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Permit 4 . E IVE / Plumbing Permit Application Building Fixtures FEB 2 2022 City TigardOF � r1 of CITYnRV ReceiveDate/By:d Z I 122 - ' Permit No.: MST2021 00415 ■ 13125 SW Hall Blvd.,Tigard,ON 'A'^ `'�+ ^ Plan Review _ Phone: 503.718.2439 Fax: 50 . 8-1"�0`t,�DIVISION, Date/By: elb/ 0)., / 467 Other Permit No.: Inspection Line: 503.639.4175 Date Rea /B 2 runs: ® See Page 2 for IIC�A}{1) Ready/By:Y B Internet www.tigard-or.gov Notified/Metho Supplemental Information ( . A'I i.,,,, v . _, d•k .,. , - ,u61d9.-1. � Z .. - .,-,':,S\-, Cxr ., x• t .,,,mm., _„ ew construction ❑Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ly ,t^` '"A'TEG I A CF • ,a''' SFR(1)bath 312.70 1-and 2-family dwelling ElCommercial/industnal SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 0 Master builder ❑Other: Fire sprinkler( 1228sq.ft.) ✓ Page 2 ��k ' ' n4i `t10N Site utilities: Job site address: 16627 SW Botany Bay Ln. Catch basin or area drain 18.76 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.:1197(ADU) Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 � s,.. . 1 z ' Backwater valve 12.51 t � c t. a . `x rtaz a!7 w',. _ i• um sF. .,. "' . , Clothes washer 25.02 MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ', 4,- t i ',• 0 "i1N3 * Expansion tank 12.51 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 Phone: 8167805( 360) ( ) Ice maker 12.51 1a�,,a Fax,4 3 Acr PEA Interceptor/grease trap 25.02 Business name: Alliance Plumbing,LLC Medical gas(value:$ ) Page 2 Contact name: Gavin?homes 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 I Phone:(503 )492-3490 Fax::(503 )912-6438 Tub/shower/shower pan 12.51 E-mail: gavin@allianceplumbing.net Urinal 25.02 y Water closet 25.02 ..• l' .... ..... . .... .... ..,I3f ... 5',; Water heater 37.52 Business name: Alliance Plumbing, LLC Water piping/DWV 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) g,, � a State surcharge(12%of permit fee) Authorized signature:Hannah Thomas v.,=,, ... TOTAL PERMIT FEE Cete Print name: Hannah Thomas ,o,zZ o 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. I:\Building\Permits\PLMO-PerrpitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) CITY OF TIGARD MASTER PERMIT s ' Permit#: MST2021-00415 COMMUNITY DEVELOPMENT T[GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/26/2022 Parcel: 2S 107AA 19700 Jurisdiction: Tigard Site address: 16627 SW BOTANY BAY LN Subdivision: ROSHAK RIDGE Lot: 197 Project: Polygon at Roshak Ridge, Lot 197 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 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 SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 Wi Svc or Fdr: 0 Ea add'I 500 sf: 2 201-400 amp: 0 201-400 amp: 0 W/O SvciFdr 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 Y 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: 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 oc,nn1-nn1(1 fhrni,nh nAR o49-nM-nnon Vnii mev nh+oin n rnm,nf+ho n,loc nr rrirort n„nctinnc tn nl INr h,rollinn 6111/1')1007 nr 1 Hnn 110 e1dd Issued By: HUUM VRA'v Pe,W646' Permittee Signature: Or't'Af tati,cati-o-v. Call 603.639.4175 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. ' ' Building Permit Application Residential '` r� FOR OFFICE USE ONLY City of Tigard RE �� V Received QA 1� /r� / No.: �t,�c/ - Date/By;•a II 7A - Permit Permit: �—W cif 5 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review \ IN Phone: 503.718.2439 Fax: 503.598.1960 p y ry q Date/By: b .J Other Permit: T I GA R.D Inspection Line: 503.639.4175 S E r L v`� Date Ready/By:: ` El See Page 2 for Internet: www.tigard-or.gov OF.tin Apr) No�ed/M od:/ I Supplemental Information CITY I Iry�r r" TYPE OF VON REQUIRED DATA:I-AND 2-FAMILY DWELLING IXI 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. f 0 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ ii 1 / �l 0 Accessory 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 ,sp 3 Job site address: 16627 SW BOTANY BAY LN New dwelling area: 1228 square feet City/State/ZIP:Sherwood,OR 97140 Garage/carport area:, ">7S square feet Suite/bldg./apt,no.: I Project name:r or at Roshak F dge 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.: 197 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. SFU:New home construction Elevation:221100AR/221000AR Duplex Valuation: $ JType:Duplex_Projected Start:February 2022 Existing building area: square feet Deferrals:Please defer payment of transportation&park SDCs until occupancy. New budding 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: la APPLICANT 0 CONTACT PERSON V9 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 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* 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/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: ©M 0,A,.4 ig./ e7 is 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:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Ptllechanicat Permit Application = c s`n x ` ,. .• . y I, . RECE ■ r eived I City of Tigard 1 l�V PermitNnitA ( 40 C{ tI Uate.By 1/��� �1iL 13125 SW Hall Blvd.,Tigard,OR 97223 - i Plan Review • Phone: 503.718.2439 Fax: 503.598.1960 1 7 ZOZ1 Daie/Dy, Other Permit: Inspection Line: 503.639.4175 S E P 3 -- --- Tlt`iAItil Date Ready/13y: lads; Id See Page 2 for Internet: www.tigard-or.gov olibedRdetlwd: p� ��C'TY OF�IGAR'N Supplemental Information TYPE OF W6IeC"'NIN(/ENGIIdVEtFER NCi COMMERCIAL FEE* SCHEDULE - 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 ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:S CATEGORY OF CONSTRUCTION • RESIDENTIAL EQUIPMENT/SYSTEMS FEES° DI-and 2-family dwelling ❑Commercial/industrial U Accessory building For special information usecheckliss J Multi-family 0 Master builder x❑Other: ADU Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: 16627 SW BOTANY BAY LN Air conditioning 46.75 _ Furnace 100;000 BTU(ductslvents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ductslvents) 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.: 197 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 IN PROPERTY OWNER a TENANT Other: 23.32 ' . Environmental exhaust and ventilation: Name:Polygon WLH,LLC Range hood/other kitchen Address:703 Broadway St.,Ste.510 equipment 33.39 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 IN APPLICANT 0 CONTACT PERSON Other: 23.32 Business name:Polygon WLH,LLC Fuel piping: • 514.15 for first four S4.03 for each additional Contact name:Tonja Morris Furnace,etc. Address:703 Broadway St.,Ste 510 Gas heat pump Wall/suspended/unit heater City/Slate/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace Range E-mail:permitsubmlttalstatayl0rmOrrlSOft.COm Barbecue CONTRACTOR Clothes dryer(gas) _ Business name:Pro Heating de 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 not obtained within 180 aI•a b days after it has been accepted as complete. Authorized signature: n" . Fee methodology set by Tri-County Building Industry Service Board Print name:Elia Duran Date: 10/30/20 I t hiIdA.a1Pnm+AMF- P.-.n,6>nn MAI II tin. •,n as,n n.mv.v.n.mma. RECEIVED Electrical Permit Application SEP FUR OFFICE r'I t 1 ) city oft Tigard .AL' 7Z0, . • 13125 SW Hall Blvd.,Tigard,OR 972237 !.1 B -w� Phew-. 503.718.2439 Fax: 303.59apI NNIN ,, r,�' Related Permit a: Inspection line: 503.639.4175 NGIN•. , . rats - a ::..c Interuet:www.tigrdtt.guv �E "iitlal.." .am TYPE OF WORK MAN REVIEW IN New construction ❑Addition/alteration/replacement Please deck all dun apply(submit a sets of plan.wrap rmrma7 O Service or ka4r 400 amps m more ❑Building over three atones, 0 Demolition ID Other: where the avmlable salt amens ❑Meccas and boatyards CATEGORY OF CONSTRUCTION acne,10,000••q.a hso was« 0 Fbeang Willow ❑1_and 2-family dwelling 0 Commercial/industrial 0 Accessory building lea to ground„or m m e&14,000 0 Commereinlhse agricdnual CI Multi-family0 Master builder ADU amps for all other installationbu eg,. ®OU1a: ❑Fpumpc pq plmwis ll,Mm of 150 KVAor .SR BSITE INFORMATION AND.LOCATION ❑Fffie.4Y4574e41. larger separately chorea lob#: lob site address:16627 SW BOTANY BAY LN 0 Addition°farw voter load of system. 10mIP a since. 0"n-,-E".•'1-Z"."1-3", City/Stale/ZIP: Tigard,OR 97140 0 son or 100Ce rraiaemial nmil* nee"pae`y O lBehbcure facilities ❑aoacaeoed•Monte parks. Suite/bldg./apt#: Rr JR.t name: Polygon at Rashak Ridge O liarattlaus bcanrma ❑Supply voltage fa mare than ❑Service or frets 600 amps or more 600 volts rominel Cross street/directions to job site: FEF.$CHIdDUI,E oaerbtia 1 Of,. I Each I Tw I • New eettal Subdivision:Polygon at Roahak Ridge ' Lot 8: 197 Iodides'flatbedgarage or nalti family dwelling anti Talc map/parcel#: 1,000 eq.ft.or arias 168-54 4 . DESCRIPTION OF WORK _ Ea.add'15011 sq.B atpMim 33.92 Limited energy'residence! 75.00 2 2 New construction.Type SFU (v d above so R) Limited mum muludamdy 75.00 2 residential(with above sq.fr.) ®'PROPERTY.OW74£R: I ❑TENANT Reparable Enemy ❑See Page 2 Services or tedkn Installation,altenlioa,arid/or reloadlw Name: Polygon Homes WLH LLC 200 amps or lnw 100.70 2 Address: 703 Broadway St.,Ste 710 201 amps to 400 amps 113.56 2 401 amp to 600 amps 200.34 2 City/StaWLIP: Vancouver,WA 98660 601 amp to 1,000 amps 301.04 2 Phone:(360 )946 8674 Fax ( ) Oter 1,000 amps or vein 552.26 2 Etna 0AlamiAbouhafs@taylorrnonison.com-PerrnitSnlan .ylremorrisop coin Temporary services or feeders i on,alteration,and/or Owner installation:This installation is being made on property that I own which is not 200 eaPo or lea 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201.raps to400 amp 125.08 2 Owner signature: _Date: 401 amp tu599 amps 16E54 2 .I7 APPLICANT I - CI CONTACT PERSON Bruckeheaib-new,dtaraGoa or exkesbo, r panel A.Fee for branch occults with Business name: Polygon Homes WITI LLC above service or feeder lea, each branch uironit 7.42 2 each Contact name Omar Aland Aboohafa B.For fray tend simuita wtdmoa Address: 703 Broadway St.,Ste 710 Wanda' or fee,firstcircuit 56.18 2 City/State/ZIP:Vancouver,WA 98660 Farb*API Mewl Wreak 7.42 2 Phone:(360 )946 8674 Fax:: MlsaW eaeoss(service or feeder sot inducted)( ) Fiob momfee toed or modular 67114 2 Email:OAlamiAboohafs@taylolmorrison.wen-PermitSubmittals(d tayltmnorrison.coin dwelling.service am or Radar Reoaanaa only 67.84 2 CONTRACTOR Prop or irrigation circle 67.84 2 Business name: Wallace Electric Sign or outline lighting 67.84 2 Addrcse: 105 Dresden St Signal eircun(O«,. .- en .- m� o See Page 2 2 Panel,alteration,or eoomsion. ,,,, StatearP: Astoria,OR 97103 Each additional Ioopecuoa over Nowahk la any oldie above Additional inspection 0 to men) 66.25/hr Phone:(503 308 0563 Fax:( ) Investigation(1 hr tin) 90.00/hr Email:David(ajwallacewir s.com Industrial plant(1 banal 78.1K/hr — bap:Minna for which to fee is 94 W!M CCB Lie.:224868 Electrical C1441 35 specifically listed(x>u Min) I, ELECTRICAL.PERMIT FEES Suprv.Electrician signature,required: ok I ll r' Subtotal: Print name:Mils 0 L. i[ Date: y/4tiIrzrf""' O Plan Review Required(25%of permit fee): /�,f[//(///�(a//t/J✓� [/ State em�bargo(12%of permit fix): Authorized sitgwt `�`^„ TOTAL PERMIT FEE: Prim nave: 7ti permit appnnaaa expires If a permit I.not obtained within 1110 �q•n_h 1 x A/i.4,.1 Date' itz !7 1 dap aster a has heed araptea as eaespMle Lteaaa�otBtC_m tMp"-_9.11 16dosdor Km—Y01170015 /bJ6i1551f1110 CaLwrs . limber oCsspeetim*mlousa ire,permit ` ' ' Plumbing Permit Application cGCEIVEID Building Fixtures �G 20 FOR OFFICE USE ONLY Cityof Tigard SU 11 Received N r (5 ellAvin By,, Permit No.: it 111 v 13125 SW Hall Blvd.,Tigard,OR 97223 e Phone: 503.718.2439 Fax: 303.598.1960 C�(OF�,I',g/�i - 't71 Other Permit No.: T I G API) Inspection Line: 503.639.4175 � A Nllq,,-�"` dy/By: 1wic: 63 See Page 2 for Internet: www.tigard-or.gov ?LOP"' Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE r a New construction ❑Demolition For special Information use checklist. Description l Qry, I Ea. l 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 5t1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 ❑Accessory Multi-family Each additional bath/kitchen 25.02 ❑Master builder ®Other: ADU Fire sprinkler( sq.ft.) _ Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 16627 SW BOTANY BAY LN Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Drywall,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name:_dtNr■BitlBaPolygon 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: Polygon at Roshak Ridge Lot no.: 197 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 New construction SFU Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER 1 ❑ TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixture/sewer cap 25.02 Address:703 Broadway St.,Ste 510 Floor drain/floor sink/hub 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 C+ APPLICANT 0 CONTACT PERSON interceptor/grease trap 25.02 Business name:Polygon WLH,LLC Medical gas(value:$_) Page 2 Contact name:Tonle Morris 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@polygonhomes.com polygonhomes.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:G&B Plumbing&Sons Inc Water P 1P in WV 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 Lic.:184372 Plumbing Lic.no.:pb634 t State surcharge(12%of permit fee) Authorized signature: +*rrj 1 l TOTAL PERMIT FEE Print name:Steve Fowler Date: O/3O/2� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tn.Counry Building Industry Service Board 1:1Buadiaeoam PLMU•PermilApp.dae Ia/e1N4 4404616T(faN2'COMMEBJ City of Tigard RECEIVED ® COMMUNITY DEVELOPMENT DEPARTMENT e 11111 SEP 1 7 2021 T i G A Ft D Building Permit Review — Residential CITY OF TIGARD Building Permit #: /111/5 -00 f'{ PLANNING/ENGINEERING Site Address: 1 t 2 0 v7 3(/J` g got L Project Name: f Q Oil i0 s� M Lot #: Lc 1- /q7- Planning Review � Proposal: . \ kQA A-DU 4 0(" ,,6 auteibty P1.Verify address/suite# active in Accela. 101.1.n River Terrace: ❑ No Yes,River Terrace Review Addendum Site Plan Elements: Erosion Control R3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper eRetained trees with drip line and tree protection measures @Drawn to scale(standard architect or engineer scale) Footprint of new structure(including decks)and FFE C1 forth arrow ®Utility locations&easements(required for new and additions) bite address,project or subdivision name and lot number jPSidewalk/driveway approach WApplicant information(name and phone number) a on of we s sep c tems-- W1Lot dimensions and building setback dimensions AiStreet tree size,type and location n9uewk c— — a --- l mnh h t ?Street names s t 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? ►I�_. ENo ,Clean Water Services —Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified rEebNo Received: ❑ Ycs El No 07 Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: irYes,applicant was notified ❑ No Received: Yes ❑ No ee' SDC Exemption for ADU applied for: erFP Yes ❑ No Received: ❑ Yes ❑ No Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified e No Applied For: ❑ Yes ❑ No,stop intake l ' Land Use Case#: 142(12.021 - (W0 S ® Zoning: 4-, Required Setbacks: Front: (2t Rear: (,0 t Side: 31 Street Side: 8 t Garage: 2$2) t IP Building Height: Max. Height: N/A- Actual Hei ht: 2.lg F UP Landscape Area: Z v % ® Lot Coverage Max: ` a % Entrance ® Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows V Minimum 12%of area of all street-facing facades Garage Ig4 Garage door is behind widest street-facing wall ❑ Yes it No,one of the following is met: W 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. 0 Garage door width is ❑ 12'or less ❑ 50%or less of facade RP 60%or less and includes 7 of following: 0 Covered porch ❑ Recessed entrance Wall offset al,Roof eave Roof offset ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch 10 Gable,hip,or gambrel roof Dormer ❑ Accent siding g7 Window trim ❑ Window recess ❑ Window projection ❑ Balcony ® Visual Clearance Cr Urban Forestry Plan -aT Sensitive Lands: ❑ Yes Of No Type: VPConditions met prior to issuance of building permit Notes: Approved By Planning: /Za Date: q 1-1'Revisions (after Building Submittal only) 6. Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved l:\Building\Forms\B1dgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: 4 Mizi Site Plans; # �7 Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: [>Planning A Engineering 0 Permit Coordinator ?® Building Workflow Sign-off: 140 Sign-off for Planning(include notes from planning review) Route Application Documents: IN Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Building original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: pl,Q. Date: �lZi� Engineering Review i 'Slope at building pad: /d2rp 8 Conditions "Met"prior to issuance of building permit Easements (encroachments)per engineering conditions of approval and plat IffWater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes V'No Assess Water Quantity Fee in-lieu: E Yes V2(No LIDA Facility on lot: ❑ Yes e No LJ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: [YApproved by Engineering: Date: 9/ /L/ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review pi 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 SDC Fees Entered: Wash Co Trans Dev Tax: rJ yes ❑ N/A knrc`P Tigard Trans SDC: Yes 0 N/A Parks SDC: / Yes 0 N/A LIDA ❑ Yes / N/A f OK to Issue Permit Approved by Permit Coordinator: Date: 101 Z0 Z 1 I:1Building\Forms\BldgPemiltRv w_RES_122419.docx RECEIVED 7 City of Tigard SEP 1 7 2021 COMMUNITY DEVELOPMENT DEPARTMENT G CITY OF TIGARD T 1 A R D River Terrace Building Permit Review AlIVROgivivNEERING Building Permit #: /I51-05V CV 415 Site Address: I &Z-f- S LA! 1564 ?ay - Project Name: � gm L / Lot #: /GZ' ew dw 1 subdivision name;Addition or Alteration=last name of owner) Plan :. ' Review of River Terrace Plan District Design Standards (18.640.070I.): Is the projec ubject to the plan district design standards? ❑ Yes ❑ No lY D i 21 J vcoo Q 1.Articulation: a . 'nimum of 1 element per each street-facing facade that has 30-60 ft.of frontage.An additional element required fo ots with over 60 ft. of street frontage shall be provided every 30 ft. Porch min. 5 ft. dee Balcony w/ access 2 Window Projection Vertical Wall Offset a P ft.deep min. 2ft., 5 ft.wide min.2 ft.,6ft.wide Gabled :.rmer ❑ ❑ ❑ ❑ ❑ 2.Eyes on the street a minim . of 12%of each street facing facade must include window .r entrance doors. Percentage Shown: 3.Entrances: At least one entrance m t meet both of the following standards: ❑ Parallel to stree ,angle no more than 45" from street, ❑ Max. 8 ft. setback from longest street- . ing wall or open onto • ch Entrance opens to a porch: 0 Yes ❑ No If yes,all the following apply: ❑ 25 :.ft. min. ❑ One street facing entry ❑ ft.max. roof above floor of porch ❑ 5 ft. depth min. • 30%min.porch roof coverage 4.Detailed Design:All buildings shall include a mi. of fiv. of the following elements on all street-facing facades: ❑ Covered porch min. 5 ft wide x 5 ft. deep IN Recessed entry area min. 5 ft.wide x 2 ft.deep ❑ Wall offset min. 16 inches 0 ►inner min. 4 ft.wide ❑ Roof eave min. 12 inch projection ❑ Roo offset min. of 2 ft. ❑ Roof shingles either tile or wood ❑ Gable, .'p or gambrel roof design ❑ Roof pitch oriented south mi 00 sq. ft. ❑ Horizont.. lap siding min.3-7 inches wide ❑ Accent siding min. 40%o treet facade ❑ Window tri ' .2 1/2"wide by 5/8"deep ❑ Window recess min.3 ' ches for all street facing ❑ Bay window mi 5 ft.wide by 2 ft. deep j ❑ Balcony min. 5 ft. , de x 3 ft.deep with inside access ❑ Attached garage is • %or less of street facade 5. Garages an t arports: May face the front or side lot line on a corner lot. Setbacks: No closer . front or side lot line,than longest street-facing wall. ❑ Yes ❑ No. If No (Che. one): ❑ Ma extend up to 5 ft.if there is a covered front porch and garage does not extend beyond t' - front porch. ❑ 1 ay extend up to 5 ft.where the garage is part of a two-story building and there is a window at e second story above the garage that faces the street with a min. area of 12 sq.ft. Width: (Check one) ❑ 12-foot-wide garage door 0 40%max.of street facade ❑ 50%max. of street facade with 7 detailed design elements Notes:Approved By Planning: kseitl/L Date: /'2-' /2_f 1417.docx G City of Tigard . Deferral Until Occupancy Request T I G ARD Washington County Transportation Development Tax (TDT),Transportation and Parks System Development Charges (SDCs) This form is to be signed and submitted prior building permit issuance or, if no building permit is required,then upon land use approval(TMC 3.24, as amended by Ordinance No.21-09). Date: 10/4/2021 Site Address: 16627 SW BOTANY BAY LANE Project Polygon at Roshak Ridge Land Use Case or MST2021-00415 Name: Building Permit#: Tax Lot Total Parks 2S7 07AA 19700 $5,839.00 #: Lot 197 Amount*: TDT Total TSDC $225.00 Amount: N/A Amount*: *The total TSDC amount shown above is the sum of$ 0 for TSDC-Improvement,$ 225.00 for TSDC- Reimbursement,and$ 0 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 l'DT,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: DrtaA.4 .u:46eu Date: 10/05/21 Developer: 0 .Alamo' Meth Date: 10/05/21 Permit Coordinator: AIWA G '- ' Date: 10/4/2021 Plan# 1% s-i Dolot.eix ( .y Cti ILLUS V-11-0( Floors \ Large Bed rooms Small 1.HOUR FIRE RATED EAVES We '. LAV 3 A-b Tub 1- Basement Vent S 1st Floor 122,..8 Water Heater 2nd Floor ND CE DK A-bus AC y).<5 3rd Floor School 1 R-3 Total �2�$ 1,3 -�,,�r-$.�\A.L '_ Garage 5 D I.i 7is Total t 5 O �' � ` os #for Elec FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT III Transmittal Letter >i(i A R I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: NI sin kg,m1S1--lsZpn6 DATE RECEIVED: DEPT: BUILDING DIVISION FROM: Ate A S RECEIVED NOV 2 2021 COMPANY: I�v (a2 `I RRk'Jtl NIoR 41 U1ec'I—ZIC 61FYOFTIGARD PHONE: 3�j Q It Co S6 Rill DING DIVISION! By EMAIL: yy-j C is ( io L." ,� RE: 166.15 / 16G 1 SW @*(l ray (N ' 1145r4,WW 4 (Site Address) (Permit Number) - Ip �� �� f1(Projfame or subdivision lot number) — -- -ATTACHED ARE THE FOLLOWING ITEMS: 'Copies: Description: ' ,Copies:. : Description: �I Additional set(s) of plans. ,2 Revisions: ep ` OU�ttRUU IeCl—- Cross section(s) and details. Wall bracing an orfateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: / FOR OFFICE USE ONLY Routed to Permit Technic' ., Date: I.)(/ ' ZI Initials: Fees Due: Yes o Fee Descri ton: e ______ / Amount Due: i\s"' —_- _ $ $ t� $ Special Instructions: / Reprint Permit(per PE): ID Yes No v ❑ Done Applicant Notified: '-C/�Date: //i 7/i 1 Initials: 1:\Building\Forms 1TransmittalLetter-Revisiioons 073120.doc