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Permit
CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2021-00435 Date Issued: 01/25/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107AA22200 Jurisdiction: Tigard Site address: 16615 SW DARWIN LOOP Subdivision: ROSHAK RIDGE Lot: 222 Project: Polygon at Roshak Ridge, Lot 222 Project Description: New detached dwelling. NO FINAL INSP UNTIL DEFERRED SDCs ARE PAID BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 5 First: 978 sf Basement: 842 sf Left: 3 Parking Spaces: 0 Height: 29 Bathrooms: 4 Second: 1333 sf Garage: 416 sf Front: 8 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 3153 sf Value: $436,820.30 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: 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 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: 4 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: 6 201-400 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 3153 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 3 One Hour Fire Rated Eaves PHONE PHONE: 360-695-7700 FAX: Total Fees: $34,865.22 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 Qc9..nn1-nn1 n Thrn,inh f1AR Q59-nn1-noon Vn,,mnv nhtnin 9 nnnw of that nilne nr rliratnt niiatetinne fn rti IAIr by nnllinn cnn 9Z9 10R7 nr I Ann 119 9Zdd Issued By: Ho i(y Va v� De Wee Permittee Signature: O'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 job site at the time of each inspection. Building Permit Application £I&T ' • Residential RECEIVED FOR OFFICE USE ONLY Received/a. n I ' City of Tigard �y Date/Bya/f i ' Permit No.: 1' . 040 5 I • 13125 SW Hall Blvd.,Tigard,OR 97223 SEP 2021Plan Review 1 tv� �J/��7 j„/ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: { (/ Other Per �SGL�-1 ��O T 1 G A R n Inspection Line: 503.639.4175 CITY tOFr TIGARD Date Ready/By: Jy �.— VI See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION otified/Metho • a,. 4 Supplemental Information TYPE OF WORK V 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 ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION 43�1 f2n ® m 1-and 2-family dwelling 0 Comerciallindustrial Valuation: $ J" ❑Accessory building El Multi-familyNumber of bedrooms: 5 ❑Master builder ❑Other: Number of bathrooms: 1 JOB SITE INFORMATION AND LOCATION Total number of floors: 3 1 5Cj(J)5 Job site address: 16615 SW Darwin Loop New dwelling area: 3,153 square feet 133 City/State/ZIP:Sherwood, OR 97140 Garage/carport area: 416 square feet C 7�tJ Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: X square feetis l C. Cross street/directions to job site: Deck area: 147 square feet Other structure area: X square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Polygon at Roshak Ridge Lot no.: 222 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. /Deferrals: ew Construction/Type: SFU /Elevation plan:222503D Valnation: $ YES-deferral of TSDC fees and park SDCs until occupancy. Existing building area: square feet Projected start: 2022 New building area: square feet El 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 ❑ CONTACT PERSON 6)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 703 Broadway St., Ste 510 — - FLS plan review fee(if applicable): Address: 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* 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 City/State/ZIP:Vancouver, WA 98660 $180.00and 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: l: M.42iL.cXC.Qhii.;4469 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: 09/23/2021 *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 A City of Tigard "PlicalTECEIVED Received FOR OFFICE USE ONLY Date/By: Permit No 1.... 5r2oz1....(zel....35. .. '. .. 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503.718.2439 Fax: 503.598.I 960 SEP 2 3 2021 Plan Review Dataly Other Permit: Inspection Line: 503.639.4175 Jur% 2 See ii 2 for Tlii.41‘..1) CITY OF TIGARD ND'ialit7t:ecati5ertilliYod Pai., Internet. 11-ww.tigard-or.2cw Supplemental Informariou BUILDING DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST —Mechanical'perrwt fees*are based on the value of the work I:3 New construction D Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead.and profit. _ Value.S CATEGORY OF CONSTRUCTION RESIDENTIAL EQUMME/NT/SYSTEMS FEES* [2 I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use c.heck/in, __.... Multi-family 1:j Master builder 0 Other: Description Qry. Ea. Total_ Heatinglcooling: JOB SITE INFORMATION AND LOCATION Air conditioning I 46.75 Job site address: 16615 SW Darwin Loop Furnace 100.000 BTU(duos/vents) . 46.75 City/State/ZIP.Tigard,OR 97224 Furnace 100 000t BTU(ductsNents) 1 54,91 Heat pump Suite/bldg./apt.no. Project name: Polygon at Roshak Ridge lill 6731..°612 • Duct work _ Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or h . onic) 23,32 Unit heaters(fuel-type,not electric). in-wall,in-duct,suspended.etc. 46.75 Flue/vent for any of above 23.32 Other. 23.32 Subdivision: Polygon at Roshak Ridge Lot 110..: 222 _____ Other fuel appliances: Tax map/parcel no.: Water beater 23.32 DESCRIPTION OF WORK Gas -.lace/insert !Mil 33.39 Flue vent for water heater or gas New construction,type:Single-Family Units fir..lace 1111 23.32 ____ — Log liehter •as) 23,32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chunneylliner/flue/vean 23.32 Other 23.32 r4 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 Slagle-duct exhaust(bathrooms, City/State/ZIP:Vancouver,WA 98660 1 toilet compartments,utility rooms wi'3.P , Phone:(360)695-7700 Fax.( ) AmeaCrawlsoace fans_ CI APPLICANT D CONTACT PERSON Other __......._ Fuel .i.ino: Business name:Polygon WLH,LLC 514.15 for first four:$4.03 for each additional i Contact name:Tonja Morris , Furnace,etc. 1, _ — Address:703 Broadway St.,Ste 510 1 Gas heat pump 1 W'allIsuspendediunit heater Ciry/State.,ZIP:Vancouver,WA 98660 Water heater _ ... Phone,(360)695-7700 I Fax:.(360)6934442 Fireplace Ranste E-mail:permitsubmittalslayl0fM0ffiS011.COM 1 - Barbecue 'V CONTRACTOR Clothes dryer(Qas) Other: Business name:Pro Heating&Cooling MECHANICAL PERMIT FEES* Address: NW Aiociek Dr,Ste.1104 Subtotal i ' City/State/ZIP:Hillsboro,OR Minimum permit fee(590.00) Plan review(25%of permit fee) Phone:(3601 270-1590 Fax ( ) State surcharge(12%of permit fee) CCB tic.:209001 TOTAL PERMIT FEE 1 - This permit application expires if a permit is not obtained wiiiio-i-80 8ti,a, luftzt_rz, days after it leas been accepted as complete. AllthOr1=1 Simaturc: • Fee mahodology set'bi.i, Tri-Criunry Building Industry Service Board , - Print name:Elia Duran I Date. 10/30/20 1 f lrboilg4....1Prrmstc$145r P.r.nit A.m.NIA,11.4o, Electrical Permit ApplicatioRECEIVED FOR(i•r1-I( r I ,, . '"„ City of Tigard c� Roomed Permit* p 2T202,('00 •13T 114 ■ 13125 SW Ilan Blvd.,Tigard,OR 97223 S E P 2 eJ 2021 I Plan Review 11' . Phone 503.718 2439 Fax 503.598 1.960 UstAv Related Permit e 1.1 D. Inspection line: 503 639 4175 CITY OF TIGARD Ready tarealy pis ' 0 see Page 2 for Internet. www.ugard-orgov ;-".I':' DING DIVISION _1 oiifi lalioe. . sapNeme■m Iarermati» TYPE OF WORK PLAN REVIEW IN New conslr[lction Q Addition/alteration/replacement Please chock all that apply(submit j sets of plans winems checked) { 0 some or feeder 4110 amps at more 0 Building met three notes 0 Demolition Other: where the available fault current CI Marinas nod boatyard. kt CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating bwldmgs ® I-and 2-family dwelling 0 Commerciallindustrial ❑Accessory building lets to gcotmd.,or exceeds 14.0110 0 Commercial-ass agtcuinual El Milli-family ❑Master builder amps Tot all other tnslallahtms butld'n,' ul ❑Other ❑Fire pump 0 lasullmmo of 150 KVA a JOB SITE INFORMATION AND LOCATION ❑Emergency system larger sepoussely dccrved a 0 Addition of sew motor load of >;yarmu. 16615 SW Darwin Loop#: Job site address' 1001TPor more. City/S1ateJZIP: Tigard,OR 97140 0 Six Of more restdeaua]marts occupancy 0 kkakh-care facilttxs. ❑Recreanonal%ruck parks. Suitc/bldgJapt.#: Project name: Polygon at Roshak Ridge ❑tlarardotts iocarirns 0 Supply voltage fur mare than 0 Service or tccdo 600 amps or more 600 colts an.aiaal Cross street/directions to job site: FEE SCHEDULE nsacripYt4 Qey. I tad 1 Tatal 1 • New residential single.or outli-family dwelling anh- Subdivision:Polygon at Roshak Ridge 1 Lot 4: 222 Includes attached garage. 1,000 ry.IL or less 168 54 4 Tax map/parcel#: Es.add'1300 s9.It orportion33 92 i L.,_ DESCRIPTION OF WORK Limited energy,residential75.00 2 (with above sq.ft.)) New cctnstrnctian.Type SFU Limed caugy,multi-family - tesideutial(with above sq.fi_) 75.00 al I"ROTEl2T1 OWNER ❑ TF.1hN'i' Renewable Energy 0 See Pt 2 , Services or feeders installation,alteration,and/or relocation Name: Polygon Homes WLH LLC 200 amps or less 100 70 2 Address: 703 Broadway Si,Ste 710 201 amps to 400 amps 133.56 2 City/State/JP: Vancouver,WA 98660 401 amps to 600 amps 200 34 2 601 amps to 1,000 amps 301 00 2 1 Phone:(360 )946 8674 Fax:( ) Over 1,000 tamps or volts 55226 2 Temporary services or feeders instaUatioo,alteration,auditor Email: OA1amiAbouhafsgtnylormorrison.cvm-PermirSubmittals@¢taylormorristm.com relocation I 1 Owner installation:This installation is being made on property that 1 own which is not 200 amps or less 59.36 I intruded 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 Branch circuits-new alteration,or extension,r er pane!❑ APPIJC�%NT I 0 CONTACT PERSON r A.Fee for[ranch esoctuts with ' Business name: Polygon Homes WI.H UK above service or feetc-r fee, each branchm sash 7"42 - Contact name: Omar Alawi Abouhafs B Fee for branch circuits wrtilma — service or(ceder fee,lust Address: 703 Broadway St.,Ste 710 beaneh circuit 56.Ift 2 City/State/ZIP:Vancouver,WA 98660 Each add'I branch circuit 7.42 2 Phan: 360 )946 8674 Miscellaneous(service or feeder rot included) ( Fax:.( ) Each manufactured or modular 67 84 2 dwelling.service arid/or feeder Email:OAlarniAbouhafsglaylomsornson.com-PcrmitSubirttttalsra;taylnlmorrison.cum icecomtcc,„sly 67 84 2 CONTRA( - Pump or tmgatiter circle 67,84 2 Business nartic: Wallace Electric Sign or outline lighting 67.84 2 Address: 105 Dresden St Signal circud(s)or lvmled-cncrgy '1] See Page 2 panel,alteration,or extcnssm ty Astoria,OR 97103 Each additional inspection over allowable in may of the above 2 City/State/ZIP: �� Additional mspa210n(I hr thin) 66 25/lu• E Phone:(503 3418 0563 Fax:( ) Invcstigat;m(t la min) 90.001 hr Email:llavid va119CCR1re5.00m Industrial plant(1 hr no) 7818Jter Cal Lk.:224868 l rlwcttms for which no lee is 9000+hr Electrical Li-'' C 1441 Sul v_ I : 6363S specifically listed OS to min) ELECTRICAL PERMIT FEES Suprv-Electrician signature.required: Subtotal I Print name:Theft,,z, (,r�yt a J•� Date. i 4 Z 0 Plan Review Required(25%of permit fccy - +�'��"'''�'��? l( State surcharge(12%of permit fee) Authorized cii eat lfe- TOTAL PERMIT I lib: Th-s permit appacahao expires if a permit is not obtained within 180 Print name: c _0 u� Date: L/z t drys after a ban b accepted as comply. � 4Ritf4ff • Humber of inspections allowed per peruut 143wMi'Wcrniii'LLC PcrimApp_ELII ER aloe Rev06'17/2013 1 W615T61/05+C01,11WF_B ' . Plumbing Permit Application_ Building Fixtures RECEIVED FOR OFFICE USE ONLY City of Tigard Received SEP 2 3 2021 Date/3r Permit lslo.,tig1io2(,004-35 .511 .II 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review '• " Phone: 503.718.2439 Fax 503.598.1 Other Permit No: Inspection Line. 503.639.4175 &TY OF TIGARD DatelnY', rn BUILDING DIVIS!ON NDaDttedleditcal.i''Ye'.1.hYo'd: Tr.GAP.D Juns ga See P2ge 2 for Internet: ta-ww.tigard-orgov Supplemental Information TYPE OF WORK FEE* SCHEDULE 12 New construction 0 Demolition For special information use checklist. — Description I Qty. 1 Ea. I Total 0 Addition/alteration/replacement 1:1 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 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ID Accessory building 44-Multi-family . Each additional bath/kitchen 25.02 0 Master builder 12 Other: Fur sprinkler(_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address. 16615 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.. 1 Page 2 Suitertildgiapt.no.: Project name:aaraletelliaaePolygon 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... 222 Fissure or item: Tax map/parcel no.: Backflow preventer 31.27 Back‘vater valve 12.51 DESCRIPTION OF WORK Clothes washes 25.02 New construction,type Single-Family Units Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 I PROPERTY OWNER 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name:Polygon WLH,LLC Floor drain/floor sink/hub 25.02 Address:703 Broadway St.,Ste 510 Garbage disposal 23.02 City/State/ZIP:Vancouver,WA 98660 Hose bib , 25.02 Phone:(360)695-7700 Fax:( ) Ice maker 12.51 ri APPLICANT D CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:5 ) Page 2 Business name:Polygon WLH,LLC Primer 12.51 Contact name:Tonja Morris Roof drain(commercial) 12 51 Address:703 Broadway St.,Ste 510 Sink,basinlavatory 02J City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4.442 Tub/shower/shower pan 12.51 E-mail:permitsubmittals@ipolygonhomes.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:G&B Plumbing&Sons Inc Water piping/DWV 56.29 Address:P.O.Box 92 Other. 25.02 Ciry'State/ZIP:St.Paul,OR 97137 Subtotal Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: 572.50 Plan review (25%of permit fee) CCB Lie.:18-1372 Plumbing Li c.no.:pb634 Authorized signature: li ()-- Cit-4) - State surcharge(12%of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days Print name:Steve Fowler Date: 1 0/30/20 after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. i Suilcbar,Pcnnits'PLARI-PermitApp doe 10,010, 440-4616Ti I 0102`COMIVEH) City of Tigard 1111 COMMUNITY DEVELOPMENT DEPARTMENT 1 T l c u D Building Permit Review — Residential Building Permit #: L(3-2O2) cos Site Address: 16615 SW Darwin Loop Project Name: Polygon at Roshak Ridge Lot #: 222 Planning Review Proposal: New detached dwelling I] Verify address/suite #active in Accela. ® In River Terrace: ❑ No ® Yes, River Terrace Review Addendum Not required per MMD2020-00044 Site Plan Elements: ®Erosion Control ®3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper t11Retained trees with drip line and tree protection measures ]Drawn to scale(standard architect or engineer scale) >F7 Footprint of new structure(including decks)and FFE ®North arrow Utility locations&easements(required for new and additions) Fl Site address,project or subdivision name and lot number k1 Sidewalk/driveway approach ]Applicant information(name and phone number) !Location 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 Existing 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? [JYAs ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Yes ❑No iJ Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ® No Received: ❑ Yes ❑ No J Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: ❑ Yes,applicant was notified ® No Received: ❑ Yes ❑ No SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No E Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified g] No Applied For: ❑ Yes ❑ No,stop intake ® Land Use Case#: SUB2015-00004J Zoning: R-7 ® Required Setbacks: Front: 8 Rear: 10 Side: 3 Street Side: na Garage: 20 ® Building Height Max.Height: N/A Actual Height: 29 I Landscape Area: 20 % © Lot Coverage Max: 80 0/0 Entrance ® Set back no more than 8'from street-facing wall ] Parallel to street or offset 45 degrees or less Windows ® Minimum 12%of area of all street-facing facades F: 13% / R: 21% Garage $] 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. ® Garage door width is ❑ 12'or less X❑ 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 ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony E Visual Clearance ® Urban Forestry Plan ❑X Sensitive Lands: ❑ Yes ® No Type: ® Conditions met prior to issuance of building permit Notes: ® Approved By Planning: i!/S G ,t Date: 9/27/2021 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved 0 Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: O03/20Z.i Site Plans: # 5 Building Plans: # 3 Building Permit#: [Enter building permit#above. Workflow Routing: l 'Planning li'Engineering [ Permit Coordinator Building Workflow Sign-off: E' Sign-off for Planning(include notes from planning review) Route Application Documents: p--Engineering: (1) copy of permit application, (1) site plan, (1)building plan and original plan review routing form. Cl7/Building: original permit application,site plans,building plans, engineer and beam calculations and st details,if applicable,etc. Notes: By Permit Technician: Date: P813d,2/ En ineering Review r Slope at building pad: LVConditions"Met"prior to issua ce of building permit ['Easements (encroachments)per engineering conditions of approval and plat 2:1/ ater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ( No Assess Water Quantity Fee in-lieu: ❑ Yes ['No LIDA Facility on lot ❑ Yes P'No [2/Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: (Approved by Engineering: . Date: l Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review I�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: CI Received Does not apply /7f SDC Fees Entered: Wash Co Trans Dev Tax: / Yes ❑ N/A Tigard Trans SDC: 7(Yes ❑ N/A See for Y\ Parks SDC: )2i(Yes ❑ N/A LIDA ❑ Yes X N/A OK to Issue Permit Approved by Permit Coordinator: 40/‘ Date: 101' 12l I:\Building\Forms\Bl dgPermitRvw_RES_122419.docx City of Tigard Deferral Until Occupancy Request T l G A R D 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: 16615 SW Darwin Loop Project Polygon at Roshak Ridge Land Use Case or MST2021-00435 Name: Building Permit#: Tax Lot Total Parks 2S107AA22200 $8,017.00 #: Lot 222 Amount*: TDT Total TSDC $3,658.00 A Amount: N/A mount*: *The total TSDC amount shown above is the sum of$ 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: Dota .Want.c46o. t_. Date: 11/4/21 v Developer: Dom-.c41etyiro.46ezl Date: 11/4/21 Permit Coordinator: I/ '1 Date: 11/3/2021 0