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Permit p CITY OF TIGARD MASTER PERMIT 11, • COMMUNITY DEVELOPMENT Permit*: MST2021-00342 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03J30J2022 Parcel: 2S107AA19000 Jurisdiction: Tigard Site address: 16754 SW DARWIN LOOP Subdivision: ROSHAK RIDGE Lot: 190 Project: Polygon at Roshak Ridge, Lot 190 Project Description: New detached dwelling. NO FINAL INSP UNTIL DEFERRED SDC FEES ARE PAID. BUILDING Floor Areas Required Setbacks Required Stones: 2 Bedrooms: 4 First: 1523 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 29 Bathrooms: 3 Second: 1898 sf Garage: 688 sf Front: 8 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 3421 sf Value: $481,994.82 Rear: 10 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 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 Footing Drain: 0 Ice Maker. 1 Hose Bib: 2 Backwater Value: 1 Bckfiw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Tvoes Air Conditioning: Y Vent Fans: 4 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 SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!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 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 3421 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 One Hour Fire Rated Eaves VANCOUVER,WA 98860 VANCOUVER,WA 98660 2 Eran Cntrl 503-639-4175 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $36,132.87 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 059_nni_nnin thmunh flaw 059-not-noon Vnu mnu nhtain a rnnu of fha ndac nr dirart nnaetinne to fll INC hu rollinn 5O 919 10R7 nr t Ann'119 91d11 Issued By: HOW-I Vaw DC.W64- Permittee Signature: Ow AppL-. o-'t ciy 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. 1 • 'Mechanical Permit Applicatit}t EVEI V E IFOROFFI jJSEONLY City of Tigard Received QQ��(J},t/ l�� ��Y1 //� v Dalen3 v Olti�2i IV` 1 \,'. kY1SSW-k— W342._ ,1 13125 SW Hall Blvd.,Tigard,OR 97223 ! = f 0/' plop Review i Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:SV' (n,' -DOt T GAR l? Inspection Line: 503.639.4175 CIT`(O F TIGARI) Dole Ready/By: )uric. 0 See Page I for tv Internet: ww.ligard-or.gov '3UILDING DIVISIOPI Notited)Method: Supplemental Information _ TYPE OF WORK - COMMERCIAL PER° SCHEDULE—USE CHECKLIST - Mechanical permit fees*are based on the value of the work 1.'" New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition D Other: mechanical materials,equipment'labor,overhead,and profit. Value:S CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling 0 CommerciaVindustrial 0 Accessory building For special information use checklist I j Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 Job site address: 16754 SW Darwin Loop Furnace 100,000 BTU(docu/"eets) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,0001'BTU(duds/vents) 54.91 Suite/bldg./aptno.: Project name: Polygon at Roshak Ridge Heat pomp 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 Lot no.: 190 Other. 2332 Other Fuel appliances: Tax map/parcel no.: Water heater , 23.32 DESCRIPTION OF WORK Gas fireplacennset 33,39 Flue vent for water heater or gas i New construction,type:Single-Family Units fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ® PROPERTY OWNER Q.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 Ea APPLICANT 0 CONTACT PERSON Other. 23.32 Business name:Polygon WLH,LLC Fuel piping: SI4.15 for first four;S4.03 for each additional Contact name:Tonja Morris Furnace,etc. Address:703 Broadway St.,Ste 510 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace Range E-mail:permitsubmlttalsttaylormorrison.com Barbecue dtkCONTRACTOR 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'o of permit fee) Phone:(360)270-1590 Fax:( ) State surcharge(1.2%of permit fee) CCB lic.:209001 TOTAL PERMIT FEE [� a This permit application expires if a permit Is not obtained within 180 Lb n. days after it has been accepted as complete. Authorized signature: L.C.LL 'J • Fee methodology set by Tri-County Building Industry Service Board Print name:Elia Duran Date: 10/30/20 t-lnniHinelPmmir;lMPr'Pmn:ltnn AO112 Av A An act T'rlr ern WY.•nr/ o, ' ' ' Electrical Permit Application RECEIVE FOR OFFICE USE 0\I.1- • e . City of Tigard RnaW9edy $ Ztiki l� prom,:i. �—p(�,�2 0 13125 SW Hall Blvd.,Tigard,OR 97223 1 „' 0 rs. PlenReview RelotcdPermita: Phone: 503.718.2439 Fax: 503.598.1960 paterBy- Q(ru" COZ�� ll .hu Inspection Line: 503.639.4175 CITY OF TIGARC Readyfatdny funs: Pi Ste Page 2for Internet: www Tigard-or,Rov aw /Notifiei/Method_ Supplemental Information I �1 TYPE OF WORT LIILDING DIVISICN PLAN REVIEW' IN New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets al-plans writams checked) 0 Demolition ❑Other: El5,avice or feeder 400 amps a more ❑Building over three stones. where the assailable fault current ❑Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO volts or 0 Floating building% ® I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building h`aa to ground,or exceeds 14,640 ❑commercrrl-ass agricultural amps for all other installations buildtugr. ❑Multi-family ❑Master builder 0 Other: Li Fire pump 0 Installation of 150 KVA or JOB SrFE INFOILMATlON ANTI) LOCATION ❑Emergrory system. larger separately delvrd Job#: Job site address:16754 SW Darwin Loop II100HP Qom new motor load of r�t`� City/State/ZIP: Tigard,OR 97140 ❑Six of more rosideatial moils ' ❑Health-care facilities 0 Recreational%dticle parks- Suite/bldg./apt.#: Project name: Polygon at Roshak Ridge ❑lLa amour locations 0 Supply voltage for snore than ❑Service or fi t S.r 600 amps oo more 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE. naerialioa I ntr. I Each i 'l'otol I ' New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: 190 Includes attached garage. Tax map/parcel#: 1,000 mg ft.ar less 168.54 4 Ea add'1500 sq.R or portion 33.92 1 _ DESCRIPTION OF WORK Limited energy,resideniral 75.00 2 New construction.Type SFO (with above sq.ft.), Limited energy,muki-family 75.00 2 residential(with above sq.ft.) , I PROPERTY OWNER 0 TENANT Renewable Energy IIScr Page 2 Services or feeders installation,alteration,aid/or relocation Name: Polygon Homes WLH LLC 200 amps or less 100.70 _ 2 Address: 703 Broadway St.,Ste 710 201 amps to 400 amps 133.56 2 City/State/ZIP: Vancouver,WA 98660 401.nips s 10600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:(360 )946 8674 Fax:( ) over 1,000 amps or volts 55226 2 Temporary services or feeders installation,alteration,and/or Email: OAlamiAbouhafs@taylormorrison.com-PermitSubmittals@tayiotmorrison.com relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rein,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 1 Owner signature:_,__. ..._ ,._ Date: 401 amps to 599 amps 168.54 2 0 APPLICANT ❑ CONTACT PERSON Branch circuits-new,littera or extension,per panel Business name: PolygonA.Fee for branch circuits with Business Homes WLH LLC above service or fouler fee, 7.42 each branch evouit Contact name: Omar Allard Abouhafs B.Fee for branch circuits withosa service or feeder fee,first Address: 703 Broadway St,Ste 710 branch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98660 Each add'I blanch circuit I 7.42 2 Phone- 360 946 8674 Miscellaneous(service or feeder not included) ( ) Fax::( ) Each manufactured or modular 67 84 2 Email:OAiamiAbouhafs r@laylormorri son.com-PennilSubmitta)s@taylonnorrison.com dwelling,service a tm°r foedcr Reconnect tmly 67.84 2 CONTRACTOR Pump or trngatim circle 67.84 2 Business name: Wallace Electric Sign or outline lighting _ 67.84 2 Address: 105 Dresden St Signal eircurt(s)or b ited-enagy ❑ seePage 2 2 panel,alteration,or extension. City/State/ZIP: Astoria OR 97103 Each additional Inspection over allowable in any of the above Additional inspection(l far min) 66 25/hr Phone:(503 3118 0563 Fax:( ) Investigation(I hr min) 90.00/hr Email:Davidtwallaccwires.com Industrial plant(I far rain) 78,18l far. . Inspections for which no lee is COB Lie.:224868 Electrical Li C 1441 Su 1,' . 6363S specifically listed CA hr min) 90 00/far Suprv.Electrician signature,required: ELECTRICAi;PERMIT An.ES ,8(` 44 a„,_..- - Subtotal- Print name:D14ti te Dale: N�j IG.f ❑Flan Review Required(25%of permit foe): /// '' `I a'FF• State surcharge(12%of permit fee): Authorized signature joe. l f�(t, TOTAL PERMIT FEE: This permit application aspires If a permit is nut obtained within 180 Print name: 6314 19 Date: (f /�2.1 days niter It has been accepted as complete. f b ' Number of mspechaus allowed per permit. g , jll: ill iaiW8i.C_PermeApp_ELR 021 dcc fa 0697R015 I ' 15T(tut5R:01dma r ,Elunibing Permit Application CEI 11 ED Building Fixtures 02 FOR OFFICE USE ONLY City of Tigard Rec6ved 17 v /2.% Permit N°.: AS�� (O3�2 13125 SW HaU Blvd.,Tigard,OR. 97223CITY OF TIGARD Y r a Pla / Phone: 503.7182439 Fax: 503.598geLDING DIVISION DB1ne/BRevY'iew Other PermitN°.: g(F>Q�Q�-��'' TIGARD Inspection Line: 503.639.4175 Date Ready/By: lea: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑Demolition For special Information use checklist Description J Qty. I Ea. j Total ❑Addition/alteration/replacement ❑Other. New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312,70 .l-and 2-family dwelling ❑CommerciaUndustrial SFR(2)bath 437,78 ❑Accessory building Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder ❑Other Fire sprinkler(_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 16754 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 Suite/bldg./apt.no.: I Project name:iMa4aY.fikil•Polygon at Roshak Ridge Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft:_) Page 2 Storm sewer(no.linear R:_) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Polygon at Roshak Ridge I Lot no.: 190 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:Single-Family Units Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 El PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixtureisewercap 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 Interceptor/grease trap 25.02 Business name:Polygon WLH,LLC Medical gas(value:S_) Page 2 Primer 12.51 Contact name:Tonja Morris Roof drain(commercial) 12.51 Address:703 Broadway St.,Ste 510 Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:permitsubmittals@polygonhomes.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:C&B Plumbing&Sons Inc Water pinB/D t W V 56.29 P 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 Lie.:184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE This permit application expires Ira permit is not obtained ts thin 180 days Print name:Steve Fowler Date: 10/30/20 after It has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Roam hBuildm rPenaitsPLMU-PaotirApp.doc I 0/OIA9 440.4616T(101172/COAUWEB) ZJ AYSl / Plan# ZZ.2—]�G � 1 (3 Z1 Floors _ Large L I Bed rooms y Small 79 WC 3 LAV S /0.d:---1`a - I G LG-n 62 v: L EZ Tub Basement Ll Vent 1st Floor 1523 l J Water Heater 1 2nd Floor `$et s AC y,L.j 3rd Floor School ��/ R-3Total 3I2A L,\,-- c....e_. Garage (`yse Total Li i D l Lck,Uh dy �j�" \ in (l I #for Elec LI si csJi-'1'( -tA):(S:1-4_, ,e Lt n -c-0 ty\- v(-, ,,k di.tte-3 no)-- new.;\--(_.1.-- VliA-- 2 • ,r_. b -14- a S' also La a k- - b (1 ,_s-s 2)� i I i G ins ' 6,54, r-f--‘ r r \IM-G...ot Dlr. P City of Tigard _ " Deferral Until Occupancy Request CountyWashingtonTransportationDevelopment ax rans ortati Pk System Transportation andars TIGARD W �on T (TDT),T p 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: 16754 SW Darwin Loop Project Land Use Case or Polygon at Roshak Ridge MST2021-00342 Name: Building Permit#: Tax Lot Total Parks 2S107AA19000 $8,017.00 #: Lot 190 Amount*: 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. [DT 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: Ohra-2,.A .A6eulc�,l� Date: 11/4/21 Developer: 0 +- Date: 11/4/21 Permit Coordinator: AVA G ✓1n" 't/ Date: 11/4/2021 City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT 114 T l c A><D Building Permit Review — Residential Building Permit #: t Lo' t OD 92- Site Address: 16754 SW Darwin Loop Project Name: Polygon at Roshak Ridge Lot #: 190 Planning Review Proposal: New house ® Verify address/suite# active in Accela. ® In River Terrace: ❑ No ® Yes, River Terrace Review Addendum Site Plan Elements: ®Erosion Control See comment below 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) InFootprint of new structure(including decks)and FFE ®North arrow ®Utility locations&easements(requited for new and additions) ®Site address,project or subdivision name and lot number $]Sidewalk/driveway approach ®Applicant information(name and phone number) IBLocation of wells/septic systems ®Lot dimensions and building setback dimensions ®Street tree size,type and location OSquare footage of buildings to be demolished ®Street names t1Fxisting structures on site ®Comer elevations (2'contours if more than 4'differential) L Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? FAA ❑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 JJ Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs Required: ❑ Yes,applicant was notified 13 No Received: ❑ Yes El No • SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No ® Public Facilities Improvement (PH) Permit: Required: ❑ Yes,applicant was notified ® No Applied For: ❑ Yes ❑ No,stop intake ® Land Use Case#: SUB2015-00004 ® Zoning: R-4.5 ® Required Setbacks: Front: 8 Rear: 10 Side: 3 Street Side: 8 Garage: 20 ® Building Height Max. Height: na Actual Height: 29 ® 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 $] Minimum 12%of area of all street-facing facades F: 14%/S: 12% Garage ® Garage door is behind widest street-facing wall X 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°s floor. lI Garage door width is ❑ 12'or less Xl 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 ® Visual Clearance ® Urban Forestry Plan ® Sensitive Lands: ❑ Yes ® No Type: ® Conditions met prior to issuance of building permit Notes: MMD2020-00044-only need to meet desi sten ards in 18.290 X❑ Approved By Planning: `�/ ' 4 Date: 8/19/2021 Revisions (after Building Submittal onl Reviewer Date Revision 1: Approved El Not ApprovedAny-,4,1e. (0(%.21 Vat Revision 2: ❑ Approved El Not Approved 1:1Bui(ding\Form s1B1 dgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: fink" Site Plans: # ") Building Plans: # Building Permit#: Oi Enter building p t# above. � ��' Workflow Routing: I�Planning Engineering ❑,/Permit Coordinator L,d'Building Workflow Sign-off: [Sign-off for Planning(include notes from planning review) Route Application Documents: [Engineering: (1) copy of permit application, (1) site plan, (1)building plan and original plan review routing form. Di/Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Date: 2c Z1 Engineering Review Slope at building pad: 3 O (21 Conditions"Met"prior to issuance of building permit 1'Easements (encroachments)per engineering conditions of approval and plat 1--Water Quality/Quantity Facility / Assess Water Quality Fee in-lieu: ❑ Yes p�c� No Assess Water Quantity Fee in-lieu: ❑ Yes Ih No / LIDA Facility on lot ❑ Yes ZeNo [ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes:�� Ild` Approved by Engineering: Date: Revisions (after Building Submittal only) Reviewer Date Revision 1:. ❑ Approved ❑ Not Approved Revision 2: E 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: Al. — I l 1412D2I Revision Notice 2: Date Sent to Applicant: SDC Exemption:?f ❑ Received Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: J" Yes ❑ N/A SDc l rrtc Parks SDC: 7t Yes ❑ N/A LIDA ❑ Yes Al N/A XOK to Issue Permit Approved by Permit Coordinator: /,-., Date: 01(212021 I:1Bui lding\FonnsBB1 dgPennitRvw_RES_122419.docx City of Tigard : il Parks SDC Charge (Parks) 11 TIGARD Notification of Fee and Payment Options Please sign and return prior to building permit issuance. This advises you that the total Parks SDC charge for this project is as shown below and outlines the payment options that may be available to you. This total includes Parks SDC-Improvement,Parks SDC-Reimbursement, and either Parks-Neighborhood or Parks-Neighborhood River Terrace charges as relevant. This form is to be signed and submitted prior to issuance of a building permit. 7 City of'1'igard �� � N✓LIl.�'V Date: 9/2/2021 Site Address: 16754 SW Darwin Loop Project Polygon at Roshak Ridge- Land Use Case Name: Lot 190 or Permit #: MST2021-00342 Tax Total Parks 25107AA19000 $10,903 Lot#: SDC Amount*: *The total Parks SDC amount shown above is the sum of$ 6.278 for Parks-Improvement,$1,739 fot Parks- Reimbursement,and either$ N/A for Parks-Neighborhood or$2.886 for Parks-Neighborhood River Terrace. This constitutes my request to use the Parks SDC payment option or combination of options I have selected below. [This selection can be changed up to the time a building permit is issued.] I realize that SDC charges are due and payable at the time a building permit is issued unless those charges are Deferred or are financed through Installment Payments. ❑ Cash.Check,or Credit Card,payment due at building permit issuance. ® Deferral until Occupancy,payment due before issuance of an occupancy permit. Payment of the Parks SDC may be deferred until issuance of the occupancy permit. In requesting this option,I understand that any deferred Parks SDC must be paid prior to issuance of a Certificate of Occupancy. For a deferral request to be accepted both the Property Owner and the Developer must sign this request. ❑ Credit Voucher(for developer-built required public improvements, subject to approval,completion,and acceptance of creditable improvements.) PLEASE NOTE: Parks SDC Credits must be redeemed at the time Parks SDC Payment is due,either at the time the building permit is issued or,if payment is deferred,prior to issuance of an occupancy permit. If you expect to claim Parks SDC Credits be sure the improvements,any creditable payments,and your Request for Credits is complete either before your building permit is to be issued or,if payment is deferred,before you request an occupancy permit. No refund of Parks SDC Payments will be made if Credits are submitted mote than 30 days after issuance of the relevant building or occupancy permit. ❑ "Bancroft"or Installment Payments (separate application required.) Om.a2.46-01.4. A6au�a�a Onr.aA..Aganu'A6aufla., PROPERTY OWNER DEVELOPER DATE: 9/2/21 DAI'L: 9/2/21 I:\Community Development\Permit Coordinator\SDC Forms\Payment Option Forms City of Tigard INI g g q Transportation System Development Charge (SDC) T i G A h D Notification of Fee and Payment Options This advises you that the total TSDC for this project is as shown below and outlines the payment options that may be available to you. This total includes charges for TSDC-Improvement,TSDC-Reimbursement,and TSDC-River Terrace,if relevant. This form is to be signed and submitted prior building permit issuance or, if no b ilding perm' 's re ired, then upon land use approval (TMC 3.24, as amended by Ordinance No. 21-09). City of Tigard Date: Site Address:9/1/2021 16754 SW Darwin Loop Project Polygon at Roshak Ridge- Land Use Case or MST2021-00342 Name: Lot 190 Building Permit #: Tax Total TSDC 2S107AA19000 $10,348 Lot#: Amount*: *The total TSDC amount shown above is the sum of$6,690 for TSDC-Improvement, $386 for TSDC-Reimbursement,plus $ 3,272 for TSDC-River Terrace,if relevant. This constitutes my request to use the TSDC payment option or combination of options I have selected below. [This selection can be changed up to the time a building permit is issued.] I realize that TSDC charges are due and payable at the time a building permit is issued unless those charges are Deferred or are financed through Installment Payments. ❑ Cash. Check,or Credit Card,payment due at building permit issuance. O Deferral until Occupancy,payment due before issuance of an occupancy permit. Payment of the TSDC may be deferred until issuance of the occupancy permit. In requesting this option,I understand that any deferred TSDC must be paid prior to issuance of a Certificate of Occupancy or final inspection. For a deferral request to be accepted both the Property Owner and the Developer must sign this request. ❑ Credit Voucher for developer-built required public improvements, subject to approval,completion,and acceptance of creditable improvements.) NOTE: TSDC Credits must be redeemed at the time TSDC Payment is due,either at the time the building permit is issued or,if payment is deferred,prior to issuance of an occupancy permit. If you expect to claim TSDC Credits be sure the improvements,any creditable payments,and your Request for Credits is complete either before your building permit is to be issued or,if payment is deferred,before you request an occupancy permit. No refund of TSDC Payments will be made if Credits are submitted more than 30 days after issuance of the relevant building or occupancy permit. ❑ "Bancroft"or Installment Payments (separate application required.) Oma,t..R&ha.A6au Dom.4hamo,46acuf PROPERTY OWNER DEVELOPER DATE: 9/2/21 DATE: 9/2/21 I:\Community Deve]opment\Permit Coordinator\SDC Forms\TSDC Combination Payment Option Form 112718 AMS