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Permit ,,„ CITY OF TIGARD MASTER PERMIT ` II I a COMMUNITY DEVELOPMENT Permit#: MST2021-00368 Date Issued: 01/26/2022 Ti G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel 2S 107AA22100 Jurisdiction: Tigard Site address: 16609 SW DARWIN LOOP Subdivision: ROSHAK RIDGE Lot: 221 Project: Polygon at Roshak Ridge, Lot 221 Project Description: New detached dwelling. NO FINAL INSP UNTIL DEFERRED SDCs PAID. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 5 First: 1211 sf Basement: 763 sf Left: 3 Parking Spaces, 0 Height: 28 Bathrooms: 4 Second: 1715 sf Garage 485 sf Front: 8 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 3689 sf Value: $509,862.34 Rear: 10 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump; N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 7 201-400 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 SF VB R-3 3689 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 2 Geo Tech Report Required Prior To Pour PHONE: PHONE: 360-695-7700 FAX: Total Fees: $37,122.98 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR QS9-fVN-M1 n thrn,inh AOR Qc9-nnl-nnon Vnn may nhfain a rnnv of fho n doe nr ri irorf ni ioefinne fn rli INC by Tallinn cr11 9'39 10127 nr 1 AM 4'79 914A Issued By: Nothd V61-4 'De' Wege' Permittee Signature: fw,,L1f"7.1;tyi4-i n,n. 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. ar- 'Building Permit Application AA/ B-a !Of Residential RECEIVED FOR OFFICE USE ONLY City of Tigard Received y" b Z/ 4 Permit No/sf j1 OD 36,i' ftft 13125 SW Hall Blvd.,Tigard,OR 972d�G 10 2021 Date/By:Plan Revie ■ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: i I a Other Permits/ f�2C i i DD i2 3 ci I I G A R D Inspection Line: 503.639.4175 CITY d ���A�(] Date Ready/By )� ) .1. ® See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION tified/Metho • A_ I 'j Supplemental Information TYPE OF WORK REQUIRED DATA: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 ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application5toqfcaleS3' 4 ® 1-and 2-family dwelling ❑Commercial/industrialValuation: $ElAccessory building ❑Multi-familyNumber of bedrooms: 0 Master builder 0 Other: Number of bathrooms: 4 JOB SITE INFORMATION AND LOCATION Total number of floors:3 l f i Job site address: 16609 SW DARWIN LOOP New dwelling area: 3,689 square feet 11(S City/State/ZIP:Sherwood,OR 97140 Garage/carport area: 485 square feet 1 all.,_ Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: square feet 7 ii5 Cross street/directions to job site: Deck area: 1ig square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Polygon at Roshak Ridge I Lot no.: 221 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. `New Construction/Type: SFU/Elevation plan: 222803B. Valuation: $ Deferrals:YES(deferral of TSDC fees&park SDCs until occupancy.) Existing building area: square feet 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 Broadway St., Ste 510 Occupancy groups: City/State/ZIP:Vancouver,WA 98660 Existing: Phone:(360) 946-8674 Fax:( ) New: ® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name:Polygon Homes WLH LLC (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name:Omar Alami Abouhafs Address: 703 Broadway St., Ste 510 FLS plan review fee(if applicable): Total fees due upon application: City/State/ZIP:Vancouver,WA 98660 — Amount received: Phone:(360)946-8674 Fax::( )360 693-4442 E-mail: perm itsubm ittals taylormorrison.com-OAlamiAbouhafs@taylormorrison.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* a Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name:Polygon Homes WLH LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:703 Broadway St., Ste 510 Solar Installation Specialty Code checklist. City/State/ZIP:Vancouver, WA 98660 Permit Fee(includes plan review $180.00 and administrative fees): Phone:( )360 695-7700 Fax:( )360 693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 Total fee due upon application: $201.60 Authorized signature: (31124A." .415., J,G� 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: 08/09/2021 *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 It EC E IU E I,Received Permit N DaIeJBA /y ' " 13125 SW lull Blvd.,Tigard,OR 97223 y �l !�s'� s }� d i = • Phone: 503.718.2439 Fax: 503.598.1960 AU Cl 1 0 2021Plan Review Other Permit: Inspection Line: 503.639A175 DateBe: 7!{ifiRi} Date Ready/13y Janis 10 See Page 2 for _---_. Internet. aww.tigard-or.sov CITY OF TIGARD Notificd/Miethod CITY Supplemental Information BUILDING DIVISION TYPE OF WORK 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 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:S CATEGORY OF CONSTRUCTION ItESIDENTL•I.EQUIPMENT/SYSTEMS FEES* IN 1-and 2-family dwelling ❑Commerciallindustrial ❑Accessory building For special information use checklist. I j Multi-family ❑Master builder ❑Other: Description Qty. Ea. _ Total JOB SITE LNFORMATION AND LOCATION Heating/cooling: • Air conditioning I 46.75 Job site address: 16609 SW Darwin Loop Pomace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no. Project name: Polygon at Roshak Ridge _ V Heat pump 61.06 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.: 221 Other. 23.32 ----- Other fuel appliances: Tax map/parcel no.: Water heater A_ 23.32 _ DESCRIPTION OF WORK Gas fireplace/insert 33.39 - Flue vent for water heater or gas New construction,type:Single-Family Units fireplace 23.32 Log lighter(gas) 23.32 --•' Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ►4 PROPERTY OWNER 0 TENANT Other. 23.32 ' Environmental exhaust and ventilation: _ Name:Polygon WLH,LLC Range hood/other kitchen Address:703 Broadway St.,Ste.510 _ww� equipment i 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/crawlspacc fans 23.32 0 APPLICANT 0 CONTACT PERSON Other: ._ 23.32 Business name:Polygon WLH,LLC Fuel piping: $14.15 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/State/ZIP:Vancouver,WA 98660 Water heater _ Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace Range E-mail:permitsubmittalsttaylOrmOrrison.COM Barbecue k ..... r 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%of permit fee) CCB lie.:209001 TOTAL PERMIT FEE _ This permit application expires if a permit is not obtained within 180 Qt��Q days after it has been accepted as complete. Authorized signature: "" ` ' Fee methodology set by Tn-County Building Industry Service Board Print name:Elia Duran j Date' 10/30/20 I rsnnilA:nelt.,m.O.Arr V..,nit 4n.11411111 Ann „,.: Electrical Permit Application CEIVEC) ft)R OFFICE USE ONLY' 1 City of Tigard i 1 0 2021 Received perniit6 r ,1ate,RCi z i lh• 13125 SW Ila1!Blvd.,Tigard,OR 97223 '0 ,3.rt r Pin Review twisted Permit it Phone 503.718 2439 Fax. 503 s9$196o OF TIGARD Date iv inspection Line! 503 639 4175 T1fiARL7 q3r Ready[)anAy runs See Page 2for Internet: Vnvw.Ugard-or. ov �/ISION Noti$cdrMethud. Supplementallnformation �Qry TYPE OF WORK PLANREVIEW 1 New construction ©Addition/alteration/replacement please cheek all that apply(submit 1 sets of plans weittars checked) 0 Demolition ❑(}the!; ❑Sri rice or feeder 400 amps inmore El13udttag over three stones where the available fault current 0 Marinas and Ixxatvasd CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 yaks or ❑Floating buildings ® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building li°s-5 to mound,or exceeds 14•0uo 0 Commerci d_n5e a ncuItur„1 ❑Multi-family ❑Master builder 0 Other ainps for all other to Whitton buildings ❑Fire pump 0 Installation of 150 KVA or JOB SITE INFORMATION AND 1,0(",AT1ON 0 Emergency system larger separately dcrn•ed 16609 SW Darwin Loo ❑Addition of new motor load el system.#: Job site address: p 100I1P or more. ❑.'A”`t' "J 2 "1-3", City'/Slate/ZIP: Tigard,OR 97140 ❑Six or more residential units occupancy ❑Health-ears facilities. 0 Recreational seh+ek parks- Suitc/bldg./apt.#: 1 Project name: Polygon at Roshak Ridge ❑tiazardotec locations ❑Supply voltage for more than ❑Service or feeder 600 amps or more 600 volts nominal Cross street/directions to job site: _ FEE SCHEDULE Aescripfioe I Qtr. I Each I 'Total I • New residential singe-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: 221 Includes attached garage. — Tax map/parcel#: I,Wo,y ft.or less 16$54 4 Ea.add'!500 sq.ft or portion I 33 92 1 DESCRIPTION OF 11'()1tK Limited energy,nnidismal Nets construction_Type SF[) (with above sq.ft.) 75.00 7. Limited ota:tgy,multi-family 75.00 residential(with above sq.ft.) Renewable Energy 0 See Page 2 El PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: Polygon Homes WLH LLC 200 amps or less 100.70 2 Address: 703 Broadway St.,Ste 710 201 amps to 400 amps 133.56 2 401 aunps to 600 amps 200 34 2 City/State/Z_IP: Vancouver,WA 98660 601 amps to 1,000 amps 301 04 2 Phone:( 360 )946 8674 Fax:( ) Over 1,000 amps or volts 552.26 2 Email: OAlamiAbouhafs to lormorrison.com-PermitSubmittal to'lormorrison-com Temporary services or feeders installation,alteration,and/or y �� Y relocation 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 125 08 2 Owner signature: ,- Date: 401 amps to 599 amps 168 54_ 2 El APPI.IC 1N f ❑ CONTACT PERSON circuits-new,alteration,or extension,per panel A Fee for branch circuits with Business name: Polygon Homes WI.H LLC above service or feeder lee, _ each branch circuit 7.42 Contact name: Omar Alarni Abouhafs R Fee for branch circuits without Address: 703 Broadway St.,Ste 710 service or feeder fee,first Sb.1 R 2 branch circuit City/State/ZIP: Vancouver,WA 98660 Each addl branch circuit 7.42 2 Phone: 36Q 946 8674 Miscellaneous(service or feeder not included) ( ) Fax::( ) Each h manufactured or modular 67 84 2 Email:OAlamiAbouhafsAtaylormorrison.com-Pt:•rmitSubmittals@taylormorrison.com dwelling,service and/or feeder I Reconnect only 67 84 2 CONTRA('!Ok_ Pump or in gritior]circle 67.84 2 Business name: Wallace Electric Sign or outline lighting 6784 2 Address: 105 Dresdtxt St Signal ctrcutt(r)or limited-energy ncrgy ❑ see Page 2 2 panel,alteration,or extension. City/StatefZIP; Astoria OR 97103 Each additional inspection over allowable in any of the above Additional inspection(1 Fir min) 66 25/hr Phone:(501 3)8 0563 Fax:( ) Investigation(1 hr min) 90.00/hr • Email: David@wallacewires.com Industrial plant(I hrrnin) 78 181hr Inspections for which nu fee is ceB Lie.:224868 Electrical Li'• CI 441 Su _1 .: 6363S specifically listed CAhr min) 90 00/hr Suprv.Electrician signature.required: ELECIRICAI, PERMIT FEES Subtotal Print name:D 449 cti Jr/ (Dale: I!G Jz t `❑Plan Review Required(25%of permit fee): , State surcharge(12%of permit fee) Authorized signature TOTAL PERMIT FF L - This penult application expires if a permit is trot obtained within 180 Print name: s�- L�'_ y Date: t days after bun been accepted as complete.e; am it - inspections allowed per permit i ceding'd'rratiu'�C tc,yernntApp_ELR EREike Rev 06'1112011 4 0r46150 * Number of ins 11/05,COMAVER Plumbing, Permit Application_ en Building Fixtures RECEIVE I FOR OFFICE USE ONLY City of Tigard "AUG ( Received Permit No.: +� ,, • 't 13125 SW Hall Blvd.,Tigard,OR 97223°t U U [�Q2� Date/By: M�''� `W`Z�df t� Plan Review Phone: 503.718.2439 Fax 503.598 9 y OF TIGARD �fe/By' ie Other Permit No.: Inspection Line: 503.639.4175 Date Road�B TIGARD Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Furls.y. ePent Inr Supplemental Information TYPE OF WORK FEE* SCHEDULE Z 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) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ^ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory buildingSFR(3)bath 500.32 -Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( _sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 16609 SW Darwin Loop Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name:OtalirsoirliiioleePolygon 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.: 221 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:Single-Family Units Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixture/sewer cap - 25.02 Floor drain/floor sink/hub 25.02 Address:703 Broadway St.,Ste 510 Garbage disposal 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone:(360)695-7700 Fax:( ) lee maker 12.51 ® APPLICANT ❑ CONTACT PERSON lnterceptorigrease trap 25.02 Business name:Polygon WLH,LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Tonja Morris - 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 Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name:G&B Plumbing&Sons Inc Water piping/DWV 56,29 Address:P.O.Box 92 Other: 25.02 City/State/ZIP:St.Paul,OR 97137 Subtotal Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lie.:184372 Plumbing Lic.no.:pb634 State surcharge(12%of permit fee) I Authorized signature: TOTAL PERMIT FEE I Print name:Steve Fowler Date: 10/30/20 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fec methodology set by Tri-County Building Industry Service Board t.tauilding.Ptamits;PLMtt-PermitApp.doe 10,01/Os 440-4616T(10/02/COM'WVEB) City of Tigard r COMMUNITY DEVELOPMENT DEPARTMENT rt a T1cARD Building Permit Review — Residential 1 Building Permit #: wl.51-Z.-o 2- - 00 3 6, Site Address: 16609 SW Darwin Loop Project Name: Polygon at Roshak Ridge Lot #: 221 Planning Review Proposal: New House • Verify address/suite#active in Accela. ® In River Terrace: ❑ No ® Yes, River Terrace Review Addendum See comment below_ Site Plan Elements: 1E]Erosion Control 7L]3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper 1®Retained trees with drip line and tree protection measures ®Drawn to scale(standard architect or engineer scale) .*1 Footprint of new structure(including decks)and FFE kiNorth arrow 7C1Utility locations&easements(required for new and additions) I4Site address,project or subdivision name and lot number ®Sidewalk/driveway approach AApplicant information(name and phone number) INtocation of wells/septic systems Lot dimensions and building setback dimensions ®Street tree size,type and location Square footage of buildings to be demolished ®Street names ilaExisting structures on site ®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? Ilya ❑No impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes ❑No II Clean 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 1�41 No Received: ❑ Yes ❑ No a SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No R 1 Public Facilities Improvement (PFI) Permit Required: ❑ Yes,applicant was notified 17 No Applied For: ❑ Yes ❑ No,stop intake © Land Use Case#: SUB2015-00004 5i1 Zoning: R-7 Required Setbacks: Front: 8 Rear: 10 Side: 3 Street Side: na Garage: 20 ® Building Height Max.Height: NSA Actual Height: 28 )10 Landscape Area: 20 % E Lot Coverage Max: 80 Entrance ® Set back no more than 8'from street-facing wall n Parallel to street or offset 45 degrees or less Windows ® Minimum 12%of area of all street-facing facades F: 17% R: 20% Garage ® Garage door is behind widest street-facing wall ® Yes ❑ No,one of the following is met: r ❑ 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. AGarage door width is ❑ 12'or less 1E 50%or less of facade El60%or less and includes 7 of following: r ❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony ® Visual Clearance E Urban Forestry Plan U Sensitive Lands: ❑ Yes ® No Type: ® Conditions met prior to issuance of building permit Notes: MMD2020-00044-Design standards in 18.290 a ly only. ® Approved By Planning: a Date: �l 30 l�'u V Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: r//0/2/ Site Plans: # Building Plans: # 3 Building Permit#: -ET Enter building permit#above. Workflow Routing: e'Planning C 4 ngineering iermit Coordinator Building Workflow Sign-off: B'''Sign-off for Planning(include notes from planning review) Route Application Documents: 1,2--Engineering: (1) copy of permit application, (1) site plan, (1)building plan and original plan review routing form. �I'Building: original permit application,site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: t2444--- Date: %9/v/2.' Engineering Review 4 Slope at building pad: Zdg /2'Conditions"Met"prior to issuance of building permit ®'Easements (encroachments) per engineering conditions of approval and plat PyWater Quality/Quantity Facility: ,�/ Assess Water Quality Fee in-lieu: ❑ Yes [1 No Assess Water Quantity Fee in-lieu: ❑ Yes [ki\lo LIDA Facility on lot ❑ Yes 1/*No Cl/Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: VApproved Approved by Engineering: Date: r/372, only) Reviewer Revisions (after Building Submittal Date Revision 1: ❑ 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 yfSDC Fees Entered: Wash Co Trans Dev Tax: , Yes ❑ N/A Tigard Trans SDC: 7Yes ❑ N/A Parks SDC: � Yes ❑ N/A LIDA ❑ Yes 0 N/A OK to Issue Permit ////Approved by Permit Coordinator: /q Date: CA Ikc 1202 I:\Building\Forms\BI dgPermitRvw_RES_122419.docx City of Tigard s= " Deferral Until Occupancy Request T I G A RD Washington County Transportation Development Tax (TDT),Transportation and Parks System ' Development Charges (SDCs) This form is to be signed and submitted prior building permit issuance or, if no building permit is required,then upon land use approval(TMC 3.24,as amended by Ordinance No.21-09). Date: 11/3/2021 Site Address: 16609 SW Darwin Loop Project Polygon at Roshak Ridge Land Use Case or MST2021-00368 Name: Building Permit#: Tax Lot Total Parks $8,017.00 2S107AA22100 #: Lot 221 Amount*: TDT Total TSDC $3,658.00 Amount: N/A Amount*: *The total TSDC amount shown above is the sum of$ 0 for TSDC-Improvement,$386.00 for TSDC- Reimbursement,and $3,272.00 for TSDC-River Terrace,if applicable.. *The total Parks SDC amount shown above is the sum of$6,278.00 for Parks-Improvement,$ 1,739.00 for Parks- Reimbursement,and either$ N/A for Parks-Neighborhood or$ 0 for Parks-Neighborhood River Terrace. This constitutes my request to defer payment of the TDT,TSDC, and Parks SDCs, as provided above, until occupancy. Payment of the TDT,TSDC, and Parks SDCs may be deferred until issuance of the occupancy permit. In requesting this option, I understand that any deferred TDT,TSDC, and Parks SDCs must be paid prior to final inspection or issuance of an occupancy permit. TDT may only be deferred if the TDT is greater than the amount for a single-family residence. I further understand that the amount of TDT due on deferred obligations shall be the amount in effect at the time of issuance of the building permit. For a deferral request to be accepted both the Property Owner and the Developer must sign this request. Property Owner: 6'1n4 ..Aktxe'.c96eli/La Date: 11/4/21 Developer: Om ,.A6w'.A6.9u Date: 11/4/21 Permit Coordinator: ATM oelfrWk Date: 11/3/2021