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Permit
CITY OF TIGARD MASTER PERMIT _ e COMMUNITY DEVELOPMENT Permit#: MST2021-00358 Date Issued: 03/30/2022 T I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S107AA22800 Jurisdiction: Tigard Site address: 16673 SW DARWIN LOOP Subdivision: ROSHAK RIDGE Lot: 228 Project: Polygon at Roshak Ridge, Lot 228 Project Description: New detached dwelling. NO FINAL INSP UNTIL DEFERRED SDCs PAID. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 948 sf Basement: 830 sf Left: 3 Parking Spaces: 0 Height: 27 Bathrooms: 4 Second: 1188 sf Garage: 422 sf Front: 8 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 2966 sf Value: $412,709.52 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 Bckfw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywall-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 Fum<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"500 sf: 5 201-400 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+ampNolt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAG 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 2966 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 Geo Tech Report Required VANCOUVER,WA 98660 VANCOUVER,WA 98660 Prior To Pour 2 One Hour Fire Rated Eaves 3 Ersn Cntrl 503-639-4175 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $34,098.76 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR Oc9-nM-nnin tsrminh OAR qc nni_nnOn Vnu may nhtnin a nnm,nr the ndae nr'lira,.nuaerinne M co INC In,naninn cm 919 1O129 nr 1 Rnn RRO 91dd Issued By: F�o(tt� VawDl.Wage Permittee Signature: ON'A� Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the iob site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY !`=t' City of Tigard Received :; - e g Permit No.: _ 't 13125 SW Hall Blvd.,Tigard,OR 97223 DatePlan/By:t Phone: 503.718.2439 Fax: 503.598.1960 Daie/B w ys Other Permit: Inspection Line 503.639.4175 Date Rc Yliirilili Date ReadyBy. heir See Page 2 for Internet: www.tigard-or.gov Notified/Method! Supplemental Information TYPE OF WORK COMMERCIAL FEE' SCfFDULE — USE CHECKLIST Mechanical permit fees'are based on the value of the work it.1 New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑Other mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FEES>. ® I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building Far special information use checklist I j Multi-family 0 Master builder 0 Other. Description Qty. Ea Total JOB SITE INFORMATION AND LOCATION Beating/cooling; Air conditioning I 46.75 Job site address: 16673 SW DARWIN LOOP Furnace 100,000 BTU(ducts/vents) _ 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(duds/vents) 54.91 Suitebldg./apt.no.: Project name: Polygon at Roshak Ridge Heat purrrp 61.06 Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or Hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspende4,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Polygon at Roshak Ridge Lot no.: 228 Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 3339 ^New construction-Type SFU Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 3339 Wood fireplacermsert 23.32 Chimney/liner/flue/vent 23.32 laPROPERTY OWNER 0 TENANT Other. 23.32 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,utility rooms) 23.32 Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32 ca APPLICANT ❑ CONTACT PERSON Other. 23.32 Fuel piping: Business name:Polygon WLH,LLC 514.15 for first four,54.03 for each additional Contact name: Omar Alami Abouhafs Furnace,etc. Address:703 Broadway St.,Ste 510 Gas beat pump Wall/suspended unstheater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(MO)693-4442 Fireplace — E-mail:per mitsubmittalsltaylOrmOrriSOfl.COM flange 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(590.00) Plan review(25%of permit fee) Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee) CCB lie.:209001 TOTAL PERMIT FEE r�� This permit application expires if a permit is not obtained within 180 (}/ days after it has been accepted as complete. Authorized signature: • Fee methodology see by Tn-County Building Industry Service Board Print name:Elia Duran Date: 10/30/20 t.lfniAiwe\FrrmbatMFC Anmi,Ann NnlIt d, AAA ALIT-III In.u-n..m,Co, Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY Ci of Tigard Received ty $ Permit No.: It 13125 SW Hall Blvd.,Tigard,OR 97223 Dale/BY' Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Other Permit No.: inspe Dak R Re ction Line: 503.639.4175 ate T I G A A D Ready/By: hnir ® See Page 2 for Internet: www.tigatdorgov Notifieniathod: Supplemental Information TYPE OF WORK FEE' SCHEDULE ®New construction ❑Demolition For special information use checklist Description I Qty. I Ea. 1 Total 0 Addition/alteration/replacement ❑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 ❑Commercial/industrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 ❑Accessory %Multi-Multi Each add:tional bath/kitchen 25.02 ❑Master builder El Other: Fire sprinkler( sq.ft.) Paget JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 16673 SW DARWIN LOOP Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Drywall,leach line or trench drain 18.76 Footing drain(no.linear ft: ) Page 2 SuiteibldgJapt.no.: I Project name:iRwarhaiwilialrePolygon 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.: 228 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 El PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixmrdsewer 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 ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name:Polygon WLH,LLC Medical gas(value:S_} Page 2 Contact name: Omar Atami Abouhafs Primer 12.51 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 1251 E-mail:permitsubmittals@polygonhomes.com Urinal 25.02 CONTRACTOR Water closet 25,02 Water heater 37.52 Business name:G&B Plumbing&Sons Inc Water piping/MY 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: S72.50 CCH Lic.:184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee) h State surcharge(12%of permit fee) Authorized signature: e� j+".`_ TOTAL PERMIT FEET Print name:Steve Fowler Date: 1 0/30/20 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 Sonice Board- t.\Budding\PvmictuPLMU-PermiiApp.doc i0/01+09 440-46I6T(Ida?'COMAVEBI City of Tigard ■ III COMMUNITY DEVELOPMENT DEPARTMENT 'PI T i G A R D Building Permit Review — Residential Building Permit #: S 7'2-p 2J - 00 35 ? Site Address: 16673 SW Darwin Loop Project Name: Polygon at Roshak Ridge Lot #: 228 Planning Review Proposal: New house ® Verify address/suite #active in Accela. ® In River Terrace: ❑ No o Yes, River Terrace Review Addendum Site Plan Elements: ®Erosion Control K3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper Retained trees with drip line and tree protection measures ®Drawn to scale(standard architect or engineer scale) ®Footprint of new structure(including decks)and FFE ❑X North arrow ®Utility locations&easements(required for new and additions) ®Site address,project or subdivision name and lot number ®Sidewalk/driveway approach ®Applicant information(name and phone number) Ill ocation of wells/septic systems ®Lot dimensions and building setback dimensions ®Street tree size,type and location llquare footage of buildings to be demolished ©Street names IExisting structures on site 11 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? [s ❑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 Received: ❑ Yes ❑ No ® Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: E Yes,applicant was notified It No Received: ❑ Yes ❑ No In SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No ® Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified E No Applied For: ❑ Yes ❑ No,stop intake ® Land Use Case#: SUB2015-00004 al Zoning: R-7 ® Required Setbacks: Front: 8 Rear: 10 Side: 3 Street Side: na Garage: 20 E Building Height: Max.Height: N/A Actual Height: 27 1 Zl Landscape Area: 20 % 0 Lot Coverage Max: 80 Entrance ® Set back no more than 8' from street-facing wall p Parallel to street or offset 45 degrees or less Windows 0 Minimum 12%of area of all street-facing facades F: 13% I R:16% 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 2°"floor. f7 Garage door width is ❑ 12'or less 1z7 50%or less of facade ❑ 60°/u 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 1 Visual Clearance X❑ Urban Forestry Plan E Sensitive Lands: ❑ Yes X❑ No Type: ® Conditions met prior to issuance of building permit Notes: MMD2020-00044 only required to eet standard�s in 8.290. ❑X Approved By Planning: ! w�' L ( N"' '� Date: 9/2/2021 Revisions (after Building Submittal only) (J Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved 0 Not Approved 1:1Building\Fortes\BI dgPermitRvw_RES_122419.docx Building Permit Submittal p Original Submittal Date: O/ //2—/ Site Plans: # Building Plans: # Building Permit#: Banter building permit#above. Workflow Routing: g•-"Planning Engineering 1ermit Coordinator 1:-.Bttilding 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. 'uilding: original permit application,site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: /,'ScD/114k--/C-4— Date: 7 -/ ?- Engineering Review [ ,/Slope at building pad: I� Conditions "Met"prior to issuance of building permit trEasements (encroachments)per engineering conditions of approval and plat "Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes lNo Assess Water Quantity Fee in-lieu: ❑ Yes V No LIDA Facility on lot: ❑ Yes No y/ I(� Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: O Approved by Engineering: Date: 9//�� Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review ilZf 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: yes ❑ N/A Tigard Trans SDC: 7f Yes ❑ N/A Parks SDC: rp Yes 0 N/A LIDA 0 Yes ❑ N/A /- OK to Issue Permit Approved by Permit Coordinator: / r q Date: - 1'KO [2OL I I:1Building\Forms1Bl dgPerm itRvw_RES_122419.docx City of Tigard q Deferral Until Occupancy Request TIGARD Washington County Transportation Development Tax (lDT),Transportation and Parks System Development Charges (SDCs) ra 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: 16673 SW Darwin Loop Project Land Use Case or Polygon at Roshak Ridge MST2021-00358 Name: Building Permit#: Tax Lot 2S107AA22800 Total Parks #: Lot 228 Amount*: $8,017.00 TDT Total TSDC Amount: N/A Amount*: $3,658.00 *The total TSDC amount shown above is the sum of$ 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 1'DT,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 1DT 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: Ohea-• Date: 11/4/21 Developer: Oma.-.A2a0u .46euia Date: 11/4/21 Permit Coordinator: ATM iNtlek Date: 11/3/2021