Permit nIII CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2021-00397
T f C:A R n 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/30/2022
Parcel: 2S107AA18900
Jurisdiction: Tigard
Site address: 16740 SW DARWIN LOOP
Subdivision: ROSHAK RIDGE Lot: 189
Project: Polygon at Roshak Ridge, Lot 189
Project Description: New detached dwelling. NO FINAL INSP UNTIL DEFERRED SDCs PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1238 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 27.5 Bathrooms: 3 Second: 1718 sf Garage. 486 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2956 sf Value: $410,916.56 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 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
Bcklw 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: 5 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 SrvclFeeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea adds 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+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 2956
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
PHONE PHONE: 360-695-7700
FAX:
Total Fees: $33,991.30
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
Q59-nnlsn In+hrnnnh()AP Q59-OM_nmon Yru ma.,nhfain n rnnu of Ihs nIlse nr Arran.nueefinne+n CH INC by Tallinn cm 949 1QR7�nrr,1l non
,1'1�7,144
Issued By: H Vctw 1 _Wegl Permittee Signature: Ow Ar"f�� "" v"
Call 503.539.4175 by 7:00 a.m.for the next available inspection date.
This panne 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.
I air- , .--,„ ,...',
B-.ilding Permit Application ' -ct -,rZ
1ECE��ED
Residential q FOR OFFICE USE ONLY
Cityof Tigard ,„-' 0 ,' WV Received �/ Ll i r ��
g DateB : Permit No.: I t .ri
N.....: . 13125 SW Hall Blvd.,Tigard,OR 9722j-t-�OF TIGARD Plan Rey iew� 2.-, Z( j_ Ma
Permir[Wp d7i4�ODz t
Phone: 503.718.2439 Fax: 503.598.1 DateB : Alt- d F vf/
I 1,,,,,`t, Inspection Line: 503.639.4175 Date ReadyBy: id See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISIONe/NNooti�fied/Meth ' ( Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction ❑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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. ../
® 1-and 2-family dwelling ❑CommerciaUindustrial Valuation: $ y' Iq l tf
❑Accessory building 0 Multi-family Number of bedrooms: 5
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors:2 3q 2-
Job site address: 16740 SW Darwin Loop New dwelling area: 2,956 square feet 111
City/State/ZIP:Sherwood,OR 97140 Garage/carport area: 486 square feet,',-3c1..,
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: )2(r}/ square feet
REQUIRED DATA:CONLMERCIAL-USE CHECKLIST
Subdivision: Polygon at Roshak Ridge I Lot no.: 189 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
�Iew Construction/Type: SFU/Elevation plan:222300 D(R) Valuation: $
Deferrals:YES-deferral of TSDC fees and 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 Oa9 BUILDING PERMIT FEES*
Business name:Polygon Homes WLH LLC (Neese refer m fee schedde)
Structural plan review fee(or deposit):
Contact name:Omar Alami Abouhafs
FLS plan review fee(if applicable):
Address:703 Broadway St., Ste 510
City/State/ZIP:Vancouver,WA 98660 Total fees due upon application:
Amount received:
Phone:(360)946-8674 Fax::( )360 693-4442
E-mail:permitsubmittals@taylormorrison.com-OAlamiAbouhafs@taylormorrison.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CQNTRACTOR , 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
and administrative fees):
Phone:( )360 695-7700 Fax:( )360 693-4442 State surcharge(12%of permit fee): $21.60
CCB lie.:207247 /J A[ `_ ,_ Total fee due upon application: $201.60
k
Authorized signature: OJ'YLU/L 4GQ.YJZG.rye& This permit application expires if a permit is not obtained
I(/J within 180 days after it has been accepted as complete.
Print name:Omar Alami Abouhafs Date: 09/09/2021 *Fee methodology set by Tr-County Building Industry
Service Board.
l:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Mechanical Permit Application E�EIVR �0 �g`t �O��OFFICE LSE ONLY
Cityof Tigard permit No.: �7n71 i/rn�(4�
'i 13125 SW Hall Blvd-,Tigard,OR 97223 W Ut ✓V G
i Phone: 503.718.2439 Fax: 503.598.1960 r : 0 f; 2C L• `.'. OtherPermit:SWt (�+ K2/5
Inspection Line 503.639.4175 i pale Ready/By: - mra: uv v.�t
YltiAlai y/By: S3 See Page 2for
Internet: www.tigard-or.gov CITY OF TIGARD Noti&ed/Mahod:
F�{II C n� Supplemental Information
TYPE OF WLDING DIVISION COMMERCIAL FEE*SCHEDULE -USE CHECKLIST
is)New construction 0 Addition/alteration/re lacement Mechanical permit fees*are based on the value of the work
P performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY_OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES
®1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist
i j Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
KM SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning I 46.75
Job site address: 16740 SW Darwin Loop Furnace 100,000 HTU(ducaheots) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+ETU(duas/vents) 54.91
Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge Heat pump 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,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Polygon at Roshak Ridge I ono.: 189 —
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water beater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
- Flue vent for water heater or gas
New construction-Type SFU fireplace 23.32
Leg lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace insert 23.32
Chimneyltiner(flue/vent 23.32
Other toPROPERTY OWNER 0 TENANT Environmental
23.32
Envi exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
Address:703 Broadway St.,Ste.510 equipment 33.39
Clothes dryer exhaust 33-39
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust toilet compartments,uathrooms,
tility rooms) 23.32
Phone:(360)695-7700 Fax:( ) Atticicrawlspaccfans 23.32
IF) APPLICANT ❑ CONTACT PERSON Other 23.32
Business name:Polygon WLH,LLC Fuel piping:
S14.1.5 for first four;S4.03 for each additional
Contact name: Omar Alami Abouhafs Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas beat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water beater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
E-mail:permitsubmittals@taylormorrison.com
Ra
nge
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Pro Heating&Cooling Otter
MECHANICAL PERMTC FEES*
Address: NVV Alociek Dr,Ste.1104
Subtotal
City/State/ZIP:Hillsboro,OR Minimum permit fee(S90.00)
Phone:(360)270-1590 Fax ( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic..209001 TOTAL PERMIT FEE
This permit application expire if a permit is not obtained within ISO
"�'Ir'�'' I �'' 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
r1Miiidi wiPrnn*c1MFC Pnm,.l Ann mnl II Aer 4.41 ani+r.,,m„rn„m,ro,
•
Electrical Permit Applicati FOR OFFICE USE ONLY
City of Tigard E C E I VE Received / iryEri
Permit 8: i-i �'
• 13125 SW Hall Blvd,Tigard,OR 97223 „ _. f>melB V Al t
II Phone: 503.718.2439 Fax: 503.548.1960T, .} L �' l�Z�pl t5jj r Review Related PemtitG!) ES/7(_ ail, .j11
TIGAfiO LtSpcCtiOn Line:g503.639.4175 CITY OF TfGARV Ready Datdny - Sour: 7-`12 See Page for f/
Internet: www.li and-or,govNotificdhicthnd. Supplemental Information
TYPE OF witiltrvNin rnIs flnl PLAN REVIFR; -
®New construction ❑Addition/alteration/replacement Please check all that apply(submit I seta of plans w/items chocked)
❑Demolition 0 Other: 0 Service or feeder 400 amps 0,more ElBuilding over storms three sto
where the available fault current ❑Marinas and boatyards
CATEGORY OF CONSTRUCTION ex000ds 10,000:mps at 156 volts or 0 Floating buldmga
® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building eta to ground,Of eareedx 14.060 ❑Commerciat-asn agricaiturel
amps for as other installations buildings
❑Multi-family 0 Master builder ❑Other: 0 Fire pump 0 installation of 150ICVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately denied
Job#: Job site address:16740 SW Darwin Loop 100iti x mare.❑Addibm mOrc.ew ate load of sys an.
❑•A", L','1.2',•t-3",
City/State/ZIP: Tigard,OR 97140 ❑sue or more residential units occupancy
❑Health-care facilities ❑tiecreauonal vehicle park;.
Suite/bidgiapt.#: Project name: Polygon at Roshak Ridge ❑tiazarda,a locations ❑Supply voltage far more than
❑Servire or teedea 600 aotps or more. 600 volts seminal.
Cross street/directions to job site: FEE SCHEDULE -
-
tleuripmms I Qt,Qty., I Lath I ratai I •
New residential single-or multi-family dwelling null.
Subdivision:Polygon at Roshak Ridge Lot#: 189 Includes attached garage.
1,000aq.ft or less 168 54 4
Tax map/parcel#:
Fa addl 500 sq.R.or portion 33.92 I
DESCRIPTION OF WORK _ Limited energy,residential
• (with above sq.ft) 75.00 2
New construction.Type SFU Limited cony.m dti•fimily '
residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ Sec Page 2® PROPERTY O\�'NER ❑ TFNAIti _l' Services or feasters installation,alteration,and/or relocation
Name: Polygon Homes WLH LLC 200 amps or leas 100.70 2
201to 400 amps133.56 2
Address: 703 Broadway St.,Ste 710 amps ,
City/StateJZIP: Vancouver,WA 98660 — 401
1 amps to 600 amps 200.34 2
601 amps to LOCO amps 301.04 2
Phone:( 360 )946 8674 I Far( ) Over 1,000 amps or volts 552.26 2
Email: OAIamiAbouhafs to Itxmorrison.com-PefmitSubmittal Temporary services or feeders installation,alteration,andJnr
(� Y sQtayltxmorrisoacom 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 to 400
amps lzsos 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
0 CONTACT PERSON Broach circuits rr nr ,altcrafioo or extension,per panel 0 APPLICANT I
• A.Fee for branch circuits with
Business name: Polygon Homes Will LLC above service or fonder tee,
each branch circuit 7.42
Contact name: Omar Aland Abonhafa B.Fee for branch circuits without
Address: 703 Broadway St.,Ste 710 service err fee ter fee,first 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Eachadd'l branch circuit 742 2
Phtlnc(360 )946 8674 Fax:: Miscellaneous(service or feeder not included)
( ) Erich manufactured or modular 67.84 2
Email:OAlamiAbouhafsglaylormt%rison.com-PcnnitSubmittals aitayiormorrison.com dwelling,a mayor reeler
Rom onlynly 67 84 2
CONTRACTOR Pump or in%gatien circle 67 84 2
Business name: Wallace Electric Sign or outline lighting 67.84 2
Address: 105 Dresden 5t Signal circuits)or limited�crgy 0 See Page 2 2
panel,alteration,or extension_
CUY/Sta> 1P: Astoria,OR 97103 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66 25/la
Phone:(503 308 0563 Fora:( ) Investigation(1 ht min) 911.00/hr
Email: David@wallaccwires.com Industrial plant(1 hr mint 78.18l hr
Inspections for which no fee is
Electrical S6363S specifically 9FEESr
CCB LiC.:224868
Suprv.Electrician signature,required: ELECYRiCAI PEBMI Subtotal-
PrintFEE9
�—
name:Dt4v 47 c. Date: df/� /�t 0 Plan Review Required(25%of permit fee):
Efc/ State surcharge(12%of permit fee):
Authorized signature 57,
, TOTAL PERMIT FEE:
'Deis permit application expires if a permit is not obtained withie ISO
Print name: 40 CA/e4�Gd{ Date: zip- / e . I days after It here been seamed as complete.
7 la f z • Number of inspections allowed per permit.
L+a dalinglcrmilcthtC-tk r¢dApp_FS.a Ean,.des Rev06/17,2615 d i:4b15T(I IASICOMIWE9
r
Plumbing Permit Application RECEIVED
e
- ° Building Fixtures -. Cl ^ ZOT FOR OFFICE USE ONLY
Cityof Tigard Received l b r Permit No.: All r i0'{/(`,./
q 131 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGAR�'1e'Ry q ' 1 !7J t r fd C, Y
Phone: 503.7182439 Fax: 503.598.1• n Review
Other Permit No.:M/1' '.01141.
Inspection `UILDINGDIVISI e y_
TI G ARD Date ReadylBy: huh: 63 See Page 2 for
Internet: www.tigard or.gov Notified/Method:Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath _ 312.70
,1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath _- 437.78
SFR(3)bath 500.32
❑Accessory building VI-Multi-family
Each additional bath/kimhen 25.02
❑Master builder ❑Other. Fire sprinkler( sq.R) ...-. Page 2
JOB SITE INFORMATION AND LOCATION Site utilities;
Job site address: 16740 SW Darwin Loop Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 DcY ell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:R.1_L1tI ..rolygon 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 R: ) Page 2
Storm sewer(no.linear ft.: I Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Polygon at Roshak Ridge I Lot no.: 189 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
Ejectors/sump 25.02
PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name:Polygon WLH,1.LC Futurrlsewercap 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 Intemeptor/grease trap 25.02
Business name:Polygon WLH,LLC Medical gas(value:$_) Page 2
Contact name: Omar Alami 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 12.51
E-mail:permitsubmittals@polygoabomes.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:C&B Plumbing&Sons Inc Water PsPi>g/D WV 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: $72.50
Plan review (25%of permit fee)
CCB Lie.:184372 Plumbing Lie.no.:pb634
State surcharge(12%of permit fee)
Authorized signature: � TOTAL PERMIT FEE
Print name:Steve Fowler Date: 1 0/30/20 Thu permit application expires if a permit Is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\BaildvglPennits\PLMU-PesmilAip doe ItM01A9 440-4616T(10/02/COM/WEB)
Plan # ,p02232���
Floors a Large ad
Bed rooms 5 Small S
WC
LAV S"
Tub 3 Basement
Vents 1st Floor �aJ$
Water Heater 1 2nd Floor 111
AC �R,g 3rd Floor . q
School R-3 Total 2-1 Sip
\c` �« Garage y Qi�
Total 311/1
S S #for Elec S
City of Tigard
1111
' COMMUNITY DEVELOPMENT DEPARTMENT
C
TIGARD Building Permit Review — Residential
Building Permit#: M51(1.01/' — 00 104 '
Site Address: 16740 SW Darwin Loop
Project Name: Polygon at Roshak Ridge Lot #: 189
Planning Review
Proposal: New single detached dwelling
❑r Verify address/suite# active in Accela. ❑r In River Terrace: ❑ No ❑r Yes, River Terrace Review Addendum
Site Plan Elements: S rosion Control
O. copies of site plan on 8-1/2"x 11"or 11 x 17"paper "Lftetained trees with drip line and tree protection measures
Dprawn to scale(standard architect or engineer scale) Footprint of new structure(including decks)and FFE
el orth arrow LJtility locations&easements (required for new and additions)
INaddress,project or subdivision name and lot number Sidewalk/driveway approach
13-pplicant information(name and phone number) _"ocation of wells/septic systems
13 .t dimensions and building setback dimensions Street tree size,type and location
l'quare footage of buildings to be demolished Street names
I xisting structures on site _Joiner elevations (2'contours if more than 4'differential
12 of area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? L'h'es o
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es ° o
QClean Water Services-Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑Yes,applicant was notified ❑r No Received: ❑Yes ❑ No
❑r Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs
Required: 11Yes,applicant was notified ❑e No Received: El Yes El No
o❑ SDC Exemption for ADU applied for: ❑Yes ❑s No Received: ❑Yes ❑No
❑a Public Facilities Improvement (PFI) Permit:
Required: ❑Yes,applicant was notified ❑r No Applied For: ❑r Yes ❑No,stop intake
❑ Land Use Case#: SUB2015-00004 ❑ Zoning: R-7
❑° Required Setbacks: Front: 8/12 Rear: 10 Side: 3 Street Side: 8 Garage: 20
❑e Building Height: Max. Height: N/A Actual Height: 27.5
❑o Landscape Area: 20 % ❑a Lot Coverage Max: 80
Entrance . Set back no more than 8'from street-facing wall ❑e Parallel to street or offset 45 degrees or less
Windows •. Minimum 12%of area of all street-facing facades
Garage ° Garage door is behind widest street-facing wall ❑r 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'd floor.
ElGarage door width is 12'or less El 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 itch ❑ Gable,hi or gambrel roof Dormer
- Accent siding Window trim U Window recess U Window projection ❑ Balcony
e❑ Visual Clearance ❑r Urban Forestry Plan
QSensitive Lands: ❑ Yes LI No Type:
❑ Conditions met prior to issuance of building permit
Notes: 4Q1)k
CIApproved By Planning: SPV Date: 09-13-2021Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
1:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal 4
Original Submittal Date: �/ IM
Site Plans: #
Building Plans: # ¶
Building Permit#: ® Enter building ermit#above.
Workflow Routing: Planning la Engineering ® Permit Coordinator ® Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
1 Route Application Documents: ® Engineering: (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: Date: 14, 7,...
Engineering Review
fir Slope at building pad: 3
gliConditions"Met"prior to issuance of building permit
K.,ew
Easements (encroachments)per engineering conditions of approval and plat
ater Quality/Quantity Facility.
Assess Water Quality Fee in-lieu: ❑ Yes 'No
Assess Water Quantity Fee in-lieu: ❑ Yes �Er No L`LIDA Facility on lot: ❑ Yes r No
I1 Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
[Approved by Engineering: Date: Zl 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
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
DC Exemption:SDC ❑ Received Does not a,ply
Fees Entered: Wash Co Trans Dev Tax: g�(Yes ] N/A
Tigard Trans SDC: ti Yes ❑ N/A
Parks SDC: Yes ❑ N/A
LIDA UYes ON/A
❑ OK to Issue Permit
Approved by Permit Coordinator: 4- Date: / .(
I:\Building 1 Forms\BldgPerm itRvw_RES_122419.docx
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T 1�,�,® D River Terrace Building Permit Review Addendum
Building Permit #: ,iirj'S',jl,\-, 00'7 cA ' . .
Site Address: I tY7 4O s w r(,v'i(e, Lmae
Project Name: Polygon at Roshak Ridge 1 Lot #: (( 0(
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review ofRiver ?'terrace P1ari District Desikri Standards (18.640.O70.1):
Is the project subject to the plan district design standards? ❑Yes ❑r No (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. .ormex
ft. deep min. 2ft.,5 ft.wide min.2 ft., Eft.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:
reet-facing wall ❑Parallel to street, . gle no more than 45° from street,
El Max. 8 ft. setback from longer
or open onto pot
Entrance opens to a porch: ❑Yes I o
If1es,all the following apple. ❑25 sq.ft . ' .
One street facing entry ❑12 f ax.roof above floor of porch
❑5 ft.depth min. ❑3''/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 Dormer 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 • . 21/2"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 'a 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. o 5 ft.if there is a covered front porch and garage does not extend beyond the fro .orch.
❑May extent, 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 facade
I 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: SPV Date: 09-13-2021
I:1BuiIdingl-ornrs\BIdgPermilRvw_RES_RT_I21417.doer
City of Tigard
1,1 . ° Deferral Until Occupancy Request
T I GARD Washington County Transportation Development Tax (1'DT),Transportation and Parks System
' Development Charges (SDCs)
This form is to be signed and submitted prior building permit issuance or,if no building permit is required,then
upon land use approval(TMC 3.24, as amended by Ordinance No. 21-09).
Date: 11/3/2021 Site Address: 16740 SW Darwin Loop
Project Land Use Case or
Polygon at Roshak Ridge MST2021-00397
Name: Building Permit#:
Tax Lot 2S107AA18900 Total Parks 8 017.00
#: Lot 189 Amount*: $ '
TDT Total TSDC $3,658.00
Amount: N/A Amount*:
0 for TSDC-Im rovement 386.00 for*The total TSDC amount shown above is the ofsum $ p $
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,$1,739.00 for Parks-
Reimbursement,and either$ NIA 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 I'DT 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: 0)1E44-.Aga.mi.Aea6 Date: 11/4/21
Developer: Oman A1aJtu:/6" Date: 11/4/21
Permit Coordinator: ATM GeA `" Date: 1113/2021