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Permit (81) CITY OF TIGARD MASTER PERMIT 1111 8 COMMUNITY DEVELOPMENT 4,1 • /0 /,/o Permit#: MST2015-00250 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/28/2016 Parcel: 2S1080001504 Jurisdiction: TIGARD Site address: 15192 SW 154TH AVE Subdivision: POLYGON AT BULL MOUNTAIN Lo Project: Polygon at Bull Mountain, Lot 59 Project Description: New SF. 8/10/16, REPRINTED to add 2nd water heater. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1571 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 4 Second: 2160 of Garage: 665 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3731 sf Value: $459,686.56 Rear: 15 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 Storm Sewer 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 Drains: 0 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: N 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: 7 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 3731 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $35,287.52 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 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 .232.1987 or 1.800.332.2344. Issued By ►'�,_ODee i` Permittee Signature: �( Cr� Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Building Fixtures RECEIVED ., . . , . . FOR. ,OFFICT USE ONLY City of Tigard ' ' R,..,,,ivA 1 , Duicat't, ; eta ma:‘,t; ItitS 1 2,(3 115-001:50 1 . 24 13125 S-9,111a1HIlvc1,. rigtuat IIR 0722A 1 101.2016 ' Pltu 8,!.tleu.. I.• Inspection 1 Me 503,639,112'i . . „ CITY OF TIGARD ! [axe titetah-Itt., „ i, inn. . II See Patte 2 for ' • , Internet- NNAvu...tigatal-ort.t..tak 1,,,,,x,tttlied"N.lethmi 1 Suppiementiii information 1 I 14G-DIVISION--- -• . , . , . TITE OF 1* , • - , , 1 , 11-44,* SCIlitilOttLit: 1 , 1 For speciut infontiatioit use checklist El\ev‘.conaruction I D i/cmolition I , .., ...... : (It, ' 1 a ; 101a1 t t Cl.kdtlitiontaltertnioo:replas:emetti 1 ri()tiler, , Nett I-2-lanli1y tittellings f int:ludo i oo u For,-,K•11 Hulot ,o1>>>g lin) C ATFGORN OF (()NSTRItClION I Silt it)luith 1 t 1 ".70 - -I- : , I st k 12 i ts:111) is and 2-Utmitt dtotiling Lj t'on-mtercnillincluNtrial I Aecessor,: building i L]: Vhalti-Ittrnik i.„,„11 Nlaster buitda 0 Other: ' '•5 . ,,, .,.... (I hi ! Pane JOB srrE INFORNIA'lltAN AND 1 OCATION Ii ::crig tillIOr:8: I : I ,k)1.1 site address: i 51 q a .s')/1/1 /5 yl-h Ptye i 1 c,och lin or:trea dram : t : Ci0t1StataaftP:Tigard,OR 97224 . . . 1 . Soilut bldg./apt.not. I Projeo Willie: l'filygOil iri. It till 13011titaiti . ! ' 01,11121ktoured home titilitie;, 21102; ! ; I 1 Ifrostt street directions Io.job site: :•,•r Ng-kW:101o; I I 18 ,t6 • , : , Ram drain t8gmeet.{)r 1 18 76 ! 7 : . 2,i11111:113 SeVect(>ki, linear U. i : Pan' I l'auc II), -- , •t5 Subdt\ision: Polygon at Bull Mountain 1 ot tui . , I,ixt ore tir item: ' l Pock[hut prc..-‘eliter ! 31.22t , lttx maptparcel DO.: 12 si ; 1 OPSCRIPTION (:)4,' :WORK 1 1 '11nwoms'i 'iIsc 2.., - 11C1C1, 2ND 1-Vbi-watir .t\ecd-tr „„. i I- 1),,h„„sher . . , 25-0, . 1 - 1 — ---i I I Drinkinn fountai-n I :1 1 I 1:jectordtmitip ..„.....„, .... „... . ..„ tEi PROPERTY OVVN.P11- D '1' % J -8PI81:ANII801, , I, "1 - , I J51151 C,',C110)"erip Name: Itolygon VOA I,Ii„C. I ' ::::51t2 Address: 1(19 East 13'Street I 1 t .....„„ , rIarliage dkgot•al ttII I)„,, ' t I tiot:Stalg/I1P: N aaletnit er,%,),A 98660 It 110,e, Nu I ,•• . I I ..5 ot• • I : Phone:(360)695-7700 I 1-1",;:1 I ' i Ice niakcr APPLICANT D CONTACT PERSON I 191-cretItIor"roast:999 . 25 02 1 i 1 : -i 1 Niealical;,..ttp t‘ahte 2; ) : I',>'>2 ' ii Iinsiness name: PoR gun NV1.11,1,11' I 1 t 12211 ; Citntact natne:Angela.I;rajewski - i ; 1 1 11001 diam tcomintacialt 21 12 Address: 109 East 13th Street : 1 ctink/ha:-:iieltn.aka, I .'' f).' ; , 11-, , Cit:il"')ta11 teltIP: '4'90)118er,AN A 98660 1 , souir tmii8(potable u,inert6'''.,1 • -t- 1 .111011cf(360)695:7700 I l t ',(360t 693-4442 ; ; I tih: tia.n\a..t121115- ca:pan I : 12,51 I i t- ! : - 1 12-r-nail:,A,rtgeta.(;rajevski'llnt:polygonhotnes.co1-'1 Mal a,tia.•.. 2..,ft?. . . C(.)STRACTOR , , I ' 1 i ''' 1 ! litiaMetts name: 801. Plumbing 1,1,e I \\ L-r iipso t()WV tidot8s: PO Bus 8c I t duet • t...t Itt" . . „ ' ( ity:Stale/ZIP:Cot) rett OR 971119 Subtotal j 1 Plume:(503)351-3903 i Fax:( I . 0fittunum perubt tee' ':;;2 a0 _ Han re‘ir\N- i 2 5'''-o of permit 1,:c) , I r:('13 I ie.: 180345 ; Plumbing I it 14,2, l'ii1582 ! ! — —... Sit Is,t,tachartstat t 12'1.,of permit it:e) I )auht)rit8.8i signature: .• titte,,,attort— lot:xi 1,1:00411 1,1 I, 4-i-oiL2.,..›,--• , Ube..permit aiplicatioo eNvires if a nermit is not obtained 14 ithin ISO thrk‘ Print name: 114-antion Eanter , Dato: _9 _1,, after it flax,been areepted as coraptere. , ,`"„ .. -;ce Teetle,4101,r,..aa Is, be)ooni3 i1aililor2 OrloAri Ser'..ie.'liemJ 1 II ii'' NI>>> P1 511.1',HrwAN:d.oc 12,01,ti l rl ielr II .2.,2,t'ir,3 IIIII) CITY OF TIGARD MASTER PERMIT INs COMMUNITY DEVELOPMENT Permit#: MST2015-00250 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date issued: 03/28/2016 Parcel: 2S1080001504 Jurisdiction: TIGARD Site address: 15192 SW 154TH AVE Subdivision: POLYGON AT BULL MOUNTAIN Lot: f1 Project: Polygon at Bull Mountain, Lot 59 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1571 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32 Bathrooms: 4 Second: 2160 sf Garage: 665 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3731 sf Value: $459,686.56 Rear: 15 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 Storm Sewer: 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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 Tvoes Air Conditioning: N 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: 7 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr. Occupancy Group: Square Feet: NEW SF VB R-3 3731 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 109 E 13TH STREET 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $35,200.50 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 952-001-0010 through 0 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ",;2)/ C—__ Permittee Signature: OA) /�Gie -rlON Call 503.639.4176 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. BuildingPermit Application © C l Ls a? /42 s— RECEIVED �. ideas FOR OFI I( F: l SE()\1.1 • City of Tigard Received/a/,?/�- , — PecmitNotys7,20/3•„„eVe?50 t ■ 13125 SW Hall Blvd.,Tigard,OR 97223 DEC 2 1 2015 Plan Review^ ` n I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Z J0)) Other Pernyl;SaijQ 'O/S%OB/dro i i c ,,R1., Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: �i / Tuns: ® See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method:�/'�O �b La" Supplemental Information IL o . . / ®New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the s„ , ''*' c sg - r work indicated on this application. ® 1-and 2-family dwelling ❑Commercial/industrial Valuation4- J 6�.6 $ -1: rc.-- Z..3_,,,__ _Cti-itt 0 Accessory building 0 Multi-family Number of bedrooms: 4 0 Master builder 0 Other: Number of bathrooms: Al.., � � _ ° Total number of floors: 2 .. # Y ,.. k s�,at__. s ,..;its, Job site address:15192 SW i64'"-r4re- 5 /¢"/,./E— _ New dwelling area: 3'7/5 \ square feet 139��, � City/State/ZIP:Tigard,OR 97224 Garage/carport area: LS[ 5 square feet Suite/bldg./apt.no.: Project name:Polygon at Bull Mountain Covered porch area: ' square feet 16 0 • Cross street/directions to job site: Deck area O to square feet 45-1 , Other structure area: 4,40 square feet ' a!: .- '£ l Subdivision: Lot no.:59 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 theprofit for the • - r work indicated on thisappli application. New Single Family Detached Construction Valuation: $ Existing building area: square feet New building area: square feet 3 ,v 'N Number of stories: Name:Polygon WLH,LLC Type of construction: Address: 109 E 13th Street Occupancy groups: City/State/ZIP:Vancouver,WA 98660 Existing: Phone:(360)695.7700 Fax:(360)693.4442 New: Business name:Polygon WLH,LLC .. rte.. h „.„ . : Structural plan review fee(or deposit): Contact name:Maggie Gordon FLS plan review fee(if applicable): Address:109 E 13th Street City/State/ZIP:Vancouver,WA 98660 Total fees due upon application: Phone:(360)695.7700 Fax::(360)693.4442 Amount received: E E-mail:maggie.gordon@polygonhomes.com , . g: Commercial and residential prescriptive installation of � ' �,: ;,; w, _ roof-top mounted PhotoVoltaic Solar Panel System. Business name:Polygon WLH,LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:109 E 13th Street 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.:204238 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Maggie Gordon Date: 12/11/15 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) L ` RECEIVED Electrical Permit Application FOR OFFICE l'Si-:ON 1.1 , City of Tigard DEC 21 2015 Received wa2-�t� •� Datenv: Permit N r • 13125 SW I fall Blvd.,Tigard,OR 97223x'-rt,� r^1c •;GAR Plan Review t 0 Phone 503.718.2439 Fax: 503.598.1909' !1�1�SJ 'Illi•: (Aber Permit' ` F.It Inspection Line: 503.639.4175 BUILDING DIVIS1•'�ateReady/liy: Allis 0 See Pufar Internet wwwtigard-or.gov Notified/Method: ... •s Supplemental Information *� - aa�� TrZ.43 ."s? " " vWi - . . e' �cLrAXr _At ®New constru_ction 0 Addition/alteration/replacement Pluck check all that apply(submit 2 gets of plana\./items checked below) 0 Service or fw•dcr 400 amps or more 0 Building mer three stories ❑Demolition 0 Other: where the available fault current 0 Marinas and boat,.ards q zr cscccds 10,000 amps a1 150\Tilts or 0 Floating buildings ht' ) �' , CA�166(R3'r OF (S�]S-,,,,". � L •• •. _w.....>`i ��.r.. ...s++....�., ey...J:.p...rte* ....r .•- ,! - - °��• less to ground.or exceeds 14.000 0 Commercial-use agricultural ® I-and 2-family dwelling 0 Commercial/industrial ❑Accessory building amps for all other installations buildings 0 Multi-family 0 Master builder■ � 0 Other:1 ❑Fire puntlt 0 Installation 75 k:VA or .�krrgi�c :17. I 9W0c.05j �I+Yl�-r �i.`�0�J\ 1 Ill .1- \.. stem -ff�:.�zs'�x',3K':)•-Lx+;z�•t ?Z�... .?:FF`.';"t�:w";'.: � ., �`• '. � `-.: ..'? o Tit.\\mnlor load of . . _ I . 1: tergcney syst• huger separ tc\dens sys `'�' ❑Addition f � ❑"A-• ..1:•• "1 '.. ,. �.. \5 i Q2 5 D `5� - d,,, a-❑1.(x.01 IP nr Mtge. occupancy Job no.: Job site address: W / r� VRecreational\chicle parks _ s or more rcsldemial 0 f Cil '/State/%IP: ❑tlealih-care facilities 0 Supply\ohage liar more than ❑I larardous lueations 600\ohs nominal Suite/bldg./apt.no.: Project name:Po`\t 9jy O 1` ❑Service or feeder 600 amps or more Cross street/directions to job site: Description I Qty. I Fre. I Total l New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.:5I.txx)sq R.or less 168 54 4 ^la.add'l 500 sq.It.or portion "7 33 92 I Tax map/parcel no.: Limited energy.residential 7-(N) 7 f-r 7 � t-E '. a : ' (with above sq.ft) Limited energy.multi-family 75 00 New electrical service and wiring residential(with above sq Il.) - Services or feeders installation,alteration,and/or relocation .00 amps or less 100.70 q�p"- ' a.�. ha•.i~.n' ' 'f,., E 201 amps to 400 amps 133.i6 2 •y_e �. ;.;-.404,. -....-.tea-.-..:ave-.s.r.-- . .. - .... Name: Pc`� 401 amps to 601)amps 2(8).34 601 amps to 1,000 amps +01.04 2 Address: k b a Lt. \to'44 y-�` Over 1.000 amps or volts 552 26 City/State/7_1P: BVI [actOpctljer (^ /Vy rja ��J v T Temporary services or feeders installation.alterat' .and/or � ` relocation Phone: ) tg a 5;MD Fax:tD) l¢(XV' -4-U'Z--- 2(k)amps or less 59 36 I 201 amps to 400 amps 125 08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 16k 54 intended for sale,lease.rent,or exchange.according to ORS 447,449.670.and 701. Branch circuits-new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with t::7- ~a � l .-...:,-;i4,;;. , 44 above service or Ieedcr lee. 2 . rn . >a. y. each branch circuit Business name: Po B.Fcc for branch circuits without service or feeder fce.first 56 I k Contact name: m (-_ �Clr branch circuit 1hu� Each add'I branch circuit 7 42 Address: ' O b Miscellaneous(service or feeder not included) City/State/ZIP: `1n � � A Each manufactured or modular dwelling service _ j 67 k4 ) _ Q, `�'1W� "1�QVL Phone:( ) Fax: :( ) Reconnect only 67 84 • 2 ` /� }�,�y� - Pump or irrigation circle 67 R4 i 2 h-mail Y�(1 Qfl 'f....4.80r ^� I 1 1V+ r1 CD �,,( NSign or outline lighting 67 84 .='- i 4'..#'`:... i s 4rft:f.: x. :-1 1i 1 .. Signal circuit(s)or limited-energy Business name:Simply Electric panel,alteration-or extension I'agc 2 i . - Each additional inspection over allowable in any or the above Address:PO Box 822408 Additional inspection(I hr min) 66 25/hr Investigation(I hr min) 66.25/hr City/State/ZIP:Vancouver,WA.98682 Industrial plant(I hr min) 78 1 k/hr Phone:(503)849-8202 Fax:(360)314-4945 Inspections for which no fee is 91).00/hr specifically listed(Ye hr min) CCR Lie.: 204615 I Electrical Lie.: , 067 Suprv. Lie.: 4394S * .x, EGEcTR1C 3,`f' 7t11IIT: ES ' tic,"-i-'5 f- Subtotal Supn &.(G. Electrician signature, rcyuircd: Plan Ian rcviety(25%of permit lee) Print name: Victor Zarzhitsky Date: I 117/2015 State surcharge(12%ofpermit lee)_ TOTAL PERMIT ft:l:. Authorized signature: This permit application expires if a permit is not obtained within 181) r,�. days after it has been accepted as complete. a l tilt name: . I ale': • 1\ her of inspections allowed per permit 19uddtngPrn i,i'.El.r-Permit.\pp doe 07.01:10 Jon-Jb15ll 11.II%(om,wCa . ECEIV'ED FOR 011.1(E ISL.(��Ll Mechanical:Permit.Annhca on 1 2015 )•.,0.-,/75r020/.5'—'000.2 .. +C1iy ofTigard _ DEC �+ .rro/'ffr+2A/.�DD�.Sd narasy ,i 13125 SW[call Blvd.,'l'izard,.OR 97223 el NOW $03:7;83439' F 5p 45 . -Y OF TICARD ( �,a.�1' 6111-19.41 l 75:rgovBUILDING 0IV1SI0 I. B Seerapc;ioi lotemet SoppleemeaiytIaf.. ._et: -•,...." . --S..-, .r" -^a,.. .2 .E( f.l , �F Y E-ipA ..r i:c 6•.,., &yl. 6&f. B�.-ti i i ;C f 't S.`-'„-1,72-:,-,',.-,-----1--,.:.--,-... .,-,--.7:4. . . ... - -al x are basad m ttre'value of the work- :El New rroaistiitctirni .0 Additimtialte is4omrre01acat<aiY ;performed.Indicate value jmnnded to the nearest dofarj of all O pj jpp 0 Other: mechmieal.matamts overhead. profit- .. : ah=x sa res Pc Commercial/m strial ❑Accessory building For ailnfan"a iOrr xis Oe _ ®i and2=famtlyd�txiligg [3 I �y Total 0 Multifamily 0 urtaster builder 0 e '�°a -,P1 y.._. ... ',.,.....-.-,:--..----- --_,,,d...:4,-,:..,......,,-a .. 1C.,._.,,. !•.6ta` �F F - r : ;3' _ ;,, ..- -:,t- . .^ -t. { .. +ffCOa '. 467$ , rad-41° C.S4tsr.._ 1CZ Z 5Lo r y ht-1/6--- > xIoolaclo 131i1 datuF,ssits) 1 46.75 .Pacnaca 1t1C1,U00+.BTi)(aLrcts'vestsj 3491 61.06 ,to_ PrbjeCtsminm Duet Work 2332 fir-hook hot water system - 2332 (VSs�tteeildirectioas w job site Ralcterttisk Wei tr;aior or hyc). 23.32 _. U .batfli(#14.,-tYPY.Ft daxdc). . M1.#n-Mitif suspa •lac. . 46.75 lIselreat.fof.tafyof skive 2332 I Lotno.:5q ;od-applfanccs: _ ��T" �'4 c C Ike/Wert 2332- 33 c ^r % vel-f watarfir exau$es 2332 L"og.liglitet(gh0 2332 - _ _ _. Vtrl 3339 • WofHl. mm2332 t. . 23:32 2332 i -` - tutjl rsklttasC sad vtatlFai101a: 'g (DOTDIrraPinrfhwest $mi&ChLog3/aherta► . I 33.39 . -:: ,+iddntes e9 E I3-St : tauibis dc+'erzithetst 1 .3339 sai�sdfax erclisarst tbsB3Yoa¢ris, satove*,W 9 61 . ataity.rodais) 4 2332. Fax: } 9nid�awisoke fa 23 Fhoob`7809 d 2332 vim m_w 4u2! pag:' 8tlaiiitsi?t P $orthwatx $1433 ler first four,54.03 for.eseh addilioaat zit ) G6oiaeti . Em..,. • .... cm199 Ts.13,*St ytraiiiinspeadedVanikbrear. .citYgiiiT,*010er,l;YA98661 Wirrr�eiotr•-�;_: —_._---_. l Fac:( ) tieplarie l OW 816- . - a DaBre: rtr: t�. • _ . toiai Argrc.ILSiVP '�lE fit.no _ ,._.,,.:n T /filial' um fseD 40) P • r/ :T3pid►4iR,97?14 -- P1su imiiiiii(23 4 arpeitoa SoeT T 992464 Fate(5Q3)536-66B. _ _ w (-12%dQpermit ) TOTAL PEIMQT:P'EE. 6{3 C.' f�(�'l 'O Thicpita It spOce.a cus#[a Permit b oof,Mifacd within 110 days al'rer it bai be as acttPtad es sampleir Authorized signature: • Ex rodbobolosy gatby iri•Goemty Balding industry Service Board 'frininirtii Art Aliatiieri I?atm11120/2015 i Ara o4otizaa 4404itrr(ilirricwusnves) 1 • ----r aECE VED plumbing Permit ApPlicatiol� roux oil-leer L F 1)%1_,NBuilding Fixtures DEC 21 2015 i„ea P t>40-itifT;laIS-ova25d City of Tigard 13125 SW Hall Blvd.,Tigard,OR 972 v I G AR fl P�review other Permit No.: 60 Phone: 503.7182439 Fax: 503.598. OF inspection Line: 503.6394175 BUILDING DIVISr O ,1;a!` 0 SeePage 2 for Indernet www.hgard ogoy Supplements!f information ,- ! , ' For special inforrumfon use checklist �" ou 0 Demolition J Description 1 Qty. i Ea. 1 Total i=New esaon 0 Other New 1-2-family dwellings(includes 100 ft for each utility connection) , 0 pddhao/altetaRiodtzPlacanenT L - ¢` i .ma y SFR(1)bath 312.70 t Fit fir, mow-• a' __ bath 437.78 s `�`' �r - --r: SFR(2) � 3n. •►: 1-and 2-family dwelling 0 Comm ri c SFR(3)bath I 50032 . 1 L Accessory bolding ❑Multi-family Each additional bath/kilehen 25.02 . O Fite sprinkler(___sci ft) . Page 2 • Muer builder - - hies: _ , � -�:�.- Site uhf } '„t :' ---77.--'7--H--:1.-----1 �/ Cafes basin or area dram M1 4,. . a �s .,..,, ., � �TV� 18.76 ' Job site address: i ,al.. Drywdl,leach lure or tralcll drain Footing drain(no.linear ft:_� Pager 2 CiLY/StatelLlP= 1- J Q� `1 M 50.03 �_ `J Project name:W..60��W , ,tel' 1 Manufactured home utilities 10.06 Suitrlb►dgJapt v Manholes Cress streeUdinxtious to job site: Rain drain connector 18.76 Sanitary sewer(no.linear ft:_.J Page 2 Storm sewer(no.linear ft:__) Page 2 • • • , Water service(no.linear 1i:___) . Page 2 • SulL neo.: Fixture or item: f 31.27 ��,Z Tax map/parcel SOW prevent= + .5 ►'Z•-j`. Tax map/p»l no.: Backwater valve 1 12.5\ 25.02 I --= -- Dtsbwasher 1 25.02 e9 ,02 7r� �� 25.02 . 9 +�I�li�V , �''+�i , Ejectors/marp 25.02 r- ,:,°-:. - -----. .-.7-77"1-_'--r-- -, = -.�-- .- _ stat tank 1251 Y _ - = � _ _>:,L; Fotuadscvacap 25.02 P o - -= Floor drain/floor sink/hub 25.02 Nam- 25 02 Z .(�rL Address: ` pYt ` STFCMSt Grobage disposal t ��i City/St�L1P: (�,(1C(f) U\) (5ir Hoseb 1 25.02 72 Phone: ►` • Fax( ) t ' ` : , r - $teromtor/grease trap 25.02 ,d _` �i� ; _ Medical gas(value:S ) Pae 2 Business nater D l _ u1MLx,vIke. Primer 12.51 ContactRoof drain(commercial) 12.51 Adores D► Sink/basin/lavatory25.02 City/State/ZIP: Ca-. . ^6)G Solar units(potable water) 62_54a x _t rttb/showedshowrr pon. 1261 'i5.(72 Pi> ( 3)3.51 -39633 I Fa :( ) • Urinal 25.02 .•1M. _ y Qat,r timet Bina . 1,i .l V�� 25.02 _ W ater beater ( 3752 Y}.50...1 / � � piping/DVN 56.29 Business num=T,b ,. p M3 !A_L Waterpipi 25.02 Address: r 5. Otho' City/State/ZIP: �-/ 0' 81619 Subtotal . hfmimum permit fee: 57250 ::.Tim[ Pbcant 3 -3903 Fax:( ) - - . Plan review 25%of permit fee) CCB Lia: L B6345" Plumbing Lie.r> 1582. State surcharge(12%of permit fee) `TJ TOTAL PERMIT FEE PrintAuthorizedne signature •itis permit application expires if a permit is not obtained within 180 days �/ Dem Si after it has been accepted as compldr Print r18r[1C •' [.-�^ � '- I / / .Fee methodology set by Tri-Comity Building Industry Service Board lhoc 10/01/1:19 4404616T(10/02/CUMIWFS) LAIMAI d City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT ■ T i G A R o Building Permit Review — Residential . Building Permit #: risTao/,'—D4 50 l/ ____,:2eZ Site Address: I •k : ' - ; ; - , l K Project Name: Pokvion a+ 9u.`k Ntousli- l,i f1 Lot #: Bei (New okYlling= subdivision name;Addition or Alteration=last name of owner) Planning Review osal: (' j S Pro site address/suite# exists and actio in permit system. River Terrace Neighborhood: Yes ❑ No Sit Plan Elements: NI?lree(3)copies of site plan xisting structures on site e plan must 12g on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished yawn to scale(standard architect or engineer scale) oor elevations Forth arrow Utility locations(required for new,may apply for additions) S' e address,project or subdivision name and lot number ()cation of wells/septic systems pplicant information (name and phone number) Erosion control(including drainage-way protection,silt fence t dimensions and building setback dimensions stgn,location of catch basin,etc.) of area,building coverage area,percentage of coverage and S,rieet names /impervious area (applicable if R-7,R-12,R-25&R-40) VStreet tree size,type and location 1i Property corner elevations (2 foot contour lines if more than -H-Existing trees to be retained with drip line,and tree oot differential) protection measures Clean Water Services—Service Provider Lettey(lot platted prior to 9/10/1995): /Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No g Public Facili�ti Improvement (PFI) Permit: � /Required: Yes,applicant was notified No Applied For: pd Yes ❑ No,stop intake �d Eland Use Case#: SUB201 S-00002_fl oning: R- LI,5 Eil8etbacks: Front j Q 1 Rear 1 5' Side 5 t Street Side I 3 Garage V Landscape Requirement: 2,0 % wuilding f Coverage Maximum: 0 o Height: Maximum Height 3O Actual Height 2.5c.S ' Lld Visual Clearance -e—/Easements giSensitive Lands: Yes No Type S/ ,t� ,1 42Z71--ik1"Aps D Urban Forestry Plan fJ ❑ Conditions "Met"prior to issuance of building permit Notes: G17�7/ Yt2 il74,,s rn J _ �?�' '77J . �GC�/ f / J,d>7i►1 ce I/ eom_ Approved By Planning: ,, ,4_ Date: A//5"--- Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_070915.docx i Building Permit Submittal Original Submittal Date: /o2//6//s Site Plans: # 3 Building Plans: # ,3 Building Permit#: Enter building permit#above. Workflow Routing: 'Planning D---Egineering rmit Coordinator C7 Building Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: u—Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. i2 uilding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: 2>-1L._ Date: /�`..2//S Engineering Review ,Er Slope at building pad: S 0 ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 4 No Assess Water Quantity Fee in-lieu: ❑ Yes CZ No LIDA Facility on lot: ❑ Yes ,Z No ❑ NOT Approved by Engineering: Date: Notes: M T e--0•1 -1 cx---s 4 aYL it-' bDa.rz, S urRo—'. .OW4, rc, Is4 A✓E. Pili iu-T Approved by Engineering: /it/KC tv . Date: /Z /2.33/ l�' Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review I 111 Conditions "Met"prior to issuance of building permit 4:///// pApproved, NOT Released: 46e t .a1-4/,; Date: /2- ��s Notes: , Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: ❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A Tigard Trans SDC: ❑ Yes ❑ N/A Parks SDC: ❑ Yes ❑ N/A �Y,•K to Issue Permit Approved by Permit Coordinator: I:\Building\Forms\BldgPermit Rvw_RES_070915.docx 6. Dianna Howse From: Dianna Howse Sent: Thursday, March 24, 2016 4:16 PM To: maggie.gordon@polygonhomes.com Cc: Albert Shields;#Building Permit Technicians; chris.walther@polygonhomes.com Subject: Polygon at Bull Mountain, Lots 59-62 Attachments: PolygonAtBullMountain_FeesDue_Lots_59-62.pdf Hi Maggie, Sorry for the delay in getting the permit fees to you. Albert and I were waiting for information to confirm the amount of transportation credits that could be applied towards these permits. We originally thought that it was all transportation (Washingt,n County and Tigard), however we are only able to credit the Washington County TDT portion at this time. If you have any questions about that, please email or call Albert at 503-718-2426. I have attached the invoices for all four of these permits. You will see the total fees due on page two of each MST invoice where the Wa-hington County TDT amount has been deducted from the total of the permit and sewer permit fees. Thank you and please let me know if you have any questions. Dianna Howse Building Division Ser :ces Supervisor City of Tigard I Community Development 13125 SW Hi1I Blvd., Tigard, OR 97223 503-718-21D° From: Alb 2rt Shields Sent: Thu:-.clay, Mar 24, 2016 12:52 PM To: Dianna Howse; T m Hochstatter Cc: #Build i Permit TTechnicians; Mike White; Cheryl Caines Subject: 1 Mtn Pe,mits �� h-vcompletion f the infrastructure at Pol on at Bull Mountain and Planningand onfirmir that we a substantial 0 C Polygon Engineerin ; are OK h issuing the next 4 building permits, bringing the total issued to 8. Those permits are: Lct 59 -- M !2015-0: "'50 Lc t 60— M 2015-0n: 51 Lot 61—M:)12015-OU252 Lot 62—MST2015-00253 Credit Voll, her num' rs should be available this afternoon. A' ert Shir- From: Maggie Gordon [mailto:Maggie.Gordon@polygonhomes.com] Sent: We,'nesday, March 23, 2016 7:48 AM T : Deb! t riamskl .anna Howse C, : #Build Perm' ochnicians; Mike White S 'eject: F ': Bull f l Question 1 Good Mor ng! Hop all is well. A couple questions. For Polyg, ,t Bull untain lots 45-50—I don't show any record of having paid plan review fees or them having permit numbers. 1 fanning said they've been done with Bull Mtn for a few weeks now. Wc under ,nd from Mike White that in the next few days we'll be able to pull the following permits: Lot 59 2015-O0,70 Lc' '9— ' 2015-C 1 Lo 1 — 2015-C ' 2 Lo r,2 - 1 -2015-8!253 Ca we I e get al t':e permit fees associated with each lot so we can have a check cut and be ready! Tb s M ggic )rdon C' 1ST` TION RDINATOR m. Ic;i on@h , ;onhomes.com O' 1 47C!1 w iorne n 41 Fr n: rmailto:MonicaB@tigard-or.gov] S t: ,de/ b' 2, 2016 6:19 PM T M eG S ?E: nnestion M P' ni ni of Bull Mountain a few weeks ago. T kr Mo Frog n: r 2 Gnr mailto:Maggie.Gordon@polygonhomes.com] Sen ', 2016 3:03 PM To: I Cc: oD Sup cul! ion Hi r or, — 1 ' ave en plan review fees on the following lots at Bull Mtn and was wondering if they are still in Plan lir Lots 2 Thank, Marc; !tic � CONS, SON RDINATOR ma,c�ic� n�, �nhomes.com Office www pr- Dm 6 G -t or received by City of Tigard employees are subject to public record laws. If requested, e-mail n. y er ger party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the >mpliance with the Oregon Administrative Rules"City General Records Retention Schedule." 3 CITY OF TIGARD FEE AND PAYMENT HISTORY 11111 C 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD MST2015-00250 - 15192 SW 154TH AVE, TIGARD, OR 97224 -O 7 .5'9 Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due Building Permit-New Construction 230-0000-43104 $2,458.74 $2,458.74 $2,458.74 Plan Review 230-0000-43106 $751.34 $751.34 $750.00 12/23/15 Check 401195 $1.34 12%State Surcharge-Building 100-0000-24001 $295.05 $295.05 $295.05 Wash Co Trans Dev Tax-SF Detached 405-0000-43320 $8,113.00 $8,113.00 $8,113.00 Tigard Trans SDC Improvement-SF 415-0000-43300 $5,402.00 $5,402.00 $5,402.00 Detached Tigard Trans SDC Reimbursement-SF 415-0000-43301 $312.00 $312.00 $312.00 Detached Tigard Trans SDC River Terrace-SF 415-0000-43302 $2,642.00 $2,642.00 $2,642.00 Detached Parks SDC Improvement-SF Dwelling 425-0000-43300 $4,248.00 $4,248.00 $4,248.00 (detached/attached) Parks SDC Reimbursement-SF 425-0000-43301 $1,001.00 $1,001.00 $1,001.00 Dwelling(detached/attached) Parks SDC River Terrace-SF Dwelling 425-0000-43302 $1,953.00 $1,953.00 $1,953.00 (detached/attached) DC Provision Review, SF-Ping 100-0000-43112 $88.00 $88.00 $88.00 Info Process/Archiving-Lg$2.00(over 230-0000-43135 $34.00 $34.00 $34.00 11x17) Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $75.00 $75.00 $75.00 11x17) Metro Const. Excise Tax 230-0000-24010 $551.62 $551.62 $551.62 Tig-Tual School CET-Residential - 230-0000-24102 $4,477.20 $4,477.20 $4,477.20 Permit Fee-Elect(per dwelling unit) 220-0000-43103 $405.98 $405.98 $405.98 Limited Energy 220-0000-43103 $75.00 $75.00 $75.00 12%State Surcharge-Electrical 100-0000-24001 $57.72 $57.72 $57.72 Furnaces< 100K BTU 230-0000-43102 $46.75 $46.75 $46.75 . Z-107-- 5.9 Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due • Water Heater 230-0000-43102 $23.32 $23.32 $23.32 Gas Fireplace 230-0000-43102 $33.39 $33.39 $33.39 Range Hood/Other Kitchen 230-0000-43102 $33.39 $33.39 $33.39 Clothes Dryer Exhaust 230-0000-43102 $33.39 $33.39 $33.39 Single Duct Exhaust(Bathrooms, Toilet, 230-0000-43102 $139.92 $139.92 $139.92 Utility Rooms) Fuel Piping 230-0000-43102 $14.15 $14.15 $14.15 12%State Surcharge-Mechanical 100-0000-24001 $38.92 $38.92 $38.92 SFR-Baths 230-0000-43101 $525.34 $525.34 $525.34 12%State Surcharge-Plumbing 100-0000-24001 $63.04 $63.04 $63.04 Erosion Control w/Development 100-0000-43134 $461.40 $461.40 $461.40 Plan Review 230-0000-43106 $846.84 $846.84 $846.84 Totals for Fees $35,200.50 $35,200.50 $750.00 $34,450.50 Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount 401195 Check 070705 Polygon WLH LLC 12/23/2015 $750.00 Total Payments: $750.00 Balance Due: $34,450.50 5w%_ 1- `'1 ...5i3 1 449 _39, s' , 5"0 Al 0 p // 3. at r17 0 - " ---)- vaae 707-e-4-• 4( .34 'ZR , -CO CITY OF TIGARD FEE AND PAYMENT HISTORY 6il ... .1 l 2 _. 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD SWR2015-00180 - 15192 SW 154TH AVE, TIGARD, OR 97224 GO j ,5 Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due Sewer Connection Fee 500-0000-25500 $5,100.00 $5,100.00 $5,100.00 Sewer Inspection-Residential 230-0000-43118 $35.00 $35.00 $35.00 Totals for Fees $5,135.00 $5,135.00 $0.00 $5,135.00 Payor: Receipt Date Receipt Amount Pa Receipt# Payment Method Check# y Total Payments: $0.00 Balance Due: $5,135.00 CITY OF TIGARD FEE AND PAYMENT HISTORY . II j* 4 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD MST2015-00251 - 15166 SW 154TH AVE, TIGARD, OR 97224 Z-0 j 0 Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due Building Permit-New Construction 230-0000-43104 $2,467.58 $2,467.58 $2,467.58 Plan Review 230-0000-43106 $751.34 $751.34 $750.00 12/23/15 Check 401196 $1.34 12%State Surcharge-Building 100-0000-24001 $296.11 $296.11 $296.11 Wash Co Trans Dev Tax-SF Detached 405-0000-43320 $8,113.00 $8,113.00 $8,113.00 Tigard Trans SDC Improvement-SF 415-0000-43300 $5,402.00 $5,402.00 $5,402.00 Detached Tigard Trans SDC Reimbursement-SF 415-0000-43301 $312.00 $312.00 $312.00 Detached Tigard Trans SDC River Terrace-SF 415-0000-43302 $2,642.00 $2,642.00 $2,642.00 Detached DC Provision Review, SF-Ping 100-0000-43112 $88.00 $88.00 $88.00 Info Process/Archiving-Lg$2.00(over 230-0000-43135 $36.00 $36.00 $36.00 11x17) Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $44.50 $44.50 $44.50 11x17) Metro Const. Excise Tax 230-0000-24010 $553.55 $553.55 $553.55 Tig-Tual School CET-Residential 230-0000-24102 $4,538.40 $4,538.40 $4,538.40 Plan Review 230-0000-43106 $852.59 $852.59 $852.59 Permit Fee-Elect(per dwelling unit) 220-0000-43103 $405.98 $405.98 $405.98 Limited Energy 220-0000-43103 $75.00 $75.00 $75.00 12%State Surcharge-Electrical 100-0000-24001 $57.72 $57.72 $57.72 Furnaces< 100K BTU 230-0000-43102 $46.75 $46.75 $46.75 Water Heater 230-0000-43102 $23.32 $23.32 $23.32 Gas Fireplace 230-0000-43102 $33.39 $33.39 $33.39 Range Hood/Other Kitchen 230-0000-43102 $33.39 $33.39 $33.39 Clothes Dryer Exhaust 230-0000-43102 $33.39 $33.39 $33.39 r Z/O7 6' 0 Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due Single Duct Exhaust(Bathrooms, Toilet, 230-0000-43102 $139.92 $139.92 $139.92 Utility Rooms) Fuel Piping 230-0000-43102 $14.15 $14.15 $14.15 12% State Surcharge-Mechanical 100-0000-24001 $38.92 $38.92 $38.92 SFR-Baths 230-0000-43101 $525.34 $525.34 $525.34 12%State Surcharge-Plumbing 100-0000-24001 $63.04 $63.04 $63.04 Erosion Control w/Development 100-0000-43134 $461.40 $461.40 $461.40 Parks SDC Improvement-SF Dwelling 425-0000-43300 $4,248.00 $4,248.00 $4,248.00 (detached/attached) Parks SDC Reimbursement-SF 425-0000-43301 $1,001.00 $1,001.00 $1,001.00 Dwelling(detached/attached) Parks SDC River Terrace-SF Dwelling 425-0000-43302 $1,953.00 $1,953.00 $1,953.00 (detached/attached) Totals for Fees $35,250.78 $35,250.78 $750.00 $34,500.78 Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount 401196 Check 070705 Polygon WLH LLC 12/23/2015 $750.00 Total Payments: $750.00 Balance Due: $34,500.78 �ccji2 .74_ S'i 3 5: v77 i `f ? 3 7, uiesrf- Co cP, //3, at 7—A7_ C,L/7 l,,`DiLe(74-‘IZ 77 4— 4-4c ' 1 3/1 .5,:g - 7cP Z--c9 7— 60 CITY OF TIGARD 7FEE AND PAYMENT HISTORY g 113125 SW Hall Blvd.,Tigard OR 97223 i 503.639.4171 TIGARD SWR2015-00181 - 15166 SW 154TH AVE, TIGARD, OR 97224 (? 7-- cP 0 Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due Sewer Connection Fee 500-0000-25500 $5,100.00 $5,100.00 $5,100.00 Sewer Inspection-Residential 230-0000-43118 $35.00 $35.00 $35.00 Totals for Fees $5,135.00 $5,135.00 $0.00 $5,135.00 Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount Total Payments: $0.00 Balance Due: $5,135.00 CITY OF TIGARD FEE AND PAYMENT HISTORY . q it . 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD MST2015-00252 - 15138 SW 154TH AVE, TIGARD, OR 97224 4 o T (e, Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due Building Permit-New Construction 230-0000-43104 $2,295.20 $2,295.20 $2,295.20 Plan Review 230-0000-43106 $751.34 $751.34 $0.00 12/23/15 Credit Card 401197 $1.34 $750.00 12/23/15 Check 401202 Plan Review 230-0000-43106 0 4, ,0 ',tom $751.34 $0.00 12/23/15 Credit Card 401197 $1.34 J� $750.00 12/23/15 Check 401202 12%State Surcharge-Building 100-0000-24001 $275.42 $275.42 $275.42 Wash Co Trans Dev Tax-SF Detached 405-0000-43320 $8,113.00 $8,113.00 $8,113.00 Tigard Trans SDC Improvement-SF 415-0000-43300 $5,402.00 $5,402.00 $5,402.00 Detached Tigard Trans SDC Reimbursement-SF 415-0000-43301 $312.00 $312.00 $312.00 Detached Tigard Trans SDC River Terrace-SF 415-0000-43302 $2,642.00 $2,642.00 $2,642.00 Detached Parks SDC Improvement-SF Dwelling 425-0000-43300 $4,248.00 $4,248.00 $4,248.00 (detached/attached) Parks SDC Reimbursement-SF 425-0000-43301 $1,001.00 $1,001.00 $1,001.00 Dwelling(detached/attached) Parks SDC River Terrace-SF Dwelling 425-0000-43302 $1,953.00 $1,953.00 $1,953.00 (detached/attached) DC Provision Review, SF-Ping 100-0000-43112 $88.00 $88.00 $88.00 Info Process/Archiving-Lg$2.00(over 230-0000-43135 $36.00 $36.00 $36.00 11x17) Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $77.00 $77.00 $77.00 11x17) Metro Const. Excise Tax 230-0000-24010 $506.58 $506.58 $506.58 Tig-Tual School CET-Residential 230-0000-24102 $4,119.60 $4,119.60 $4,119.60 Permit Fee-Elect(per dwelling unit) 220-0000-43103 $405.98 $405.98 $405.98 Limited Energy 220-0000-43103 $75.00 $75.00 $75.00 Revenue Payment Fee Description Acc,,,,“ "t,,mber F,,,, ^•-count Invoiced Paid Date Paid Method Receipt# Due 12%State Surcharge-Electrical 100-0000-24001 $57.72 $57.72 $57.72 Furnaces< 100K BTU 230-0000-43102 $46.75 $46.75 $46.75 Water Heater 230-0000-43102 $23.32 $23.32 $23.32 Gas Fireplace 230-0000-43102 $33.39 $33.39 $33.39 Range Hood/Other Kitchen 230-0000-43102 $33.39 $33.39 $33.39 Clothes Dryer Exhaust 230-0000-43102 $33.39 $33.39 $33.39 Single Duct Exhaust(Bathrooms,Toilet, 230-0000-43102 $116.60 $116.60 $116.60 Utility Rooms) Fuel Piping 230-0000-43102 $14.15 $14.15 $14.15 12%State Surcharge-Mechanical 100-0000-24001 $36.12 $36.12 $36.12 SFR-Baths 230-0000-43101 $500.32 $500.32 $500.32 12%State Surcharge-Plumbing 100-0000-24001 $60.04 $60.04 $60.04 Erosion Control w/Development 100-0000-43134 $461.40 $461.40 $461.40 Plan Review 230-0000-43106 $740.54 $740.54 $740.54 Totals for Fees $750.00 �✓ 3 M,59 3 y VS9,S9 33 ?oar, s' Receipt# Payment Method Check# Pavor: Receipt Date Receipt Amount 401197 Credit Card Polygon WLH LLC 12/23/2015 $750.00 401201 Credit Card Polygon WLH LLC 12/23/2015 $-750.00 401202 Check 070705 Polygon WLH LLC 12/23/2015 $750.00 Total Payments: $750.00 Balance Due: $33,708.25 ��. / * 3, ePY.3- 0 ‹ Ait c 0 k /1-3, rt it c, 1-7" t-c.9T 6,i CITY OF TIGARD FEE AND PAYMENT HISTORY , v IN i 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD SWR2015-00182 - 15138 SW 154TH AVE, TIGARD, OR 97224 L p r , / Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due Sewer Connection Fee 500-0000-25500 $5,100.00 $5,100.00 $5,100.00 Sewer Inspection-Residential 230-0000-43118 $35.00 $35.00 $35.00 Totals for Fees $5,135.00 $5,135.00 $0.00 $5,135.00 Receipt# Payment Method Check# Pavor: Receipt Date Receipt Amount Total Payments: $0.00 Balance Due: $5,135.00 CITY OF TIGARD FEE AND PAYMENT HISTORY . •sn : • _ 13125 SW Hall Blvd.,Tigard OR 97223 • 503.639.4171 TIGARD MST2015-00253 - 15108 SW 154TH AVE, TIGARD, OR 97224 Z-07- 6 ,2-- Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due Building Permit-New Construction 230-0000-43104 $2,467.58 $2,467.58 $2,467.58 Plan Review 230-0000-43106 $751.34 $751.34 $750.00 12/23/15 Check 401198 $1.34 12%State Surcharge-Building 100-0000-24001 $296.11 $296.11 $296.11 Wash Co Trans Dev Tax-SF Detached 405-0000-43320 $8,113.00 $8,113.00 $8,113.00 Tigard Trans SDC Improvement-SF 415-0000-43300 $5,402.00 $5,402.00 $5,402.00 Detached Tigard Trans SDC Reimbursement-SF 415-0000-43301 $312.00 $312.00 $312.00 Detached Tigard Trans SDC River Terrace-SF 415-0000-43302 $2,642.00 $2,642.00 $2,642.00 Detached Parks SDC Improvement-SF Dwelling 425-0000-43300 $4,248.00 $4,248.00 $4,248.00 (detached/attached) Parks SDC Reimbursement-SF 425-0000-43301 $1,001.00 $1,001.00 $1,001.00 Dwelling(detached/attached) Parks SDC River Terrace-SF Dwelling 425-0000-43302 $1,953.00 $1,953.00 $1,953.00 (detached/attached) DC Provision Review, SF-Ping 100-0000-43112 $88.00 $88.00 $88.00 Info Process/Archiving-Lg$2.00(over 230-0000-43135 $36.00 $36.00 $36.00 11x17) Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $49.00 $49.00 $49.00 11x17) Metro Const. Excise Tax 230-0000-24010 $553.24 $553.24 $553.24 Tig-Tual School CET-Residential 230-0000-24102 $4,538.40 $4,538.40 $4,538.40 Permit Fee-Elect(per dwelling unit) 220-0000-43103 $405.98 $405.98 $405.98 Limited Energy 220-0000-43103 $75.00 $75.00 $75.00 12%State Surcharge-Electrical 100-0000-24001 $57.72 $57.72 $57.72 Furnaces< 100K BTU 230-0000-43102 $46.75 $46.75 $46.75 • L- .. Revenue Payment Fee Descr., Ac. !,..r !" • ^-,mount Inv, -ed Paid Date Paid Method Receipt# Due • Water Heater 230-0000-43102 $23.32 $23.32 $23.32 Gas Fireplace 230-0000-43102 $33.39 $33.39 $33.39 Range Hood/Other Kitchen 230-0000-43102 $33.39 $33.39 $33.39 Clothes Dryer Exhaust 230-0000-43102 $33.39 $33.39 $33.39 Single Dint L,:.,ust(Bathrooms, Tail t, 230-0000-43102 $139.92 $139.92 $139.92 Utility Rooms) Fuel Piping 230-0000-43102 $14.15 $14.15 $14.15 12%State Surcharge-Mechanical 100-0000-24001 $38.92 $38.92 $38.92 SFR-Baths 230-0000-43101 $525.34 $525.34 $525.34 12%State Surcharge-Plumbing 100-0000-24001 $63.04 $63.04 $63.04 Erosion Control w/Development 100-0000-43134 $461.40 $461.40 $461.40 Plan Review 230-0000-43106 $852.59 $852.59 $852.59 Totals for Fees $35,254.97 $35,254.97 $750.00 $34,504.97 Receipt# Payment Method Check# Pavor: Receipt Date Receipt Amount 401198 Check 070705 Polygon WLH LLC 12/23/2015 $750.00 Total Payments: $750.00 Balance Due: $34,504.97 //3 , e-e C iT vat(eeEz 3/, 5.2IP , 77 L0T 0 oZ 1 <-- CITY OF TIGARD IFEE AND PAYMENT HISTORY _I1 . . 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TEGA.RD SWR2015-00183 - 15108 SW 154TH AVE, TIGARD, OR 97224 GQ j ,2_, Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due Sewer Connection Fee 500-0000-25500 $5,100.00 $5,100.00 $5,100.00 Sewer Inspection-Residential 230-0000-43118 $35.00 $35.00 $35.00 Totals for Fees $5,135.00 $5,135.00 $0.00 $5,135.00 Receipt# Payment Method Check# Pavor: Receipt Date Receipt Amount Total Payments: $0.00 Balance Due: $5,135.00 Albert Shields From: Albert Shields Sent: Wednesday, December 30, 2015 4:48 PM To: Maggie Gordon (Maggie.Gordon@polygonhomes.com) Cc: Cheryl Caines; Susan Shanks; Mike White Subject: Permit Applications, Bull Mountain Area 7 -MST2015-00250, -00251, -00252, -00253, Attachments: Conditions- 12-30-2015.pdf Maggie, in reviewing the permit applications for MST2015-00250, -00251, -00252, and -00253 we find that there are two issues with the applications that must be resolved before we can release them for plan review, let alone issuance: 1. Each of these applications calls for an address on "Rio Grande Terrace" but we find no such street on the draft final plat that we have received. Instead, we find that the street on which those lots are located is "154th Ave." If your intention is to establish "Rio Grande Terrace" as the street name please submit to us a plat that is revised accordingly. Please let me know which way you want to go. 2. Multiple Conditions of Approval under the governing Land Use Case,SUB2015-00002 that are required to be met before final plat approval and/or issuance of building permits remain Not Met. I've attached a printout of the Conditions on which I have highlighted those that must be met before we can continue to process these permit applications. We will put these applications on "Hold" until the requisite Conditions have been met. Please let me know if you have any questions. Albert Shields City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT = r Request for Permit Action RECEIVED l ��;Al;l) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.ugard-or.gov MAY 0 3 2016 TO: CITY OF TIGARD CITY OF TIGARD Building Division BUILDING DIVISION 13125 SW Hall Blvd.,Tigard, OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner [Applicant ❑ Contractor ❑ City Staff Check(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) 1�o11 On J t..14 LLC L (fir s L Mailing Address: ' ) t St J S'1 ai-tbi City/State/Zip: \nCotuv x vu crkie o0 Phone No.: 3V)- o l5 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): ❑ CANCEL/VOID PERMIT APPLICATION. ❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ® REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: MST2015'.00V50 Site Address or Parcel#: 151(I'D- 8vA) 1514411 Pm- Ti YQ,Tr 9a pro DR tr1 L1 Subdivision Name: .1.(o A /AT I► !I( f Lot#: EXPLANATION: kf,L'hri GQ changed darne1r -Dfric wa h 1 � LLe_ --&>eJ2- d-Pd Ce Lc col O Signature: AdLAI �, ,�jv A. Date: 6P5//b Print Name: A a ' & i r9Q r j Refund Policy ,J I. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. .\l1 refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. Route to Sys Admin: Date By Route to Records: Date 24, /4 Refund Processed: Date /✓/rit By 4Y Invoice Processed: Date By Permit Canceled: Date q/j!f— By, — Parcel Tag Added: Date By I:\Building\Forms\RegPermitaetion_u966314.doc Electrical Permit Application RECEIVEFOR OFFICE USE ONLY Cl Tigard O �I "eceived Permit§ <5/�ff tr7's `�etO as g Date/By Y 0 III 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review - j Phone: 503.718.2439 Fax 503.598.1960D„eIBy_ Related Permit g: Inspection Line: 503.639.4175 MAY 2 3 2 016 ,may Date/Br :lurk H See Page 2 for 11G,"ARD Internet wwwtigard-or.govNo' hod tifiedMel : SupplementalInformation ® 0 DIVISIUIV. i _ s:_/_;.. :F.�,,is New cottstrtiction•- Addition/altera Please check all that apply(subma 2 s�ofplaos mortems checked): ❑Demolition 0 Other: - ['Service or feeder 400 amps or more ❑Building over three stories. ° where the available fault current Marinas and •*. �„ ... .rl' ..� ; O��lOl`��OmasU.',��PI?IV %�ze . , : ;., exceeds 1 "aaMat 150 volts o ❑Plaiting badins a. ®1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building lex to ground,or exceeds 14,000 D Commercial-use agricultural amps for all other installations. buildings. 0 Multi-family - 0 Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or •. :'.'•_JOB SIT$,INFQ..R kittlON..tNp L 0,Xt.•I,QP1I. .`.J.... . &na8enay system. larger separately derived ":' 1�' 1 (J W 15�1 l�Addition of new motor load of system. Job*: Job site address: +41 1001.1p or more, 0"A","E","1-2","1-3", City/State/DP:Tigard,OR 97224 - ❑six or more residential=its, occupancy. 0 Recreational vehicle ❑Beahh-ora facilities. parks. Suite/bldg./apt#: Project name:Polygon at Bull Mountain ❑Ilazardota locations. 0 Supply voltage for more than 0 Service or feeder 600 amps or more, 600 volts nominal Cross street/directions to job site: 7.,-:::fi' fes:3( DgJGs :t; ' • :,.,:*„...,;',. ..a-, ' Description Qty. I Earn . ITotal 1 • New residential single-or multi-family dwelling unit. Subdivision:Polygon at Bull Mountain Lot#: 5q Includes attached garage. Tax map/parcel#' 1,000 sq.R or less 168.54 4 Tar,_. _:f :.,.... 33.92 �- ,. ._1 : . D :TION::pF.s.:UIttC�::': - Limited 'dentia ......�.. - � :,.:.-...,. .:amu:•.:.:..,'n .. �.. .. .:-.... "q: , _..L. •IrAi�u'-�ifY:J.. ,>rSG�'_ �')'.. '• : .. energy,residential 75.00 2 C6/1A/66' Con/i722A'C�2 DAi 6--Kis rnlG Limited lived abbesq,energy,multi-family 75.00 2 /v 15:2//% residential(with above sq.ft.) --.•- ❑ Sec Page 2 --"�<< Services or feeders instaliationzalteration,and/or relocation .............. Name:Polygon WLH,LLC 200 amps or less 100.70 2 Address:109 East 13th Street 201 amps to 400 amps . 133.56 2 401 amps to 600 amps 20034 2 City/State/ZIP:Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2 Phone:(360)695-7700 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders Installation,alteration,and/or Email: . 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 2 Owner signature: Date: 401 amps to 599 amps - 168.54 2 ;;_.a.r _ Y- -z,� , Branch circuits—new,alteration,or extension,per panel max. . - - A.Feu for branch circuits with Business name:Polygon WLH,LLC above service or feeder fee, 7.42 2 each branch circuit Contact name:Angela Grajewslci B.Fee for branch circuits without Address:109 East 13th Street service or feeder fee,first 56.18 2 branch circuit _ City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 1Vllsceilaneous(service or feeder not Included) Phone:(360)695-7700 Fax::(360)693-4442 ' Each manufactured or modular ' dwelling,service and/or feeder 67.84 2 Email:Angela.Grajewski®polygonhomes.com Reconnect only 67.84 2 :rly �,�p -:t• :t '.s. .;tv '1;r ,. 684 :.;..- ,.:ate:ae�s...:,. ..:. ::.,.:Q. ,... -.... . : i ... Pu orirri tion circle 7. 2 ,47�t?.+� :c;;.,•::,..:,r� •-.:':r: rap ga Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2 Address:61t11`i. St Johns Rd Signal circuit(s)or limited energy ❑ Sa Page 2 2 panel,alteration,or extension. City/State/ZIP:Vancouver WA 48661 Each additional Inspection over allowable in any of the above Additional inspection(1 hr rain) 66.251 hr Phone:(253)320-1657 Fax:( ) Investigation(I hr min) 90.0W hr Email:bdaniels®gweusa.com Industrial Plant(1 hr min) 7818/hr Inspections for which no fee is 90,00/hr CCB Lic.: C1158 Electrical Lic.: 208174 Suprv.Lic.: 4496S $ r .>!li �y(~A�hr°un) . - � " I 5i}'i.` x^ !4':3ItitJi'1:'i'"t:'1tti=_ i ' •;.'.Fa':\_i Suprv.Electrician signature,required: ••(111.f.11.P, I•i.e Subtotal: Print name: Joan P Albert • Dater-3-t,c, 0 Plan Review Required(25%of permit tee): _ State mrcharge(12%of permit fee): Authorized signature: ' .. --_�r_,�� TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Bill Daniels/ Date.3—ao days after it has bees accepted as complete. * Number of inspections allowed per permit l:lawlar permhslQ.C_PermitApp ELR BRRdoc Rev 06/17/2015 40-4615•ItIIA'S/COM/WEB Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 15192 SW 154TH AVE, TIGARD, OR, 97224 Residential - Master Permit 199 Electrical ﬁnal FAIL MST2015-00250 David Young Remove smoke detector covers to test. All else ok. Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 15192 SW 154TH AVE, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection FAIL MST2015-00250 David Young Subdivision requirements for issuance of ﬁnal inspections not met at this time. No C of O issued. Fix vapor barrier in crawl, and remove debris from crawl. Provide insulation certiﬁcation. Final erosion control approved. Street tree certiﬁcation received. Moisture content form received. High efﬁciency lighting form received. Blower door test results checked. Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 15192 SW 154TH AVE, TIGARD, OR, 97224 Residential - Master Permit 699 Mechanical ﬁnal PASS MST2015-00250 David Young Note: no AC installed at time of ﬁnal inspection. Permit and inspection required at time of installation. Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 15192 SW 154TH AVE, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection PASS - C of O MST2015-00250 David Young Corrections from previous inspection complete. 8 lots approved for C of O's to be issued upon approved ﬁnal inspections. Insulation certiﬁcation checked. C of O left on kitchen island. Violation Summary: Inspector Contractor