Loading...
Permit (50) V RECEIVE') City of Tigard • COMMUNITY DEVELOPl(4EMT DEPARTMENT 1111 AUG 1 4 2017 I Request for Permit Action 11 I' RD TIGARD 13125 SW Hall Blvd. • Tigard,Oregon 97223 • 503-718-2439 •www.ti rd-or` oov O` $l� ar� INC DIVISION TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner g Applicant ❑ Contractor ❑ City Staff Check(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) Ph\l,cj ‘.)klU 'Li C. Mailing Address: 1 a bri)(la L \o L SA- S City/State/Zip: \1ckf(.owJex- I w c9&o p 0 Phone No.: 3V l.Q vl 5 -T103 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#: Mss l-On—60 t •Ca BOJ 7 -Co/7/ Site Address or Parcel#: t53b1 Sk).) Peace. �Nt 1�ie, Project Name: Pbt U cn ,� 1 V`o L tc u r' Subdivision Name: Lot#: ( 3 EXPLANATION: NO no.,t kos\S ttt c( vuevt ti � ♦ it* rim 4° . i mL.... 4 A * /? I .' - _S tz. . D 7 00..27" Signature: tifi/Piha / Date: 6 / ( - Print Name: (v f(MO'P 111(11 Refund Policy (/ 1. The city's CommunityDevelopment Director,Building Official or CityEngineer 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 • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort € has been expended.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. All 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. 1/r/ 77 1-iv c/ c'7Z S e_ We-7,u 1' 1'7/%3 FOR OFFICE USI: ONLY Route to Sys Admin: Date By Route to Records: Date 9 /9 >') By r Refund Processed: Date/I/A- By ,A; Invoice Processed: Date By Permit Canceled: Date �'/„S// 7 By . P Parcel Tag Added: Date By I:\Building\Forms\RegPermitAction 49231W.doc CITY OF TIGARD RECEIPT 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: Polygon at Bull Mountain, Lot 13 IR &-5' &':7-1) 7-4 Site Address: 15307 SW PEACE AVE /`95.T 0/'7 eo3,7 - Receipt Number: 412109 - 08/02/2017 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2017-00209 Building Permit-New Construction 230-0000-43104 $2,877.44 MST2017-00209 Plan Review 230-0000-43106 $751.34 MST2017-00209 12%State Surcharge-Building 100-0000-24001 $345.29 MST2017-00209 Wash Co Trans Dev Tax-SF Detached 405-0000-43320 $8,278.00 ii MST2017-00209 Tigard Trans SDC Improvement-SF 415-0000-43300 $5,488.00 pC Detached MST2017-00209 Tigard Trans SDC Reimbursement-SF 415-0000-43301 $317.00 4 Detached MST2017-00209 Tigard Trans SDC River Terrace-SF 415-0000-43302 $2,684.00 sr Detached MST2017-00209 Parks SDC Improvement-SF Dwelling 425-0000-43300 $4,356.00 ir (detached/attached) MST2017-00209 Parks SDC Reimbursement-SF 425-0000-43301 $1,207.00 r Dwelling(detached/attached) MST2017-00209 Parks SDC River Terrace-SF Dwelling 425-0000-43302 $2,003.00 V (detached/attached) MST2017-00209 DC Provision Review, SF-Ping 100-0000-43112 $90.00 MST2017-00209 Info Process/Archiving-Lg$2.00(over 230-0000-43135 $48.00 11x17) MST2017-00209 Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $62.50 11x17) MST2017-00209 Metro Const. Excise Tax 230-0000-24010 $669.92 MST2017-00209 Tig-Tual School CET-Residential 230-0000-24102 $5,578.05 MST2017-00209 Permit Fee-Elect(per dwelling unit) 220-0000-43103 $473.82 MST2017-00209 Limited Energy 220-0000-43103 $75.00 MST2017-00209 12%State Surcharge-Electrical 100-0000-24001 $65.86 MST2017-00209 Air Conditioning 230-0000-43102 $46.75 MST2017-00209 Furnaces< 100K BTU 230-0000-43102 $93.50 MST2017-00209 Water Heater 230-0000-43102 $46.64 M5T2017-00209 Gas Fireplace 230-0000-43102 $33.39 MST2017-00209 Other, Fuel Appliances 230-0000-43102 $23.32 MST2017-00209 Range Hood/Other Kitchen 230-0000-43102 $33.39 MST2017-00209 Clothes Dryer Exhaust 230-0000-43102 $33.39 MST2017-00209 Single Duct Exhaust(Bathrooms,Toilet, 230-0000-43102 $116.60 Utility Rooms) MST2017-00209 Fuel Piping 230-0000-43102 $14.15 MST2017-00209 12%State Surcharge-Mechanical 100-0000-24001 $52.94 MST2017-00209 SFR-Baths 230-0000-43101 $500.32 MST2017-00209 Laundry Tray 230-0000-43101 $25.02 MST2017-00209 Water Heater 230-0000-43101 $37.52 MST2017-00209 12%State Surcharge-Plumbing 100-0000-24001 $67.54 MST2017-00209 Erosion Control w/Development 100-0000-43134 $536.40 MST2017-00209 Plan Review 230-0000-43106 $1,119.00 Total: $38,150.09 Page 1 of 2 Receipt Number: 412109 - 08/02/2017 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 071664 JDRINKWATER 08/02/2017 $38,150.09 Payor: Polygon WLH, LLC Total Payments: $38,150.09 Balance Due: $0.00 Page 2 of 2 CITY OF TIGARD RECEIPT s 2 . ,_ 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD 70 Project Name: Polygon at Bull Mountain, Lot 13 /62-S72 `� ��� � Site Address: 15307 SW PEACE AVE .Sid,e /"7 —eo,2 7y Receipt Number: 412110 - 08/02/2017 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID SWR2017-00184 Sewer Connection Fee 500-0000-25500 $5,300.00 ( SWR2017-00184 Sewer Inspection-Residential 230-0000-43118 $35.00 C Total: $5,335.00 PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 071664 JDRINKWATER 08/02/2017 $5,335.00 Payor: Polygon WLH, LLC Total Payments: $5,335.00 Balance Due: $0.00 Page 1 of 1 CITY OF TIGARD MASTER PERMIT .114--- - I ''' COMMUNITY DEVELOPMENT Permit#: MST2017-00209 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/02/2017 Parcel: 2S108DB01500 Jurisdiction: Tigard Site address: 15307 SW PEACE AVE Subdivision: POLYGON AT BULL MOUNTAIN Lot: 13 Project: Polygon at Bull Mountain, Lot 13 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 1542 sf Basement: 826 sf Left: 5 Parking Spaces: 0 Height: 30 Bathrooms: 3 Second: 2167 sf Garage: 739 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 of Right: 5 Detectors: Yes Total: 4535 sf Value: $558,268.04 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain 0 Storm Sewer 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 2 Water Lines: 100 Drains: Bckflw Prevntr: 0 Catch Basins: 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: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 2 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'I 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: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group:Y Square Feet: NEW SF VB R_3 4535 Owner: Contractor: POLYGON WLH LLC POLYGON WLH,LLC Required Items and Reports(Conditions) 109 E 13TH ST,STE 200 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $38,150.09 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: /14. , --d14 Permittee Signature: rc—e-- . �jo�i ea 5' Call 503.639.4176 by 7:00 a.m.for the next available Inspection date. / This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each Inspection. .$uilding Permit Application Z-07 ii itivarog RECEIVE FOR OFFICE l SE City of TigardReceived C/1 /17 MAR 2 8 2017 Dale/BY: Permit No e 13125 SW Hall Blvd.,Tigard,OR 97223 FaiBY:.eywia6y. �57�D/7-+��lPhone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD ' `7- otherPermit:�al �U12-°6I? - TiG, t Inspection Line: 503.639.4175 BUILDING D Read I Iuris: H See Page 2 for Internet: www.tigard-or.gov IVISIO i otified/Method /1/ �� Supplemental Information -..,..a.. a; tl x.amwL , C , ,a.z�a i„fi �'11::4it,, 5 ''',. .�-.C.+.,.i ef ' s °, x1 fl v SS �{ ” 4 wyi � ViAZ .: -2a. .w.:Y a �vbN,3u .w' .aJ„." .1, .' ::::. IfkS,E.-2': -; .w1,. a.tc.�.$ «�Px,:, ;?,11'12.. M .L.i., ,. m � .x.a ®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 ' ; �� '', ,+,.,Ri a K".a'_,<` s x r';-4',','''''::!--4-`,..-.:' ,�.. '�`,.r z <,,,, -,& 1u'�`'..'� : T 7-",,,''''t a, work indicated on this application. i„s„ w4*' � .a' . .a, „:".,6- '+.m ' `-"w-� tib,....,.,r»"r.. ,,:.,. ,1 r. ...'t. ; Q cidxv i ® 1-and 2-family dwelling 0 Commercial/industrial Valuation; (1 V � k--.,___,___Ai # Z 0 Accessory building 0 Multi-family Number of be rooms: C„ ❑Master builder 0 Other: Number of bathrooms: 3 � � : "1ap ¢ra �i i .�t � r ,��ii fr ��� ��,,` :,:,gR7C:3PAa Total number of floors: 1. 3-LKas.-6a,„7 Li Job site address: 1S 61 `��P■ir a 1Q� tes New dwelling area: y� : square feet City/State/ZIP:Tigard,OR 97224 11 U�� 1V Grarage/carport areaO'` . square feet Suite/bldg./apt.no.: l Project name:Polygon at Bull Mountain Covered porch area o ix_ square feet, 0 Cross street/directions to job site: Deck area: S T C square feet 4a Other structure area: square feet Subdivision:Polygon at Bull Mountain ' Lot no.:16 ' 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 ::6- , .„'r: I �rip t ,.fi: a 'v' t a '":`' Fif e . ., work indicated on this application. Valuation: $ Existing building area: square feet � New building area: square feet 'u. r r ` 'ts e � 4 y e i� e toiit Number of stories: Name:Polygon WLH,LLC Type of construction: Address:109 East 13th Street Occupancy p y groups: City/State/ZIP:Vancouver WA 98660 Existing: Phone:(360)695-7700 Fax:( ) New: ,,,,:: :-4:-' ow �. V . ` i aYa iaa4 ixxA� ,0 ?s $ ia> ::* �f ',i � � d9:�m �i�t4� °?��Pr - a: ._e ' '"i) xm�':r,,r4, ' .:::)'It tBusiness name:Polygon WLH,LLC Contact name:Angela Grajewski ` Structural plan review fee(or deposit): Address:109 East 13th Street FLS plan review fee(if applicable): City/State/ZIP:Vancouver WA 98660 Total fees due upon application: Phone:(360)695-7700 l Fax::( ) Amount received: E-mail:Angela.Grajewsld@polygonhomes.com .J........_ t 1 , `-are . - � Commercial and residential prescriptive installation of " ' ,_ `as-r 1,Y,4::-,.,, _ t 3� hr _,;,,L, roof-top mounted PhotoVoItaic Solar Panel System. Business name:Polygon WLH,LLC Submit two(2)sets of roof plan with connection details Address: 109 East 13th Street and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00 Phone: 360 695-7700 and administrative fees): ( ) l Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60 CCB lie.:204238 - Total fee due upon application: $201.60 Authorized signature: a7(5/l./� This permit application expires if a permit is not obtained L v within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name:Angela Grajewski Date:1/20/2017 Service Board I:tBuildinglPermitslBUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) • ',..,,.,,,, '‘.. , ;'..". ' : ,, Mechanical Permit Annlication I UR i/1 1 it 1 I I (i\$ N City of Tigard ,,!t 3 ,-,,,I.,. Chne41 : 12:511111 13125 SW Hall Blvd..Tigard,OR 97223 Plan Review 'Phone: 503.718.2439 Fax: 503,598.1940 -,' '' ' i.. '', Dareftly: Other Permit; 'Inspection Line: 503.639,4175 " ‘-'' '` ' Date Readyn3y: tarts- -, See Paee 1 roc . -lnicmct: u•tvw.tigard-er,gov - , -- - . — ':'1, ". NetiliedArtelhod; Supplemental Information , { t,5 3-.":.'''''';'''T":"q•7:"---7.3;;:5,4:,'..,jA:Y.":".4-","?:'..As'-ti;Vyt.i.'re"1,";:t i';.iiIS'is;.L., ,:ili.:','?""::''ij.-.-t':NIt.$tt:';;;Vili.„Z.,:, ,`''''...i'-:;''':d " •'-'4''' -''.- - '. ' ' . ' ''.. '..:L.. •' ''''...- '-'''. - ''-' ' - ''' ' Mecionmal omit fees*aro bated on the value of the work Oa New construction U Addition/alteration/replacement performed.indicate the value(rounded to the nearest dollar)oral! 0 Demolition 0 Other: mechanical materials.utuipment.labor,overhead,and profit. '..4-t•-•...:1-',,,;?:',:?--.---'-1‘...7......11.' '''4;:.-'.74.;?,..g..--.-11...-.-,'"'t -fr.3;t,.-t.s,,c7:-.V.......0.1..P.;4'.,[..i...r..-,,,,1-7.11,111;1.,,i4k.-5',.1....,..H4'.:I.,-It.!-.0......--)‘.--4,'-a,....,-"--Z-A.,.. i'1'....e.'4,-,..'-..-.74 tr.ci,,zs' :,,,t_rit,s,t,ar,,N,,,..,1..,,,Frr!..4.3„.. fr..,,),,t,h,:..,.•-.7-1*.,„;,44t„...„, C! I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For spidal Infenntiffoi rise&tektite Multi-family 0 Master builder 0 Other: Description I Qty. I ca. I Total 4-J..: flea onmr. 15,,i,..- ..,,,,t;sil,'„.:j:!I.i,:.i.r_ ,1) tJ-1,c ill, :::',V):1 1,t .5-.1 Fe.*':',;`,-..,. ,,,,-..t,,,, •,.,-, 7.-...1 - Air condidoen r 46,75 Job site address: 5 Sw i)to et, A.Jr___ Farnate 100,000 011.1(ductsiseras) ).. 46,75 City/Shoe/ZIP;Tigard,OR 97224 Furnace 100.0004-BTU(densivents) 54.91 Heat pump 61.06 Suite/bIdgJapt,no.: j Project name;Polygon at Bull Mountain Duct work , Cross street/directions to job site: Hydronic hot water system , 23.32 Residtmtial boiler(radiator or hydronic) 2332 Unit heaters(fuel-type,not electric), in-wall,in-duet.SusOunded.de. 46.75 Flue/vent for any of above 1 23.32 , Subdivision:Polygon at Butt Mountain I Lot no.:/3 Other: Other Feel epplianter 2332 Tax map/pan:e)no.: Water heater 1-, 23.32 7-:`,7''':-1•7 ' ' '"-''' ': ;5:17-5- , `K&`:'-::9-7-7,... ;':i'-',::Ti': Oa fireolacefiesen I 33.39 ...........-..-..,... , ..--::, . .,...-...,............,...:,.,......:,r....- -_--,..-..... ...,.........”....-.•....--,,,a-_,..,...-.....,e,...... t&.,'2,....r.t-,44,,f,;,..`,,".„.-.A. • Fitie vent for walla heatcr or ps V ) ' -OO 9 fireplace 2332 Log fle.hter(aa) 23.32 Wood/pellet stove 33.39 Wood Ownlaerofinscrt 23.32 Chininey/linerffluehrent 23.32 : , ,, ,i-T24;..-1,-,,7-"it'-:7';':"e7;i1TrriE,,`:n E-7'.4iFT-Ic:I.:53T7,„:•IfFr.,..-7-Z- jirr.7--t"?.T7TE7-`,7Z7. Other 2332 •:-I'....:.-,"-7..-,--1.V.,....4. ".,.'..11::.... ..-r-f:II....?;....„41 '"-,!,:d.::.;..„.,!,..,:1-,..:-.2,4,::,...,,,,A-,,-.z....-.....L.,;.,....,-, Egvirogmegigi gammas and vgatgailaii; Name:Polygon WL11,LLC Range hood/oliter kftchen equipment 33.39 A drInsa: 109 East ir Street Clothes dryer exhaust 4 33.3 City/State/ZIP:Vantouver,WA 98660 Singio-dueTexbaust(bathrooms, toilet compartments.utilit rooms) 2332 •Phone:(360)69S-7700 Fu:( ) . Artiderawlspace fans 23.32 ,t.;,-,•,!;z:,:3.7..--.5.;-.-;-7;)--••••i'7:;.vf1-57..--;:,r'.-':Z:7:;_c.c11.2, r:L'i2',3..i7':7,:i-Firl',,W-107k-l--,..fii:P;',747i':':'::--.:;--. Oilltc 2332 " • lletPillirlt; Business florae:Polygon W1.31,LLC E , S14.15 for Brat foam S4.03 tor eadkaddittoost Contact narnix/Vith pie Thorpe FUrtitlet,do. I Gna heatpumn Address:109 But 13th Street WillIstispended/unit heater C4ty/State.f4P:Vancouver,WA 98660 Water heater Phone:(360)6954700 [Fax::(360)693-4442 Fireplace f Kamp i . E-nual;,,i ci 01e. iti&ati ,ir iI1 ,e, i A i .,414,. . 4,44 Barbecue , I ""Alf'177.,'i.4^," A"ei.,--,1".:-.-., 7-"'‘,.....1:'-•::?A'-,1":,; :" :‘' am=dryer(gas) ,IL.':-...---:`,-.'-•'..-:,:..':,..:".....-.,..:,.--,.';:.:4.....'7-.---',v-'t '''''4:•:,',i-VT:',':...-..','-_fg...fil:,-..7.-'1—;,:-.4.2.1..7"-i.,"..Lif...:„ Bu.siness mune:Apex Mr LLC ..: . 6-,-,.-2-,17-1ZF.:5,-.3';,,,:i:,,:-=.,:-',::i.-,:; Address:18004 NE/214ve A Stebtond • Cily/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00) Plan review(25%of pennit fee) Phone:(360)3424109 Fax:(340)326-1769 Stale rawharge(12%of pamil Foe) . CCD lie.:203034 i--- TOTAL PERMIT FEE This peendt application mulcts trot pcer annit is aobtained withia ISO days attacit hat beta accepted at complete. Authorized signature: * Fee methodology sm by Tri-Oeuery Building Industry Service Bared Print naroef / I Date: 4-tov-A- 1 a•akibriArthilaiEC.fetwitApp.P4431 43 dot 443-44(7T(lutrairosuutra) • Electrical Permit Application rt,rtulrt( l til .).r \ II City of Tigard Received ����17123 SW'Hat!Blvd.,Tigard,OR 917223 f?stNBr• Phone; 503.718.2439 Fax: ,03.797'4960. Inspection Lute: 503.639.4175 Reedy may. Interna: www.tigard-or;gov ,';'+ ' Notified/Method: FEERiEtil Asir ►_4 New construction ❑Addition/aitetatio mcnt : .� s , as--ch ts►ttpFpttr ;P(raoedtedc d1 that epyty{,mbeai,jute• _vr�itaas eLeolxd). DService or feeder amps of more 0&defes over roe merle,. Q Demolition (]Other: A .. x what Sac available fault wont Q Marinas mod*satyr*. ` . , ., ,. e 7..:^"ti.:::,---,07,-f�Ci t,' ' P" 'w-?s� ,^^ ' ?__ tweeds 10.000 mops at 150 volts or CI Flaring buildings. 1-and 2-family dwelling 0 Commercial/industrial ■ Accessory building less to round.or=Weds 14,000 pCanuniceed-use egrieolmtat ❑Multi-family 0 Master builder 0 Other amps for all other iertdletitms. building. OFae pump, ❑installation of 150 KVA or =.,--.:-.7,:::; .t.< s, l:t,r t Y ,V Vi', a, .... . .. _ ,3.s;;,, __.: ,_.. !�tautxZ,ettry:pian• tsrsex sepagetfy derived Job 8: Job site address: A- 'TA / I a 0 tulip or more.Addition of new mane toad of. Cl system. "1-2","1-3; City/5tait;lZ[P:Tigard,OR 97224 ❑Six or more residential units, oagpanay. 1 ❑HedSatmefaafltdes. a Reariationel vehlde pada, Suite/bldg./apt.8: Project name : r�1 - 'r.. . O ltsmrdo�u locations. 0 Supply voltage for mote dean Crass street/directions to job site: h g Q Service or feeds 600 amps or more 600 volts mammal Ips • ‘1-4, 0,..:00,:m •..,Qi - ,!.-,:',2 kielA 7Twai a ii�A New residendel single-or maiti-family swelling unit. Subdivision: �--,r rt let.,1 [!. ! Lot is lin Iseledp attached garage. Tax ttlap/parcci# 1,000 sq.R.or less 1 168.54 4 ._. i :..... -.IT,t?r ,,..,err;:r..5, tl.:;13 i>ti._. ..1.'`.,:!:::„Y-', ;:::,;T:'-;:t,vV. Em.mdd•I 700 5Q.R.or portion (1 33.92 } Limited energy,residential 75,00 2 (WN1 abo a Sp.It) ,'7,`,.."1:' ` ..v..p,f.. ,.p._.-7.,7•::,• _r L residential(pith above s9 to 2 Name:ADVL Land Holdings,LLC .._. , ._ .,....,•.. Renewable Energy El See Page 2 Services or feeders(nstaltatattendee,attattendee,and/or relocation Addles=7600 R.Hrtublttree Ranch Road City/State/Z1P:Scottsdale,AZ 85258 200 amps or less 100.70 2 Phone:(602)694-4031 Fax ( ) 201 amps to 400 amps 133,.56 2 Entail: 401 snips to 600 amps 20034 2 • Ovvser instaltatione This installation is being made on property that I own which is not 601 amps to 1,000 amps 301.04 2 Intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Owner 5igtratlrrC: Dtt1tl Over 1,000 amps or volts 552.262 } % 4 `t� r �' ;� �— TT I• Temporary services or feeders imataltatioa,alteration,and/or . :�+x._ .ro.rs:v:�.t—:�.,:al.:�,....:::,1< ! .ai...:.�`,5 r.1w.,: •.:c Monition Business name:William Lyon Homes,Inc. 200 amps or less 59.36 1 Contact came: L^ . t d 201 amps to 400 amps 125.08 2 Address;189 East 13th Street 401 amps to 599 amps 168.54 2 City/State/74P:Vancouver,WA 98660 • Branch circuits-new,alteration,or extension, panel Phone:(360)695-7900 Fax::(360)693.4442 A.Fee for branch clavier with above service or feeder fee. 1 i.d •• 4 0 , /04( J 1/1,0 iii 1/ J a�d each branch t ircuit 7.42 2 B Fee for branch circuits without • Business name:alameda electric ixar,cheircuir 56.18 2 Address:3415 me 44th Each*II branch circuit 7,42 2 cityrstaoerzlP MO19, R v!Z Miscellaneous(service or feeder mol ioclade� a.Z••f Each manufactured or modular 67:84 2 Phone:(503)3192192 Fax:( ) dwdlittyv service ander[ceder ,.� Email:sulatpdx@asteom Reconnect only 67.e4 a. CCB Lim: •199188 Electrical Llc.: c923 Pumpor irrigation circle 63.84 : .2,' Sign aro Bine lighting Suprv.Electrician signature,required: / DI67,84 I Signal tircmit(sj or limirod inevgy Print name; kl fir -a Date: pamd,alteration,orextension, ❑Set.Pose 2• •_ '.3 •- Each additional inspection over allowable in any of[hi abouts' • ' Authorizedel_. .,, s Add tional inspection hr min) 66,25/hr' .. Print name: r r ti Date"" 2,y' /. tmesdgation(i hernia) 90.0d/hr tYsetssa hoes itc ..jELI .IteAcc Ray 06/17/2015 HO•461Stt1t/D57Co34JwEa ``•'f`r Plumbing Permit Application' Building Fixtures -,r' i nit tit i i( i= 1 til: ONI.', City of Tigard Reeeivsd 13125 SW Hall Blvd.,Tigard,OR 972,1 a t, DarclBy: Permit No.: . P{an Review Phone: 503.718.2439 Fee; 503 59f�1960 .11 t i i) Inspection Linc 503 639 4175 . t bate/Re actor Permit No.: Internet: www.tigard-or.gov bast Rudy/@y Suns. 0 See Page 2 for -.4.'.. .. v .. .. ; Notifiesd/Method h• + �"' S plemestri Information `,7:."-.1:,1:;1,',,.*-•.'-"„- -7, -..'0,..,',', -,7,-- e �-...4. eta _Ii Ait�4 �r" .c'. tf'. xi ,_ 4'' c' c:',-k' - . W.',.: 0 5': .1',• .h,,,IT� '•iEr'�`N., `•�'3`aYi ®New construction 0 Demolition Per special ir�Prmariorr aft clrecklitt: � . © ddraan/alterauon/teplacement Other -- Description j Qty. i Ea. 1 Total A .. t New i-2-family dwellings(includes 100 ft.for each utility connection) it C ,, `h i• v1,! ,1 G''•••t C'UuC.,*.. r crN 'i ` ' ` '* xri yAz,.i SPR(1)bath 312.70 0 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ©Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Maste:r builder 0 Other Fire sprinkler( ft.) ;ly ,,r,d, 1, :0,6; t'_:� r� r .`•0 '?,, a47.. 4rb a,..:,+,,;4.'�, q ,, ,e3 .,tL 7.4 6Q Page 2 - - te .n ,A,,,,. .„.,,,_„3+, ' fd „ a ,,,,,,,;,3 �' ' , x ',''�„ MC utilities: Job site address: r 3 IP SA/ ).a pg p („ Catch basin or area drain I 18.76 City/State/ZIP:Tigard,OR 97224 Drywetl,leach lisle,or trench drain 18.76 Suitelbldg./apt:no.: 1 Project name:Polygon at Bull Mountain Footing drain(no.linear ft.: ) Page 2 Manufactured home utilities 50,03 Cross__sti'eet/directlons to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: l Page 2 , Storm sewer(no,linear It: ) Page 2 Water service(no.linear 11.: ) I Page 2 Subdivision:Polygon at.Bull Mountain Lot JJ no.. 1 /5 >:biture or-hem: fax map/pareci no _ Bar;1.-flowpreventet I 1 31,27 � z.'' ,ern .'-c,k. `;.it• } 1+ 'f'<-( �l :;-.-P 'a' , ). .:: BltCirw'91Q' valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 .:...; . � �. Ejectors/sump 25.02 �r,c 'c 1 iiL 3•{J �' ( - • <.r ''::''',';'1„,,;''2A;‘,1/9:. Expansion tank Name:Polygon WI-11,LLC Fbitureisower cap 25.02 Address:;09 East:134 Street Floor drain/floor sink/hub 25,02 City/State/ZIP:Vancouver,WA 98660 Garbage disposal 25.02 Hose bib 25.02 Phone:(30)695-7700 Fax ( ) tee maker .. '. ..,...1=-1-.544,.......1.7,7.... 1 .51i, 'Li , 1 c tEin t Interceptor/greasee trap 25.020. a>....I-:-.1.1...,,,--i., iia ,: �71fF: c. .), �r. r„ a • Business now:Polygon WLi;LLC Medical gas(val!ie;$ _ ) Page 2 C°Ptact uta ne:NjGha -] Ole 7/)6 - Prim 12.51 Address:109 East 13th Street r' W Roof drain(commercial) 12.51 Sink/basin/lavatory L4z,(4 ,z, / 25.02 City/Sttte/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 J Fax::(360)693-4442 • Tub/shower/shower pan 12.51 F-n►ei� 4 / n Urin If /i / I 25.a2 1 ; k y` �� .4 Ff 1.V . , LIj,�� �rA� Water closet y; 1:2W r r -:.iGs1 ah t 25.02 _ . .`:._ • F.: -- :: ' Water heater Business flame:BAL Plumbing LLe 37.52 Water piping/DWV 56.29 Addtats:PO Box 85 h Oter. • 25.02 City/State/ZIP:Corbett OR 97019 Subtotal Phone:(;503)351-3903 Fax ( ) Minimum permit fee: $72.50 CCB Lie.i 180345 Plumbing Lie.no,:PBIZ82 ,, 1 Plan review (25%of permit fee) 1-4.2.,,,s...,... y - �_ j 1 o State surcharge of mrr Feta) rlutisorlxed signature: "'L./�"• t TOTAL PBR)v111 FEE I Priiit name:Brandon Lancer ! Dace:: I This permit application expire*ifs perm t is not obtained within ISO days after it been accepted es complete. "Foe methodology set by Id-County Building Industry Service Board. 1:iBvildingiPmmh tpLMU•PermitApp.dm Iculiti9 440-4616T(Io/02/cowWEE) City of Tigard a COMMUNITY DEVELOPMENT DEPARTMENT 11111 i T I G n R D Building Permit Review — Residential Building Permit #: Aj45i /?Oo„20? Site Address: 15'507 31Z 'P RC.E A\JE Project Name: 1� nan q}- uta Ma41 z-1-rA`►') Lot #: t-3 (New d g=subdivisi n name;A dition or Alteration=last name of owner) Planning Review Proposal: A-Q.Q 5FFL. erify site address/suite# exists and active in permits tem. [ River Terrace Neighborhood: ❑ No l� Yes,See River Terrace Review Addendum Attached Site Plan Elements: rr L'Three(3) copies of site plan v 0Existing structures on site Site plan must h on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished l�rawn to scale(standard architect or engineer scale) floor elevations dorth arrow Platy locations&easements(required for new and additions) Site address,project or subdivision name and lot number ,Sidewalk/driveway approach ErApplicant information(name and phone number) Location of wells/septic systems �C�Lot dimensions and building setback dimensionsExisting trees to be retained with drip line,and tree quare footage of buildings to be demolished protection measures NLot area,building coverage area,percentage of coverage and Er�/Street tree size,type and location [ impervious area(applicable if R-7,R-12,R-25&R-40) treet names i IProperty corner elevations(2 foot contour lines if more than 6 toren water quality facility required if>1,000 sf of ```` 4 foot differential) impervious area is created or replaced. 140" Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified $ No Received: ❑ Yes E No E6 Public Facilities Improvement (PFI) Permit: M2-0 0—D0077 Required: 0 Yes,applicant was notified 0 No Applied For: ✓ PP C'J' Yes 0 No,stop intake VLand Use Case#: 51\ 2-0)5 --COCO2 2/Zoning: --Z_�!,55 Required Setbacks: "f Front 7 Rear (GJ Side 5 Street Side (CJ Garage '2,0Landscape Requirement: \ Lot Coverage Maximum: \ Vo Building Height: Maximum Height 3 p Actual Height 2q )J Visual Clearance II Sensitive Lands: 0 Yes 0 No Type 6 Urban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: 5o11'ti. c:01-7dt 110Y1S o4 S U 2o1'J-000Oz cly'P 144[1 cytxt -I-ccr y I/1-5 Approved By Planning: Ai2(6,0045t._ Date: (Q/5 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved 0 Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved I:\Building\Forms\BldgPermitRvwRES 051617.docx S Building Permit Submittal Original Submittal Date: _ Site Plans: # Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: Planning 1Engineering [ 'Permit Coordinator ,7!/ Building Workflow Sign-off: Sign-off for Tanning(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. C. Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Or Date: Wir,l/7 al Engineering Review .,,0.Slope at building pad: L ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments) per engineering conditions of approval and plat .E7" Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes .eNo Assess Water Quantity Fee in-lieu: ❑ Yes ..No LIDA Facility on lot: ❑ Yes 0---No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: ___"4 Date: 6, 1 7 Revisions (after Building Submittal only) Reviewer Date Revision 1: E Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved, NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: SDC Fees Entered: Wash Co Trans Dev Tax: trYeS71 ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA ❑ Yes ?N/A r OK to Issue Permit Approved by Permit Coordinator: g/ / Late: a / 1 v- I:\BuildingForms\BldgpermitRvw_RES_051617.docx City of Tigard II DEVELOPMENT DEPARTMENT 11111 T I G A R D River Terrace Building Permit Review Addendum Building Permit #: . Site Address: L57o7 510 PEA-cc- A.\JE Project Name: Pc Nc2r? c,,.{- -g to t i tvtotivil-tA Lot #: �3 (New dwelling=subdivision name;Addition ?or Alteration=last name of owner) Planning Review of River Terrace Plan District Design Standards (18.660.070.I). Is the project subject to the plan district design standards? ❑ Yes (gl No 1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additio element required for lots with over 60 ft. of street frontage shall be provided every 30 ft. Porch min. 5 ft. deep Balcony w/access 2 Window Projection Vertical Wall Offset a ft. deep min. 2ft., 5 ft. wide min. 2 ft.,6ft.wide Gab . dormer 0 0 0 ❑ 0 2. Eyes on the street: a minimum of 12% of each street facing façade must include win•.ws or entrance doors. Percentage Shown: 3. Entrances:At least one entrance must meet both of the following standar. : ❑ Parallel t. treet,angle no more than 45°from street, ❑ Max. 8 ft. setback from longest street- facing wall or open . to porch Entrance opens to a porch: 0 Yes ❑ No If yes,all the following apply: ■ 5 sq.ft. min. ❑ One street facing entry ■ 12 ft.max.roof above floor of porch ❑ 5 ft. depth min. ❑ 30%min.porch roof coverage 4. Detailed Design:All buildings shall include a , . of five of the following elements on all street-facing facades: ❑ Covered porch min. 5 ft.wide x 5 ft. deep ❑ Recessed entry area min. 5 ft.wide x 2 ft. deep 0 Wall offset min. 16 inches ❑ Dormer min.4 ft.wide 0 Roof eave min. 12 inch projection ❑ Roof offset min. of 2 ft. ❑ Roof shingles either tile or wood 0 Gable,hip or gambrel roof design ❑ Roof pitch oriented south . 00 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide ❑ Accent siding min.40%of• eet façade ❑ Window trim min.2 1/z"wide by 5/8"deep ❑ Window recess min. 3 ' , es for all street facing ❑ Bay window min. 5 ft. wide by 2 ft. deep ❑ Balcony min. 5 ft.wi. x 3 ft.deep with inside access 0 Attached garage is 35% or less of street façade 5. Garages and C. .orfs:May face the front or side lot line on a corner lot. Setbacks: No closer to f .nt or side lot line,than longest street-facing wall. ❑ Yes 0 No. If No (Check one): ❑ May ext- d up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch. ❑ May e• end up to 5 ft.where the garage is part of a two-story building and there is a window at the second story above . e garage that faces the street with a min. area of 12 sq.ft. • Wi. : (Check one) II 12-foot-wide garage door 0 40%max. of street facade ❑ 50%max. of street facade with 7 detailed desi! elements Notes: , ,L! : s•• .1 " - v1 q rt . Approved By Planning: friOtto Date: (Q/5 7(7 I:\BuildingTormslBldgpermitRvw_RES_RT_062216.docx FOR OFFICE USE ONLY-SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. CityINCiof Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ' r Transmittal Letter T (,A It n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: QOM DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED JUL 11 2017 FROM: .14 An CITY OF TIGARD 3UILDING DIVISION COMPANY: Ltitey, NW 4f e,,,a/ roo-,,a}4 1 PHONE: 9 7/ - S/07_ Vis' By:lJ .-r RE: J Ae 5W `,Cfrci t.J . ! '572&/7-010A0?(Sr dis) (Permit Number) Q (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: , Copies: Description: Copies: Description: Additional set(s)of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. X Engineer's calculations. Other(explain): REMARKS: FOR OFFICE USE ONLY Routed to Permit Tec ician: Date: 7:J) -� )7 Initials: --1:1 Fees Due: ❑Yes No Fee Description: Amount D : $ $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes j.tif No ❑ Done Applicant Notified: Date: , Initials: I;\Building\Forms\TransmittalLetter-Revisions 061316.doc City of Tigard COMMUNITY DEVELOfP�IUD7 PARTMENT RECEIVED ' z IIRe uestforP ��� ° rza1c ermi9t Actlon qA T GA R o 13125 SW Hall Blvd. • Tigard,Oregon 97223 • 503-718-2439 •www.ti rd-o ov INC DIVISION TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner g Applicant 0 Contractor 0 City Staff Check(1)one REFUND OR Name: INVOICE TO: (Business or Individual) Pb\• t`kirt L\ ,L Mailing Address: 1 b Z-)Y1)O2' U1t1 c , u y_ 51 City/State/Zip: V pA cOt weir i w c 9 W n Phone No.: 3c0D L O vi 5 --VI 03 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): 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). 0 REMOVE/REPLACE CONTRACTOR ON PERMIT(do not cancel permit). Permit#: mst1Afl-)7,09 ¶f Sa', 2oi 7 -00/FY p x Site Address or Parcel#: 153D1 5V..) Pnue. Project Name: pl lil.,(3orl k- ?-)kw 1\k 0 l intaA Subdivision Name: Lot#: 13 EXPLANATION: I 1o,1nS {�1Q1' �>U�r2 Sv�h T ttt c( wer_t Signature: �, iYl✓�e,4491e I Date: � (2i) I Print Name: lJf(M0tP Tjt� Refund Policy 1. 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. All 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. }; / V 7 �/�r? tLcf ez�. --C.6 C-. / C-&----s 7-0 .n/ j /73' FOR OFFICE USE ONLY Route to Sys Admin: Date By Route to Records: Date 9 /* /7 By JAIrs Refund Processed: Date 00/9-- By .:.' Invoice Processed: Date By Permit Canceled: Datel/ 7 By ► Parcel Tag Added: Date By I:\Building\Fonms\RegYermitAction 923/al/ CITY OF TIGARD RECEIPT 14 2 13125 SW Hall Blvd.,Tigard OR 97223 - 503.639.4171 TIGARD Project Name: Polygon at Bull Mountain, Lot 13 ` -I-NS� / e Site Address: 15307 SW PEACE AVE /7f 7- 0/'7 Lr>v3.2 ,/' I Receipt Number: 412109 - 08/02/2017 I CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2017-00209 Building Permit-New Construction 230-0000-43104 $2,877.44 MST2017-00209 Plan Review 230-0000-43106 MST2017-00209 12%State Surcharge-Building100-0000-24001 $751.345 MST2017-00209 Wash Co Trans Dev Taxx -SF Detached $378.09 405-0000-43320 $8,278.00 te MST2017-00209 Tigard Trans SDC Improvement-SF 415-0000-43300 $5,488.00 Detached MST2017-00209 Tigard Trans SDC Reimbursement-SF 415-0000-43301 Detached $317.00 MST2017-00209 Tigard Trans SDC River Terrace-SF 415-0000-43302 $2,684.00 Detached MST2017-00209 Parks SDC Improvement-SF Dwelling 425-0000-43300 (detached/attached) $4,356.00 ir MST2017-00209 Parks SDC Reimbursement-SF 425-0000-43301 Dwelling(detached/attached) $1,207.00 MST2017-00209 Parks SDC River Terrace-SF Dwelling 425-0000-43302 $2,003.00 V (detached/attached) MST2017-00209 DC Provision Review, SF-Ping 100-0000-43112 MST2017-00209 Info Process/ArchivingL $2.00(over $90.00 11x17) g 230-0000-43135 $48.00 MST2017-00209 Info Process/Archiving-Sm$0.50(up to 230-0000-43135 11x17) $62.50 MST2017-00209 Metro Const. Excise Tax 230-0000-24010 MST2017-00209 Tig-Tual School CET-Residential $669.92 MST2017-00209 230-0000-24102 $5,578.05 Permit Fee-Elect(per dwelling unit) 220-0000-43103 $473.82 MST2017-00209 Limited Energy 220-0000-43103 $75.00 12%State Surcharge-Electrical 100-0000-24001 $65.86 MST2017-00209 Air Conditioning 230-0000-43102 MST2017-00209 Furnaces< 100K BTU $46.75 MST2017-00209 230-0000-43102 $93.50 Water Heater 230-0000-43102 $46.64 MST2017-00209 Gas Fireplace 230-0000-43102 MST2017-00209 Other, Fuel Appliances $33.39 230-0000-43102 $23.32 MST2017-00209 Range Hood/Other Kitchen 230-0000-43102 MST2017-00209 Clothes Dryer Exhaust 230-0000-43102 $33.39 $33.39 MST2017-00209 Single Duct Exhaust(Bathrooms, Toilet, 230-0000-43102 Utility Rooms) $116.60 MST2017-00209 Fuel Piping 230-0000-43102 $ 2.15 MST2017-00209 12%State Surcharge-Mechanical 100-0000-24001 $52.94 MST2017-00209 SFR-Baths 230-0000-43101 MST2017-00209 Laundry Tray $500.32 230-0000-43101 $25.02 MST2017-00209 Water Heater 230-0000-43101 $37.52 MST2017-00209 12%State Surcharge-Plumbing 100-0000-24001 MST2017-00209 Erosion Control w/Development $67.54 p 100-0000-43134 $536.40 MST2017-00209 Plan Review 230-0000-43106 $1,119.00 Total: $38,150.09 Page 1 of 2 I Receipt Number: 412109 - 08/02/2017 l CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 071664 JDRINKWATER 08/02/2017 Payor: Polygon WLH, LLC $38,150.09 Total Payments: $38,150.09 Balance Due: $0.00 Page 2 of 2 .! CITY OF TIGARD RECEIPT 1111 $ . 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIG ARE/ Project Name: Polygon at Bull Mountain, Lot 13 / ""'S 7 �'f�� � Site Address: 15307 SW PEACE AVE L ..2-0 e /7 —00,2 7r i, Receipt Number: 412110 - 08/02/2017 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID SWR2017-00184 Sewer Connection Fee 500-0000-25500 $5,300.00 rl` SWR2017-00184 Sewer Inspection-Residential 230-0000-43118 $35.00 C Total: $5,335.00 PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 071664 JDRINKWATER 08/02/2017 $5,335.00 Payor: Polygon WLH, LLC Total Payments: $5,335.00 Balance Due: $0.00 Page 1 of 1