Permit CITY OF TIGARD MASTER PERMIT
' ' ' COMMUNITY DEVELOPMENT Permit#: MST2021-00367
Date Issued: 03/21/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 107AA18500
Jurisdiction: Tigard
Site address: 16701 SW DARWIN LOOP
Subdivision: ROSHAK RIDGE Lot: 185
Project: Polygon at Roshak Ridge, Lot 185
Project Description: New detached dwelling. NO FINAL INSP UNTIL DEFERRED SDCs PAID.
BUILDING
Floor Areas Required Setbacks Required
Stones: 3 Bedrooms: 5 First: 1238 sf Basement: 763 sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 4 Second: 1718 sf Garage: 486 sf Front: 8 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 3719 sf Value: $513,831.02 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
Drywell-Trench Drain: 0 Other Fixtures: 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'I 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 3719
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 Geo Tech Report Required
VANCOUVER,WA 98660 VANCOUVER,WA 98660 Prior To Pour
2 Ersn Cntrl 503-639-4175
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $40,513.77
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
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Issued By: ?/ -'V� V 1 1 Permittee Signature: a pi,1W.01.1
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 Applica7 ,+ ��- IZP
ResidentialCEI V E� FOR OFFICE USE ONLY
City of Tigard AUG 16 2021 Received (�
' Date/By: 6 let Permit No
n MsT2e?.l -t:X� rG7
,1 . 13125 SW Hall Blvd.,Tigard,OR 97223• Phone: 503.718.2439 Fax: 503.59 t 6�OF TIGARD Date/By:PlanReview i/fi8 V Date A* other Pe J12 74 24—p0 Z 3f
IIGARI) Inspection Line: 503.639.4175 BUILDING DIVISION DRdy/By: r f' HI See Page 2 for
Internet: www.tigard-or.gov etified/Method: l 141 „ A Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction 0 Demolition Permit fees*are based on the value of the work perfonned.
Indicate the value(rounded to the nearest dollar)of all
II 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.Valuation: $ 513 Z
®1-and 2-family dwelling 0 Commercial/industrial
, 3l .>�
$
El Accessory buildingNumber of bedrooms:
❑Multi-family
❑Master builder ❑Other: Number of bathrooms: 4
JOB SITE INFORMATION AND LOCATION Total number of floors: 3 Li;OS
Job site address: 16701 SW DARWIN LOOP New dwelling area: 3,719 square feet 1'7/U
City/State/ZIP:Sherwood, OR 97140 Garage/carport area: 486 square feet '013
I) Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: square feet 'IA
Cross street/directions to job site: Deck area: l i '1/4square feet
Other structure area: Nts1,2%.... square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Polygon at Roshak Ridge Lot no.: 185 Permit fees*are based on the value of the work performed.
I 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.
is New Construction/Type: SFU /Elevation plan: 222803D Valuation: $
Deferrals:YES-deferral of TSDC fees&park SDCs until occupancy. Existing building area: square feet
/
Projected start: 2022 New building area: square feet
I ® 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 U9 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
FLS plan review fee(if applicable):
Address:703 Broadway St., Ste 510
-
Total fees due upon application:
City/State/ZIP:Vancouver,WA 98660
Amount received:
j Phone:(360)946-8674 Fax::( )360 693-4442
E-mail: petmitsubmittals@taylormorrison.com-OAlamiAbouhafs@taylormorrison.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
1 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: OPPY.4 /1.4 469Geitid. This permit application expires if a permit is not obtained
1 within 180 days after it has been accepted as complete.
Print name:Omar Alami Abouhafs Date: 08/13/2021 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Mechanical Permit ApplicatiO�p. ����`��
City of Tigard M Vied
1 Date/By: Pcim„Nt4„za�..0
13125 SW Hall Blvd.,Tigard,OR 97223 Giro
Phone: 503.718.2439 Fax: 503.598.1960 AUG 1 6 2021 Plan Review
' I! Inspection Line: 503.639.4175 Date By: Other Permit:
tltiAltlS g CITY OF TIGARG Dale Ready,By' turfs el See Page 2 for
Internet www.Cigard-or. ov otified/Methad.
BUILDING
DIVIS'U�)j Supplemental Information T
I; TYPE OF WORK `41 'V L1 V Q L� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
i Value:S
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
I j Multi-family ❑Master builder ❑Other: Description
Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditionin' 46.75
Job site address: 16701 SW DARWIN LOOP Furnace 100.000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000t BTU(ducts/vents) 54.91
Suite/bldg,./apt.no.: Project name: Polygon at Roshak Ridge Heat pump ___ _ 61.06
Duct work 23.32
Cross streeUdirections to job site: Aydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
..____._W in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Polygon at Roshak Ridge Lot no.:
185 _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/insett _ 2332
Chimney/liner/flue/vent 23.32
® PROPERTY OWNEROther: 23.32
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,utitity_rooms) 23.32
Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32
►'2 APPLICANT ❑ CONTACT PERSON Other: 123.32
Business name:Polygon WLH,LLC Fuel piping:
S14.15 for first four;$4.03 for each additional
Contact name: Omar Alami Abouhafs Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump111111
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Range
E-mail.permitsuhmittalsi taylOrmOrriSOrl.COm Barbecue
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($90.00)
Plan review(25%of permit fee)
Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee)
CCB lie.:209001 TOTAL PERMIT FEE
___ T'his permit application expires if a permit is not obtained within 180
�,I 1)64-Pcn ..�Z. days after it has been accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date: 10/30/20
r-trinilAinn\Pnm40"^$4..m.r 5nn 110111 An.
Electrical Permit Application r..fj, rOR o1F•i(1 USU.ONl l
I City of Tigard BEC 6,..1 Removed _
Permit a .� // r� ,
• 13125 SW Ilal}Blvd.,Tigard,OR 97223 , r�auiBv S'"f 1 L'<�' a)?-r t6r--�-.
1 it, p'f flan Review Related Permit t:
Phone: 503.71$2439 Fax SO:lS98I960 :tUG 2�21 1)aturly
T 1 L.1 R I) 1nspvctlon Line' 503 b39 4175 Ready 1)atefny. rubs: 21 See Page 2 for
Internet: wwww.ugard-or.gov F TIUARD Nnttficd Mcdaod.
'' � n Supplemental Inforreabon
TYPE OFWOI '' PLAN REVW%
[ csiNew construction ❑Addition/alteration/replacement Please check all that apply(submit a sets of plans wlitems checked)
0 Demolition Other: service or feeder 400 amps to inure El Budding over three stones
-^— where the mailable fault current ❑Marinas and boatyards
CATEGORY' OF CONSfRI;("l io N exceeds 10,000 amps at 150 volts Of ❑kloattng buildings
• ® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building kin to grad,or exceeds 14•000 ❑Commercial.nse agricultural
�-•� Snips for all other installations bialdmls
❑ Multi-family ❑Master builder
a Other ❑Fire pump la Installation of 150 KVA or
JOB.SITE INFORMATION AND LOCATION ❑Emergency system larger separately derived
Job#: Job site address:16701 SW DARWIN LOOP El Addition 100I[P y n r more.ore.motor l x d of system.
❑"A","iv""1 Z"°'1-3",
City/State/ZIP: Tigard,OR 97140 ❑Six or more residential units occupancy.
'—' ❑Healthcare facilities. ❑Recreational vehicle parks.Suite/bldg.apt.#: r Project name: Polygon at Roshak Ridge El Hazardous locations 0 Supply voltage for more than
0 Service or feeder 600 amps or more 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
nrscrrption 1 Ots. 1 Each I Total I `
i New residential stogie•or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: 185 Includes attached garage.
Tax map/parcel#: 1,006 sq It.or less 168 54 4
F.a.add'1500 sq.It.or portion 33 92 1
DESCRIPTION OF WORK Limited energy,residcvtml
New construction.Type SF[J (with above sq ft.) 75.00 2
Limited energy,multi-family 75.Oo 2
residential(with above sq.ft)
Renewable Energy 0 See Patio 2
ID PROPERTY OWNER I 0 TF.NAN`I' _ Services or feeders installation,alteration,andlor relocation
Name: Polygon Homes W LH LLC 200 amps or less 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 amps to 1,000 amps 301 04 2
Phone:(360 )946 8674 Fax:( ) over 1,000 amps or volts ^552.26 2
Email: OAlamiAbouhafs@taylormorrison.con-PermitSubmittal to'lormorrison.com Temporary services or feeders installation,alteration,andEur
y relocation
Owner installation:This installation is being made on property that T 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
❑ APPI.IC tNT I ❑ 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 foods.lee, 7.42
each branch circuit --
Contact name: Omar Alarm Abouhafs B.Fee for branch circuits without
Address: 703 Broadway St.,Ste 710 service or fearer fee,first 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Each add'I branch circuit 7.42 2
Phone: 360 946 8674Miscellaneous(service or feeder not included)
) Fax::( ) Each manufactured or modular 67 84 2
Email:OAlamiAbouhafs@taylormorrison.com-PcrmitSubmittal. td lnrmorrison-con dwelling,settee arx►ror feeder
Y Reconnect only 67 84 2
CONTRA("I OR Pump or irrigation circle 67 84 2
Business name: Wallace F.lectric Sign or outline lighting 67.84 2
Address: 105 Dresden St Signal circmt(s)or irtrutod energy ID Ste Page 2 2
panel,alteration,or extension.
City/State/ZIP: Astoria OR 97103 Each additional inspection over allowable in any of the above
Additional inspection(I hr mm) 66 25/hr
Phone:(503 368 0563 Fax:( ) Investigation(1 hr min) 90.o tilt hr
Email: Davidf wallaccwires.com industrial plant(I hr min) 7$181 hr
Inspections for which no fee is
CCIl Lin.:224868 Electrical Li•• C 1441 L Su v.I. .: 6363S specifically listed(%ht min) 40.o0F hr
v ELECTRICAL PERMIT FEES '
Supra.Electrician signature,required: Subtotal- _
Print name:D. tip t Date: y/fit / i 0 Plan Review Required(25%of permit fee):
`�= 1 [ State surcharge(1291i of permit fee)
•
Authorized sii,�maiure TOTAL PERMIT FF1
- [ Tints permit application expires if a permit is not obtained within ISO
Print tame: �� Date: f f/ I?1 __ daps after it has been accepted as complete.
�-�y'� (kr( a Number of inspections allowed per permit
I.41imlding,'t'erait 4:Lt:PsrsnttApp_ELR ERt.dcc Rev06'11/201i 4 a-4615r(al/05,COWWT.2
Plumbing Permit Application Building Fixtures RECEIVE r FOR OFFICE USE ONLY
I- City of Tigard ��� �' '�� � Received
't 13125 SW Halla Blvd.,Tigard,OR 97223 Date/By: Permit Noll 5-fifyi/-i���7
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 I Other Permit No.:
1 Inspection Line: 503.639.4175 �,ITY IJF TtGARD DateJRe
TIGARD ` � 1�ISI ate Ready/By: mcu, 8 See Page 2 for
Internet www.tigard-)r.gtty UlLullNU-' Notified A4ethod: Supplemental Information
( TYPE OF WORK FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist
-- Description 1 Qty. 1 Ea. J Total _
0 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
►! t-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
11 ❑Accessory building V-Multi-family 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: 16701 SW DARWIN LOOP Catch basin or area dram 18.76
City/State/ZIP:Tigard,OR 97224 Drywall,leach line,or trench drain 18.76
i --- --- - - Footing drain(no.linear ft.: ) Page 2
Suite/bIdg./apt.no.: Project name:4itookoli•liiiiitiertPolygon 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
i
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Polygon at Roshak Ridge Lot no.: 185
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 SFU
Dishwasher 25.02
Drinking fountain 25.02 i
Ejectors/sump 25.02
-
is PROPERTY OWNER ElTENANT Expansion tank 12.51
Name:Polygon WL11,I.LC Fixturc'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:( ) Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptodgrease trap 25.02
Business name:Polygon WLH,LLC Medical gas(value:$ } Page 2
Primer 12,51
Contact name: Omar Alami Abouhafs
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:permitsubmittats@polygonhomes.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:G&B Plumbing&Sons Inc Pto Water ip g%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
CCH Lie.:184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: w y`'`- TOTAL PERMIT FEE
f Print name:Steve Fowler 1 Date: 1 0/30/20 This permit application expires if a permit is not obtained within ISO days
after it has been accepted as complete.
*Fee methodology set by Tri•County Building Industry Service Board.
i'\Building\Permits.Pt.MU-PennitApp doe I5/01,09 440-4616T(WWI/COW-Wtt l
,
i
City of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT
` C '
r1cAxD Building Permit Review — Residential
0, Kninflu ± tattigiflogini5#mifti4t!ffi(tim€d9 ikaZJ2R'2 r; o,..,t;.:i s t.[r f sa n, t.to 4 44:'4 a '11SPMtilitSltk9IN:AIWitigni ... .,•...: ,v,r 44434+t AWEVAMMANValg
Building Permit #: /'7 S rZd 2/ - 0034 7
Site Address: /6:30/ c ) PW 7l L
Project Name: POIy - J / - 'I< -(DEC Lot #: 1?S
Planning Review
Prop al: N C U,S 6 `
IIPVerify address/suite#active in Accela. 2rin River Terrace: \lo Ll Yes,River Terrace Review Addendum
Site an Elements: P Erosion Control
3 -.pies of site plan on 8-1/2"x 11"or 11 x 17"paper [t7R ined trees with drip line and tree protection measures
g P awn to scale (standard architect or engineer scale) Otprint of new structure(including decks)and FFE
r rth arrow liNr ty locations&easements(required for new and additions)
e address,project or subdivision name and lot number L/1Sidewalk/driveway approach
jApplicant information(name and phone number) []J ation of wells/septic systems
[ Lot dimensions and building setback dimensions Vf eet tree size,type and location
p� Square footage of buildings to be demolished VJS et names
r1 Existing structures on site Corner elevations (2'contours if more than 4'differe al)
Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ZI'es ❑_No,-
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes L�'1Vo
El'.-C can Water Services—Service Provider Letter of platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
W ter Meter Fixture Unit Worksheet—Additis,Remodels and ADUs
equired: ❑ Yes,applicant was notified in No �/ Received: ❑ Yes ❑ No
SDC Exemption for ADU applied for: ❑ Yes L1 No Received: ❑ Yes ❑ No
ICJ Public Facilities Improvement(PFI) Permit:
R uired: ❑ Yes,applicant was notified No Ap lied For: ❑ Yes El No,stop intake: 1Z_-� _ ,
ej
d Use Case#: ''�'�`Zals""CxzO �SUQ?AIS l-i I/J Zonin
r i g ,
quired Setbacks: Front: g Rear: 'Q► Side: 3 Street Side: Garage: 2
rr Building Height: Max. Height: Ill Actual Hei ht: 7—
ZLandscap�e rea: ?O % Lot Coverage Ma •_'U %
Entrance l2 S back no more than 8'from street-facing wall di Parallel to street or offset 45 degrees or less
Windows um 12%of area of all street-facing facades ��
Garage O Garage door is behind widest street-facing wall Lsl'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 wa nd there is a 12 sq ft.window above garage on 2nd floor.
2" Garage door width is ❑ 12'or less 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
214z. isual Clearance IJ Urban Forestry P)n
E ensitive Lands: ❑ Yes L2'No Type:
IV Conditions met prior to issuance of buildin ermit
Now .__ /1MOc71A-DOCA LI S1A tiou oho/ nee0 To hicn f 3 .Z10 .57 Av) 11
Approved By Planning: • Date: ZS 2/
Revisions (after Building Submittal nly) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
1:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date:
Site Plans: # 3
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: [%Planning a— ngineering la-Permit Coordinator [adding
Workflow Sign-off: EkSign-off for Planning(include notes from planning review)
Route Application Documents: ErEngineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
"Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: 411 Date: 9 to
Etyineering Review
Er Slope at building pad: 4_C/,0s
( Conditions "Met"prior to issuance of building permit
lJ Easements (encroachments)per engineering conditions of approval and plat
tt/Water Quality/Quantity Facility: /��
Assess Water Quality Fee in-lieu: ❑ Yes ICJ No
Assess Water Quantity Fee in-lieu: ❑ Yes P"'/No
LIDA Facility on lot: ❑ Yes 6f No
VFinal Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: _ d.3 '2/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
FfConditions"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:
xl SDC Exemption: ❑ Received 7' Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: y Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: yi Yes ❑ N/A
LIDA ❑ Yes N/A
OK to Issue Permit
Approved byPermit Coordinator: Date: 914 2o2t
PP
1:\Building\Forms\B1dgPermitRvw_RES_122419.docx
City of Tigard
~ COMMUNITY DEVELOPMENT DEPARTMENT
l 1 C.A It River Terrace Building Permit Review Addendum
Building Permit #:
Site Address: /Cc40 j Sw r 4Q_,yv IN) V001:›
Project Name: Polygon at Roshak Ridge Lot #: i gs-
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.070.1):
Is the project subject to the plan district design standards? ['Yes 0No (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
Porch . 5 ft. deep Gable. .ormer
ft. deep min. 2ft.,5 ft.wide min. 2 ft.,6ft.wide
❑ ❑ ❑ ❑
2. Eyes on the str• - : a minimum of 12%of each street facing facade must include windows . entrance doors.
Percentage Shown:
3. Entrances:At least one e ance must meet both of the following standards:
❑Parallel to street, . gle no more than 45° from street,
❑Max. 8 ft. setback from longer trees-facing wall
or open onto por
Entrance opens to a porch: ❑Yes 111 o
IfUes,all the following apply: ❑25 sq.ft. .
One street facing entry ❑12 f ax. roof above floor of porch
❑5 ft. depth min. ❑3 P/o min.porch roof coverage
4.Detailed Design:All buildings shall include a min. o iv' 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 P ormer min. 4 ft.wide
❑Roof eave min. 12 inch projection ❑R.• offset min. of 2 ft.
❑Roof shingles either tile or wood ❑Gable, . p or gambrel roof design
❑Roof pitch oriented south min. 500 sq. . ❑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 ❑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. 0 5 ft.if there is a covered front porch and garage does not extend beyond the fro .orch.
❑May extenn 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 façade
50%max. of street façade with 7 detailed design elements
Notes:
Approved By Planning: Date:
I:\Building\Forms\BldgPermitRvw_RES_RT_121417.docx
City of Tigard
Deferral Until Occupancy Request
TIGARD Washington County Transportation Development Tax (TDT),Transportation and Parks System
e 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: 9/16/2021 Site Address: 16701 SW Darwin Loop
Project Polygon at Roshak Ridge Land Use Case or MST2021-00367
Name: Building Permit#:
Tax Lot Total Parks
2S107AA18500 $8,017.00
#: Lot 185 Amount*:
TDT Total TSDC $386.00
Amount: N/A Amount*:
*The total TSDC amount shown above is the sum of$ 0 for TSDC-Improvement,$ 386.00 for TSDC-
Reimbursement,and $ 0 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: OntaA,4&ami Atual Date: 09/16/21
Developer: D4-.Vaiotz 4 euzievoct, Date: 09/16/21
Permit Coordinator: ArrADate: 9/16/2021