Permit II CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2021-00376
T t,;,4 R. r 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/16/2022
Parcel: 2S107AA19200
Jurisdiction: Tigard
Site address: 16592 SW BOTANY BAY LN
Subdivision: ROSHAK RIDGE Lot: 192
Project: Polygon at Roshak Ridge, Lot 192
Project Description: New detached dwelling. NO FINAL INSP UNTIL DEFERRED SDCs PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1050 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26.5 Bathrooms: 3 Second: 1481 sf Garage: 400 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 2511 sf Value: S348,388.38 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100
SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Bcklw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures; 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fumc100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temo Srvc!Feedsrs 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: 4 201-400 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
Y 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 SF VB R-3 2511
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
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $32,081.12
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
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Issued By: w w Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the iob site at the time of each inspection.
0/11"..
41P
Building Permit Application 44 '-q 217--
Residential RECEIVES FOR OFFICE USE ONLY
City of Tigard SEP 02 Received 2021 Date/By: 7/// 1/ 40 Permit nyr-Jsrz0z/'4k)3710
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan ReviewQ a i other PervQ f,�2�'po�' y 3
Phone: 503.718.2439 Fax: 503.598.19 Date/By: I
CITY OF TIGARDm See Page 2 for
T I G,\I:D Inspection Line: 503.639.4175 Date Ready/By: ttw� Supplemental Information
Internet: www.tigard-or.gov BUILDING DIVISION ... •ed/Method: /`�/� �j 1 I( PP
.fLiaf/
TYPE OF WORK REQUIRED DA A:1-AND 2-FAMILY DWELLING
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. 2(4
® 1-and 2-family dwelling ElCommercial/industrialValuation: S 2J 46 J t o
Number of bedrooms: 5
❑Accessory building ❑Multi-family
❑Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors:2 '),°(` 1
Job site address: 16592 SW BOTANY BAY LN
New dwelling area: 2,,511 square feet ( l l
City/State/ZIP:Sherwood,OR 97140 Garage/carport area: ��400 square feet t 0 50
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: 1 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.: 192 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
)Tew Construction/Type: SFU/Elevation plan: 222200 B Valuation: $
/Deferrals:YES-deferral of TSDC fees and park SDCs until occupancy. Existing building area: square feet
Projected start: 2022 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:
D APPLICANT 0 CONTACT PERSON U:9 BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Polygon Homes WLH LLC Structural plan review fee(or deposit):
Contact name:Omar Alami Abouhafs FLS plan review fee(if applicable):
Address:703 Broadway St., Ste 510
Total fees due upon application:
City/State/ZIP:Vancouver,WA 98660
Amount received:
Phone:(360)946-8674 Fax::( )360 693-4442
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: permitsubmittals@taylormorrison.com-OAIamiAbouhafs@taylormorrison.com
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.
Permit Fee(includes plan review $180.00
City/State/ZIP:Vancouver, WA 98660 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: $201.60
Authorized signature: Q1nf.Qi2 X ClL1n4 Aleekaitaort, This permit application expires If a permit is not obtained
within 180 days after it has been accepted as complete.
Date: 09/02/2021 *Fee methodology set by Tri-County Building Industry
Print name:Omar Alami Abouhafs Service Board.
I:\Building\Pecnits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB)
A
•
Mechanical Permit A licado ECEIVE I .. FOR OFFICE USE ONLY
.:. ... . .:..
City of Tigard Receivedq Date/By Permit No. S1 2-•I— Db,?
'r*I3125SW Hall Blvd.,Tigard OR 97223 SEP 02 2021
i - Plan Review
• Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Ocher Perms
t I tiA It I7 Inspection Line: 503.639.4175 CITY OF TIGARD Dale Ready/RT furls: I ® See Page 2 for
Internet www.`i `d-or.gov BUILDING DIVISIO 4kai6cd1Melhod Supplemental Information
TYPE OF WORK COMMERCLIL FEE*SCHEDULE—USE CHECKLIST
Mechanical permit fees*are based on the value of the work
El New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other. mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS PEES*
®1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist
I j Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning I 46.75
Job site address: 16592 SW BOTANY BAY LN Furnace 100,000 BTU(duculvems) 46.75
City/State/ZTP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg/apt.no.: Project name: Polygon at Roshak Ridge Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential.boiler(radiator or
hydronicl 23.32
Unit heaters(fuel-type,not electric),
in-wall,induct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Polygon at Roshak Ridge Lot no.: 192 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-Type SFU fireplace 23.32
Let lighter(gas) 23.32
Wood/pellet stove 33.39
Wood 6replacefinsert 23.32
Chimney/liner/flue/vent 23.32
ElPROPERTY OWNER 0 TENANT Other. 23.32
Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
Address:703 Broadway St.,Ste.510 eqm 33.39
Clotheess dry 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. O.CONTACT PERSON Other. 23.32
Business name:Polygon WLH,LLC Fuel piping:
514.15 for first four,$4.03 for each additional
Contact name: Omar Alami Abouhafs Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
W'allisuspended/unit beater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Range
E-mail:permitsubmittals(taylOrmOrri8On.000I Barbecue
,, CONTRACTOR Clothes dryer(gas)
Business name:Pro Heating&Cooling Other.
MECHANICAL PER IT FEES
Address: NW Alociek Dr,Ste.1104
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 lie.:209001 TOTAL PERMIT FEE
` This permit application expires if a permit is non obtained within 180
.i - b ` ,s ^ ,,, days after it has been accepted as complete.
Authorized signature: t/WW 'Jw t�wf s. ' Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date: 10/30/20
f.w,,:MwwlPmmistuer P...nn a,,..Uhl l:An,
• Electrical Permit Application 101:Oil-r-e rsF o.I v
City of Tigard RECEIVE 1., eeaDareeBy pamd6 It'(STZd L/"-- QUS 7(r
13125 SW Nall Blvd.,Tigard,OR 97223 pgaRevicw
r Phone: 503.718.2439 Fax. 503.598 1960 SEP P 0 2021 t i&s . Related Permit#:
inspection Lire 503 639 4175
r;t.,}I-:D iat met: www.tigard-or CITY OF TIGARD Nmtifed/Mtlhad. funs ®See neatage 2 for
Sapplamenlal latornaaoa
TITE of wobiJILDING DiVISIONJ PLAN IIEYIEW
IN New construction ❑Addition/alteration/replacement Pkase cheek an liar apply(submit E seta of pleas whims checked)
❑Demolition ❑Outer. I]Service or feeder 400 amps a mom [l Building over three stonesothe .
CATEGORY OF CONSTRUCTION exceeds10,090 rapsble err current ❑Marinas and ildrof9 tt
amps at I Sit wits Of 0 1•tawng Uuildmgv
® t-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to 8roundd,or exceeds 14600 0 Commetcial-use agricultural
builder 0 Other:r amps fors oilier v installations buildings_Multi-family ❑Master ❑Firc pomp
. ❑Installation of 150 KVA or
JOR SITE INFORMATION AND LOCATION ❑Emergency system_ larger separately derived
Job#: Job site address:16592 SW BOTANY BAY LN ❑Addition of new motor load of ysts
100rTP or mom. ❑"A",-t....i_2"•t_3'
City/State/ZIP: Tigard,OR 97140 Ell sat«mom residentialunits �cW
. ❑Health-care facilities. Q Recreational snuck parks.
Suite/bldg apt.#: Project name: Polygon at Roshak Ridge OIlmardous locations CI Supply voltage for more than
1]Semce or feeder 600 amps se more 600 volts nominal..
Cross street/directions to job site: FEE SChEDULE. .
Description 1 Qtr. I Ark .l Taut I •
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: 192 Includes attached garage.
1,000 sq ft or less 16854 4
Tax map/parcel#: Ea.add'l 500 sq.it or portion 33 92 1
DESCRIPTION OF WORK Limited energy,residential
(with above ft.) 75.Op 2
New construction_Type SFU Limited energy,multi-Einuly
residential(with above sq.ft) 75.00
[2PROPF7tTY DINNER 0 TENANT Renewable Energy O Sec Page 2
Services or ftxders installation,alteration,and/or relocation
Name: Polygon Homes WLht LLC 200 amps or less 100.70 2
Address: 703 Broadway St.,Ste 710 i 201 amps to 400 amps 13336 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:( ) aver 1,000 amps or volts 552.26 2
Temporary services or feeders inatallallun,alteration,and/or
Email: OAlamiAhouhafs@taylormorrison.com-PetmitSubmittals@taylormorrison_com relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 5936 I
intended for sale,lease,rem,or exchange,according to ORS 447,449,670,and 701. 201 amps m400 amps 125 08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
El APPLICANTI ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Polygon Homes Wi.H LLC above service or feeler fee, 7.42 7
each branch circuit
Contact name: Omar Alami Abouhafa B.Fee for branch circuits without
service or tender fee,first Address: 703 Broadway St.,Ste 710 branch %.I R 2
circuit
City/State/LIP:Vancouver,WA 98660 Each arld'I branch rircnit 7.42 , 2
Phone 360 946 8674 _Miscellaneous(service or feeder not included)
( ) Fax::( ) Each manufactured or modular 67.84 2
Email:0AlamiAboubals@taylormcaTison.com-Pe mitSubmitial awe0 rR,service encVa feeder
Y s(�taylormorrison.com rt�«anal only 67 ad 2
CONTRACTOR Pomp or urination circle 67.84 2
Business name: Wallace Electric Sign or outline lighting 67.84 2
Address: 105 Dresden St Signal cucuit(s)or limited-coma 0 See Page 2 2
treacly sticration,or ractrnsioa
Cit
y/S ZIP Astoria OR 97103 Each additional inspection over allowable in asy oofthe above
Additional inspection(1 hr min) 66 25/hr
Piscine:(503 3418 0563 Pax:( ) Investigation(I hr min) 90.tl0/hr
Finail:llavidg0 wallaccwires.Com Industrial plant(I lu min) 78.181 hr
Inspections for which no fee is 90.00!hr
CCB Lic.:224868 Electrical Li - CI441 Su rv_ I. 6363S specifically listed CA hr min)
Sirprv.Electrician signature,required: ELECTRICAL PERMif FFES -
_ a„,„,.........--- Subtotal-
Pont Witte:D ap Date: K Jjc,x 1 __CI Plan Review Required(25%of permit fee):
( Slate surcharge(1294 of permit fee):
Authorized signature TOTAi PERAIIT FEE:
Tin pump application expires ifs permit is oat obtained within 180
Print name: ei"a'ip uu� Date: z ! /Z t.�J It after has been seeepted as complete.
Fl r - • Number of inspections allowed per permit.
L1BrokbnerconitaLC_FamitApp_IIa ERE.d c Rev 0617 0is 4-o-4615T(;110 C0biVJEB
Plumbing Permit Application
Building Fixtures RECEIVE I FOR OFFICE USE ONLY
Cityof Tigard Receives
g SEP 02 2021 DateB Pc mil No. s`r�Ia�A�ne�3'�
"I 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ��VV ff//11 �A
Phone: 503.718.2439 Fax: 5o3.s98.1en OF TIGARD Date/By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Data Ready/By: luris: H See Page 2 for
Internet: www.tigardor.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
vi.?New construction 0 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)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
Xl-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder 0 Other Fire sprinlder( -fl) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16592 SW BOTANY BAY LN Catch basic 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
Suitelbldg.lapt.no.: l Project name:48eakalrfiLgaPoygon 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 fL:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Polygon at Roshak Ridge I Lot no.: 192 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New construction-Type SFU
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:Polygon WLH,LLC Fixu reJsewer cap 25.02
Floor drain/floor sink'hub 25.02
Address:703 Broadway Sty 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
Contact name:
Omar Alami Abouhafs _--- Primer 12.51
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:permitsubmittals@polygonbomes.com Urinal 25.02
CONTRACTOR Water closet25.02
Water heater 37.52
Business name:G&B Plumbing&Sons Inc Water pip ng/DW V 5619
Address:P.O.Box 92 Other: 25.02
City/State/ZIP:St.Paul,OR 97137 Subtotal
Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: S72.50
CCB Lic.:184372 Plumbing Lic-no.:pb634
Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Steve Fowler Date: 10/30/20 Thu permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set by Tri-Ceunry Building Industry Service Board.
11B ldug\Pvm itsaPLMV-PmaihApp doe 10101.wi 440-4616T(I0,O2,C0MM'EB)
' V City of Tigard
ill II
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
Building Permit #: 11 S I-2-v Z it 0 0 S7(
Site Address: 16592 SW Botany Bay Lane
Project Name: Polygon at Roshak Ridge Lot #: 192
Planning Review
Proposal: New home
❑r Verify address/suite#active in Accela. 0 In River Terrace: ❑ No ❑r Yes,River Terrace Review Addendum
Site Plan Elements: .Erosion Control
CI; copies of site plan on 8-1/2"x 11"or 11 x 17"paper ...Retained trees with drip line and tree protection measures
D rawn to scale (standard architect or engineer scale) '°ootprint of new structure(including decks)and FF t
CI worth arrow �Jtility locations&easements (required for new and additions)
rite address,project or subdivision name and lot number sidewalk/driveway approach
CIpplicant information(name and phone number) .oration of wells/septic systems
CI .t dimensions and building setback dimensions .treet tree size,type and location
II.quare footage of buildings to be demolished jtreet names
I-xisting structures on site �,omer elevations(2'contours if more than 4'differentia
CI .t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ° es o
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? 'es r o
❑° Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑Yes,applicant was notified El No Received: ❑Yes ❑ No
❑' Water Metes Fixture Unit Worksheet-Additions,Remodels and ADUs Required: ❑Yes,applicant was notified ° No Received: 8 Yes A No
0 SDC Exemption for ADU applied for: LJ Yes a No Received: Yes No
❑' Public Facilities Improvement (PFI) Permit
Required: ❑Yes,applicant was notified 0 No Applied For: ❑Yes ❑ No,stop intake
El Land Use Case#: SUB2015-00004 El Zoning: R-7
0 Required Setbacks: Front: 8 Rear: 10 Side: 3 Street Side: N/A Garage: 20
El Building Height: Max. Height: NA Actual Height: ZG ..S.-
0 Landsca.e Area: 20 °1° Q Lot Coverage Max: 80
Entrance 0 Set back no more than 8'from street-facing wall ❑r Parallel to street or offset 45 degrees or less
Windows 0 Minimum 12%of area of all street-facing facades
Garage Q Garage door is behind widest street-facing wall ❑r Yes El No,one of the following is met:
8 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°d floor.
❑r Garage door width is 12'or less ❑r 50%or less of facade 60%or less and includes 7 of following:
Covered porch Recessed entrance ❑ Wall offset 1'Roof eave ❑ Roof offset
Fire shingles Lap Siding El Roo itch ❑ Gable,hi ,or gambrel roof Dormer
_Accent siding Window trim Window recess UWindow projection ❑ Balcony
QVisual Clearance ❑ Urban Forestry Plan
❑r Sensitive Lands: ❑ Yes Ifj 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:1Building\Forms\Bl dgPerm itRvw_RES_1224I9.docx
Building Permit Submittal t
Original Submittal Date: r/2/ .24
Site Plans: # 3
Building Plans: # 3
Building Permit#: �nter building}plermit #above. - n
Workflow Routing: Nlanning L -Engineering U iTermit Coordinator ceding
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
o ' plan review routing form.
B
wilding. original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: 0C:P14 f4/ — Date: 9////Zj
Engineering Review
my a Slope at building pad: - • i
Fpr..-...,as Conditions"Met"prior to issuance of building permit ements (encroachments)per engineering conditions of approval and plat
LEI.Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes o
Assess Water Quantity Fee in-lieu: ❑ Yes ogot
LIDA Facility on lot El Yes
N Yes CJ No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
'Approved by Engineering: Date: Q 2
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
Permit Coordinator Review
0 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 a� ly
SDC Fees Entered: Wash Co Trans Dev Tax: Yes 1 N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: EYes ❑ N/A
LIDA ❑ Yes Z N/A
,r OK to Issue Permit
Approved by Permit Coordinator: Date: 61 I((e t 2—I
I:1Bui Iding\Fonns\BldgPermitRvw_RES_122419.docx
•
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: 16592 SW Botany Bay Lane
Project Name: Polygon at Roshak Ridge Lot #: 192
(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 ❑r No (Per MMD2020-00044)
culation:a minimum of 1 element per each street-facing facade that has 30-60 ft.of frontage.An additio
el- -nt required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch :•. ft.deep ft.d❑eep min.2ft.,5 ft.wide min.2 ft.,6❑ft.wide Gable. . er
CI
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 .ante must meet both of the following standards:
❑Parallel to street, . gle no more than 45° from street,
❑Max. 8 ft. setback from longer trees- facing wall
or open onto poi
Entrance opens to a porch: ❑Yes li o
If es,all the following apply: ❑25 sq.ft. in.
One street facing entry ❑12 ax.roof above floor of porch
❑5 ft.depth min. ❑3►/o min.porch roof coverage
4.Detailed Design:All buildings shall include a min. o v, of the following elements on all street-facing facades:
❑Covered porch min. 5 ft.wide x 5 ft.deep I Recessed entry area min. 5 ft.wide x 2 ft.deep
❑Wall offset min. 16 inches g wormer min.4 ft.wide
❑Roof cave min. 12 inch projection ❑R. - offset min.of 2 ft.
0 Roof shingles either tile or wood El Gable, .ip or gambrel roof design
❑Roof pitch oriented south min. 500 sq. . ❑Horiaont.. -p siding min.3-7 inches wide
❑Accent siding min.40%of street fa .e ❑Window trim .2 '/2"wide by 5/8"deep
❑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 0 Attached garage is 'o or less of street facade
5.Garages and Carports: •y face the front or side lot line on a corner lot.
Setbacks:
No closer to front o .ide lot line,than longest street-facing wall. ❑Yes ❑No. If No(Check o - :
❑May extend u. 0 5 ft.if there is a covered front porch and garage does not extend beyond the fro .orch.
❑May exten. p to 5 ft.where the garage is part of a two-story building and there is a window at the se - d story
above the age that faces the street with a min. area of 12 sq.ft.
Width• heck one)
❑ -foot-wide garage door ❑40%max.of street facade
50%max.of street facade with 7 detailed design elements
Notes:
Approved By Planning: NT Date: 9/9/21
I:UfuildingVolms1nldgPrnnitR RES RT_121417.doca
City of Tigard
Deferral Until Occupancy Request
T 1 G A R D Washington County Transportation Development Tax Calf),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: 16592 SW Botany Bay Lane
Project Land Use Case or
Polygon at Roshak Ridge MST2021-00376
Name: Building Permit#:
Tax Lot 2S107AA19200 Total Parks $8 017.00
#: Lot 192 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$6,278.00 for Paxks-Improvement,$ 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: 0m4 -44iunu- eeu Date: 11/4/21
Developer: Ohta2. Date: 11/4/21
Permit Coordinator: 161NA 4/44J Date: 11/3/2021
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Plan # 7227,001 j
Floors a Large i0
Bed rooms S Small
3y
WC
LAV 5
Tub 3 Basement 6-A ' c
,EP
Vent 6 1st Floor 1050 `J/� / L // Ge
Water Heater 1 2nd Floor 1 LI (.)/ AA---
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School � R-3 Total �1
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