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Permit l' CITY OF TIGARD MASTER PERMIT 11li. ` : COMMUNITY DEVELOPMENT Permit#: MST2021-00406 E T ' I Date Issued: 04/18/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 , Parcel: 2S107AA18700 e 1 ' " Jurisdiction: Tigard Site address: 16722 SW DARWIN LOOP Subdivision: ROSHAK RIDGE Lot: 187 Project: Polygon at Roshak Ridge, Lot 187 ADU Project Description: New attached ADU. NO FINAL UNTIL DEFERRED SDC FEES ARE PAID. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 1228 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: Bathrooms: 2 Second: 0 sf Garage: 275 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 1228 sf Value: $174,454.24 Rear: 10 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 3 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 2 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 add9 500 sf: 2 201-400 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 VB R-3 1228 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 2 One Hour Fire Rated Eaves PHONE: PHONE: 360-695-7700 FAX: Total Fees: $17,510.65 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-nfN-nnln thrnunh fAR 0c9-M1-nnQn Vnn may nhtain rnr of tha'lilac nr r ltirart ni iactinnc to(11 Mir by Tallinn cn1 9'29 10R7 nr 1 Ann'YM 9'44 Issued By: G%� 44 .. 7 Permittee Signature: 2j2 all 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. a CITY OF TIGARD MASTER PERMIT 'r1 COMMUNITY DEVELOPMENT Permit#: MST2021-00406 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/18(2022 Parcel: 2S 107AA18700 Jurisdiction: Tigard Site address: 16722 SW DARWIN LOOP Subdivision: ROSHAK RIDGE Lot: 187 Project: Polygon at Roshak Ridge, Lot 187 ADU Project Description: New attached ADU. NO FINAL UNTIL DEFERRED SDC FEES ARE PAID&WATER METER HAS BEEN UPSIZED. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 1228 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: Bathrooms: 2 Second: 0 sf Garage 275 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 1228 sf Value: $174,454.24 Rear: 10 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays. 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: Storm Sewer: 100 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 3 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 2 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: 2 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr 0 It 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 VB R-3 1228 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 2 One Hour Fire Rated Eaves PHONE: PHONE: 360-695-7700 FAX: Total Fees: $17,510.65 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 0S9-nnl-nnin fhrnfinh OAR 059-nn1-nnon VAII mw nhfnin n rnnv of fha'Iliac nr dirarf nt ic<finnc fn(II iMMC by rn0inn sn-4 739 10A7 nr 1 Ann 119 94dd Issued By: Ho-{Li Vaw De,V/2y� Permittee Signature: 0vt,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. .Y ..,.. .. .. ...... .... .. ._ . mr. ...aQe.aa . a s..t..,.. . r.r.n..0 c.t..u. ..rv...r.t ......a..< .e..aaa...a......,.... Building Permit Application Residential RECEIVE . FOR OFFICE USE ONLY City of Tigard 7 } Received J' V( 3 P� M,594Z,I_OockJ qq Permit No.: IN " 13125 SW Hall Blvd.,Tigard,OR 97223 SEP C a 20i 3 Plan Review, 'f n' -•�n' �^I••t�. II Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 1') f y v' I-" ' Other Permit:S(N 2Z0 Z(—Q'OZ C/ T 1 G A K D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris: la See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION NgLift�d/Method: Supplemental Information ��i 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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application.Valuation: $ 17 y� yam �Y , Di-and 2-family dwelling 0 Commercial/industrial 1 ❑Accessory building 0 Multi-family Number of bedrooms: 3 ❑Master builder ®Other: ADU Number of bathrooms: 2 JOB SITE INFORMATION AND LOCATION Total number of floors:2 l 5"3^ 0. Job site address: 16722 SW DARWIN LOOP New dwelling area: 1,228 square feet ,)`o�U City/State/ZIP:Sherwood, OR 97140 Garage/carport area: gi5uare feet 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: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Polygon at Roshak Ridge Lot no.: 187 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 ,✓1 T2 7 work indicated on this application. ew Construction/Type: Duplex (unit 2 out of 2) Valuation: $ irN 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: I ® APPLICANT 0 CONTACT PERSON Uk9 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 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 CONTRACTOR roof-top mounted Photo Voltaic 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 lic.:207247 /� //` /- / Total fee due upon application: $201.60 Authorized signature: DJ9'LC/t.4C.r!z e_.cy A9ez LCL4e� This permit application expires if a permit is not obtained lJ within 180 days after it has been accepted as complete. Print name:Omar Alami Abouhafs Date: 09/07/2021 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Petmits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application RECEIV ; ' FOR OFFICE USE ONLY 'Cityof Tigard •ecerved /� Date/By, al ,1vl 5 e v Permit No.: :A/) i " 1.' - 'I 13125 SW Hall Blvd.,Tigard,OR 97223 SEP Q "� ?Or! f{{ cj J 14Z�"L�N� I � Plan Review Fhone: 503.71$.2439 Fax: 503.598.1960 Date/By: Other Permit:Si/4447 l —00'04f IItiAltl) Inspection Line: 503.639.4175 I • a.teReady/By: ]iris "'✓ Internet www.tigazd-or.gov CITY OF TIGA0 See Page 2 for .r edlMcthod' Supplemental Information BUILDING DM' i ii TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ®New construction Mechanical permit fees*are based on the value of the work ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all j ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:S RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 1-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building For special information use checklist. I j Multi-family ❑Master builder D Other: Description Qty, Ea. Total JOB SITE INFORMATION AND LOCATION HeaHnR/coolinti: t Air conditioning 1 I 46.75 Job site address: 16722 SW DARWIN LOOP Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000t BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge Heat pump 61.06 Duct work 23.3232 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronie)_ 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended;etc. 46.75 Flue/vent for any of above 23.32 Other: Subdivision: Polygon at Roshak Ridge Lot no.: 187 23.32 ------ Other fuel appliances: 1 Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33-39 Flue vent for water heater or gas New construction-Type ADU 1 fireplace ?3.32 Log lighter(gas) 23,32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 2 PROPERTY OWNEROther: 23.32 0 TENANT • - --- Environmental exhaust and ventilation: Name:Polygon WLH,LLC Range hood/other kitchen _____ equipment 33.39 Address:703 Broadway St.,Ste.510 Clothes dryer exhaust_ 33.34 City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(360)695-7700 T Fax:( ) Attic/crawlspace fans , 23.32 ® APPLICANT ❑ CONTACT PERSON Other: 23.32 -- I Business name:Polygon WLH,LLC Fuel piping: S14.15 for first four;S4.03 for each additional Contact name: Omar Alami Abouhafs Furnace,etc. Address:703 Broadway St.,Ste 510 Gas heat pump — Wallfsuspendedlunit heater City/Sate/ZIP:Vancouver,WA 98660 Water beater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace Ranee E-mail:permitsubmittalsettaylofmoffiSon.COm Barbecue CONTRACTOR Clothes dryer(gas) Business name:Pro Heating&Cooling Other. p MECHANICAL PERMIT FEES* Address: NW Alociek Dr,Ste.1104 Subtotal City/State/ZIP:Hillsboro,OR Minimum permit fee(S90.00) Plan review(25%of permit fee) Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee) CCB lie.:209001 TOTAL PERMIT FEE a This permit application expires if a permit is not obtained within 180 ��G•L 11 a u n, 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: 1 0/30/20 i 1fl,,il,,,AP.rmnc%MFr P.rmb 4n,,Mill 11 rirr a.rn..r»It 1 vilernx.nc.so• RECEiV a Electrical Permit Application �P FOR OFFICE USE ONLY City of Tigard SELey 0 d hJ ?p ...ved t7amBv q 74 ® penmt it • 13125 SR'Lull Blvd.,Tigard,OR 97223 �( •��� ' U� V f0 Phone: 503.71$Z439 Fax: S03.SI$1960 CITY OF TIGAiew Related Permit io-W(.7„.0 u-o pZSY C U.i Ell Inspection Line: 503 639 4175 BUILDING DIVI S ,ny — Jars, Ea See Page 2 for Internet: www.II and-Or.8 ov Supplemental Information TYPE OF WORK - PLAN REVIEW Please check all that apply(submit sets of plans wfttems checked) ®New construction ❑AdditIon/alteration/replacemeni i 0))Cn10IlttOtl Other: El or feeder 400 amps is more 0 Building over three stones wbnrt the available fault current ❑Mammas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts of ❑Heating buildings Q I-and 2-family dwelling ❑Commercial/indtLslrial ❑Accessory building kiss to mound,or exceeds i4.000 0 Comrmetei:d-ass agneulmral q stops for all other installations butldtnrs ❑Multi-family 0 Master builder 0 Other: ❑Fire pump ❑lnstsllanrn,of 150 KVA or JOB SflE INTOR\1AT10N ANTI LOCATION 0 Emergency system larger separately dined Job#: Job site address:16722 SW DARWIN LOOP Additan !„t 10011PtTP or w more. ❑"A".'E""1 Z""1 3" City/State/Ziff': Tigard,OR 97140 ❑six or morn residcntud units occupancy ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt_#: Project name: Polygon at Roshak Ridge ❑tlazdrdbns locations ❑Supply voltage for more than ❑Service or tecde.600 amps or more 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE pearrtDtioa I ou, i racb I Total I • New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot# 187 includes attached{singe. Tax map/parcel#: 1,000 rig Il.or kss 168 54 4 Fa,add'1500 sq.(L or portion33 92 1 1 as DEM:R[1710N OF WORK Limited energy,ins dcvual (with above 75-00 2 New construction.Type ADU 1 u1 ft) F I Limited energy,multi-family — residential(with above sq.tt.) 75.00 2 © PROPERTY OWNER Energy El See Pate 2 0 TENANT Services or feeders installation,alteration,and/or relocation Name: Polygon Homes WLH LLC 200 snips or less 100.70 2 Address: 703 Broadway St.,Ste 710 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200 34 2 City/State/ZIP: Vancouver,WA 98660 601 amps to 1,000 amps 301 04 2 Phone:(360 )946 8674 Fax ( .. ) Over 1,000 amps or volts 552.26 2 Email: OAlamiAbouhats(alayformorrison.com-PermitSubmittal a fonnorrison.com Temporary services or feeders installation,alteration,and/or y 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 125.08 2. s Owner signature: Date: 401 amps to 599 amps 165 54 7. i 0 APPLIC AN' I 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch oucutts with Business name: Polygon Homes Wi.H LUC above eernoee or(mik-e rnu, each branch circuit 7 42 Contact name: Omar Alarm Abonhafs B Fee far branch circuits without Address: 703 Broadway St.,Ste 710 service or feeder fee,tint l S branch circuit 56 2 City/State/ZIP:Vancouver,WA 98660 Each edd'1 branch circuit 7.42 2 Phone:(360 )946 8674 Fax: Miscellaneous(service or feeder not included) :( ) Each manufactured or modular dwelling,service arxl/or feeler 67.84 Z Email:OAlamiAbouhafsa@taylormonison.com-PermitSubmittals(gtaylormorrison.com RCconneei only 67 84 2 CONTRACTOR y Pump or irrigation circle G7.84 2 Business name: Wallace Electric Sign or outline lighting 67 84 2 .. Siimiai circuits)or luoited-energy Address: 105 Dresden St panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: Astoria OR 97103 Each additional inspection over allowable to any of the above _ Additional inspection(I hr rain) 66 25/hr Phone:(503 308 0563 Fax:( ) Investigation(I hr min) 90.00/hr 1 Email: David@wallaccwires.com — industrial plant(1 hr min) 78 18/hr I inspections for which no ten is CCi)tic.:224868 Electrical Li • C 1441 Su .1: .: 6363S specifically listed(A;hr min) 90 0IP hr Suprv.Electrician signature,required: ELECTRICAL;PERMIT.FEES Print name: Subu�lal a tQ Date: q��AI Plan Review Required(25%of permit foc): l State surcharge(12%of permit fee) Authorized signature TOTAL PERMIT TEE: : This permit application hi expires if a permit ool.obtained within 18 Print tlarrt i�a,. — Date: rr / days after 0 has been accepted as complete. — -� _ io r Z t...____ + plumber of inspections allowed per permit. L,Anilcpnglietatili\6Lc.psrmltApp_ag tiRE:.dcc Rev 0(51/21113 4 4.d615T(O I/658C0M(WFB Plumbing Permit Application Building Fixtures RECEIVE FOR OFFICE usE ONLY City of Tigard Received Q / 'lS !/t/(/l 4 0 Permit No.: -f' -0_44106- 't 13125 SW Hall Blvd.,Tigard,OR 97223 i� " " q DafelBy. V t a ,t • / : 4 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:5 kg(Z7.o2(-(02}j Inspection Line: 503.639.4175 t)ate;By: TIGARD Internet: Line: and or. ov CITY OF TIGARD Date Ready/By: awls: B See Page 2 for g g Notiliied/Mcthod: Supplemental Information TYPE OF WORIWV'WI1'GlJ1VIJ1O11 FEE* SCHEDULE New construction For special information use checklist. ® ID F f - Description I Qty. I Ea J Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building Multi-family 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: 16722 SW DARWIN LOOP Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name:4itesitiolofte**Polygon at Roshak Ridge Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector II 76 Sanitary sewer(no.linear ft:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Subdivision: Polygon at Roshak Ridge 187 Water service(no.linear ft.:�) Page 2 YgLot no.: Fixture or item: _ WTax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.5I Clothes washer 25.02 New construction-Type ADU 1 ---- Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER 1 0 TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixture'scwercap 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 ❑ CONTACT PERSON Interceptor//grease trap 25.02 Business name:Polygon WLH,LLC Medical gas(value.S ) Page 2 Primer 12.51 Contact name: Omar Alami Abouhafs 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/showerlshower pan 12.51 E-mail:permitsubmittats@ipolygonhomes.com Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name:G&B Plumbing&Sons Inc Water Pin iP g rDWV 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 Plan review (25%of permit fee) CCB Lie.:184372 Plumbing Lic.no.:pb634 State surcharge(12%of permit fee) Authorized signature: ,r - TOTAL PERMIT FEE Print name:Steve Fowler Date: 10/30/20 1 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 Service Board l:tBuilding`3'mrnir,J'L 1LI-PermitApp.dee I0/0104 440-4616T(IU002ICOM'WEB) Water Meter Fixture Unit Worksheet For New Buildings Please complete the following information: 1 Contractor Name: Polygon Home, WLH LLC Billing Address: Street/Suite#: 703 Broadway St, STE 710 City: Vancouver State: WA Zip: 98660 1 Phone Number: 360 946 8674 Email: OAIamiAbouhafs@taylormorrison.com New Meter Address: SFU: 16724 SW DARWIN LOOP /ADU : 16722 SW DARWIN LOOP Subdivision Name: Polygon at Roshak Ridge Lot#: 187 Building Permit#: Please fill in the number of each fixture as detailed on the plans. Multiply the quantity by the point value to arrive at the point total. Add all point totals together for total fixture unit points. Fixture Unit Quantity Point Value Point Total SFU ADU Total Bar sink x 1 = Bidet x 1 = Clothes washer 1 1 2 x 4 = 8 Dishwasher 1 1 2 x 1.5 = 3 Hose bib, 1st one 1 0 1 x 2.5 = 2.5 Hose bib, each add'l 1 2 3 x 1 = 3 Kitchen sink 1 1 2 x 1.5 = 3 Laundry sink x 1.5 = Lavatory 4 3 7 x 1 = 7 Water closet, 1.6 GPF 3 2 5 x 2.5 = 12.5 Bathtub/whirlpool x 4 = Shower stall 1 1 2 x 2 = 4 Bath/shower combo 2 1 3 x 4 = 12 Total Fixture Unit Points: 55 Fixture Unit Points: 1 to30= 5/8" 37.5to89= 1" 30.5 to 37 =3/4" Meter Size: 1" Meter Cost: $ 24,886.00 ************************************************************************************* FOR OFFICE USE ONLY Fixture Units Points verified with Building(Master)Permit or Plumbing ❑ Yes ❑ No ❑ Other: Meter#: Sale Date: Receipt#: Meter Cost: Employee Name: I:/Building/Forms/WaterMeters_010121_New.docx Page 2 City of Tigard Deferral Until Occupancy Request TIGARD Washington County Transportation Development Tax (TDT),Transportation and Parks System ' Development Charges (SDCs) ondR:ftnf*mitoKmarroF.fi%ant ... 424,0141 ft4V$ tiffinitataindefInntallittglAaMi. 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: 16722 SW Darwin Loop Project Polygon at Roshak Ridge Land Use Case or MST2021-00406 Name: Building Permit#: Tax Lot Total Parks # 2S107AA18700 Amount*: $5,839.00 Lot 187 TDT Total TSDC Amount: N/A Amount*: $2,134.00 *The total TSDC amount shown above is the sum of$ 0 for TSDC-Improvement,$ 225.00 for TSDC- Reimbursement,and $1,909.00 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 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: 2m4.4.,,46.ou..A6Puda64.. Date: 11/4/21 Developer: °maw-A9/tutu' An Date: 11/4/21 Permit Coordinator: OeititAebeU Date: 11/3/2021 City of Tigard 7,1r COMMUNITY DEVELOPMENT DEPARTMENT ■ ' T 1 c A R n Building Permit Review — Residential Building Permit #: AtcT-2$9 -00 W 6 Site Address: 16722 SW Darwin Loop Project Name: Polygon at Roshak Ridge Lot #: 187 Planning Review Proposal: New ADU ❑ Verify address/suite# active in Accela. ❑ In River Terrace: ❑ No ❑ Yes, River Terrace Review Addendum Site Plan Elements: I erosion Control 01 copies of site plan on 8-1/2"x 11"or 11 x 17"paper 'LZetained trees with drip line and tree protection measures 1 0Drawn to scale (standard architect or engineer scale) footprint of new structure(including decks)and FFE 0 orth arrow %Jtility locations&easements(required for new and additions) O'ite address,project or subdivision name and lot number . idewalk/driveway approach 0-kpplicant information(name and phone number) •ocation of wells/septic systems 0 ot dimensions and building setback dimensions v itreet tree size,type and location O'quare footage of buildings to be demolished '''itreet names 1 Ixisting structures on site _Corner elevations(2'contours if more than 4'differential 0 ot 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: ❑Yes,applicant was notified ❑ No Received: ❑Yes ❑No ❑ Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs I Required: ❑Yes,applicant was notified El No Received: ❑ Yes ❑No ElSDC Exemption for ADU applied for: ❑Yes CI No Received: ❑Yes ❑No ❑ Public Facilities Improvement(PFI) Permit: Required: ❑Yes,applicant was notified 0 No Applied For: ❑° Yes ❑No,stop intake ❑° Land Use Case#: ADU2021-00007 ❑° Zoning: R-7 CIRequired Setbacks: Front: 8/12 Rear: 10 Side: 3 Street Side: 8 Garage: 20 ❑° Building Height: Max.Height: N/A Actual Height: li CILandsca e Area: 20% % Q Lot Coverage Max: 80% 0/0 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 v Garage door is behind widest street-facing wall ❑Yes El 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. CIGarage door width is III 12'or less ❑ 50%or less of facade ° 60%or less and includes 7 of following: Covered porch 0 Recessed entrance ❑Wall offset ' 1'Roof eave ' Roof offset Fire shingles I Lap Siding ❑ Roof itch 0 Gable,hi ,or gambrel roof " Dormer _ Accent siding 0 Window trim U Window recess U Window projection CI Balcony CIVisual Clearance Q Urban ForestPlan CISensitive Lands: CIYes L No Type: ❑o Conditions met prior to issuance of building permit Notes:0 Approved By Planning: SPV Date: 09-13-2021 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPermitRvw_RES_122419.docx t Building Permit Submittal �y Original Submittal Date: q/!1V 24 Site Plans: # '3 Building Plans: # 3 Building Permit#: ® Enter building ermit# above. Workflow Routing: '® Planning LI Engineering IKI Permit Coordinator a 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. 10 Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: 4PJJ/VlAt/(QJ7/tA.-4.6jJ, , Date: 4/24(24 z-I Engineering Review o Slope at building pad: ErConditions "Met"prior to issuance of building permit ErEasements (encroachments)per engineering conditions of approval and plat 'Water Quality/Quantity Facility: ( Assess Water Quality Fee in-lieu: ❑ Yes E o Assess Water Quantity Fee in-lieu: ❑ Yes o LIDA Facility on lot: ❑ Yes No g/Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes:. �/I Approved by Engineering: Date: Pi` Z Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: El Approved ❑ Not Approved Permit Coordinator Review Conditions"Met"prior to issuance of building permit El 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 a5—jly SDC Fees Entered: Wash Co Trans Dev Tax: Yes I N/A Tigard Trans SDC: ,r Yes El N/A Parks SDC: ,Yes ❑ N/A LIDA ❑ Yes Jaw', xsOK to Issue Permit Approved by Permit Coordinator: Date: 'I2312A`24 I:\Bui lding\Forms\BldgPermitRvw_RES_122419.docx 1114 City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D River Terrace Building Permit Review Addendum Building Permit #: ivi,ct-9A7A — CV 9-06 Site Address: I 6 5-Ai Day-t,,,ii\ loor Q1 Project Name: Polygon at Roshak Ridge Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Plannink.Reviety oft iver terrace Plan District 1)e<siin Standards (18.640.070.I.): Is the project subject to the plan district design standards? ❑Yes E No (Per MMD2020-00044) 1 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 ft.deep min. 2ft.,5 ft.wide min.2 ft.,Eft.wide Gable. .oorner ■ ❑ ❑ ❑ ❑ 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: • ❑Parallel to street, . gle no more than 45° from street, El Max. 8 ft. setback from longer reet-facing wall or open onto por Entrance opens to a porch: ❑Yes I o If es,all the following apply: ❑25 sq.ft . 'n. UOne street facing entry ❑12 f ax.roof above floor of porch ❑5 ft.depth min. ❑3 0/o min.porch roof coverage p g 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 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. •. ❑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 ❑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 'o or less of street facade 5. Garages and Carports: I 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: V Date: Vat 4//312-4 I:\Building\Forms\BIdgPermitRvw_RES_RT_121417.docx