Permit CITY OF TIGARD MASTER PERMIT
a COMMUNITY DEVELOPMENT Permit#: MST2021-00409
T l r_;,A It r, 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/16/2022
Parcel: 2S 107AA 19400
Jurisdiction: Tigard
Site address: 16630 SW BOTANY BAY LN
Subdivision: ROSHAK RIDGE Lot: 194
Project: Polygon at Roshak Ridge, Lot 194
Project Description: New single detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE
BEEN PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1211 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1715 sf Garage: 485 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 2926 sf Value: $406,947.88 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 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
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 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 Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 5 201-400 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 2926
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: $33,870.75
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
Oa9_nn4-nnl n rhrn,,nh r1GR Oq9-nn11'inQn Vnn magi nhlain rnnv of!ha rniAc nr,firorf mteefinne fn fll!Mr by Tallinn Sn1 9'29 1OR7 nr 1 Ron 149 9'24d
Issued By: Ha-LLq Va.w De,Wegee Permittee Signature: Ow A
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the lob site at the time of each inspection.
, .. . .. . w
4er-icty
Building Permit Application - 91 q 12,E
Residential RECEIVE 1 FOR OFFICE USE ONLY
City of Tigard .eceived . 0 4,
13125 SW Hall Blvd.,Tigard,OR 97223 SEP 0 ,. • DateBy: Zv 2�- -; -; Permit No.:µS72oZl.
III I � e J Plan Review 1F5D
ZolSWGet4OQ +"6Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: W
T I G A R D Inspection Line: 503.639.4175 CITY OF TIb1l1f1 V Date Ready/By: , ® See Page 2 for
Internet: www.tigard-or.gov Notifi Method: 4 be /� Supplemental Information
BUILDING I� `
(VISION (`/%j�j
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. (go
Lb(® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ / 1 4�r "
El Accessory building El Multi-familyNumber of bedrooms: 5
❑Master builder El Other:
Number of bathrooms: 3
7 JOB SITE INFORMATION AND LOCATION Total number of floors:2 3 /f
Job site address: 16630 SW Botany Bay Ln New dwelling area: 2,926 square feet
i /iS-
City/State/ZIP:Sherwood, OR 97140 Garage/carport area: 485 square feet 1 D.1
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: "...A 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 Lot no.: 194 Permit fees*are based on the value of the work performed.
1Tax 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.
/ New Construction/Type: SFU/Elevation plan: 222300 B Valuation: $
S Existing building area: square feet
Deferrals:YES-deferral of TSDC fees and park SDCs until occupancy.
Projected start: 2022 New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Polygon Homes WLH LLC Type of construction:
Address:703 BroadwaySt., Ste 510
Occupancy groups:
City/State/ZIP:Vancouver, WA 98660 Existing:
Phone:(360) 946-8674 Fax:( ) New:
® APPLICANT 0 CONTACT PERSON U49 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
Phone:(360)946-8674 Fax::( )360 693-4442 Amount received:
E-mail: permitsubmittals@taylormorrison.com-OAlamiAbouhafs@taylormorrison.com
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
tt
CONTRACTOR Commercial and residential prescriptive installation of
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 lic.:207247 Total fee due upon application: $201.60
Authorized signature: 0111.C2. ..cy yLG 46eka/;a6d. 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: 09/07/2021 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard RECEIV E b 61,02.42(-001;6 PermitNo.:AST ZoZI—
't 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
t "' Phone: 503.718.2439 Fax: 503.598.1960 1 n q Date/By: Other Permit:
Inspection Line: 503.639.4175 SEP v 7 2021 H See Page 2 for
t i A 1;I� Internet: unvw.tigard or.gov Date Ready/By: Saris
CITYpOF TIGARC jNo—rifted Method: Supplemental information - -
TYPE OF WO Il UILLJIIIY 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
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/S'k STEMS FEES*
1 t 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist
I j Multi-family 0 Master builder ❑Other: Description 1 Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heatinglcoolin;: �,
Air conditioning 1 46.75
Job site address: 16630 SW Botany Bay Ln Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100.000+BTU(ductsrvents) 54.91
Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge Heat pump _ 61.06 ti
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.: 194 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
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent v 23.32
Other 23.32
ri PROPERTY OWNER 0 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 0 CONTACT PERSON Other 23.32
Fuel piping:
Business name:Polygon WLH,LLC
S14.15 for first four;S4.03 for each additional
Contact name: Omar Alami Abouhafs Furnace,etc. 1
__
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 1 Fax::(360)693-4442 Fireplace
Range
E-mail:permitsubmittalsttayIOrmOrriSOf.COf11 Barbecue 1
ilik CONTRACTOR Clothes dryer(gas)
Business name:Pro Heating&Cooling Other:
MECHANICAL PERMIT FEES*
Address: NW Alociek Dr,Ste. 1104
Subtotal
City/State/ZIP:Hillsboro,OR Minimum permit fee(S90.00)
Plan review(25%of permit fee)
Phone:(360)270-1590 Fax:( ) State surcharge(12%ofpermit fee)
CCB lie.:209001 TOTAL PERMIT FEE
" [� ( This permit application expires if a permit is not obtained within 180
J i f) days after it has been accepted as complete.
Authorized signature: Li GL� t JJ ' Fee methodology set by Tri-County Building Industry Service Board
Print name:Ella Duran Date: 10/30/20
r 1Rnilriina4Prrm.re9Mfii P.m.i°Ann 120112 Mr ran.441 w r,a wnarnsan4+co,
Electrical Permit Application EIV_____Ci a Ti and �'(�QZo24— MS 2� 17 i li
-` 13125 SW Ball Blvd.,Tigard,OR 97223 v "'^ CjO p` ''it a '1 Z t7 09
' 3 Phone: 503.718.2439 Fax. 503.598 1960 °' uaa Reticw Rotated Permit N:
Ustcifty.
Inspection Line: 503.6394175
7ili,�RD /��}e Y See Page Zfor
Internet: www.Ugard-or CITY of rrGCl�IibiitietdlMcdwd. Inns. Supplemental Information
r� TYPE OF WORK BUILDING DIVISION LL PLAN REVIEW
l:ld New construction ❑Addition/alteration/replacement Please cheek all that apply(submit 1 sets of plans wiitcros checked)
0 Demolition ❑Other: 0 Statue m feeder 400 amps ai more 0 Building over three stones
where the available fault current 0 Marinas and boatyard,
C'ATEGORi' OF CONSTRUCTION exceeds 10,000 amps at 150 volts at 0 Floating buildings
M I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building toss to mound,or exceeds 14,000 0 Commercial-use agncaitural
amps tat ail other installations buildings.
❑Multi-family ❑Master builder ❑Other:
❑Fire pump 0 Installation of 150 KVA or
JOB SITE INFORMATION ANT) LOCATION ❑EnitrBcney system larger separately derived
Job#: Job site address:16630 SW BotanyBayLn El Addition of mew motor trod of system].
10011P or more. ❑"A"."1""1-Z","I-3",
City/State/ZIP: Tigard,OR 97140 ' ❑Six ot mate residential units occupancy
❑Health-care facilities. ❑Recreational vehicle parks_
Suitc/bldgJapL#: Project name: Polygon at Ro'hak Ridge ❑Hazardous locations 0 Supply voltage for mtnc than
0 Seduce or feedei 600 amps or more 600 volts nominal
Cross street/directions to job site: FEE SCHEDULE
Description I Q4r. I Each I 'total I •
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: 194 includes attached garage.
Tax map/parcel#: 1,0130 sq f.or less 168 54 4
Ea.add'!500 sq.tt,or portion 33 92 1
__. DESCRIPTION OF WORK Limited i.iaavy,n=ffidcadial
New construction_Type SFU (with above sq.fL) 75.00 2
_ Limited energy,muhi-family 75.00
residential(with above sq_ft.)
PROPERTY OWNER
RRenewable Energy 0 see Page 2
0 TENAN t Services or feeders installation,alteration,and/or relocation
Name: Polygon Homes WLH LLC 200 amps or leas 100.70 2
Address: 703 Broadway St.,Ste 710 201 amps to 400 amps 133.56 2
-- 401 amps to 600 amps 200 34 2
City/State/ZIP: Vancouver,WA 98660 60i amps to 1,000 amps 301 04
Phone:(360 )946 8674 Fax:( ) ovor 1,000 amps or volts 552.26 2
Email: OAlamiAbouhafs@r taylorntorrison-con-PerrnitSubmittal ay relocation
•lormorrison.com Temporary services or feeders iasMJtatioo,alteration.,and/or
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 1 25.08
{ Owner signature: ._ Date: 401 amps to 599 amps 168 54 2
0 APPLICANT __ ❑ 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 feeder r lee, 7 42
each branch circuit
Contact name: Omar Alarm Abouhafs H Fee for branch circuits w+ncOutr
Address: 703 Broadway St.,Ste 710 service or feeder fee,first 56 18 2
branch circuit
City/State/LIP: Vancouver,WA 98660 Each add'1 branch circuit 7.42 2
Phone: 360 946 8674 Miscellaneous(service or feeder not included)
( ) Fax::( ) Each manufactured or modular 67 84 2
Email:CAlamlAbOuhafS ' dwelling,service anti/or feeder
T
,ttftaylormorrison.cam-PcrmitSubmittals.'taylormorrison.cam Reconnect only 67 84 2
CONTRACTOR Pump or irrigation circle 67 84 2
Business name: Wallace Electric Sign or outline lipliting 67 84 2
Address: 105 Dresden St Siviai circuits)or limited-energy 0 See raft 2 2
panel,alteration,or extension.
CO/Slate/ZIP: Astoria OR 97103 Each additional inspection over allowable in any of the above
_ Additional inspection(I ter min) 66 25!In
I Phone:(503 308 0563 Fax;( ) investigation(t hr min) 90.tWit hr
Email: David(i lwal laccwires.com Industrial plant(1 hr thin) 78 18/hr
Inspections for which no lire is 90 001 hr
CC13 i.ic.;224868 Electrical Li•• C1441 Su .1. .: 6363S specifically listed(h tic min)
ELECTRICAL. PERMIT FEES
Strpn.Electrician signature,required: Subtotal
Print name:' f0 ,c4:04,44.44:tf, Date: tI /
/L /z f , 0 Plan Review Required(25%of permit foe):
t State surcharge(12%of permit fee)
Authorized signature TOTAL PERMIT FEE:
I1 �' Titus permit application expires if a permit is not obtained within ISO
Print name: �l '¢ Date: /( / days after It has been accepted es complete.
-----�e{u>;ra �'4 r. ... (J ( t_......_- * Number of inspections allowed per permit
LUiudtbriersinas"ILc_peTmtApp_ELR 1 RF.dcc Rev 66/I7/2015 4-0-4h15i(I i/ONCOM 4VE8
Plumbing Permit Application RECEIVE
t Building Fixtures FOR OFFICE USE ONLY
Cityof Tigard SEP �' ZQ7l Received �WR�ZI_p
�' Date/By: Permit No.
,� ' » 13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGARD 0256 Zf' ��tier
Plan Review
Phone: 503.7182439 Fax: 503.598.1960 ate Other Permit No.:
Inspection Line: 503.639.4175
BUILDING DIVISIOIc Re
TIGARD Internet: www.ti and or. Ov ate Ready/By: Juris: 0 See Page 2 for
_^ g g citified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
Z New construction 0 Demolition For special in ormation use checklist.Ea.
Description tTotal
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utilit connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312,70
1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
/` SFR(3)bath . ._
❑Accessory building 42-Multi-family 500.32
- 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: 16630 SW Botany Bay Ln Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywetl,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:i til.slriiielgePolygon 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 It:_) Page 2
Storm sewer(no.linear ft.:_) I Page 2
Water service(no,linear ft.: ) Page 2
Subdivision: Polygon at Roshak Ridge Lot no.: 194 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
New construction-Type SFLJ Clothes washer 25.02
Dishwasher 25.02
_.... _ Drinking fountain 25.02
Ejectors/sump 25.02
_
® PROPERTY OWNER ❑ TENANT Expansion tank 12.51 '
Name:Polygon WLH,LLC Fixture/secvercap 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 I 25.02
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
1
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Polygon WLH,LLC Medical gas(value:S ) Page 2
Contact name:
Omar Alami Abouhafs Primer 12.51 1
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:permitsubmittalsCpolygonbomes.coro Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:G&B Plumbing&Sons Inc Water tin T)W1/ 56.29
Pp g
Address:P.O.Box 92 Other: 25.02
City/State/ZIP:St.Paul,OR 97137 Subtotal
Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: S72.50
Plan review (25%of permit fee)
CCB Lie.:184372 Plumbing Lie.no.:pb634
- State surcharge(12%of permit fee)
Authorized signature:
Print name:Steve Fowler Date: 1 O/3O/ZO�< TOTAL PERMIT FEE
�' This permit application expires if a permit is not obtained within 180 days
( after it has been accepted as complete.
"Fee methodology set by Tel-County Building Industry Service Board.
1aBuildingPcrmds\Pt.MU.PasnilApp.doe I0101/09 440-46161(I0,021COMWEB)
City of Tigard
■ COMMUNITY DEVELOPMENT DEPARTMENT
e
T r c x D Building Permit Review — Residential
Building Permit#: 41Z2.( -- 0-04fea
Site Address: 16630 SW Botany Bay Lane
Project Name: Polygon at Roshak Ridge Lot #: 194
Planning Review
Proposal: New single detached dwelling
pVerify address/suite#active in Accela. Q In River Terrace: ❑ No ❑r Yes, River Terrace Review Addendum
Site Plan Elements: •rosion Control
0: copies of site plan on 8-1/2"x 11"or 11 x 17"paper 'nLitetained trees with drip line and tree protection measures
elprawn to scale(standard architect or engineer scale) footprint of new structure(including decks)and FFE
orth arrow :,'„,Jtility locations&easements(required for new and additions)
Fite address,project or subdivision name and lot number ,sidewalk/driveway approach
ell Applicant information(name and phone number) _ocation of wells/septic systems
IS ot dimensions and building setback dimensions 'itreet tree size,type and location
III'quare footage of buildings to be demolished ;street names
Ixisting structures on site ._„orner elevations(2'contours if more than 4'differential
ot 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? LA es ' o
CIClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑Yes,applicant was notified ❑No Received: ❑Yes ❑No
❑ Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑Yes,applicant was notified ❑No Received: ❑ Yes ❑ No E
❑° SDC Exemption for ADU applied for: 0 Yes ❑° No Received: ❑Yes ❑ No
❑ Public Facilities Improvement (PFI) Permit: r
Required: ❑Yes,applicant was notified ❑° No Applied For: El Yes ❑No,stop intake
CI Land Use Case#: SUB2015-00004 CI Zoning: R-7
0 Required Setbacks: Front: $i12 Rear: 10 Side: 3 Street Side: 8 Garage: 20
El Building Height: Max.Height: N/A Actual Height: 27
CILandsca.e Area: 20% % ❑r Lot Coverage Max: 80% % s
r
Entrance 113 Set back no more than 8'from street-facing wall 0 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 ❑Yes ❑No,one of the following is met:
Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
❑r Garage door width is _ 12'or less ❑ 50%or less of facade 60%or less and includes 7 of following:
Covered porch _ Recessed entrance 0 Wall offset ❑ 1'Roof eave Roof offset
Fire shingles _ Lap Siding ❑ Roof itch 0 Gable,hi ,or gambrel roof ❑Dormer
Accent siding _ Window trim U Window recess 11 Window projection 0 Balcony
ElVisual Clearance Q Urban Forest Plan
0 Sensitive Lands: 0 Yes U No Type:
ElConditions met prior to issuance of building permit
Notes:
❑ Approved By Planning: SPV Jk(9UV, likjrAtt,ttr, Date: 09-13-2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
1:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 4 017/a 1
Site Plans: # 9
Building Plans: # /
Building Permit#: a Enter building ermit# above. nn
Workflow Routing: IA PlanningEngineering [ Permit Coordinator RI Building
Workflow Sign-off: ® Sign-off for Planning(include notes from planning review)
Route Application Documents: ® Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
pBuilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: 4 caul- _ Date: 'i17i(Ad 2/
Engineering Review
HI Slope at building pad: 74
ErConditions "Met"prior to issuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility: po
Assess Water Quality Fee in-lieu: ❑ Yes
Assess Water Quantity Fee in-lieu: ❑ Yes p� o
LIDA Facility on lot: ❑ Yes CJ No
1114inal Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
-------------------
Approved by Engineering: Date: i:/?0/ /
Revisions (after Building Submittal only) Reviewer !Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved El Not Approved
Permit Coordinator Review
1c'. onditions "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:
4 SDC Exemption: ❑ Received Does not am p'G ly � �
SDC Fees Entered: Wash Co Trans Dev Tax: aYes N/A s .X..
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: ,Yes N/A
LIDA ❑ Yes N/A
)2T"OK to Issue PermitApproved by Permit Coordinator: Atl Date: Zg
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
AINIIIIIIIIIII .
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
i
T 1 G A R D River Terrace Building Permit Review Addendum
Building Permit #: t fi7 1 'ao(fag'
Site Address: L6 G 3a SW 13o4ttvt7 y t.Gt.(�.
Project Name: Polygon at Roshak Ridge / / Lot #: te,Y
(New dwelling=subdir ision name;Addition or Alteration=last name of owner)
P1aa evieW of)?iver ?terrace Alan District Design Standards (18.640.070.I.):
f irk J Is the project subject to the plan district design standards? ❑Yes El No (Per MMD2020-00044)
Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage. An additio
ele •nt required for lots with over 60 ft.of street frontage shall be provided every 30 ft.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
t Porch ;.. 5 ft. deepGable. .ormer
r ft. deep min. 2ft.,5 ft.wide min.2 ft.,6ft.wide
E I ❑ ❑ ❑ El
r2. Eyes on the str• : a minimum of 12%of each street facing facade must include windows • entrance doors.
r Percentage Shown:
3. Entrances:At least one e' ance must meet both of the following standards:
❑Max. 8 ft. setback from longes eet-facing wall
❑Parallel to street, . gle no more than 45° from street,
or open onto por
Entrance opens to a porch: ❑Yes I o
IfLes,all the following apply: ❑25 sq.ft 'n.
One street facing entry ❑12 f ax.roof above floor of porch
❑5 ft.depth min. ❑30/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 I l ormer min. 4 ft.wide
❑Roof eave min. 12 inch projection ❑R.- offset min. of 2 ft.
❑Roof shingles either tile or wood 0 Gable, •'p or gambrel roof design
❑Roof pitch oriented south min. 500 sq. .. 0 Horizont.. ap siding min. 3-7 inches wide
❑Accent siding min. 40%of street fa .e ❑Window trim • ' . 2 1/2"wide by 5/8"deep
❑Window recess min. 3 inches for I street facing ❑Bay window min. ft.wide by 2 ft. deep
❑Balcony min. 5 ft.wide x 3 ft. .eep with inside access El Attached garage is 3 'o or less of street facade
5. Garages and Carports: ,ay face the front or side lot line on a corner lot.
Setbacks:
No closer to front o ide lot line,than longest street-facing wall. ❑Yes ❑No. If No (Check o
❑May extend u. o 5 ft.if there is a covered front porch and garage does not extend beyond the fro .orch.
❑May exten. p to 5 ft.where the garage is part of a two-story building and there is a window at the se . d story
above the .. 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: sev Date:Vigt '2/(31-zl
I:\BuildingWons\BldgPermitRvw_RES_RT_121417.docx
City of Tigard
1,1 Deferral Until Occupancy Request
TIGARD Washington County Transportation Development Tax (TDT),Transportation and Parks System
Development Charges (SDCs)
MAIIIAMOVATIMAMMIWYOKIVIAMIWANW
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: 16630 SW Botany Bay Lane
Project Polygon at Roshak Ridge Land Use Case or MST2021-00409
Name: Building Permit#:
Tax Lot Total Parks
#:
2S107AA19400 Amount*: $8,017.00
Lot 194
TDT Total TSDC
Amount: N/A Amount*: $3,658.00
*The total TSDC amount shown above is the sum of$ 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: Dtna4,4game 46, Date: 11/4/21
Developer: Ootaz.9gama.4 Anzia64, Date: 11/4/21
Permit Coordinator: Date: 11/3/2021