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Permit
---IFEIVED Plumbing Permit ApplicatiO CEVED Building Fixtures FEB 2 2022 Km Ohl ii E. I Sl: ONI l City of Tigard �pr nn ppt�yy Received n Permit No.: MST2021-00413 is 13125 SW Hall Blvd.,Tigard,OR 9'�d I IV7/1f1L Date/By: 2 l�Z ,, Plan Review J III C Phone: 503.718.2439 Fax: 503.5 BIN DIVISION Date/By: .�/1i '�a- Other Permit No.: Inspection Line: 503.639.4175 Date Ready/By:7 uric: RI See Page 2 for 1 i.''A 11 l) Internet` www.tl aid-or. oV g g g Notified/Meth .22 Supplemental Information '''‘NV ?: :' ew construction ❑Demolition For special information use checklist. Description 1 Qty. . Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) i � z .- + o�o!fi , �' _ SFR(1)bath 312.70 -and 2-family dwelling IDCommercial/industrial SFR(2)bath 437.78 El Accessory buildingSFR(3)bath 500.32 ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other 1228 Fire sprinkler( sq.ft.) ✓ Page 2 t t Site utilities: Job site address: 16611 SW Botany Bay Ln. Catch basin or area drain 18.76 Ci /State/ZIP: Drywell,leach line,or trench drain 18.76 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.:1198(ADU) Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 _ , `` 4 Backwater valve 12.51 f tiK gam - ,,,.r, ' ... ,, Clothes washer 25.02 MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 2 OWN R '` .41n - Expansion tank 12.515 �.rr r Taylor Morrison Fixture/sewer cap 25.02 Name: y 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: 816-7805( 360) Fax ( ) Ice maker 12.51 Interceptor/grease trap 25.02 Business name: Alliance Plumbing, LLC Medical gas(value:$ ) Page 2 Contact name: Gavin Thomes 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 Phone:(503 )492-3490 Fax::(503 )912-6438 Tub/shower/shower pan 12.51 E-mail: gavin@allianceplumbing.net Urinal 25.02 �,�r1 � 7 Water closet 25.02 ° ' . 4 Water heater 37.52 Business name: Alliance Plumbing,LLC Water piping/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 Plan review (25%of permit fee) CCB Lic.: 184601 Plumbing Lic.no.: PB732 State surcharge(12%of permit fee) Authorized signature:Hannah Thomas +u , m.,..s Date.202201271620.-W TOTAL PERMIT FEE Print name: Hannah Thomas 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\PLMU-Peru utApp.do. 10/01/09 440-4616T(10/02/COM/WEB) „ CITY OF TIGARD MASTER PERMIT I� COMMUNITY DEVELOPMENT Permit#: MST2021 00413 T f G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/09/2022 Parcel: 2S107AA19800 Jurisdiction: Tigard Site address: 16611 SW BOTANY BAY LN Subdivision: ROSHAK RIDGE Lot: 198 Project: Polygon at Roshak Ridge, Lot 198 ADU Project Description: New attached ADU. NO FINAL INSP UNTIL DEFERRED SDCs PAID. BUILDING Floor Areas Required Setbacks Required Stones: 1 Bedrooms: 3 First: 1228 sf Basement: 0 sf Left: 3 Parking Spaces. 0 Height: 25 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 Drywell-Trench Drain: 0 Other Fixtures: 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 Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea addl 500 sf: 2 201-400 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 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 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 One Hour Fire Rated Eaves 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 oc9-nM-nni n fhrniinh nAR QS9-nM-nnon vnii mw nhfofn n nnnv of 1ho rn i nr dironf nilcef{nnc In ni iMC h,, - IIfnn Aryl 9'39 10A7 nr I Ann 139 9'1A2 Issued By: Ho{l y Vav�Pe- 1nlege Permittee Signature: 0l - 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. Building Permit Application RECEIVED Residential FOR OFFICE USE ONI.A City of Tigard SEP 1 7 2421 Received A W2 I i -'J`^7 (�/ '/ (�(/ V Permit No.: S I .Z N--dO{1 3 111 13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGARU Plan Review ✓ Phone: 503.718.2439 Fax: 503.598.1960 y Afie Other Permit T 16�.R 1> Inspection Line: 503.639.4175 pLANNING/ENGINEE1 eady/I`: ? Clt � 69 See Page 2 for Internet: www.tigard-or.gov �tified/Metho. C 1/ ( {i' Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING El 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 CATEGORY OF CONSTRUCTION work indicated on this application. t„� ❑ 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ \1 t y Z ❑Accessory building 0 Multi-family Number of bedrooms: 3 ❑Master builder ®Other: ADU Number of bathrooms:2 JOB SITE INFORMATION AND LOCATION Total number of floors:1 ' ()J Job site address: 16611 SW BOTANY BAY LN New dwelling area: 1228 square feet City/State/ZIP:Sherwood,OR 97140 Garage/carport area:''2,.�quare feet Suite/bldg./apt.no.: Project name:Polyc Roshak Ridge 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.: 198 Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. SFU:New home construction Elevation:221100BR/221000BR Duplex Valuation: $ Type:Duplex_Projected Start:February 2022 Existing building area: square feet Deferrals:Please defer payment of transportation&park SDCs until occupancy. 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: El APPLICANT 0 CONTACT PERSON U9 BUILDING PERMIT FEES* Business name:Polygon Homes WLH LLC (Please refer lo fee schedule) 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::( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: 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: (. he .4kaltdb.460 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 Print name:Omar Alami Abouhafs Date: 09/20/2021 Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit ApplicatiollRE,'EIv� FOR OFFICE USE,ONLY , Received City of Tigard Date/By! Permit No. /I5 fii.07, _An I '! 13125 SW Hall Blvd.,Tigard,OR 97223 rf rl�, Pl,o Review T _ Phone: 503.718.2439 Fax: 503.598.1960SEP1 L U Datt,73y; Other Pcrnuc k I trA It l i Inspection Line: 503.639.4175 Date Ready/By' huis 0 See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD N066,00dhod Supplemental Information PLANNING/ENGINEERING -- _ _ "" TYPE OF WORK COMLMERCLAL 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)ot`all 0 Demolition Q Other: mechanical materials,equipment,labor,overhead,and profit. Value:S CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES' 0 I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building _ For special information use checklist. I j Multi-family ❑Master builder 0 Other: ADU Description Qty. Ea. YT Total JOB SITE INFORMATION AND LOCATION Heating/cooling: ^^^ _ Job site address: 16611 SW BOTANY BAY LN Air conditioning 1 46.75 Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000e 13TU(ducts/vents) 54.91_ _ Suiterbldg./apt.no.: Project name: Polygon at Roshak Ridge Heat pump 61,06 - Duct work __ 23.32 Cross street/directions to job site: ydronic 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.: 198 Other 23.32 — ___ Other fuel appliances: Tax map/parcel no.: Water beater 23.32 1 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 ® PROPERTY OWNER ❑ TENANT Other 23.32 -- - Environmental exhaust and ventilation: Name:Polygon WLFI,LLC Range hood/other kitchen I ----- 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 it APPLICANT 0 CONTACT PERSON Other: 23.32 _ Business name:Polygon WLH,LLC Fuel piping: _ __ S14.15 for first four;$4.03 for each additional Contact name:Tonja Morris Furnace,etc. Address:703 Broadway St-,Ste 510 Gras heat pump Wall/suspended/unit heater ) City/State/ZIP:Vancouver,WA 98660 Water heater_ __ Phone:(360)695-7700 rFax::(360)693-4442 Fireplace Range E-mail:permitsubmittals taylormorrison.com Barbecue CONTRACTOR Clothes dryer(gas) Business name:Pro Heating&Cooling Other: MECHANICAL PERMIT FEES' Address: NW Aloclek Dr,Ste.1104 Subtotal City/State/ZIP:Hillsboro,OR Minimum permit fee(590.00) 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 ,7 A_L I J a ^ � days after it has bees accepted as complete. Authorized signature: t�C - Per methodology set by Tri-County Building Industry Service Board Print name:Elia Duran Date: 10/30/20 r,,„„,r„o,pr,.,„ ., p.,...a4n..ram,z,in, d ;inn✓sew-,_4,„,......„,„#!..,.„„,...ft.."tN,...tf/tN.„,,,,,..lr �.ew..wn.:.w�uu+ubarsebsi u. RECEIVED Electrical Permit Application SEP 1 7 i ui, til•i.il 1 I SI u•I ti City of Tigard Received Permit b INi u 13125 SW Hall Blvd,Tigard,OR 97223 �/OFT t.• 11 ' '�! a Phone 503 718.2439 Fax. 503 598.1960 Cl l d 'ING Related Permit 7 i 1 L Inspection Line 503.639 4175 Pit% NING/ l5l y- funs. 0 See Page 2 for Internet: www.tigard-or.gov Notifed/Metlnd, Supplemental Informaties TYPE OF WORK _ PLAN REVIEW - ®New construction 0 Addition/alteration/replacement Please cheek all Mai apply(submit 1 sets of pines w/isms checked) ❑Demolition0 Other: So rice or feeder 400 amps ow more 0 Budding over three stones CATEGORY OF CONSTRUCTION exceed `ec avail fault cuneat 0 Menu o and boatyards amps at 130 volts or 0 Floating build,nly. 0 I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building lesv to wound,or exceeds 14,0 00 0 Comme, al-,r,c agnculwral ❑Multi-family ❑Master builder ADU for all rnha,maau,mons build s ®(.hhCr. ❑Fire PAP ❑bandWion of 150 KVA Of JOB SITE INFORMATION AND LOCATION °Emergency system. laws separately derived Job#: Job site address:16611 SW BOTANY BAY LN ❑Aamtr a of new motorload of Fyrtino. 1001IP or more. Q"A',")•;-.'•1-2'°."1-3", City/StateIZIP: Tigard,OR 97140 ❑sax or Marc residential units occupancy .. ..._._ ❑Hcaltb-cace facilities ❑Recreational vehicle parka Suite/hi dgiapt.#: Project name: Polygon at Roshak Ridge ❑tda ardous locat„a,.h 0 Supply voltage for mare than ❑Service or feeder 600 amps or more 600 volts notmnai. Cross street/directions to job site: FEI SCHEDULE nangties _ -1 Qb cash [ Total I • New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: 198 Includes attached garage. Tax map/parcel#: 1,000 q ft.err less 1 68 54 4 En add'l 500 sq n.or portion 33 92 1 DESCRIPTION OF WORK Limited energy,residential th above tl 75.00 2 New construction.Type S I ( ) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy ❑See Page 2 ® PROPERTY OWNER © 7F,NAN I' Services or feeders installation,alteration,and/or relocation Name: Polygon Homes WLH LLC 200 amps or less lOD.70 2 2 Address: 703 Broadway St.,Ste 710 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200 34 2 CityfStatefZrP: 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 Temporary services or faders installation,alteration,and/or Email: OAlatniAbouhafsgtaylofmorrison.corn-PennitSubmittals@taylormarrison_com relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 5936 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps tn400 amps 125 08 2 Owner signature: Date: 401 amps to 599 amps 168 54 2 ❑ APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel Business name: PolygonA.Pee far branch eumuts with Homes WI.11 LLC above service or locales foe, 7 42 each branch circuit Contact name: Omar Aland Abouhafa B Fee for branch circuits without Address. 703 Broadway St.,Ste 710 bra brancha nrb ice circuitull f tee,first 56 18 2 e _ City/State/ZIP:Vancouver,WA 98660 Each add't branch circuit 7 42 2 Phone: 360 94b 8674 Miscellaneous(service or feeder not included) ( ) Fax::( ) Each manufactured or modular 67 84 2 Email:OA1amiAbouhafs@taylom1orrison.com-PermitSubmittals@taylnrmorrison-corn dwelling,aer.lce a av x feeder Reconnect only 67 84 2, CONTRACTOR Pump or irrigation circle _ 67 84 2 Business name: Wallace Electric Sign or outline lighting 67 84 2 - -'- -- signal crreuet(s)or limited-energy ( Address: 105 Dresden St panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: Astoria OR 97103 Each additional inspection over allowable in any of the above Additional inspection(I ht min) 66 25/hr Phone (503 3(08 0563 Nutt tt( ) Investigation(1 hr men) 90 00/ht - Industrial plant(1 hr min) 78 18/hr Frnail: llevid@wallacCwires.com • Inspections for which no tee IS 90 00/hr CCB Lie.:224868 Electrical Li''C1441^ Su .I, .• 6363S specifically listed OS hr min) ELECTRICAL:PERMIT FEES Suprv.Electrician signature,required: a".....,„...--- Subtotal Printflame:779t1 s4p, c Date: J,/L/�t ____0_ Plan Review Required(25%of permit fee) e ! State surcharge(12%of permit fee) Authorized signature T CTIAL PERMIT FEE: This pennit application expires if a remit is aol obtained within 190 Print name: ,fir Date: days after It ban been*eclipsed d as complete. ...._..........._---�..gi.'W' 7•� a Number of inspections allowed per permit. 1.+8wlchn nutauTd t:_PcnntApp El.a ERE doe Rev 0517/2015 �/OSFCOM/WER „ - - , , Plumnin2 Permit Application R • ;Building Fixtures Fox OFFICE USE ONLY City of Tigard II S:Polal 2021 Pc-il"-fillS17-0 2(-OM 13 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review _. ' I Phone: 503.718.2439 Fax: 503.598.1960 CI ORTIGARD Other Permit No.: Inspection Line: 503.639.4175 TIGARD PLANNI OMMERING Jari,, ei Sec Page 2 for Internet: www.ligard-or.gov Supplemental Information TYPE OF WORK FEE* SCHEDULE IS New construction 0 Demolition For special information use checklist. Description I Qty. I Ea. I Total 0 Addition/alteration/replacement Ej Other: New 1-2-family dwellings(includes 100 ft fur each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ctl-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 0 Accessory building 41FMulti-family Each additional bath/kitchen 25.02 0 Master builder X 0 Other: ADU Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 16611 SW BOTANY BAY LN 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:allosiMagaPolygon 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.: 198 Fixture or item: Tax map/parcel no.: Backflow proventcr 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 New construction SFU Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 1.1 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 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone:(360)695-7700 Fax:( ) Ice maker 12.51 EI APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:S ) 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/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 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 City/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.:184372 Plumbing Lie.no.:pb634 --- - - State surcharee(12%of pennit feel Authorized signature: TOTAL PERMIT FEE This permit application expires If a permit is not obtained within IN days Print name:Steve Fowler Date: 1 0/30/20 after it has been accepted as complete. "Fee methodology set by Tn-County Building Industry Service Board, 1:14ukling,PercruiskPLMU-Perm(tApp doc 10101:04 440-461AT(I 0(02(ComigrE B) W City of Tigard RECEIVED 11/11 p COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Building Permit Review — Residential SEF 1 C nAvU QF TIGARD II s Z �Ci ? PLAN G/EN(31NEERINt3 Building Permit #: ,v � ( � ,J Site Address: 1bk I( £ yr / Project Name: g r� c k a l Lot #: I " d t Planning Revie Proposal: -kckk kW Verify address/suite#active in Accela. J In River Terrace: ❑ No /2 Yes,River Terrace Review Addendum Site Plan Elements: C+ rosion Control is33 copies of site plan on 8-1/2"x 11"or 11 x 17"paper Witetained trees with drip line and tree protection measures F1Drawn to scale(standard architect or engineer scale) R Footprint of new structure(including decks)and FFE North arrow Utility locations&easements(required for new and additions) ASite address,project or subdivision name and lot number Sidewalk/driveway approach [Applicant information(name and phone number) ' Lot dimensions and building setback dimensions eistreet tree size,type and location loStreet names ❑1~s""ng.„1-,,`,-,,,—,^*' .ite Comer 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? RbYes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? [ Yes ❑No ® Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified No No Received: ❑ Yes ❑ No p Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: ?3' Yes,applicant was notified ❑ No Received: ?'.E Yes ❑ No SDC Exemption for ADU applied for: tii Yes ❑ No Received: ,P Yes ❑ No [ia Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicantca� was notified ,ea No Applied For: ❑ Yes ❑ No,stop intake Rk Land Use Case#: 4-1?U 7.A2-1 —6000 4 //��I Zoning: K.—7 I� Required Setbacks: Front: t Rear: to I Side: Street Side: r qZ Garage: 20 E' Building Height: Max. Height: i/4 Actual i : 2-6 t Landscape Area: % % p � ❑ Lot Coverage Max: Entrance iv Set back no more than 8'from street-facing wall eig)Parallel to street or offset 45 degrees or less 1 Windows ai Minimum 12%of area of all street-facing facades Garage DGarage door is behind widest street-facing wall ❑ Yes (lN) No,one of the following is met: 1 Zo 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. tR Garage door width is ❑ 12'or less ❑ 50%or less of facade .@1 60%or less and includes 7 of following: law Covered porch ❑ Recessed entrance f Wall offset eiD1'Roof eave WRoof offset ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch 2 Gable,hip,or gambrel roof Dormer ❑ Accent siding filo Window trim ❑ Window recess ❑ Window projection ❑ Balcony io Visual Clearance 4 Urban Forestry Plan 'Sensitive Lands: ❑ Yes No Type: Conditions met prior to issuance of building permit Notes: pApproved By Planning: Date: ` / ,_I_Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: 0 Approved 0 Not Approved I:\Building\Forms\BldgPennitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: 4/r"/7 Site Plans: # Building Plans: # 'f Building Permit#: [ Enter building permit# above. Workflow Routing: I Planning © Engineering Permit Coordinator lk 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. I] Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: Engineering Review Slope at building pad: /4 O 7/Conditions "Met"prior to issuance of building permit Easements (encroachments)per engineering conditions of approval and plat V Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes /No Assess Water Quantity Fee in-lieu: ❑ Yes [CVNo LIDA Facility on lot: ❑ Yes No fli4inal Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: Date: f12e/2/ Revisions (after Building Submittal only) Reviewer !Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review Conditions "Met"prior to issuance of building permit LI 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: re Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA ❑ Yes /I N/A OK to Issue Permit Approved by Permit Coordinator: Date: IO 5 L 20 2 I:\Building\Forms\B1dgPermitRvw_RES_122419.docx RECEIVED City of Tigard SEP a1 q COMMUNITY DEVELOPMENT DEPARTMENT CITY OF TIGARD C PI ANNING/ENGIN ERING River Terrace BuildingPermit Review Addendum TIGARD Building Permit #: 451-2 2A 110 (3 Site Address: v (N f Vc1 tf/I Project Name: �Q q AA,a Lot #: L (New dw its =subdivision name;Addition or Alteration=last na e of owner) •ning Review of River Terrace Plan District Design Standards (18.640.070.L): Is the p .'ect subject to the plan district design standards? ❑ Yes ❑ No 4pv Z- 5 _ —( 90 }c 1.Articulatio • a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional element require. or lots with over 60 ft. of street frontage shall be provided every 30 ft. Porch min. 5 ft. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dor . r ft. deep min.2ft., 5 ft.wide min.2 ft.,6ft.wide ❑ ❑ ❑ ❑ ❑ 2. Eyes on the street: a minim . of 12%of each street facing facade must include windows or -• ance doors. Percentage Shown: 3.Entrances:At least one entrance mu meet both of the following standards: fa. ng wall ❑ Parallel to street,a.' e no more than 45° from street, ❑ Max. 8 ft, setback from longest street- or open onto pore. Entrance opens to a porch: ❑ Yes ❑ No If yes,all the following apply: ❑ 25 sq.ft in. ❑ One street facing entry ❑ 12 .max. roof above floor of porch ❑ 5 ft. depth min. ❑ ,1%min.porch roof coverage 4. Detailed Design:All buildings shall include a min. of .+- of the following elements on all street-facing facades: ❑ Covered porch min. 5 ft.wide x 5 ft. deep \\ Recessed entry area min. 5 ft.wide x 2 ft. deep ❑ Wall offset min. 16 inches ❑ Dormer min.4 ft.wide ❑ Roof eave min. 12 inch projection ❑ Roo offset min. of 2 ft. ❑ Roof shingles either tile or wood ❑ Gable, .ip or gambrel roof design ❑ Roof pitch oriented south min. 500 .. ft. ❑ Horizont. lap siding min. 3-7 inches wide ❑ Accent siding min. 40%of street 'acade ❑ Window tri .2 1/2"wide by 5/8"deep ❑ Window recess min.3 inches .r all street facing ❑ Bay window mi 5 ft.wide by 2 ft. deep ❑ Balcony min. 5 ft.wide x t. deep with inside access ❑ Attached garage is %or less of street facade 5. Garages and Carp. s:May face the front or side lot line on a corner lot. Setbacks: No closer to fro. or side lot line,than longest street-facing wall. ❑ Yes ❑ No. If No (Chet' .ne): ❑ May exte.• up to 5 ft.if there is a covered front porch and garage does not extend beyond the . ont porch. ❑ May - end up to 5 ft.where the garage is part of a two-story building and there is a window at th- econd story above t e garage that faces the street with a min. area of 12 sq.ft. Width: (Check one) ❑ 12-foot-wide garage door ❑ 40%max. of street facade ❑ 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: ,c.p ` Date: I:\Building\Fonns\BldgPern itRvw_RES_RT_121417.docx �- City of Tigard 14 'I Deferral Until Occupancy Request T I G A.RD Washington County Transportation Development Tax (TDT),Transportation and Parks System Development Charges (SD Cs) ,Y'x.TlAN}Y}, 14106m*rdu:JRB'AtlY riMacetrAWAWSWIted0i4A(RM040141046fi ..s rYJd6MilErNOW .:. AMV1,00,AWMINRAWAMY AMMO p-."';:..t r •,, 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: 16611 SW BOTANY BAY LANE Project Land Use Case or Polygon at Roshak Ridge MST2021-00413 Name: Building Permit#: Tax Lot Total Parks 2S107AA19800 5 #: Lot 198 Amount*: $ ,839.00 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 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: Dtvcar-.A&aine: 4'6ea Date: 10/05/21 Developer: Dmaz 4&41u.46eci4- Date: 10/05/21 Permit Coordinator: ik,a1VA Oelfrteirb Date: 10/4/2021