 ft.wide x 2 ft. deep ['Wall offset min. 16 inches li It ormer min. 4 ft.wide ❑Roof eave min. 12 inch projection ❑R• - offset min.of 2 ft. ❑Roof shingles either tile or wood ❑Gable, .ip 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 .e 0 Window trim ' ' .2 1/2'wide by 5/8"deep 0 Window recess min.3 inches for . 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 • : 0 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 50%max.of street facade with 7 detailed design elements Notes: Approved By Planning: Date: I:\Building\Porms\BldgPemitRvw_RES_RT_I21417.docx RECEIVED Water Meter Fixture Unit Worksheet For New Buildi v 1 7 ?p?1 Please complete the following information: CITY OF TIGARD Contractor Name: Polygon Home, WLH LLC PLANNING/ENGINEERING Billing Address: Street/Suite#: 703 Broadway St, STE 710 City: Vancouver State: WA Zip: 98660 Phone Number: 360 946 8674 Email: OAlamiAbouhafs@taylormorrison.com New Meter Address: SFU: 16574 SW DARWIN LOOP/ADU : 16576 SW DARWIN LOOP Subdivision Name: Polygon at Roshak Ridge Lot#: 204 Building Permit#: Please fill in the number of each fixture as detailed on the plans. Multiply the quantity by the point value to arrive at the point total. Add all point totals together for total fixture unit points. Fixture Unit Quantity Point Value Point Total SFU ADU Total Bar sink x 1 = Bidet x 1 = Clothes washer 1 1 2 x 4 = 8 Dishwasher 1 1 2 x 1.5 = 3 Hose bib, 1st one 1 1 2 x 2.5 = 5 Hose bib, each add'! 1 1 2 x 1 = 2 Kitchen sink 1 1 2 x 1.5 = 3 Laundry sink x 1.5 = Lavatory 3 4 7 x 1 = 7 Water closet, 1.6 GPF 2 3 5 x 2.5 = 12.5 Bathtub/whirlpool x 4 = Shower stall 1 1 2 x 2 = 4 Bath/shower combo 1 2 3 x 4 = 12 Total Fixture Unit Points: 56.5 Fixture Unit Points: 1to30= 5/8" 37.5to89= 1" 30.5 to 37 = 3/4" Meter Size: Meter Cost: $ 24,886.00 ********************************************* *************************************** FOR OFFICE USE ONLY Fixture Units Points verified with Building(Master) Permit or Plumbing ❑Yes ❑ No ❑ Other: Meter#: Sale Date: Receipt#: Meter Cost: Employee Name: l:/Building/Forms/WaterMeters_010121_New.docx Page 2 City of Tigard ° 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: 11/3/2021 Site Address: 16574 SW DARWIN LOOP Project Polygon at Roshak Ridge Land Use Case or MST2021-00410 Name: Building Permit#: Tax Lot Total Parks 2S107AA20400 5 #: Lot 204 Amount*: $ ,839.00 TDT Total TSDC N/A $2,134.00 Amount: Amount*: *The total TSDC amount shown above is the sum of$ 0 for TSDC-Improvement,$ 225.00 for TSDC- Reimbursement,and $1,909.00 for TSDC-River Terrace,if applicable.. *The total Parks SDC amount shown above is the sum of$4,727.00 for Parks-Improvement,$ 1,112.00 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'4- Date: 11/3/2021 Developer: D/na'-4&m4;46eliia6rd. Date: 11/3/2021 Permit Coordinator: AIWA Oetfrtek Date: 11/3/2021