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Permit FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPAR'1MEN'I Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Building Review-Allyson Armstrong DATE RECEIVED: DEPT: BUILDING DIVISION FROM: Taylor Morrison Northwest LLC (Omar AA) RECEIVED COMPANY: Taylor Morrison Northwest LLC MAR 6 2022 I Y OF I IGAH' By PHONE: 360 695 7700 ul nlnl( nllnClnl EMAIL: 0AlamiAbouhafs@taylormorrison.com RE: 14452 SW 165th Avenue MST2021-00370 (Site Address) (Permit Number) Polygon at Roshak Ridge, lot 177 (ADU-1) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. 3 Revisions: Utily sheet U5 (W/o hose bib) Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: The hose bib in ADU-1 (middle unit) need to be removed to reduce the size of the water meter needed, from 1-1/2"to 1". O \L run.anaJ rr A$:I P1Jr►.btr� 3/_/Z2 FOR JJFFI;E USE ONLY ^ `� Routed to Permit Technicia . „Date: / Z7i/ Z) Initials: /`�7`1" Fees Due: ❑ Yes ❑ o e Description. Amount Due: Special Instructions: Reprint Permit(per PE : El Yes No ElDone Applicant Notified: k/-fig Date: `2 /2 u(42Z Initials: ��hl v FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 1 11 a Transmittal Letter T I C;A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: AIIi. SOY) /-219h51-ROl DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: (A.•D'YIOi 2 Ai CU.1pm �O� Oh en OCT 2 6 2021 COMPANY: )Ccw I,.t ocr c Ni n24 k l ue ct LLC CITY OF TIGA PHONE: (n O , ( (0 0 674 3UILDING DIVISII 1i �_ pp EMAIL: ©-a--)Qvrrlf a•�UU114s 6 itayforz,y r', . c - - RE: � MST 2.0�1 - O0369 ( i e Address) (Permit Number) a) -0 T (P Ait-tt�1-7 /P /- Jan^ame or subdivision name and lot number J �� ac `' 00 31 I ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: ,° ''M € Additional set(s) of plans. 5 Revisions: v✓tda ,t9,1 I=1 Cross section(s) and details. Wall bracingand/or lateral ahal sis. Y Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: 'PO O FICE USE ONLY ` Routed to Permit Technician:, ,Bate: i( �1 7. ( Initials: Fees Due: U Yes �o V Fee Descript on: Amount Due: $ )7;fir.P 5 $ Special Instructions: Reprint Permit (per PE)• ❑ Yes No ❑ Done /Ar!C Applicant Notified: p � Date: /' /.A`1/ ) Initials: I:\Bui lding\Forms1TransmittalLetter-Revisions_073120.doc FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT i _ Transmittal Letter T 1(i,11z I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Ali C9� l�Rrmon DATE RECEIVED: DEPT: BUILDING DIVISION CEI1 E D FROM: 61,c& ALoJa ?i NOV 2, gob COMPANY: ( � CO 1�1ca�tS9l, Mr*kotNPCI LI CITY 0F TIGARD 3UILDIfUG DIVISION By. PHONE: '. //�0 0 �� 94 6 8� EMAIL: (9 24227c f2l3/�//,1S G tb3(6 (h11w iARA (,,t ti, RE: 5_9, 4(felt ,5 r,(1 /6r ' /'1 SUQ�1— f �� Site Address) Ai-143- (Permit Numberq o,r Qace0J2 - ,d /- 00340 (Pr ' c ame or subdivision name and lot nunber)CI / 00 3 '71- ATTACHED ARE THE FOLLOWING ITEMS: 'Copies: Description: ,?Copies: j Description: Additional set(s) of plans. 3 Revisions: D.A. `je(.-akc 157ed Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): / i J� J REMARKS: 2 r iOy cee /�ZCUSe-J c1 e - 2 , LI- P-toi b4'e 4 cJ2d Z * IV irevCG-- // fir' Pr, p r 5'e. 9 _- Q L4-o • 3 cC 2 . FOr OFFICE USE ONLY Routed to Perm ician: Date: 4 I i (a-t Initials: Fees Due: f✓YI 0 No Fee Descripti n: Amount e $1/2„, -,)1\ riA/\:4-1,\ S fis. o $ t-(5 pb 1° VSGt $ s� ,1--r - $ 1 1o' f Special Instructions: Reprint Permit(per PE : ❑ Yes No'� ❑ Done Applicant Notified: Date: if ��5 /2.) Initials: J I:1B u i I d i n g\Forms 1Tr an sm itt a l Letter-R ev i s i on s_073120.do c CITY OF TIGARD MASTER PERMIT :� a . COMMUNITY DEVELOPMENT Permit#: MST2021-00370 Date Issued: 05/23/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S107AA17700 Jurisdiction: Tigard Site address: 14452 SW 165TH AVE Subdivision: ROSHAK RIDGE Lot: 177 Project: Polygon at Roshak Ridge, Lot 177(1 of 2)ADUs Project Description: New attached ADU(1). NO FINAL INSP UNTIL DEFERRED SDCs PAID. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 947 sf Basement: 64 sf Left: 3 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1007 sf Garage: 448 sf Front: 8 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 2018 sf Value: $287,945.36 Rear: 15 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: Storm Sewer: 100 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker. 1 Hose Bib: 1 Backwater Value: 1 Bckflw Prevntr. 0 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 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 2 Fum>=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: 3 201-400 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 ADU Vt R-3 2018 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 Fire Rated Conditions VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 Ersn Cntrl 503-639-4175 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $19,938.78 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 oco_nn1-0nin fhrn,nh now QF9-On1-nnfrl Vnn mov nhfain a rnnv of tha n.lac nr dirarf,l acenne M r111Nrt hw rallinn cO 7k7 1QR7 nr 1 Ann 11]'144 HoU.y Vag.De,Wegr, Issued By: Permlttee Signature: O in., Afrpt.L.c.49.4-Lan, Call 503.839.4175 by 7:00 a.m.for the next available inspection date. This penult card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the lob slte at the time of each inspection. ' ' Building Permit Application f, Residential RECEIVED FOR OFFICE USE ONLY Cityof Tigard Received /� D tit75T 21 i2 37e) 91 2021 � Y: // !N fJ • 13125SW Hall Blvd.,Tigard,OR 97223 A AUG 3 Plan Review` �pp� 1 Permit Phone: 503.718.2439 Fax: 503.598.li9 Y OF TIGARD Date/By: It -I 21 Other Perna: Ili ,�iA, Inspection Line:g5a0�3.63g4175 BUILDING DateRceadye :� ( 7 Ilu�� ®PP Page2for Internet: www.tigard-or.gov ov tified/Menrod: Supplemental Information TYPE OF WORK REQUIRE I)DATA:1-AND 2-FAMILY DWELLING ®New construction D 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 ❑Commercial/industrial Valuation: $ S7/ !ys, 'f' ❑Accessory building ❑Multi-familyNumber of bedrooms, 4 Master builderNumber of bathrooms: 3 ❑ ®Other:N ADU 1 ��� JOB SITE INFORMATION AND LOCATION Total number of floors:3 -Lott Job site address: 14452 SW 165TH AVE New dwelling area: .27313.8... square feet ,007 City/State/ZIP:Sherwood,OR 97140 Garage/carportarea: 448 square feet 9 Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: square feet u li Cross street/directions to job site: Deck area: 5'7>< square feet Other structure✓area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Polygon at Roshak Ridge I Lot no.: 177 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. Dew Construction/Type: Triplex-ADU 1 (unit 2 out of 3) Valuation: $ eferrals:YES-deferral of TSDC fees and park SDCs until occupancy. Existing building area square feet Projected start: 2022 New building area: square feet 0 PROPERTY OWNER ❑ 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: 0 APPLICANT ❑ CONTACT PERSON U9 BUILDING PERMIT FEES* (Please refer to 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: E-mail:pennitsubmittals@taylormorrison.com taylormorrison.com-OAIamiAbouhafs@taylormorrison.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of 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 tic.:207247 Total fee due upon application: $201.60 Authorized signature: ()MCUL ,ry ea-kne .ry IYBalitt!l- This permit application expires if a permit is not obtained L/ within 180 days after it has been accepted as complete. Print name:Omar Alami Abouhafs Date: 08/30/2021 *Fee methodology set by Tri-County Building Industry Service Board. I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB) Mechanical Permit Applicat CE IVE D FOR OFFICE USE ONLY '" "r "` City of Tigard RCCC1VGd Permit No. 13125 SW Hall Blvd.,Tigard,OR 97223 A Ili n I 1 PlaPlan Review f ZA Zd 'co ?d Dat By: -� -� : Phone: 503.118.2439 Fax: 503.598.1960 � Other Permit: Daue7By: Y l z,h f:l i Inspection Line: 503.639.4175 CITY Ur I I(G AR D Date ReadyBy. hris. H See Page liar — Intemet www.ligard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK U DIVISION�t COMMERCIAL FEE* SCHEDULE- USE CHECKLIST Mechanical permit fees*are based on the value of the work ►4 New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipments labor,overhead,and profit. Value:$ CATEGORY.OF CONSTRUCTION RESIDE/41;444 EQUIPMENT/SYSTEMS FEES' ®1-and 2-family dwelling ❑Commerciallindustrial 0 Accessory building For special information use checklist I j Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total JOH SITE INFORMATION AND LOCATION Heating/eaoliur_ Air conditioning I 46.75 Job site address: 14452 SW 165th AVE _.._._._...._ Furnace 100,000 BTU(ducutvems) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(docts/vcats) 54.91 Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge He81 pip 61.06 Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydmnic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 2332 Subdivision: Polygon at Roshak Ridge Lot no: 177 Otba 23.32 -- Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplaceltnsert 33.39 - Flue vent for water heater or gas New construction-Type ADU 1 fireplace 23.32 Loa lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ® PROPERTY OWNF�t 0TENANT• Other 23.32 Environmental exhaust and ventilation: Name:Polygon WLH,LLC Range hood/other kitchen equipment 33.39 Address:703 Broadway St.,Ste.520 Clothes dryer exhaust 3339 City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms, toilet compartments,utility moms) 23.32 Phone:(360)695-7700 Fax:( ) Attic/erawlspace fans 23.32 ® APPLICANT 0 CONTACT PERSON Other: 23.32 Business name:Polygon WLH,LLC Fuel piping: S14.15 for first four;54.03 for each additional Contact name: OmarAlami Abouhafs Furnace,etc. Address:703 Broadway St,Ste 510 Gas beat pump W alLisuspcnded/umit heater City/State/ZIP:Vancouver,WA 98660 Water,heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace Range E-mail:permitsubmittalstataylormorrison.cOm Barbecue ri• }t 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 lic.:209001 TOTAL PERMIT FEE (�\ Thus permit application expires ifs permit is not obtained within 180 VWQ, l e,-r�n., days after it has been accepted as complete. Authorized signature: JJJJ • Fce methodology set by Tri-County Building Industry Service 9oard Print name:Elia Duran Date: 10/30/20 t-11in1idinnw...ne.u.mr canna Ann nevi is an, . . Electrical Permit ApplicatioiR E C E I VE D uoR 0VFlCE USE ONLY City of Tigard Received pe,m t MS fie ?ZI- Dv37c ., " 13125 SW Hall Blvd.,Tigard,OR 97223 A L C Plan Review Phwc. 503.71$2439 Fax: 503.598.1 y Related Permit it: r Ready It inspection Line: 503.639.4175 �� Read bat lurk a for Tr LIA RP Internet: www.tl and-or�goy �I .' ,'n n.1' n',"7r.,1 Notific ethed_ S Seems t Supplemental g g Supplameatil Iatormanon TYPE OF WORK PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please cheek all that apply(submit j sets of plans wtitams checked): 0 Demolition ❑0 �; ElSasiee or feeder 400 amps oi more CIBadding over three stones. where the mailable fault current 0 Marinas and bostvardht CATEGORY OF CONSTRI iCTION exceeds 10,000 amps at r50 volts or ❑Floating troikhnas I-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to mound,or exceeds 14.000 ❑Commercial-mcagicuitaral ❑Multi-family ❑Master budder0 Other amps ha as othtr installations Installation ❑Fire pump. ❑Installation of 150 KVA Or JOB SIFE INFORMATION AND LOCATION system larger separately derived lob#: Job site address:14452 SW 165th AVE ❑10011E a moref ilek motor l a d of sys m IgOtlP or more. ❑"A",-£.."1 2«."1-3' City/State/ZIP: Tigard,OR 97140 ❑SIX or more residential am s occ yrua=Y ❑Hcalltrearc facilities ❑Rccdeat anal vetuck parks. Suite/bldg./apt.#: Project name: Polygon at Roshak Ridge ❑1Wardous locations 0 Supply voltage for more than 0 Service or feeler 600 amps as more 600 volts nominal. Cross shreet/directions to job site: • FEE SCHEDULE ' - ,...� Descending .1 Qtr. I Lath ,I 'fatal I • New residential single.or multl-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot*: 177 includes attached garage. I,000 sq-ft.or loss 168.54 4 Tax map/parcel#: Ea add'1500 sq.R.or portion 33.92 1 DESCRIPTION OF WORK Limited merge,residential (with above 11.) 75.00 2 New construction.Type ADU 1 Limited extra,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy 0 Sec Page 2 D 0 TENANT PROPERTY OWNERServices or feeders installation,alteration,and/or relocation Name: Polygon Homes WLHLLC 290 amps or km 100.70 2 Address: 703 Broadway SL,Ste 710 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/StateZIP: Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2 Phone:(360 )946 8674 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: OAIamiAbonhafstgtaylonnorrison.com-PermitSubmittals( 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 en 400 amps 125 08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 0 APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for laanch circuits with Business name: Polygon Homes WI.H LLC above service or feeder fee, each branch comet 7.42 2 Contact name: Omar Alarm Abouhafs B.Fee for taancb circuits witlaxA service or feeder fee,fist Address: 703 Broadway St.,Ste 7l0 56.18 2 btane.b circuit City/State/ZIP:Vancouver,WA 98660 Pacer add'I branch circuit 7.42 - 2 Phone 360946 8674 Miscellaneous(service or feeder not inducted) ( )946 ( ) Each manufactured or modular 67 84 2 dwelling, 1Oe and/or f perEmail:OAiamiAbouhafs@taylormorrison.com-PetmitSubmittalsataytntmOlri30n.C[B1 oanc only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 _2 Business name: Wallace Electric Siga or outline bathing 67.84 2 Address: 105 Dresden St signal cireuet(s)or limited-energy ❑ See Page 2 2 panel,alteration,ux cxi asicei City/Stater/JP: Astoria,OR 97103 Each additional inspection over allowable in any of the above Additional inspection(l hr min) 6625/hr Phone:(503 31$0563 Fax:( ) Investigation(1 hr min) 90.00/hr Finail' David(u3wallaccwires.coID industrial plant(1 hem n) 78.1$1 br lnspeniens for which no fee is 90.00/hr CCB Lie.;224868 Electrical ' -C1441 --ISSu rv. I. .7 6363S specifically listed(141u min) Suprv.Electrician signature,required: / . . ELECTRICAL PERMIT.FEES �-1 Subtotal- Print name:7) 4p ��+�Y Date: it/ 1� /z f —D Plan Review Reyuired(25%of permit feu): State surcharge(12%of permit fee)' Au horized signature TOTAL PERMIT ME: ISa permit application expires if a permit bi not aMaiued widths 140 Print name: 77��,�, � Date: ��tt// days after it has been accepted p c000plw- h 4{. _.. _ 7 l �1_t_.., a Number of mixtures s allowed per permit. Lt8mldingti'vmils'5LC Per t&pp_ELR IRE.dcc Rev 06l7f1015 I.ii//±i-lt15T(11kf5Koh0A041 Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of Tigard R EC F I VE."received Permit wn: 13125 SW Hall Blvd.,Tigard,OR 97223 ate By. �57�(j u...no j 70 v Phone: 503.7182439 Fax: 503.598.1960 Plan Rev ew 11, . . . Other Permit No.: Inspection Line: 503.639.4175 D TIGARD Datete By. Ready/By: rats: See Paget for Internet: www.tird-or. ov ga 8 Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction 0 Demolition For specialinfornrrion use checklist Description I Qty. I Ea. I 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 X.1.and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building .Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 CI Master builder 0 Other: Fire sprinkler( sq.ft.) Paget JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 14452 SW 165th AVE Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 DryweB leach line,or trench drain 18.76 Footing train(no.linear 1t:_) Page 2 Suite/bldg./apt.no.: I Project name:Iiesl.itnAL_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 ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Polygon at Roshak Ridge I Lot no.: 177 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 ADU I Dishwasher 25.02 Drinking fountain 25.02 Ejecrors/sump 25.02 CO PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixmresewer 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:$_) Page 2 Contact name: Omar AlarmAbouhafs 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®polygonhomes.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:G&B Plumbing&Sons Inc Water piping/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.:pb634 Plan review (25%of permit fee) Authorized signature: +"v State surcharge(12%of permit fee) TOTAL PERMIT FEE Print name:Steve Fowler Date: 10/30/20 This permit appltcatioa expires if a permit is not obtained within 180 days after it has been accepted as complete. "Fee methodology set by Tit-County Building Industry Service Board. 1•1BoildioglPvmiu1PLMU-PermitApp.doe 10mIN9 440-4616T(10,O2ICOMM1,'EB) ' City of Tigard :ligCOMMUNITY DEVELOPMENT DEPARTMENT 1 ci�s D Building Permit Review — Residential Building Permit #: /''l S 'j Zd 21 — DD 3 7 0 Site Address: 14452 SW 165th Avenue Project Name: Polygon at Roshak Ridge Lot #: 177 Planning Review Proposal: New attached ADU (1) ElVerify address/suite# active in Accela. ❑✓ In River Terrace: 0 No ❑✓ Yes, River Terrace Review Addendum Site Plan Elements: ✓ rosion Control Q: copies of site plan on 8-1/2"x 11"or 11 x 17"paper f'" Detained trees with drip line and tree protection measures OD rawn to scale (standard architect or engineer scale) ;Footprint of new structure(including decks)and FFL 0 orth arrow ✓�.Jtility locations&easements (required for new and additions) D.ite address,project or subdivision name and lot number sidewalk/driveway approach III pplicant information(name and phone number) OK ✓ ,ocation of wells/septic systems 12 of dimensions and building setback dimensions �itreet tree size,type and location UII.quare footage of buildings to be demolished street names II xisting structures on site °Torner elevations (2'contours if more than 4'differential_ 11 .t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? "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 ❑✓ Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): Required: El Yes,applicant was notified Q No Received: ❑ Yes ❑✓ No ❑✓ Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs Required: ❑Yes,applicant was notified No Received: ❑ Yes No Q SDC Exemption for ADU applied for: Yes ❑✓ No Received: ❑ Yes ° No ❑✓ Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicantA was notified 0 No Applied For: ❑ Yes CI No,stop intake Q Land Use Case#: ' f 9U?OZO- 00D2 ❑✓ Zoning: R-4.5 QRequired Setbacks: Front: 8 Rear: 15 Side: 3 Street Side: N/A Garage: 3 ❑✓ Building Height Max.Height: 30 Actual Height: 4 ElLandsca e Area: 20 % 0 Lot Coverage Max: 80 Entrance ✓ Set back no more than 8'from street-facing wall Q 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 ❑Yes ❑ No,one of the following is met: EiDoor 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%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 0 Gable,hi ,or gambrel roof Dormer _ Accent siding Window trim UWmdow recess U Window projection ❑ Balcony ❑✓ Visual Clearance ❑✓ Urban Forestry Plan ❑✓ Sensitive Lands: ❑ Yes ✓ No Type: ❑✓ Conditions met prior to issuance of building permit Notes: Q Approved By Planning: )(11- z Date: 919/21 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Foans\BI dgPermitRvw_RES_122419.docx Building Permit Submittal li Original Submittal Date: 7/3 i/Z1 Site Plans: # 3 Building Plans: # 3 Building Permit #: f—En�ter building p�ermitt#above. Workflow Routing: Un�P tanning Igineering Permit Coordinator _uilding Workflow Sign-off: Bn'�Srign-off for Planning(include notes from planning review) Route Application Documents: I�rngineering: (1) copy of permit application, (1) site plan, (1) building plan and Ek on plan review routing form. wilding: original permit application,site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: •c/� "' —A Date: J'/(v/'�/ Engineering Review Slope at building pad: /al. Conditions"Met"prior to issuance of building permit Easements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: rnrn�� Assess Water Quality Fee in-lieu: ❑ Yes L� o Assess Water Quantity Fee in-lieu: 0 Yes �J,No �j. LIDA Facility on lot 0 Yes �� No CJ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Ly Approved by Engineering: _i,- Date: 9//3/e/ 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: i ❑ RecSDC Exemption: eived J!I Does not a7ply SDC Fees Entered: Wash Co Trans Dev Tax: / yes N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A • LIDA 0 Yes a N/A OK to Issue Permit Approved by Permit Coordinator: k L Date: 9 11kl? `ZDZ 4 I:\Bui lding\Forms\BldgPermitRvw_RES 122419.docx City of Tigard III .1 COMMUNITY DEVELOPMENT DEPARTMENT C . TIGARD River Terrace Building Permit Review Addendum Building Permit #: Site Address: 1yy52 (OS+t- fJC Project Name: Polygon at Roshak Ridge Lot #: - (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of River Terrace Plan District Design Standards (18.640.070.I.): Is the project subject to the plan district design standards? ❑Yes 3 No (Per MMD2020-00044) culation: 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 :.; ft. deep ft deep min.2ft.,50 ft.wide min.2 ft.,6❑ft.wide Gable. .ormer 2.Eyes on the str v: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: ❑Max.8 ft. setback from longes trees- facing wall ❑Parallel to street :le no more than 45° from street, or open onto por Entrance opens to a porch: ❑Yes I I o If es,all the following apply: ❑25 sq.ft. in. UOne 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 v 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 P ormer min.4 ft.wide ❑Roof eave min. 12 inch projection ❑R. • offset min.of 2 ft. ❑Roof shingles either tile or wood ❑Gable, .'p or gambrel roof design ❑Roof pitch oriented south min. 500 sq. . El Horizont.. ap siding min. 3-7 inches wide ❑Accent siding min.40%of street fa •e ❑Window trim • ' .2 1/2"wide by 5/8"deep ElWindow 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 'o or less of street facade 5. Garages and Carports: - ay face the front or side lot line on a corner lot. Setbacks: No closer to front o -ide lot line,than longest street-facing wall. ❑Yes 0 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 exten• 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 t'.r 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 11 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: Date: • Q2r C\Buildmiforms,BldgPennitRvw_RES_RT_121417.dax City of Tigard Deferral Until Occupancy Request TIGARD 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: 9/16/2021 Site Address: 14452 SW 165TH Ave Project Land Use Case or Polygon at Roshak Ridge MST2021-00370 Name: Building Permit#: Tax Lot 2S107AA17700 Total Parks #: Lot 177 Amount*: $5,839.00 TDT Total TSDC $225.00 Amount: N/A Amount*: *The total TSDC amount shown above is the sum of$ 0 for TSDC-Improvement,$ 225.00 for TSDC- Reimbursement,and$ 0 for TSDC-River Terrace,if applicable.. *The total Parks SDC amount shown above is the sum of$4,727.00 for Parks-Improvement,$ 1,112.00 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 [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: 6dA- 46.m.‘ .A6e Date: 09/16/21 Developer: 4 46e - Date: 09/16/21 Permit Coordinator: PTO OetiKelfb Date: 9/16/2021 PD0 1 Plan # m4 -r[) --ir,�l ( I (, �l-� `�` Floowcrs 3 Large Bed rooms y Small r,„,_ ,a_4..j ,,,,s ,_1_‘ I u LAV Tuubb Basement lel Vent ji() 6- 7- s He ( 00—]1st Floor Water Heater ) 2nd Floor DO AC I')1 D 3rd Floor School �� cAr--1 R-3Total 0-014B ND -kNrtip�.C..11--. Garage L a-- ' [-- tLkAe... Total oa a-boo k bs 3 0 #for Elec