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Permit / Plumbing Permit Applicat1l�, I V L Building Fixtures iEB 2 2022 roR t>rricl': I si,: oyl.v City of Tigard Received 2 Z1 22 Permit No.: MST2021-00441 ili /�C 13125 SW Hall Blvd.,Tigard,OR 97-2 31 Y OF 1 I�.INII� Date/By: i Plan Review • Phone: 503.7i8.2439 Fax: 503.5 8J1 fGQING DIVISION Date/By: ,?//// 9. A j Other PermitNo.: Inspection Line: 503 639 4175 1 11�� IV4� Date Ready/By: inns See Page 2 for l i c \1 !) Internet www.tigard-or.gov y y /� Supplemental z'O'' d T t'. -:. a Fiji oil a�� -e) hod(// S7'";?s, ..t,•f,E* SC1r�+1l Vir;� 1 ° `;. Notified/Met Information ic [ New construction 0 Demolition 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) CATItGORY.O SFR(1)bath 312.70 and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( 1228sq.ft.) t/ Page 2 l u JOP I. :,, �? (t Site utilities: Catch basin or area drain 18.76 Job site address: 16646 SW Botany Bay Ln. Drywell,leach line,or trench drain 18.76 City/State/ZIP: 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: I Lot no.:1195(ADU) Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 a Backwater valve 12.51 6z..gi n . " Clothes washer 25.02 MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 O ) El Expansion tank 12.51 • '4 ? se . . ' Name: Taylor Morrison 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 25.02 816 7805 Phone:( 360 ) Fax ( ) Ice maker 12.51 0 APPLICANT if,. ACT Pt*iN n erceptor/grease trap 25.02 Business name: Alliance Plumbing, LLC Medical gas(value:$ ) Page 2 Contact name: Gavin Thomes 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@allianceplumbing.net Urinal 25.02 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:( 503)912-6438 Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: 184601 Plumbing Lie.no.: PB732 Authorized signature: Hannah Thomas y o"�„ s ---- - State surcharge T(1 L f PERMIT fee) TOTAL FEE 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. l:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) CITY OF TIGARD MASTER PERMIT 'PI ' COMMUNITY DEVELOPMENT Permit#: MST2021-00441 Date Issued: 01/25/2022 T I G A R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S 107AA19500 Jurisdiction: Tigard Site address: 16646 SW BOTANY BAY LN Subdivision: ROSHAK RIDGE Lot: 195 Project: Polygon at Roshak Ridge, Lot 195-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: 26 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 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 3 Clothes Dryers: 1 Heat Pump: N Hoods'. 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 2 Furn>=1D0K: 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'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 Fire Rated Conditions VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 Ersn Cntrl 503-639-4175 PHONE: 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 a9-nn1-nnln thrn,inh nap ac9-nnLnnan vn,i rn ,,nh+nin n nnn„of the mice nr rlirant n,ioctinnc to fit INC h.,noirinn 5111 919 10A7 nr 1 Rnn 119 91da Issued By: I Io�L i Vaw Di Wc. e Permittee Signature: Ow Ar� 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 lob site at the time of each inspection. ' ' ' Building Permit Application Residential RECEIVED FOR OFFICE USE O\I.I Received �C���rrr ]/��� City of Tigard � 7 PemtitNonAb1�.02(.0 7 I IN Dan Rev -C • 13125 SW[fall Blvd.,Tigard,OR 97223 S E P 2 1 2021 Plan Review /� Phone: 503.718.2439 Fax: 503.598.1960 Date/By: (. � Z( A-A- der Pe u-w T I IiA R U Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: ly�,���.e��-. H See Page t for Internet: www.tigard-or.gov BUILDING DIVISION N.. ed/Method:l ! / di I 'le Supplemental Information TYPE OF WORK REQUIRED DATA: -AND 2-FAMILY DWELLING ©New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ ' I I -I 3(1 IDAccessory building ❑Multi-family Number of bedrooms: 3 ❑Master builder ®Other: ADU Number of bathrooms:2 JOB SITE INFORMATION AND LOCATION Total number of floors:1 6 S Q 3 Job site address: 16646 SW BOTANY BAY LN New dwelling area: 1228 square feet VD-g..$ City/State/ZIP:Sherwood,OR 97140 Garage/carport area: MS-square feet Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Polygon at Roshak Ridge I Lot no.: 195 Permit fees*are based on the value of the work performed. Tax map/parcel no.: j/�+/� 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 2021 Existing building area: square feet Plea 3,f/ S )( feu on tel ©Coin . New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name:Polygon Homes WLH LLC Type of construction: Address:703 Broadway St., Ste 510 Occupancy groups: City/State/ZIP:Vancouver,WA 98660 Existing: Phone:(360 946 8674 Fax:( ) New: ® APPLICANT 0 CONTACT PERSON 09 BUILDING PERMIT FEES* Business name:Polygon Homes WLH LLC (Please referto fee schedule) Structural plan review fee(or deposit): Contact name:Omar Alami Abouhafs FLS plan review fee(if applicable): Address:703 Broadway St., Ste 710 Total fees due upon application: City/State/ZIP:Vancouver, WA 98660 Phone:(360) 695-7700 Fax::( ) Amount received: E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of 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/StateafP: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 //// � 1 ��/"- ,� Total fee due upon application: $201.60 Authorized signature: Oht4: L 6 y(�,(/.{'j'f/. .R6OLucu.,w,d This permit application expires if a permit is not obtained ((�J within 180 days after it has been accepted as complete. Print name:Omar Alami Abouhafs Date: 09/17/2021 *Fee methodology set by Tn-County Building Industry Service Board. 1:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit ApplicatiR EC E P M E D' FOR OFFICE USE ONLY Received � { Cityof Tigard Permit�Ta " 131SW Hall lvd.,Tigard,OR 97223 S E P 1 2021 Date/By: f*1 Stzo21,6044f ' OPlao Review ���111 Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit: InspectionLine: 503.639.4175 CITY OF TIGARD Yli.lAilli f pt r, Date Ready/By: furls. H See Page 2 for Internet. www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information 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 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:S CATEGORY_OF CONSTRUCTION RESIDENTLAL EQUIPMENT/SYSTEMS FEES* 0 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist I, j Multi-family ❑Master builder ❑x Other. ADU Description Qty. Ea. Total JOB SITE INFOR'LATION AND LOCATION Heating/cooling: • Air conditioning T 46.75 Job site address: 16646 SW BOTANY BAY LN Furnace 100.000 BTU(duenlvents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace I00,000*BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge Iieai pump 61.06 Duct work 23.3232 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydroniel 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.: 195 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/msert , 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/nue/vent 23.32 2) 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/crawle pace fans 23.32 ® APPLICANT 0 CONTACT PERSON Other: 23.32 . Business name:Polygon WLH,LLC Fuel piping: S14.15 for first fouri S4.03 for each additional Contact name:Tonja Morris Furnace,etc. Address:703 Broadway St.,Ste 510 Gas heat pump Wall/suspended/unit beatet City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace E-mail:permitsubmittaisttaylormorrison.com Ba Barbecue ( CONTRACTOR Clothes dryer(gas) Business name:Pra Heating&Cooling Other: MECHANICAL PERMIT FEES* Address: NW Alociek Dr,Ste.1104 Subtotal City/State/ZIP:Hillsboro,OR Minimum permit fee(S90.00) Plan review(25%of permit fee) Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee) - CCB lic.:209001 TOTAL PERMIT FEE This permit application expires if a permit is ant obtained within 180 (�j�0, a [r\un days after it has been accepted as complete. Authorized signature: J a * Fee methodology act by Tri-Counry Building industry Service Hoard Print name:Elia Duran Date: 10/30/20 r.114ntWineAPrrmir414Rf P..nn.14n.601111 Am Electrical Permit Application G'" GI V C I ul:nbi ii I l �l WA l City of Tigard SEP 2 1 2021 D a HST2021 a. is IN • 13125 SW Hall Blvd..Tigard.,OR 97223 Plan Review a ' Phone: 503.718.2439 Fax: 5ro.598.19®iTY OF TIGARO DD....B AalmaaPemata: Internet S r9°175 BUILDING DIVISIO+ggv N o See Page� ;� upplessewl leferm.aos TYPE OP WORK ' ` • El New construction PLAN REViiW 0 Addition/alteration/replacement Plan cheek all that amply(submit taus of plans,.eons shacked): O Service or fader 4a0 amps re min ❑e Bu lding over fine stones ❑Demolition 0 Other: obere me arenna&fault current ❑Maria sod boatyard.. CATEGORY OF CONsTitVCTioN - eroods 10,000 amps at 150 wIN or ❑Floating buildings i-and 2-family dwelling ❑CoIDmcrcislfindustrial 0 Accessory building run m ground,or eme«4 14,000 ❑Comma eid-me agricultural Emily 0 Master builder ADU saps fin all mbar i°stimnms buildings Multi- al other CI Fitt O iosdll.00a of 150 KVA m - JOB SITE INFORMATION AND LOCATION I]rmeraaey ayssem. I+rlp+eepmdd3 derived Job#: Job site address:16646 SW TOWNSVILLE ST Owed maraew volts loads arras IMP or more 0 City/State/ZIP: Tigard,OR 97140 Dux«mta d a aces a id pray ?T, l 3', Orlmab.ao facilma. O Rev,aomal vehicle putts. Suite/bldg./apt it: Project name: Polygon at Roshak Ridge 0 Hasardous locations ❑Supply voltage for mom man Cuss streetltlirectitms to job site: Osmvics or teem 600 amps or more. 600 volts m®ml .FF.E SCFIF.DILE - ' ' ,.,, . Doseriatiae I Ow. I Ewa I rid I • New resident's/single-or oukFfamgy dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: 216 Iodides attstked prage. Tax map/parcel if: g.It or kin 168.34 4 DESCPIPTION OF.WORK Limited FEa.add?500 m1.R d portionportion33.92 1 energy,r}summed 75.Op 2 New construction.Type SFU (with above sq.ft.) Lurid maim mulu.fhmdy 75.00 2 1 residential(with above sq.ft) . ®-PROPERTY-OWNER 1, 0 TENANT Renewable Energy ❑See Page Name: PolygonHamesWLHI1,C Services orfeedershutallatlonolferatioo,aad/orreocatilr _ 290 amp or km 100.70 2 Address: 703 Broadway St Ste 710 201 amps to 400 amps 13336 2 City/StateJ2IP: Vancouver,WA 98660 40l amp w600 ads 200.34 2 601 amp to 1,000 amps 301.04 2 Phone:(360 )946 8674 Fax:( ) Over t,000 nape or volts 55226 2 Email: OAIamiAboohafgaigylormorrison.corm-PCrmitSO Temporary services or feeders Installation,alteration,and/or LsmttalsOtaylonnotrisoacom relocation Owner installation:This installation is being made on property that I own which is not 200 amp.or less 5936 I intended for sale,lease,rent or exchange,according to ORS 447,449,670,and 701. 201 amm to400 mops 125.08 2 Owner signature: _ Date: 401 amp to 599 amp 168-54 2 • f] APPLICANT- I ❑ CONTACT.PERSON Brack circuits—sew,alteration,or extension,per sort A.Fee for branch circuits with Business name: Polygon Homes WLH LLC above malice or feeder fed Contact name: Omar Alarm Abouhafe each branch aimed7-42 B.Fee for branch circuits Waiver r Address: or 703 Broadway St.,Ste 710 'm"ere branch circircuitfonder fee,rust 56.18 2 City/Slate/Z.IP:Vanrgwer,WA 98660 Eaohndd'I branch Monk 7.42 2 Mlbeenaasoas(service or feeder not indsdedl Phone:(360 )946 8674 Farr:: ( ) Emil I tled or modular 6734 2 Email:Oa larniAbouhafs@laylormorrison.com-Perms dwelling-service sailor feeder Submlttalse taylormorrison.com CONTItAC1'OR . Reooanoesamly 67.84 2 Pump or impael circle 67.84 2 Business name: Wallace Electric Sign or outline lighting 67.84 2 Address: 105 Dresden St Signet mrcua(q or limited-energy and,Monition,ore tension 0 See Page 2 2 City/Slate.ZIP: Astoria,OR 97103 Each additional inspection over allowable la stag drie above Additirmd inaction(1 Ir mas) 66.25/hr Phone:(503 38 0563 Fax:( ) lnvcatiplion(1 brmin) 90.009br lodus Email:David@wallaccwires.com o al plant(1 Macon a) 78,18/hr Inspomiona for which no foe is — CCBLic:224868 Eltxtriea] C1441 6363S alsed0oaliylist<d(xhrmm) 90o0/hr Supra Electrician signature,required: 'e��,�[/7 ELECTRICA. PERMIT FFES Print name: - Subtotal: {rap e,6, nate: IAA( 0 Plan Review Required(25%of panic fay 1 Stale surcharge(12%of permit fee): Authorized signature i ts✓ TDTAL PERMIT ITL-. Ptnit name: �aa [ Tilt}emit appnwo anespira if.permit i not ebtainedwitl.Ma n �.e J,df Date: (j�//Zi gags after It has been accepted sa samp.ete 4/e//PIa'6r • Hof inspections allowed per permit. illu0 ntital/:_Padblpp_ELI FREdes Itm W1712013 IsipeC5420W 111 1 • , Plumbing Permit Application HECEIVE Building Fixtures A `ECEIVE I FOR OFFICE USE ONLY CityofTi and EP 2 Received 7/t ,q' p ,� v 131 5W Had Blvd.,Tigard,OR 972.23S 1 2021 Date/BY' Permit NogST2021.-0 xl�N ■ Plan Review Phone: 503.7182439 Fax: 503.598. OuurPermitNo.: Y OF TIGARD DateBy: T I G A R D Inspection Line: 503.639.4175 pate Ready/By: Jurist H See Page 2 for Internet: www.ligard-of.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑Demolition 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 [`j 1-and 2-familydwelling SFR(2)bath 437.78 ` g 0 Commercial/industrial SFR(3)bath 500.32 ❑Accessory building multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: ADU Fite sprinkler( sq.R.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 16646 SW BOTANY BAY LN 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.: ) Page 2 Suite/bldg./apt.no.: 1 Project name:Altaa4aL•Ritlgapolygon 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 Stone sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Polygon at Roshak Ridge Lot no.: 195 Fixture or kern: Tax map/parcel no.: - Backflow 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 ea PROPERTY OWNER r 0 TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixture'sewer cap 25.02 Address:703 Broadway St.,Ste 510 Floor drain floor sink lwb 25.02 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 Sirtkbasidlavatory, 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:permitsubmittals@polygoohomes.com U 25.02 Watcrcloset 25.02 CONTRACTOR Water heater 37.52 Business name:G&B Plumbing&Sous Inc Water piping/DW V 56.29 Address:P.O.Box 92 Other: 25.02 City/State/ZIP:St.Paul,OR 97137 Subtotal Phone:(503)868-1417 I Fax:(971)727-8170 Minimum permit fee: S72.50 CCB Lic.:184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee) < State surcharge permitfee) Authorized signature: TOTAL PERMITFEE Print name:Steve Fowler Date: 10/30/20 Tbis permit application expires if a permit is not obtained within 180 days after It has been accepted as complete. 'Fee methodology set by Tri-County Building Industry Service Board. I:VBuilding\Pamds\PLMU-PermitAppdnc 10/0IAI4 440-4616T(IOr02/COMMIE9i ' City of Tigard 1111 COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review — Residential TIGARD Building Permit #: H I-20D-06 4L( Site Address: l i 6 L{ 1p S 0 rot-q'�,t� g /iuv�( Project Name: p or2 av}' i2-v,5 L1 / 12i Lot #: lc(3Planning Review °( r v " Proposal: k kik A-0 V IX Verify address/suite# active in Accela. CZ In River Terrace: 0 No sgl Yes,River Terrace Review Addendum Site Plan Elements: i2Erosion Control gi3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper 1RRetained trees with drip line and tree protection measures [)raven to scale(standard architect or engineer scale) Footprint of new structure(including decks)and FFE PNorth arrow KUtility locations&easements(required for new and additions) Site address,project or subdivision name and lot number idewalk/driveway approach [Applicant information (name and phone number) ❑Loi,atte.i efwefls/ c1 y,h ii,i SLLot dimensions and building setback dimensions .- tr -si ,y e and loea .__ quare emolished — OStreet names ❑Exisuug suut-iures uu aicc ' U.ui�r d vatiovs (2'(Atnuuis if rrrare drari 4'differential) ,i6Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? Wes No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes ®'No ® Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ,,7 .Yes; rca_rwas tired n NT„ ere Cd Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: g Yes,applicant was notified ❑ No Received: ?' Yes ❑ No Z SDC Exemption for ADU applied for: FP Yes ❑ No Received: ❑ Yes El No p Public Facilities Improvement (PF1) Permit: Required: [Yes,applicant was notified ❑ No Applied For: libYes CINo,stop intake I Land Use Case#: A-Do Z612( - 000®6 e Zoning: R.— K Required Setbacks: Front: ,L Z' Rear:_j 0 F Side: 3l Street Side:_ F Garage: e2-0 g Building Height: Max. Height: 34 Actual Height: 2% ® Landscape Area: '"d'� % Lot Coverage Max: ,(J/A' Entrance id Set back no more than 8'from street-facing wall ,Al2 Parallel to street or offset 45 degrees or less Windows le Minimum 12%of area of all street-facing facades Garage WI Garage door is behind widest street-facing wall ❑ Yes J® No,one of the following is met: rd 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 2"a floor. IN Garage door width is ❑ 12'or less ❑ 50%or less of facade 1",X76Q%or less and includes 7 of following: Covered porch Recessed entrance El Wall offset ❑ 1'Roof eave X Roof offset ❑ Fire shingles 147 Lap Siding ❑ Roof pitch 4P Gable,hip,or gambrel roof le Dormer ❑ Accent siding ❑ Window trim ❑ Window recess 0 Window projection ,J0 Balcony Visual Clearance , Urban Forestry Plan t Sensitive Lands: ❑ Yes W No Type: Conditions met prior to issuance of building permit Notes: L Approved By Planning: A-P(�k �t{ Date: 71._ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved l:\Building\Forms\BldgPermitRvw_RES_122419.docx Building Permit Submittal ' t Original Submittal Date: �994/ 112/ Site Plans: # 3 Building Plans: # 3 Building Permit#: Enter building permit#above. Workflow Routing: Er Planning Pr-Engineering Permit Coordinator I Building Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: Pr.Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Er Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: _ Date: /O/0'7/2M" Engineering Review "Slope at building pad: /p":< C3;Conditions "Met"prior to issuance of building permit hQ Easements (encroachments) per engineering conditions of approval and plat E Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes P/No Assess Water Quantity Fee in-lieu: ❑ Yes L['No LIDA Facility on lot: ErYes ❑ No Q"Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: 2' Approved by Engineering: Smer3 Ke ,Pk% Date: ID/if I zoZ Revisions (after Building Submittal only) Reviewer Date Revision 1: D 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 Does not apply f SDC Fees Entered: Wash Co Trans Dev Tax: / Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A See Cacl �Q° 1�rry� Parks SDC: /Yes ❑ N/A LIDA ❑ Yes !" N/A OK to Issue Permit Approved by Permit Coordinator: Date: 11`( [20 l:\Building\Fonns\BldgPermitRvw_RES_122419.docx • City o and .�Ti g' COMMUNITY DEVELOPMENT DEPARTMENT i C TIGARD River Terrace Building Permit Review Addendum Building Permit #: �ST2d2I OO'14( Site Address: t 6 �U4 F0 3 (/0. Project Name: Q b p.,17 as Lot #: (New dwelli g�subdivision name;Addition or Alteration=last name owner) Planning Review of River Terrace Plan District Design Standards (18.640.070.1., Is the project bject to the plan district design standards? El Yes ❑ No NU1 t.1 n74 avo 1.Articulation: a nimum of 1 element per each street-facing facade that has 30-60 ft. of frontage. A_. additional element required for • with over 60 ft. of street frontage shall be provided every 30 ft. :. cony w/ access 2 Window Projection Vertical Wall Offset a Gabled dormer Porch min. 5 ft. deep ft. deep min.2ft.,5 ft.wide min. 2 ft.,6ft.wide ❑ ❑ ❑ ❑ ❑ 2. Eyes on the street:a minimum o ' %of each street facing facade must include win".ows or entrance doors. Percentage Shown: 3. Entrances:At least one entrance must me- both of the following standards: ❑ Max. 8 ft, setback from longest street- facing •11 ❑ Parallel to str•-t,angle no more than 45° from street, or open onto •,orch Entrance opens to a porch: El Yes El No If yes, all the following apply: ❑ 25 s• t.min. ❑ One street facing entry ❑ 1 t.max.roof above floor of porch ❑ 5 ft. depth min. I 0%min. porch roof coverage 4.Detailed Design:All buildings shall include a min. off•e of '.- following elements on all street-facing facades: ❑ Covered porch min. 5 ft.wide x 5 ft.deep ❑ Re -ssed entry area min. 5 ft.wide x 2 ft. deep ❑ Wall offset min. 16 inches ❑ Dorm- min.4 ft.wide ❑ Roof eave min. 12 inch projection ❑ Roof o et min.of 2 ft. ❑ Roof shingles either tile or wood ❑ Gable,hip •r gambrel roof design ❑ Roof pitch oriented south min. 500 sq. . ❑ Horizontal la, siding min. 3-7 inches wide El Accent siding min. 40%of street fac..e ❑ Window trim . 2 1/2"wide by 5/8"deep ❑ Window recess min.3 inches for .. street facing ❑ Bay window min. > ft.wide by 2 ft.deep O Balcony min. 5 ft.wide x 3 ft. •-ep with inside access ❑ Attached garage is •%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 or '.e lot line,than longest street-facing wall. ❑ Yes ❑ No. If No (Che. one): El May extend up s 5 ft. if there is a covered front porch and garage does not extend beyond t' - front porch. ❑ May extend • to 5 ft.where the garage is part of a two-story building and there is a window at . c second story above the gar •e that faces the street with a min.area of 12 sq.ft. Width: ( eck one) ❑ 12-'oot-wide garage door ❑ 40%max.of street facade ❑ 50%max. of street facade with 7 detailed design elements Notes: ` Approved By Planning: Aviciik 4/��/� Date: I o/�C a 1:1Building\on,BIdgp.irRvw RES RT_I21417.docx t GG City of Tigard Deferral Until Occupancy Request T I G A RD Washington County Transportation Development Tax crDT'),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: 16646 SW BOTANY BAY LANE Project Polygon at Roshak Ridge Land Use Case or MST2021-00441 Name: Building Permit#: Tax Lot Total Parks 2S107AA19500 #: Lot 195 Amount*: $5,839.00 TDT Total TSDC Amount: N/i4 Amount*: $2,134.00 *The total TSDC amount shown above is the sum of$ 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)12 no 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: Oma.t- Date: 11/3/2021 Developer: Off-.R ae-Weeu a, Date: 11/3/2021 Permit Coordinator: ATM ( n .J . Date: 11/3/2021 Plan# 1M.GE s-r ` i"" 0,4Yti k,),tiS R Vlv-4 Floors \ Large Bed rooms 3 Small I.NOUR FIRE RATED EAVES WC LAV 3 A b Tub 2 Basement �/ Vent S 1st Floor i2Z33, Water Heater 1 2nd Floor AC .y..p..6 3rd Floor School L R-3 Total 12„3,..LS jJ D -c,,,r-.4_1p -e... Garage .2_1 S— s ,..„....s 04..;,4J-tvls Total 15 03 2 D-e_. ".kos #for Elec