Permit CITY OF TIGARD MASTER PERMIT
,1111
COMMUNITY DEVELOPMENT Permit#: MST2021-00378
Date Issued: 04/28/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107AA20600
Jurisdiction: Tigard
Site address: 16587 SW DARWIN LOOP
Subdivision: ROSHAK RIDGE Lot: 206
Project: Polygon at Roshak Ridge, Lot 206
Project Description: New detached dwelling. NO FINAL INSP UNTIL DEFERRED SDCs PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 5 First: 1509 sf Basement: 862
sf Left: 3 Parking Spaces: 0
Height: 28 Bathrooms: 4 Second: 2187 sf Garage: 705 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 4558 sf Value: $642,130.48 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 5 Garbage Disp: 1 Water Heaters: 2 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: 6 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add,500 sf: 9 201-400 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 4558
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 Geo Tech Report Required
Prior To Pour
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $34,368.02
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
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Issued By:c ./� 1, 029.-,0 Permittee Signature: <i .
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. v 1
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.
Building Permit Application 4'_ 7 Xifib 'ij • elf 121
Residential RECEIVED
FOR OFFICE USE ONL1
Received/y s�
City of Tigard G 31 2021 Date/By:'Z i i Z./ �d Permit NoI1S T 3 L i„. 00 2
lii • 13125 SW Hall Blvd.,Tigard,OR 9722 u Plan Review 1 W
m Phone: 503.718.2439 Fax: 503.598.196 Date/By: ei pZ?0� A4 - Other Permi•�1� 4I—/"l's
T I G A R D Inspection Line: 503.639.4175 Gay OF TIG�RD Date Ready/By: L ® See Page 2 for W
Internet: www.tigard-or.gov BUILDING DIVISION otified/Method: Supplemental Information
TYPE OF WORK REQUIRED D TA: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
work indicated on this application.
CATEGORY OF CONSTRUCTION U Li 1 i 'n _
® 1-and 2-familydwellingValuation: $ (/fir)
❑CommerciaUindustrial
❑Accessory building ❑Multi-family Number of bedrooms: 5
❑Master builder ❑Other: Number of bathrooms: 4
JOB SITE INFORMATION AND LOCATION Total number of floors: 3 ��to3
Job site address: 16587 SW DARWIN LOOP New dwelling area: 4,558 square feet f S7
City/State/ZIP:Sherwood,OR 97140 Garage/carport area: 705 square feet `5tf:/
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: Square feet
Cross street/directions to job site: Deck area: 156 square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Polygon at Roshak Ridge I Lot no.: 206 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
1>1ew Construction/Type: SFU/Elevation plan: 223003 FR Valuation: $
% /Deferrals:YES-deferral of TSDC fees and park SDCs until occupancy. Existing building area: square feet
Projected start: 2022 New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Polygon Homes WLH LLC Type of construction:
Address:703 Broadway St., Ste 510 Occupancy groups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360) 946-8674 Fax:( ) New:
® APPLICANT 0 CONTACT PERSON Uc9 BUILDING PERMIT FEES*
Business name:Polygon Homes WLH LLC (Please refer to fee schedute)
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: permitsubmittals@taylormorrison.com-OAlamiAbouhafs@taylormorrison.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
a
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: (2)1ta L 4lam' 4eewI This permit application expires if a permit is not obtained
(r'� within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name:Omar Alami Abouhafs Date: 08/24/2021 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
\r ED Received t �j
City of Tigard ECE� Y DateBy' Permit No��f 4,e. t., 0 -�7g
'f 13125 SW Hall Blvd.,Tigard,OR 972 3 Q J
I Plan Review
• Phone: 503.718.2439 Fax: 503.598.1960 AUG 31 2021 DatelBy: Other Permit:
TltcAItl7 Inspection Line: 503.639.4175 Date Ready/13y- Juris ® See Page 2 for
Internet: www.tigard-or.gov CITY OF D Notifcd/Method:
TIGAR Supplemental Information
ION
TYPE OF W C COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement perforated.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist
j Multi-family ❑Master builder ❑Other: Description Qty. MallTotal
JOB SITE LNFORMATION AND LOCATION HeaYingfcaal ng:
Air conditioning 46.75
Job site address: 16587 SW DARWIN LOOP Furnace 100,000 BTU(duculveats) 46.75
City/State/ZIP:Tigard,OR 97224 Fuunace 100,000 t BTU(ducts/vents) 54.91
61.06
Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge Heat pump
Duct work _ Eurtirtno
Cross street/directions to job site: Hydronic hot water Jystem
Residential boiler(radiator or
�dronic) INN
Unit heaters(fuel-type,not electric);
-_ _______ in-wall.in-duct,suspended,etc.
Flue/vent for any of above 2332
23.32
Subdivision: Polygon at Roshak Ridge Lot no.: 206 other.
-- Other fuel appliances:
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 SFU fireplace 23.32
Log lighter(gas) EMI
- Wood/pellet stove all 3339
Wood fireplace/insert 73.32
Chimney/liner/flue/vent 23.32
LI PROPERTY OWNER 0 TENANT Other 23.32
Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
Address:703 Broadway St.,Ste.510 equipment 133.39
Clothes dryer exhaust 33.39 la
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
—
® APPLICANT 0 CONTACT PERSON Other. 23.32
Fuel piping:
Business name:Polygon WLH,LLC
__ 514.15 for first four;S4.03 for each additional
Contact name: Omar Alami Abouhafs Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
----- Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace
Range
E-mail:permitsubmittalsitayIOrmOrfiSOfl.COM Barbecue
CONTRACTOR Clothes dryer(gas) 11: _
-
Business name:Pro Heating&Cooling Other:
MECHANICAL PERMIT FEES*
Address: NW Alociek Dr,Ste.1104
Subtotal
City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)270-1590 Fax:( } State surcharge(12%of permit fee)
CCB lic.:209001 TOTAL PERMIT FEE
( This permit application expires if a permit is not obtained within 180
QA'- �\ days after it has been accepted as complete.
Authorized signature. Wa u'�l Q'n' * Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date: 1 0/30/20
1\AniLtinelRrrmvs4L./Ff'4.rm�14nn 1lanll:Any .r An n41-1r i r 1 m,vvir.r MIMI',
Electrical Permit Applicatio FOR OFFI( F USE ofONLY
Tigard DECEIVED Received
City'PI b namoy
Permit k ,l•-IS,-+-7.2'1- OD l e-
.-14 13125 SW Hail Blvd.,Tigard,OR 97223,Q U G 31 2021 Re
Plan Review Related Permit ri' Phone: 503.718 2439 Fax. 503.598.I96 DalcrHv.
, —
h 0 Inspccilon Line: 503.639 4175 Ready batcBy luris:
Internet: www.tigard or,gov CITY OF TIG kRD SePanez for
Nouficd/Mcth°d. Supplemental Information
TYPE � DINGDIVISION
fLAly REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit g sets of plans writtmrs checked)
0 Demolition ❑Other: a Savice or feeder 400 amps to more 0 Building over three stories
when,the mailable fault current ❑Marinas and boatyard,:
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 159 volts or ❑bloating buildings
j] 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building le$s to mound,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-family ❑Master builder 0 Other: amps for all other installations buildings.
❑Fire pump 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system larger separately derived
Job# 10011P or more.
more.: Job site address:16587 SW DARWIN LOOP El ore. °t°` nit of system.
❑"A","t;,"I-2","T-3",
City/State/ZIP: Tigard,OR 97140
0 Six or more residential units occupancy
❑Health-care facilities. ❑Recreational vehicle parks.
Suitc/bldgJapt.#: 1 Project name: Polygon at Roshak Ridge ❑hazardous locations ❑Supply voltage for more than
--- 0 Service or tii.dm 600 amps or more 600 v°Its nominal
Cross street/directions to job Site: FEE BCIIEDUI E
Description I sty. I Each I Total I '
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot 4: 206 Includes attached garage.
Tax map/parcel#: 1,000 sy ft or less 168 54 4
Fa.add'l 500 sq.R.or portion 33 92 1 ,
DESCRIPTION OF WORK Limited energy,ruidea:al
New construction.Type SFU (with above sq.R) - 75.00 2
. Limited ota.rgy,multi-family 75.00
residential(with above sq.ft.)
Renewable Energy ❑ Sec Pate 2
® PROPERTY OWNER 0 TENANT s
Services or feeders installation,alteration,and/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
401 amps to 600 amps 200 34 2
City/State/"LIP: 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: OAlamiAbouhafs@taylormorrison.com-PernlitSubmittals@taylormorrison.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,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08
Owner signature: _ _ Date: 401 amps to 599 amps 168 54 2
Branch circuits--new,alteration,or extension,per panel
❑ APPI.ICANI' ❑ CONTACT PERSON
A.Fee for branch circuits with
Business name: Polygon Homes W1.H LLC above service or fcxkr fee,
each branch circuit 7 42
Contact name: Omar Alami Abouhafs B Fee for branch circuits miaow
sAddress: 703 Broadway St.,Ste 710 branch
M�ar nch circuicircuii ee or feetfee,rust 56.18 2
_ .. rl
City/State/ZIP:Vancouver,WA 98660 Each arld'I branch circuit 7.42 2
360 )946 8674 Miscellaneous(service or feeder not included)
Phone:
( Fax::( ) Bach manufactured or modular 67 84 2
dwelling,service and/or feeder
Email:OA1amiAbouhafs ;taylonnturison.com-PcrmitSubmittals@tdylarmorrison.comRec oesrcet only 67 84 2
CONTRACTOR OR - Pump or to igatiun circle 67 84 2
Business name: Wallace Electric Sign or outline lighting _ 67.84 2
Address: 105 Dresden St Signal ctrcutt(s)or limited-energy 0 see Page 2 2
panel,alteration,or extension
City/StatefZIP: Astoria OR 97103 Each additional inspection over allowable in any of the above
Additional inspection(1 hr rain) 66 25/hr
Phone:(503 30)8 0563 Pax:( ) Investigation(1 hr rain) 90.0/hr
Email: DavidF24wallaccwires.com Industrial plant(1 hr min) 78 18/hr
Inspections for which no tee is
CalLie.:224868 Electrical Li•• C1441 Su .1; .: 6363S specifically listed(i4 hr min) 90.00(hr
ELECIRICAIL, PERMIT FEES
Suprv.Electrician signature,required: Subtotal-
Print name: _ _aO Date: /L/ ❑Plan Review Required(25%ofpermit foe): _
�" / State surcharge(12%of permit fee)
Authorized si attire TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
—itillefite
Print name: .0.
» Date: zi fr /L t days after It has been accepted as complete.
•(9! Number of tnspocdons allowed per permit
I.0IIsiding+1'ermits'aLi:_pcnartApp_13.R ERE.dcc Rev06'lltlilt 4-0-4615T(1I/65K0 lwgB
Plumbing Permit ApplicatioECEIVE
Building FixturesFill- li
FOR OFFICE USE ONLY
City of Tigard AUG 31 2021 Received r'
b PennitNo.:1- S1 �1,F00.37d
.1 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
_ Phone: 503.718.2439 Fax: 503.59$.IN
Plan Review
Date/ay: Other Permit No.:
COY OF TIGARD
TIGARD Inspection Line: 503.634.4175 BUILDING DIVISION Date Ready/By: )arts. El See Page 2 for
Internet: www.tigard-or.gov Notified/Method. Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. J Total _
❑Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
X1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath _ 437.78
0 Accessory building SFR(3)bath 500.32
-Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16587 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:dieeitait d±ePolygon at Roshak Ridge Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
J - Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
on at Roshak Ridge 206 Water service(no.linear ft.: ) Page 2
Subdivision: Polygon $ Lot no.: Fixture or item: _
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New construction-Type SFU
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:Polygon WLH,LLC Fixture/sewer cap 25.02
` Floor drain/floor sinkt'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
Contact name:
Omar Alami Abouhafs Primer 12.51
Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 Sinkbasinlavatory 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:permitsubntittais®polygonhomes.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:G&B Plumbing&Sons Inc Water Pip g 1 m DWV 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.
TOTAL PERMIT FEE
Print name:Steve Fowler Date: 10/30/20 This permit application expires if a permit is not obtained within 18(1 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Sen ice Board
1.knuiidng\Permits:PLMU-PerentApp due 10/01,) 440-4616T(IO'a2!COM'wEa)
City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
111111
TIGARD Building Permit Review — Residential
Building Permit #: t 1,5 'T 2) 'Z.,r - ( 0 3 7 ?
Site Address: 16587 SW Darwin Loop
Project Name: Polygon at Roshak Ridge Lot #: 206
Planning Review
Proposal: New home
❑o Verify address/suite#active in Accela. 0 In River Terrace: ❑ No 0 Yes, River Terrace Review Addendum
Site Plan Elements: .rosion Control
0: copies of site plan on 8-1/2"x 11"or 11 x 17"paper detained trees with drip line and tree protection measures
11 II rawn to scale (standard architect or engineer scale) Footprint of new structure(including decks)and FFE
0 orth arrow *LJtility locations&easements(required for new and additions)
rite address,project or subdivision name and lot number sidewalk/driveway approach
0 pplicant information(name and phone number) ocation of wells/septic systems
0 ot dimensions and building setback dimensions street tree size,type and location
D.quare footage of buildings to be demolished Street names
II xisting structures on site °2orner elevations (2'contours if more than 4'differential-
0 of area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? LJYes 'o
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es ° o
CIClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑Yes,applicant was notified ❑ No Received: ❑Yes ❑No
0 Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑Yes,applicant was notified °j No Received: ❑ Yes ❑ No
❑ SDC Exemption for ADU applied for: _J Yes ❑ No Received: ❑ Yes ❑ No
0 Public Facilities Improvement (PFI) Permit:
Required: ❑Yes,applicant was notified ❑No Applied For: ❑Yes ❑No,stop intake
❑° Land Use Case#: SUB2015-00004 ❑° Zoning: R-7
0 Required Setbacks: Front: 8 Rear: 10 Side: 3 Street Side: NSA Garage: 20
Q Building Height Max.Height: NA Actual Height: 28
0 Landsca•e Area: 20 % CI Lot Coverage Max: 80
Entrance 0 Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows 0 Minimum 12%of area of all street-facing facades
Garage 0 Garage door is behind widest street-facing wall ❑r Yes ❑ No,one of the following is met:
❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
❑o Garage door width is 12'or less ❑r 50%or less of facade ❑ 60%or less and includes 7 of following:
Covered porch Recessed entrance ❑ Wall offset 1'Roof eave ❑ Roof offset
M, Fire shingles Lap Siding CIof Ro itch ❑ Gable,hi ,or gambrel roof Dormer
Accent siding Window trim LI Window recess U Window projection ❑ Balcony
0 Visual Clearance ❑o Urban Forest ,Plan
QSensitive Lands: ❑ Yes L"J No Type:
QConditions met prior to issuance of building permit
Notes:
Q Approved By Planning: .... `�- Date: 9i9i21
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES_122419.docx
Building Permit Submittal
Original Submittal Date: i/,i //2./
Site Plans: # 3
Building Plans: # ,3
Building Permit#: Q-'Enter buildin permit#above. !
Workflow Routing: Planning Engineering ermit Coordinator b'�tsiulding
Workflow Sign-off: U. Sign-off for Planning(include notes from planning review)
Route Application Documents: LI'Engineering: (1) copy of permit application, (1) site plan, (1)building plan and
oginal plan review routing form.
U. Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: i q...4--' Date: j' // 2/
Engineering Review
INd/Slope at building pad:
IEonditions"Met"prior to issuance of building permit
asements (encroachments) per engineering conditions of approval and plat
111 Water Quality/Quantity Facility
Assess Water Quality Fee in-lieu: ❑ Yes rNo
Assess Water Quantity Fee in-lieu: ❑ Yes o
LIDA Facility on lot 0 Yes .0No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:.,te
LP" Approved by Engineering: Date: 93/e/'
G
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
0 Conditions"Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
SDC Exemption: ❑ Received Does not a� ly
SDC Fees Entered: Wash Co Trans Dev Tax: Yes N/A
Tigard Trans SDC: Yes 0 N/A
Parks SDC: Yes N/A
LIDA ❑ Yes N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: It ii(p �
c2
I:\Building\Forms\BI dgPermitRvw_RES_122419.docx
City of Tigard
IIICOMMUNITY DEVELOPMENT DEPARTMENT
T 1 c A R D River Terrace Building Permit Review Addendum
tit
Building Permit #:
Site Address: 16587 SW Darwin Loop
Project Name: Polygon at Roshak Ridge Lot #: 206
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.070.L):
Is the project subject to the plan district design standards? ❑Yes 0No (Per MMD2020-00044)
Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft.of frontage.An additio
ele nt required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch .: ft. deep ft. d❑eep min. 2ft., 50
ft.wide min.2 ft.,6ft.wide Gable. .ormer
2.Eyes on the str- •t: 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:
CIParallel to street, . gle no more than 45° from street,
❑Max. 8 ft. setback from longes trees- facing wall
or open onto por
Entrance opens to a porch: ❑Yes 1 o
IfU-es,all the following apply: ❑25 sq.ft. in.
One street facing entry ❑12 ft 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:
ElCovered 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 ormer min.4 ft.wide
❑Roof eave min. 12 inch projection ❑R• offset min. of 2 ft.
❑Roof shingles either tile or wood ❑Gable, .ip 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 , 'n.2 1/2"wide by 5/8"deep
❑Window recess min.3 inches for 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 '0 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 ode lot line,than longest street-facing wall. ❑Yes ❑No. If No (Check o • :
❑May extend u. 0 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 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
rid 50%max.of street facade with 7 detailed design elements
Notes:
Approved By Planning: NT Date: 9/9/21
1:\Building\Form\BldgPcrmitRvw_RES_RT_121417.docx
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: 11/3/2021 Site Address: 16587 SW Darwin Loop
Project Land Use Case or
Name: Polygon at Roshak Ridge Building Permit#: MST2021-00378
Tax Lot Total Parks
#:
2S107AA20600 Amount*: $8,017.00
Lot 206
TDT Total TSDC $3,658.00
Amount: NIA Amount*:
*The total TSDC amount shown above is the sum of$ 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.
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: Dnr4.4,42anw.A6aa Date: 11/4/21
Developer: Dyiaa z.A •A6eGdadi- Date: 11/4/21
Permit Coordinator: ATM OetitMliti Date: 11/3/2021