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Permit • Oregon Residential Specialty Code II318.2 MOISTURE CONTENT AC.F NOWiLEDGEME'NT FORM Orau am the general contractor or the owner-builder at the following address: Site Address: jw . 3143 7Y(oi/2 40 oA Cil:y: ^f ard Permit it: I"6S f zoZ( _ ( 3E0 Subdivision/Lot#I: *we✓ terrace---------- 1-of IP: ZZS— a.nd/or Map and Tax Lot To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918-480-0140, I am notifying the building official that I am aware of the moisture content Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement. [Section R318.2 is provided for reference. R318.2 Moisture Content: Prior to the installation of interior finishes, the building official shall be notified in writing by the general contractor that all moisture-sensitive wood framing ing members used in constniction have a moisture content of not more than 19 percent by dry weight of dry framing members. Signature: Date: ////8/2022_ neral C • ClnnildingTorm1R -MoismreSensil iveWooddoc 09/25/OR Oregon Residential Specialty Code R408.1 MOISTURE BARRIER ACKNOWLEDGEMENT FORM I, . _ , am the general contractor or the owner-builder at the following address: Site Address: City: 1r:yard --Permit#: /ISF ZOZ.i- o Subdivision/Lot#: and/or Map and Tax Lot II: To conform with the 2014 Oregon Residential Specialty Code (ORSC), Section R408.1 Ventilation. I am notifying the building official that I have installed the Moisture Barrier as per Requirement in ORSC Section 408.1 and have taken the following steps to meet this code requirement: 'l'he ground surface of the under-floor space is covered with 6-mil black polyethylene sheetting�wi L Joints lapped 12" at seams and ,tending up the foundation walls 12". Signature: — — — — Date: ///8/ 2 eral Con ractor m Owner-Doilder • 1:\Building\=orm\R S-Moistnrel3aITicr.duc 09/13/201( Oregon Residential Specialty Code N1107 ? HIGH- EFFICIENCY INTFI OR LIGHTING SYSTEMS Permit No.: MS�ZoZ.1 �3� Jurisdiction: arc/ Site Address: u A/7 W ., / e Subdivision/Lot#: C IZi\f er Te rrox.e. Lo f h 2z.S- and/or Map and Tax Lot#: • By my signature below, I certify that a mittitnum of fifty (50)percent of the permanently installed lighting fixtures in the above mentioned building have been installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 ltunens per input watt. (Oregon Residential Specialty Code Ni 107.2)1 > --- - / Signature: Date: // /18/Zo Z Z- -- 99vfrrl eneral Contractor/Authorized Agent Print Name: �ri an a_ 3ra ce • ORSC Section N1107.2.High-efficiency interior lighting systems. A minimum of fifty(50)percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent,or a Lighting source that has a minimum efficacy of<l0 lumens per input watt. Screw-in compact fluorescent lamps comply with this - requirement. The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent,or a minimum efficacy of<l0 lumens per input watt. A BuildingWormslnHS-highaticieurylightingAloc 07101/Oft Form 6408 2017 Completion Certification—Site Inspection ���� New Homes Program—Single Family of Oregon To be completed by Verifier CLEAResu/l is a Program Management Contractor for Energy Trust o/Oregon,Inc_ Paymentinformation Incentive Payee Company Name: 'Taylor Morrison Its this payment redirected' [No Builder or Company: Taylor Morrison Redirect to Name: Verifier Payee Company Name: Performance Insulation and Energy Redirect Payee Com Affordable Housing No Solar Ready Builder Incentive- No (Solar ReedyVerifier Ince'No Site Information Development: RT4EIIM II d 1225 Axis ID: I 'REM/Rate®ID: Address: ide4T'SW Darwin Loop Street Line 2 MaltsFaaala 'No City: Tigard Stele: OR Ziff 97224 Total conditioned area(sq.f.). 3623 ii1,.1,:e Val.ane I 31,395 Housing Type: Detached single family Number of Stories: 13 Number of Bedrooms: 5 Foundation Type: Crawispace Electric Provider: Portland General Electric Gas Provider: NW Natural Gas Solar instated None Solar Installer Name/Company: BIOS Shaded fields are required for EPS sheet Verification Type Actual Model Equipment Details&NOW Slab Perimeter Insulation R- Slab Under Insulation R- Insukllon Framed Floor R- 30 Secondary Framed Floor R- Above Grade Well insulation R- 23 Below Grade Wall Insulation R- Flat Ceiling Insulation R- 49 Vaulted Ceiling Insulation R- Windows Windows U- SHGC:I Total window area: I Cooing Air Conditioning SEER: Model 4: 13ACXN036-230 Primary Heating System Details AFUE: 95 Brand Lennox Type: 'Gas Furnace HSPF: Model II: ML/96UH070XE36 Primary Heel Heating Fuel: Gas SEER: Source Comment: COP: Location: Attic Outdoor Unit(for heat pumps) ECM: No Model N: I AHRI Certificate;4805339 ri of Systems I1 — Gallons: ISO Brand: AOSmilh Water Heater Type Storage EF: 12.9 Model4: HPTU80N 130 Water Heating Fuel Electric Location: !Garage or ope AHRI Certificate:7551746 Ducts and Duct Location [Partial %ducts inside: Duel Leakage(CFM)Q 50Pa: mire Teeing Infiltration Air Changes per Hour(ACH)@ 50Pa: 3.2 I _ Ventilation Ventilation Tops HRVIERV Model: Supply Side-Air Cycler Airflow measured or why untestable? I Roof Termination — Appliances Refrigerator kWiryr Model: ENERGY STAR Diswasher kwidyr Model: GDF510PSR3S$ Percent High Efficacy Interior Lighting(%) 100% Thermostat Showerhead 1.5 GPH I Showerwend 1.5 GPH I Showerhead 1.6 GPH I IShowerhead 1,75 GPH I Nobs: _. .. CITY OF TIGARD MASTER PERMIT 1 s. g COMMUNITY DEVELOPMENT Permit#: MST2021-00380 T t C3 A R i) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/16/2022 Parcel: 2S107AA22500 Jurisdiction: Tigard Site address: 16647 SW DARWIN LOOP Subdivision: ROSHAK RIDGE Lot: 225 Project: Polygon at Roshak Ridge, Lot 225 Project Description: New detached dwelling. NO FINAL INSP UNTIL DEFERRED SDCs PAID. BUILDING Floor Areas Required Setbacks Required Stones: 3 Bedrooms: 5 First 1093 sf Basement: 862 sf Left: 3 Parking Spaces: 0 Height: 27 Bathrooms. 4 Second: 1410 sf Garage: 400 sf Front: 8 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 3365 sf Value: $463,195.62 Rear: 10 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: Storm Sewer: 100 0 Tubs/Showers: 5 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 Tvoes Air Conditioning: Y Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 6 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 3365 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 Geo Tech Report Required VANCOUVER,WA 98660 VANCOUVER,WA 98660 Prior To Pour 2 Ersn Cntrl 503-639-4175 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $35,714.30 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 QS9_gg1-qMn thrnnnh OAR Q59-nn1-nnQn Yni,may nkt in a rnm,of fhp rulpa nr dirart m,patinna Yn rll Ihll:by rallinn Sq4 949 1QR7 nr 1 Ron 449 9444 Issued By: HerUA4 Van,Pt Wuae, Permittee Signature: Ow AppLizailicrw 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. i 4 i ' Building Permit Application ! 19-'�{12 12 Residential H EC I Eli FOR OFFICE USE ONLY City of Tigard Received L� l� Permit Nu sj 7 nCO ' - g SEP 0.2 2021 Date By: / / j�/ xeV "ST�('1 i' ©L' �5O 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1•4+Ty OF TIGARD DaleBy: :7I I A* otherPer �pZ,l A)�H7 Page 2 for TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION yosDatesed/Methad: �`�� 4,114... El Supplemental Information Internet: www.tigard-or.gov. TYPE OF WORK REQUIRED DA ,:1-AND 2-FAMILY DWELLING 0 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 ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. �/, 0 1-and 2-familydwellingValuation: $ I,31 '®� v 0 Commercial/industrial , _ 1�J ❑Accessory building El Multi-familyNumber of bedrooms: 5 ❑Master builder ❑Other: Number of bathrooms:4 JOB SITE INFORMATION AND LOCATION Total number of floors:3 3-)LD � Job site address: 16647 SW Darwin Loop New dwelling area: 3,365 squarefeet t9 l0 City/State/ZIP:Sherwood,OR 97140 Garage/carport area: 400 square feet l yrI Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: r 1 square feet Qul 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 Lot no.: 225 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. Dew Construction/Type: SFU/Elevation plan: 222603B Valuation: $ eferrals:YES-deferral of TSDC fees and park SDCs until occupancy. Existing building area: square feet Projected start: 2022 New building area: square feet 0 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: 0 APPLICANT 0 CONTACT PERSON 619 BUILDING PERMIT FEES* Pkeat refer to fee schedule) Business name:Polygon Homes WLH LLC Structural plan review fee(or deposit): Contact name:Omar Alami Abouhafs FLS plan review fee(if applicable): Address:703 Broadway St., Ste 510 Total fees due upon application: City/State/ZIP:Vancouver,WA 98660 Phone:(360)946-8674 Fax::( )360 693-4442 Amount received: E-mail: permitsubmittals@taylormorrison.com-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 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 lie.:207247 Total fee due upon application: _ $201.60 Authorized signature: 6.)m44 .�/.. 46oydezad, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Omar Alami Abouhafs Date: 09/02/2021 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPetmitApp.doc 02/242011 440-4613T(l l/02/COM/WEB) Mechanical Permit Applica • FOR OFFICE USE ONLY '10EIVED Received �p'l City of Tigard Date/By Pemtit No. �.�-7p z4—003 v 'I l3125SWHa1IBlvd,Tigard,OR 97223 SEP 0.2 2021 Plan Review r .N(l Phone 503.718.2439 Fax: 503.59fl.1960 Oder Permit Date/By: FRIAR!) Inspection Line: 503.b39.4175 CITY OF TIGARD Date Ready/By: hair H See Page 2 far Internet www.tigard-or.gov NotifiedTh4e hods Supplemental Information BUILDING DIVISION TYPE OF WORK COMMERCIAL FEE' SCHEDULE- USE CIIECPLIST Mechanical permit fees'are based on the value of the work C.1 New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY,OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 1 i I-and 2-family dwelling 0 Commercialfmdustrial 0 Accessory building For special information use checklist I i Multi-family ❑Master builder ❑Other. Description Qty. Es. Total JOB SITE INFORMATION AND LOCATION Heating coaling: • Air conditioning I 46.75 lob site address: 16647 SW Darwin Loop Furnace 100,000 BTU(ducts/wilts) , 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+EMI(ducts/vents) , 54.91 , I Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge Heat pump 61.06 Dud 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.: 225 Other 23.32 Other fuel appliances: Tax map/parcel no.: Water beater 23.32 1 Gas fireplacdinsert 33.39 DESCRIPTION OF WORK 1 Flue vent for water hearer or gas New construction-Type SFU fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplaceIinsert 23.32 Chimney/liner/flue/vent 23.32 Other 23.32 ). PROPERTY OWNER TENANT 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 ❑ CONTACT PERSON Other: 23.32 Business name:Polygon WLH,LLC Fuel piping: $14.15 for first four;54.03 for each additional Contact name: Omar Alami Abouhafs Furnace,etc. Address:703 Broadway St.,Ste 510 Gas heat pump Wall/suspended/unit beater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)6934442 Fireplace Range E-mail:permitsubmittals€taylormorrison.cam Barbecue •^Dtt CONTRACTOR Clothes dryer(gas) Business name:Pro Reading&Cooling Other: MECHANICAL PERMIT FEES' Address: NW Alociek Dr,Ste.I104 Subtotal City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00) Phone:(360)270-1590 Fax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lic.:209001 TOTAL PERMIT FEE _ tt This permit application expires if a permit is not obtained within ISO q- - b , days alter it ha,been accepted as complete. Authorized signature: (.�CdJG1� ' Fee methodology set by Tri-County Building Industry Service Board Print name:Elia Duran Date: 10/30/27 rw.;u...aa,..;ealaar N..nit A,.rum is d.. ..a.:.TT,l,4,4r....mva. .Electrical Permit ApplicatioIRECE1VE I IOR OFFICE 1 Sr 11\I City of Tigard SEP 02 21)?i Rt;a Pe"ta MS7-74)Zi-003P'0 ., 13125 SW hall Blvd,Tigard,OR 97 than 223 Review 14 - Y ' Phone: 503.718.2439 Fax: 563.598.19�TY QF TIGARD D il3 _. Relatedhamit*: 11 GA Fll �°di:, ,ig�.�g�l's BUILDING DIVISION �° tors. Iiil See Supptamm>sl for TYPE OF WORK PLAN REYIEW. ®New construction ❑Addition/alteration/replacement PIcase check all that apply(submit 3 cots of plans others checked): ❑Demolition El Other: 0 Sevvice or feeder 400 amps a more I]Budding oast three stoner. where the available fault mama 0 Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 ampa at rya volts or 0 Mowing buildings ® t-and 2-famil dwellin ter to ground,or exceeds 14.Otla ❑Commemi d-toe agricalmral y g ❑Commercial/industrial ❑Accessory building Fares for all other mztsllaoors bulb:hem ❑Multi-family 0 Master builder ❑Other: ❑Ftm Ins pomp. ❑Installation of 150 KVA ar JOR SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived Job#: Job site address:16647 SW Darwin Loop ❑1001Tm more.of new orkadcf XYs un 10071Pmmoe. City/State/ZIP: Tigard,OR 97140 ❑Six«more residential omits occupancy ❑Health-care facilities. 0 Re¢cattonal,•eh,ek parks. Suite/bidgiapt.#: Project name: Polygon at Roshak Ridge ['Hazardous locations ❑Supply voltage for more than ❑Service or feeder 600 amps or mane. 600 salts nominal. Cross street/directions to job site: FEE SCHEDULE , PnrrWtiom I Orr. I Each I Total i • Ncw residential single-or multifamily dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: 225 Includes attached garage. 1,000 sq.ft or less 168 54 4 Tax map/parcel#: DESCRIPTION OF WORK Ea.add'I 500 sq.R.or portion 33.92 I Linnted energy,ouideutiil 75-00 2 (with above sq.it) New construction.Type SFU Limited energy,multi•famity residential(with above sq.ft) 75.00 2 • Renewable Energy ❑ Sex Page 2 MI PROPERTY OWNER 0 TENANT Services or feeders installation,alteration.,and/or relocation Name: Polygon Homes WLH LLC 200 amps or teas 100.70 2 Address: 703 Broadway St.Ste 710 . 201 amps to 40n amps 133.56 2 atyrslat�zlP: Vancouver,WA 98660• 401 amps to 600 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 --' Temporary services or feeders installation,alteration,and/or Entail: OAlamiAbouhafs@taytonnorrison.com-PennitSubmittals@taylormorrison-com relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 5936 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125 08 2 Owner signature:_.._.. Date: 401 amps to 599 amps 168 54 2 0 APPLICANT - 1 0 CONTACT PERSON Branch circuits—new,alteratio0,o r extension,Per panel A.Fee for branch eircuiu wah Business name: Polygon Homes W1.111 LLe above service or fe«k a fee, 7 42 2 each branch circuit _ Contact name: Omar Mimi Abouhafs R Fee for branch circuits witboar service err feeder fee,first Address: 703 Broadway St.,Ste 710 branch circuit City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 360 )946 8674Miscellaneous(service or feeder not included) phone; ( Fax::( ) Each manufactured or modular 07 84 2 dwelling.service and/or feeder Email:OAlamiAbouhafs@laylormarfison.wm-PemitSubmittals@taylormorrison.com .t..iy 67 84 z CONTRACTOR Pump or togatioa circle 07.84 2 Business name: Wallace Electric Sign or outline lighting 67.84 2 Address: 105 Dresden St Signal eircud(s)or tiautcd-energy ID See Page 2 2 panel,alteration,or extension. City/State/in): Astoria, OR 97103 — Each additional inspection over allowable In any of the above Addititmal inspection(t la thin) 66 251 hr Phone:(503 48 0563 Fax:( ) Investigation(1 hr min) 90.00/hr Email:Davidtwallacewires.com Industrial plant(l him n) 78.18/Or Inspections for which no lee is 90, 00/hr CCB Lie.:224868 Electrical Li•C 1441 Su tv_1' .• 6363S specifically listed(K hr min) ELECTRICAL PERMIT-FEES Suprv.Electrician signature,required: Subtotal- . Print name:DAtj,,0 .. Date: j'/. tz( ❑Plan Review Retained(25%of permit foe): (�F State surclinrge(11%of permit fee). Authorized signature permit TOTAL PERMIT FEE: This peit application expires if a permit 4 not*Maimed Mahn 180 Print name: boat,a U ref teg Date: £ /z t days after It inn green accepted neat. ( • Number of mspewons allowed per permit Lakildmc5YtrmilsV7.C_IrawtApp_aa T RE eke Rev 0fa'I7n015 4 151(I1/05)[OMlWF3 aPlumbing Permit Application_ Building Fixtures ECEIVE i FOR OFFICE USE ONLY City of Tigard SEP 0 2 2021 RaeeiwA Permit N° S'rz{�7. f-(��' ,� w 13125 SW Hall Blvd.,Tigard,OR 97223 �m B n Phone: 503.718.2439 Fax: 503.598. Plan Rev ew ' �PCY OF TiGARD Date/BY: Other Permil No.: TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready1By: kris: El Sec Paget for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑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 R for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 1-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 ❑Master builder 0 Other. Fire sprinkler(_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 16647 SW Darwin Loop 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:aaaYaY.➢isigtpolygon 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.: 1 Page 2 Storm sewer(no.linear R:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Polygon at Roshak Ridge Lot no.: 225 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve I2.51 Clothes washer 25.02 New construction-Type SFU Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I ❑ 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:5_) Page 2 Primer 12.51 Contact name: Omar Alami Abouhafs Roof drain(commercial) 12.51 Address:703 Broadway St.,Ste 510 Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:permitsubmittalstpolygonhomes.com U 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.Pant,OR 97137 Subtotal Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit foe: S72.50 CCB Lie.:184372 Plumbing Lic.no.:pb634 Plan review (25%of puma fee) State surcharge(12%of permit fee) Authorized signature: ; ` TOTAL PERMIT FEE This permit application expires Ira permit Is not obtained within 180 days Print name:Steve Fowler Date: 0/30/20 after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. I:coil iesTermhs1PCMO-PermMpp.doc 10AIR99 440.4616Tt iOM'-ICOM.'WEB) 1 0 City of Tigard 1 a COMMUNITY DEVELOPMENT DEPARTMENT T 1 G A a D Building Permit Review — Residential Building Permit #: MS TZd Zf —v0 5 to Site Address: 16647 SW Darwin Loop Project Name: Polygon at Roshak Ridge Lot #: 225 Planning Review Proposal: New home ❑o Verify address/suite#active in Accela. 0 In River Terrace: ❑ No El Yes, River Thrace Review Addendum Site Plan Elements: �.rosion Control It copies of site plan on 8-1/2"x 11" or 11 x 17"paper /2etained trees with drip line and tree protection measures IS P rawn to scale(standard architect or engineer scale) Footprint of new structure(including decks)and FFE CI orth arrow '';Jtility locations&easements(required for new and additions) rite address,project or subdivision name and lot number iidewalk/driveway approach CI pplicant information(name and phone number) ocation of wells/septic systems 0 it dimensions and building setback dimensions street tree size,type and location tquare footage of buildings to be demolished itreet names I xisting structures on site �orner elevations(2'contours if more than 4'differential_ 111 •t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? LPres o &impervious area(applicable if R-7,R-12,R-25 R-40) If yes,is a storm water quality facility shown? es ° o Q Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑Yes,applicant was notified ❑No Received: ❑Yes ❑ No ❑r Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs Required: ❑Yes,applicant was notified ❑r No Received: ❑Yes No ❑r SDC Exemption for ADU applied for: ❑ Yes ❑No Received: ❑Yes No ❑' Public Facilities Improvement (PFI) Permit Required: ❑Yes,applicant was notified Q No Applied For: ❑Yes 0 No,stop intake CILand Use Case#: SUB2015 00004 ❑r Zoning: R-7 ❑o Required Setbacks: Front: 8 Rear: 10 Side: 3 Street Side: 8 Garage: 20 Q Building Height: Max.Height: NA Actual Height: 2G0' r QLandsca.e Area: 20 % CI Lot Coverage Max: 80 Entrance 0 Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows 0 Minimum 12%of area of all street-facing facades Garage 0 Garage door is behind widest street-facing wall ❑r Yes ❑ No,one of the following is met: RDoor 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 2"d floor. ❑o Garage door width is 12'or less 0 50%or less of facade 60%or less and includes 7 of following: Covered porch Recessed entrance CI Walloffset 1'Roof eave A Roof offset Fire shingles Lap Siding ❑ Roof itch ❑ Gable,hi ,or gambrel roof Dormer _Accent siding Window trim U Window recess U Window projection ❑Balcony ❑r Visual Clearance ❑o Urban Forestry Plan ❑r Sensitive Lands: ❑ Yes If_l No Type: ❑r Conditions met prior to issuance of building permit Notes: Q Approved By Planning: Date: 9/9/21 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: 0 Approved ❑ Not Approved I:1Bui Iding\Fonns'BldgPermitRvw_RES_I22419.docx , Building Permit Submittal w ' 1 Original Submittal Date: 7/2/7--1 Site Plans: # 3 Building Plans: # 3 Building Permit#: EryEnter buil emit#above. "1—"Permit f�� �y� Workflow Routing: I� Planning Engineering U Permit Coordinator CI Building Workflow Sign-off: a��/-Sign-off for Planning(include notes from planning review) Route Application Documents: L� Engineering: (1) copy of permit application, (1) site plan, (1)building plan and ,,,,ofiginal plan review routing form. Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: ,04 By Permit Technician: �� Date: 9/r/Z/ Engineering Review e gSlope at building pad: Z3 In Conditions "Met"prior to issuance of building permit ❑`Easements (encroachments) per engineering conditions of approval and plat rek/VVater Quality/Quantity Facility:Assess Water Quality Fee in-lieu: ❑ Yes [ No Assess Water Quantity Fee in-lieu: ❑ Yes gZ,No , ,/ LIDA Facility on lot ❑ Yes No l� Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: IJ Approved by Engineering: Date: F/As/2/ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved 0 Not Approved Revision 2: 0 Approved ❑ Not Approved Permit Coordinator Review jaConditions"Met"prior to issuance of building permit ❑ Approved, NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: SDC Exemption: ❑ Received Does not a5 ly SDC Fees Entered: Wash Co Trans Dev Tax: Yes N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA Yes 7N/A 0 OK to Issue Permit Approved by Permit Coordinator: Date: qI I(e 1,2021 I:\Building\Forms\BldgPermitRvw_RES_I22419.docx s City of Tigard w COMMUNITY DEVELOPMENT DEPARTMENT C . TIGARD River Terrace Building Permit Review Addendum Building Permit #: Site Address: 16647 SW Darwin Loop Project Name: Polygon at Roshak Ridge Lot #: 225 (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) culation: a minimum of 1 element per each street-facing facade that has 30-60 ft.of frontage.An addio . el- -nt required for lots with over 60 ft.of street frontage shall be provided every 30 ft. Balcony Iv/ access 2 Window Projection Vertical Wall Offset a Porch '.; ft.deep ft.d❑eep min.2ft.,50 ft.wide nun.2 ft.,6❑ft.wide Gable. .a ormer 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: ElParallel to street, . gle no more than 45° from street, ❑Max.8 fr. setback from longes eet- facing wall or open onto por Entrance opens to a porch: ❑Yes li o IfUes,all the following apply: ❑25 sq.ft. in. One street facing entry ❑12 f ax.roof above floor of porch ❑5 ft. depth min. ❑3 P/°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 0 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. •. ❑Horizon.. ap siding min.3-7 inches wide ❑Accent siding min.40%of street fa .e ❑Window trim • ' .2 '/"wide by 5/8"deep ❑Window recess min.3 inches for .1 street facing ❑Bay window min. ft.wide by 2 ft. deep 0 Balcony min. 5 ft.wide x 3 ft. .eep with inside access 0 Attached garage is '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. 0 Yes 0 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. 0 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) I -foot-wide garage door ❑40%max. of street facade 50%max.of street facade with 7 detailed design elements Notes: Approved By Planning: NT Date: 9/9/21 1?Building\Forms\Bld,PmnitRvw RIS_RT_I21417.dm:z City of Tigard III . " Deferral Until Occupancy Request T I G A R D 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: 16647 SW Darwin Loop Namee:ct Land Use Case or Polygon at Roshak Ridge Building Permit #: MST2021-00380 Tax Lot 2S107AA22500 Total Parks $8 017.00 #: Lot 225 Amount*: TDT Total TSDC $3,658.00 Amount: N/A Amount*: *The total TSDC amount shown above is the sum of$ 0 for TSDC-Improvement,$ 386.00 for TSDC- Reimbursement,and$3,272.00 for TSDC-River Terrace,if applicable.. *The total Parks SDC amount shown above is the sum of$6,278.00 for Parks-Improvement,$ 1,739.00 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: OhtG/,4 tz-46a Date: 11/4/21 Developer: Ohm.4D, •.A66, - Date: 11/4/21 Permit Coordinator: OelivtAi Date: 11/3/2021