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Permit rr CITY OF TIGARD MASTER PERMIT ° COMMUNITY DEVELOPMENT Permit#: MST2021-00340 Date Issued: 03/31/2022 T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S107AA23000 Jurisdiction: Tigard Site address: 16691 SW DARWIN LOOP Subdivision: ROSHAK RIDGE Lot: 230 Project: Polygon at Roshak Ridge, Lot 230 Project Description: New detached dwelling. NO FINAL INSP UNTIL DEFERRED SDCs ARE PAID BUILDING Floor Areas Required Setbacks Required Stones: 3 Bedrooms: 5 First: 978 sf Basement: 841 sf Left: 3 Parking Spaces: 0 Height: 27 Bathrooms: 4 Second: 1331 sf Garage: 416 st Front: 8 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 3150 sf Value: S436,018.32 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 Tvpes Air Conditioning: Y Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvciFeeders 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 3150 Owner: Contractor: POLYGON WLH 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 98860 2 One Hour Fire Rated Eaves 3 Geo Tech Report Required Prior To Pour PHONE: PHONE: 360-695-7700 FAX: Total Fees: $34,853.52 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 160 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 Q59_nM-0M n thrnunh OSR Q52nf_nnOn V nn ma„nhrain a rnn..of tha n,i c nr Airarf n,mafinna fr.fll INC by Tallinn CO 1,)19 1057 nr'I Ron'fl.7 91dd NoL.y Vaw De.Wege, Ow Apv-Ux-culio-A, Issued By: Permittee Signature: 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. „ . , 6 Building Permit Application 3 — 8111121 Residential H ts„'t,to . FOR OFFICE USE ONLY �7 Cl of Tigard (� q Received �1 /a 7/ �/, Permit No. S � y u 13125 g g AUGI-1 U�l 1 U I Date/By: CI —j !/ rtill SW Hall Blvd.,Tigard,OR 97223 Plan Review q 27 '1 -,,nat JQ.��r '7�1 Phone: 503.718.2439 Fax: 503.598.19gg((� DaeBy: 7 1 of OtnerP`.•ewv^s�ee�+� LL-! 4t k�' h i,i-zJude 0 See Page 2 for T I G A R D Inspection Line: 503.639.4175 I1 Date Ready/By: S Internet: www.tigard-or.gov BU LD uG l , V1 _ otified/Method: Supplemental Information TYPE OF WORK REQUIRED DA A:I-AND 2-FAMILY DWELLING 0 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 Cl Addition/alteration/replacement El Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 3Z Valuation: $ 1 3b,O)S t ® 1-and 2-family dwelling ElCommercial/industrial Cl Accessory building ❑Multi-family � ` Number of bedrooms: 5 ❑Master builder D Other: Number of bathrooms:/ '9 JOB SITE INFORMATION AND LOCATION Total number of floors: 3 -;90 W Job site address: 16691 SW DARWIN LOOP New dwelling area: 3,150 square feet (5 ,1 City/State/ZIP:Sherwood,OR 97140 Garage/carport area: �416 square feet 97 Q Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: ‹. square feet ( ,tj Cross street/directions to job site: Deck area: 131 square feet Other structure area: square feet REQUIRED DATA:C MMERCIAL-USE CHECKLIST Subdivision: Polygon at Roshak Ridge I Lot no.:230 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. New Construction/Type: SFU/Elevation plan: 222503BR 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 CIO BUILDING PERMIT FEES* (Please refer w fee schedule) Business name:Polygon Homes WLH LLC Structural plan review fee(or deposit): Contact name:Omar Alami Abouhafs FLS plan review fee(if applicable): Address:703 Broadway St., Ste 510 Total fees due upon application: City/State/ZIP:Vancouver,WA 98660 Phone:(360)946-8674 Fax::( )360 693-4442 Amount received: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: permitsubmittals@taylormorrison.com-OAIamiAbouhafs@taylormorrison.com Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photovoltaic 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 tYand 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: $201.60 Authorized signature: O/I9.LLL. -4 d 0Z.471,r 5- This permit application expires If a permit is not obtained ��� within 180 days after it has been accepted as complete. Date: 08/16/2021 *Fee methodology set by Tri-County Building Industry Print name:Omar Alami Abouhafs Service Board. I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Applica /; FOR OFFICE USE ONLY P City of Tigard D )By: <mir No�ST2 �'W3� � ed Date/By: 0 O -i . °-13125 SW Hall Blvd.,Tigard OR 97223[1 v U t ^i Plan Review Phone: 503.7183439 Fax: 503.598.196 Date/By: obey Permit CITY Y�!t t ad7 Inspection Line: 503.639.4175 ,i Date Ready/By: lure: Fi See Page I for — j TIGAIt I7 r Internet: www.tigazd-or.gov r , Notified/Method! �t3UILD31,+(.. I"lit/��:c;^ir,,., Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work �/ New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT f SYSTEMS FEES* ®1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. 1 j Multi-family 0 Master builder ❑Other. Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning i 46.75 Job site address: 16691 SW DARWIN LOOP Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTIJ(ducts/vents) 54.91 Suite/bldgJapt.no.: Project name: Polygon at Roshak Ridge Hit pip 61.06 Duct work 23.32 Cross street/directions to job site: Hydronic hat 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.: 230 O 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 fireplacelinsert 23.32 • Chimney/liner/flue/vent 23.32 Other. 23.32 ® 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 33.34 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 Z APPLICANT 0 CONTACT PERSON Other. 23.32 Fuel piping: Business name:Polygon WLH,LLC $14.15 for first four;$4.03 for each additional Contact name: Omar Alami Abouhafs Furnace,etc. Address:703 Broadway St.,Ste 510 Gas heat pump W all/suspendedhmit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace Range E-mail:permitsubmittalsttaylormorrison.corn Barbecue CONTRACTOR Clothes dryer(gas) Business name:Pro Heating&Cooling Other: MECHANICAL PERMIT FEES* Address: Ir'W 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) GCB lie.:209001 TOTAL PERMIT FEE ['ee�� t This permit application expires if a permit is not obtained within 180 Gli.a. 1)u- .� days after it has been accepted as complete. Authorized signature: �JJJ ' Fee methodology set by Tri.Counry Building Industry Service Board Print name: Elia Duran Date: 10/30/20 t-mnil:neVnm"s.SA./ni P.rmu an.neni IS Any Electrical Permit A licatifo . ,a t. , e I , FOR OFFICE IISF O\r_V City of Tigard!IIImay' Peremi a gaTZ021-003 e'd 13125 SW Hail Blvd.,Tigard,OR 97223 , ., Plan Review - _-- s. • Phone: 503.718.2439 Fax: 503.598.1960 r>aminv. Related Permit it: .;c1 C;�1 R U Inspection Line: 503.639.4175 L,l ]Lindy Daidxy _.. )uos ' 61 See Page 2(or Internet: www.rigard-or.gov Notified/Method. Supplemental information i3Va _ TYPE OF WORK . PLAN'38EVWW. ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans writmus checked): ❑Service re feeder 400 snips or mom 0 Building over three stones. 0 Demolition ID Other: where the asailahle fault current ❑Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Fleming budding: ® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less �° ex exceeds 14,0 W El Com macron-sac agtituimn l ❑Multi-family 0Master budderamps for all other installations buddmgs- M0 Other. ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND i.00ATION ❑Em rgency system. larger separately delved .cob#: Job site address:16691 SW DARWIN LOOP El Addition ol'ote woo kind of ayttem IgOIIP Or more.. ❑"A""E-"t-Z'"1-3" City/StaS ZJP: Tigard,OR 97140 ❑six or mom residential units occupancy ❑Hcalm-care facilities. Cl it seasonal wattle parks. Suite/bidg/apt.#: Project name: Polygon al Roshak Ridge O uarardoua kasha. ❑Supply voltage for mom than 0 Service or feeder 600 amps or more. 600 volts nominal Cross sired/directions to job site: FEE SCIIEDEJLB . Derestliaa I on, I ugh I raw I • ... New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: 230 Includes attached garage. 1,000 sq-ft,or less 168.54 4 Tax map/parcel#: Ea.add'/500 sq.0.or portion 33.92 1 IWSCIUrTION OF WORK Limited energy,residential 75.00 2 (with tomcat fr.)New construction.Type SFU Limited map,multi•family residential(with above sq.ft.) 75.00 2 Renewable F.aetpy ❑ See Pane 2 ® PROPERTY OWNER ❑ TENANT Services or feeders instaiiatlout alteration,and/or relocation Name: Polygon Homes WLH ILC 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 601 ampa to L000 amps 301.04 2 Phone:(360 )946 8674 Fax:( ) Over 1,000 asps or wits 552.26 2 Temporary services or feeders installation,alteraton,and/or Email: OAlamiAbonhafs@taylamorrisoncom-PermitSubmittals(t§taylormorrison.com relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 i intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 El APPLICANT I 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel Business name: PolygonA.Fee for branch circuits with Homes WLH LLC above service or foxier foe, 7.42 each branch circuit Contact name: Omar Alami Aboubafa B,Fee for branch circuits walrus service or feeder fee,first Address: 703 Broadway St.,Ste 710 branch circuit 56,18 2 City/State/ZIP:Vancouver,WA 98660 Each add'l brunch circuit 7.42 2 360 )946 8674Miscellaneous(service or feeder trot included) ]+bane •( Fax::( ) Each manufactured or modular 67 84 2 dwelling service and/or feeder Email:0AlamiAbouhafs@taylormorrison.com-PennitSubmittals@taylonnorrison.com ..at only - 67 as 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Wallace Electric sip or outline lighting 67.84 2 Address: 105 Dresden St Signal circuu(a)or/lulled-energy Cl seePage 2 2 Panel,alteration,or extension. Each additional inspection over allowable in envy the above City/State/ZIP: Astoria 0R97103 Additional inspection(1 hr min) 6625/hr Phone:(503 348 0563 Fax:( ) Investigarcn(I hr train) 90.001 hr Email: David�a�wellacewires.com Industrial plant(Ihrtrain) 78�I81hr Inspections for which no fee as 90,00! hr CCB Lic.:224868 Electrical Li ' C1441 Su .1: .: 6363S specifically listed Ph hr min) EC.ECTRICAL P$R11in,mS.;'.' Suprv.Electrician signature,required: Subtotal Prim name: lD- Date: Id r4 I�i ❑Plan Review Required(25%of permit foe): %{�` t/ J State surcharge(12%of permit fee): Authorized signature i TOTAL Pa:MIT TEE: This permit application replies if a permit is not ebishied within 181) Print name: ;Nett ry� � .t -, Date: to(' ( _. days suer It has been accepted as complete. c' a aY.r 7 �j z- .. a Number of rnsmetums allowed per permit. ].Bench grermintELC-PmrirApp ELR.pt AN am'ON17r2015 a•ci-i6:s T(0 i/05'COM Was • . , Plumbing Permit Applicatio r- Building Fixtures ` FOR OFFICE USE ONLY Received "' zr o3(10 ` City of Tigard Date/By: P m a No. $(Z� d n 13125 SW Hall Blvd.,Tigani,OR 97223 Plan Review S Phone: 503.718.2439 Fax: 503.598.1-'Y4ij l ,:6ti i ) Date/By: Other Permit No.: TIGARD Inspection Line: 503.639.4175 8U;LJ,,ur. i-llt/r t-�r,..l DateReadyBy: mas: H See Page 2for Internet: www.ligard-or.gov - - '"' " - Notiticd/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑Demolition For special information use checklist Description I Qty. I Es. I Total 0 Addition/alteration/replacement 0 Other. New 1-2-family dwellings(includes 100 ft.for each utili connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ,1-and 2-family dwelling I 0 Commercial/industrial SFR(2)bath 437.78 ❑Access0 �px SFR(3)bath 500.32 ry buildin g 41-Multi-family Each additional boat/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AM) LOCATION Site utilities: Job site address: 16691 SW DARWIN LOOP Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.7E • Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name:name:ambei•AigisePolygon 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 I Lot no.: 230 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 New construction-Type SFU Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 • Ejectors/sump 25.02 ® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixture/sewer cap 25,02 Address:703 Broadway St.,Ste 510 Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone:(360)695-7700 Fax:( ) Ice maker 12.51 ® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Polygon WLH,LLC Medical gas(value:5_) Page 2 Contact name: Omar Alami Abouhafs Primer 12.5I 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 pip ng/DW V 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 CCB Lic.:184372 Plumbing Lic.no.:ph634 Plan review (25%of permit fee) Ay�..p`�-� State surcharge(12%of permit fee) Authorized signature: 11-113Csk, gC)L0- �.` TOTAL PERMIT FEE Print name:Steve Fowler Date: 10/30/20 Thu 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. Vauading,PermitsTLMU-PermitA .doe IOM149 440-4616T(10A2rCOM'WEB) Plan# aa�5038►Z c .2© (...�� vti(G7 Floors 3 Large 27 Bed rooms Small U.5 �.�-( al ( ,� WC r('l� 1 �,�^•^/' 1 LAV Le Tub 3 Basement qy Vent `Q 1st Floor cr7S Water Heater ( 2nd Floor `4,3 AC Np-� 3rd Floor � School IT, a.,-64 R-3 Total 315 n 9 % v Garage y (�p ��� Qek_ Total �(..p 1.L1, V oJk f 14S #for Elec Le 166. 1D-Q-ei1l- 1/3 ( L /-- 13 I , . .oh City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review — Residential TIGARD P Building Permit #: I-P(2021-1'039-d Site Address: 16691 SW Darwin Loop Project Name: Polygon at Roshak Ridge Lot #: 230 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: ®Erosion Control a3 copies of site plan on 8-1/2"x 11" or 11 x 17"paper Detained trees with drip line and tree protection measures ®Drawn to scale(standard architect or engineer scale) EFootprint of new structure(including decks)and FFE ®North arrow ®Utility locations&easements(required for new and additions) ®Site address,project or subdivision name and lot number Z 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 ntaSquare footage of buildings to be demolished ®Street names &Existing structures on site ElCorner elevations(2'contours if more than 4'differential) ELot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 1-1WitA❑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 Al No Received: ❑ Yes ❑ No ] Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: ❑ Yes,applicant was notified g No Received: ❑ Yes ❑ No 1M SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No ® Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified g No Applied For: El Yes ❑ No,stop intake ® Land Use Case#: SUB2015-00004 ® Zoning: R-7 ® Required Setbacks: Front: 8 Rear: 10 Side: 3 Street Side:na Garage: 20 ® Building Height: Max. Height: na Actual Height: 21 ® Landscape Area: 20 % ® Lot Coverage Max: 80 Entrance ® Set back no more than 8' from street-facing wall ® Parallel to street or offset 45 degrees or less Windows fez Minimum 12%of area of all street-facing facades F: 14% I R: 20% Garage N 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 ® 50°/u or less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch El Recessed entrance ❑ Wall offset ❑ 1'Roof cave ❑ 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 1 Urban Forestry Plan R Sensitive Lands: ❑ Yes ® No Type: ® Conditions met prior to issuance of building permit Notes: MMD2020-00044-only needs•o meet des n st ndards in 18.290 tI Approved By Planning: � Date: 8/1912021 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved l:\Building\Forms\BldgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: 408 /T/202-/ Site Plans: # 3 Building Plans: # Building Permit #: "Enter building permit#above. Workflow Routing: 0-Planning 8' Engineering Permit Coordinator E uilding Workflow Sign-off: 1 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. 0-Building: original permit application,site plans,building plans, engineer and beam calculation trust details,if applicable, etc. Notes: By Permit Technician: - %�j,/),1f/ Date: /'?4 2/ Engineering Review Le Slope at building pad: S19 ' Conditions "Met"prior to issuance of building permit Ili asements (encroachments) per engineering conditions of approval and plat Lr Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes l"No Assess Water Quantity Fee in-lieu: ❑ Yes L'No LIDA Facility on lot E Yes LNo gi'Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: / Date: 2/4572/ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved 0 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: 0 Received Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: tr yes 0 N/A �}��s V 1, A Tigard Trans SDC: Yes ❑ N/A Et eTr� '_4 Parks SDC: te Yes ❑ N/A LIDA ❑ Yes (Zi N/A yi OK to Issue Permit Approved by Permit Coordinator: Date: G ( 2,4 2- 1 1:\Building\Fomis\B1dgPermitRvw REs 122419.docx City of Tigard " Deferral Until Occupancy Request T I 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: 11/4/2021 Site Address: 16691 SW Darwin Loop Project Polygon at Roshak Ridge Land Use Case or MST2021-00340 Name: Building Permit#: Tax Lot Total Parks 2S107AA23000 Amount*: $8,017.00 #: Lot 230 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: Chum-4 ra 4e Date: 11/4/21 z Developer: Qht44t..4 +L 46eu/ta Date: 11/4/21 Permit Coordinator: /411/A66i140fArLi Date: 11/4/2021