Permit (86) ihiqCITY OF TIGARD MASTER PERMIT
IL COMMUNITY DEVELOPMENT ' ' Permit#: MST2018 00333
',' � Date Issued: 02/06/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ri (i •\ Parcel; 2S107AA08500
Jurisdiction: Tigard
Site address: 14471 SW 169TH AVE
Subdivision: ROSHAK RIDGE Lot: 85
Project: Polygon at Roshak Ridge, Lot 85
Project Description: New SFA. Model Home. 9/19/2019: REPRINT to add fire sprinkler system.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 90 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 30 Bathrooms: 3 Second: 562 sf Garage: 430 sf Front: 8 Smoke
DwellingUnits: 1 Detectors: Yes
Third: 562 sf Right: 0
Total: 1214 sf Value: $164,352.30 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
Other Fixtures: 1
Drywell-Trench Drain: 0
Other Fixture Units: Fire sprinkler system
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!500 sf: 2 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+a m p/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 SFA VB R-3 1214
Owner: Contractor:
POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 1 Hour Fire Rated Eaves
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $24,767.60
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 52-001-0090. 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: Permittee Signature: c (,moiAC \
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.
l . 1' I *V7-3
Plumbing Permit Application
Building Fixtures . FOR OFFICE ISE ONLY
City of Tigard 2019 Received ( �/' _
EP1 Date/B \ %S �i� Permit No.: •3 1:. �t ::2:
13125 SW Hall Blvd.,Tigard,OR 97223 y" J � j.
_ Plan Review
Phone: 503.718.2439 Fax: 503.598.196071
9'//
Date/By: ci // Ci 4647Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Jur s: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
IR New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
A eTe ', t ' e ' ' I e ' - # SFR(1)bath 312.70
❑ 1-and 2-famil dwellin - '' ' FR(2)bath 437.78
y g ❑Commercial/indus I '= ill
Accessorybuilding \ '( =FR(3)bath ■ 500.32
❑ 0 Multi-family * \�
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler(0/Vsq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: e'%7>l Catch basin or area drain 18.76
%
9�' , 9•y,�X,--' Drywell,leach line,or trench drain 18.76
City/State/ZIP: ...4,e/ (f�C /
//��
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: tl S.I Project name: 4 5-jt. i ie_ce Manufactured home utilities 50.03
Cross street/directions to job site: "(/ Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
6"//)/e tA-dh-S /,2 SOYi 'k(e, ,.S /5 Dishwasher 25.02
/ Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER - I 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker
12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: „Ay
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address:
Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet 25.02
CO TRACTOR
Business name: v
2 +gam L i L 1 j() Water heater 37.52
1 c Water piping/DWV 56.29
Address: p• 8 L Other: 25.02
City/State/ZIP: O rJFE l l V J•(' 41 7 6/7 Subtotal
Phone:(`171) 235
06611 V Fax:( ) Minimum permit fee: $72.50
CCB Lic.:j$6 ./5 Plumbing Lic.no.: /5'82
Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: /Eel /67-9/19r-ii Date:S /2-/ 1� This permit application expires if a permit is not obtained within 180 days
G after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMIbPermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
CITY OF TIGARD• MASTER PERMIT
III2 COMMUNITY DEVELOPMENT
Permit#: MST2018-00333
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/06/2019
T I c;A P.Dg Parcel: 2S107AA08500
Jurisdiction: Tigard
Site address: 14471 SW 169TH AVE
Subdivision: ROSHAK RIDGE Lot: 85
Project: Polygon at Roshak Ridge, Lot 85
Project Description: New SFA. Model Home.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 90 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 30 Bathrooms: 3 Second: 562 sf Garage: 430 sf Front: 8 Smoke
Dwelling Units: 1 Third: 562 sf Right: 0
Detectors: Yes
Total: 1214 sf Value: $164,352.30 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Tvpes Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!500 sf: 2 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
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
Ecompasing: Y
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA VB R-3 1214
Owner: Contractor:
POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 1 Hour Fire Rated Eaves
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $22,270.23
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a co y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 1.4j€:-/f '946( p�� // Permittee Signature: .C" y,/tga)A
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
_$,wilding Permit Application•
l.—�� �
REEI'
Residential FOR OFFICE USE ONLY
Cityof Tigard r� ' Received t _ J� ��� 1
g �.�F.DEC�.; f.J `6' ?1,118 DateBy: 0..\ i SST Permit No.tos c(�.�R."(321
. 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 CITY •TIC p By; �2-I('Z,� (� OtherPeruu j� \'r –(
TIGARD Inspection Line: 503.639.4175
CITY 11 OF 1 Ha teReadyBy:—f Juris: Fd See Page 2 for
Internet: www.tigard-or.gov BUILOltG DIVIS d/Method: Supplemental Information
TYPE OF WORK_ REQUIRED DATA:1-AND 2-FAMILY DWELLING
®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
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ \` -
'4 1
EI 1-and 2-family dwelling 0 Commercial/industrial
ElAccessory building ❑Multi-family Number of bedrooms: a
0 Master builder ❑Other: Number of bathrooms: 3
0(3 JOB SITE INFORMATION AND LOCATION Total number of floors: 3 `lotILI
Job site address: ' l lt'^' ) 1 Q / VQ \N.-N 3 New dwelling area: l? 1,9
square feet S(oZ
City/State/ZIP., VC 0 on�') f — Garage/carport area: 93t square feet Z
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Avco.II Covered porch area: V square feet 9t,
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Polygon at Roshak Ridge Lot no.: ( Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Polygon WLH LLC Type of construction:
Address:703 Broadway Street (_, ,l3 Occupancy groups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360)695-7700 Fax:(360)693-4442 New:
El APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH LLC {P[aocp re;errofee schedule)
Structural plan review fee(or deposit):
Contact name:Amanda Gavin
FLS plan review fee(if applicable):
Address:703 Broadway St.Ste 510
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax::(360)693-4442
E-mail:permitsubmittals@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:William Lyon Homes,Inc. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:703 Broadway St.Ste 510 Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247
Total fee due upon application: $201.60
Authorized signature '4 This permit application expires if a permit is not obtained
' within 180 days after it has been accepted as complete.
Print name:Amanda avin Date: ll I i I Q *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)
____-----------
, . .
Mechanical Permit Application FOR OFFICE USE ONIA
: City at Tigzrd „ . Reccived ,
Pennit No..:
. • 13125 SW`Hall Blvd.,Tian_ rd.Oft 97223 .
I ' Mon= 503.7182439 Fax: 503598.1960
• II ritecitir
Plan RevIew
Daim- r. Othes
haspeerion513.639.4175 • .
TIGARD Dsie Re:it:y.41y: • timl PI Stv Page I fur.
internatwww.tleard-or.gov -. 1-.4otifie.4.1.4...-thad. Supplemental Information
:,:,-...4,151;,,:;,,,..,?.,::.7,;..,7:...F.:,;..:,!,..:-,::.7..,,,,.,..,i-.::::-1..7„,=,--7--',--r.7:6-fi..,i8.v.4-..,t-*.lic.,;.E.7i,;7.,.:,-"i:.,..7:4:-.....::,.-7:;:„.,-.:, ,,:...,,7,7,. .q.i:-::::.:-:,:::,,-,f.. 7::,:.,,:-77:, TT:.tect,...„14,.NtEk ti-Ar.,7..'.7FEE., 'SClitPli.T.,E':,:;..,'.:t1Si-Cii:E...e.li.ti. ..7'...-
"" Nlechanimi permit fees.*an based on the value or the work
erti New construction 0 AddMoreatterationtre4)lacernent performed.Wit:Mete valet(rounded-to the nearest dollar1 or all 1
.
0 Demolition 0 Other: rheelunical materials.entripthent,labor.oN,erhead.and proftt.
Value-.S
. .. ..
tAtt4tii&bi..E.-i,..i:A•Sfieti:ct.ii*:.-;;*:,"- -i:i;,::5-,.-zi:,::':;;c:j-ifl:-..-1:.:7- ,----—,-.-—,--,-,-- ---------: -;---- --,-- - . ,---..--
•:.,-,.:,.:2.:- ...''''''. 7'.--:?.'.•'i:' • • ",,,: , , ' .:-.' -: ''''.'''.. ''. -----...- ..'''.- ''' RESIDEVII.:41.3QUIMENT4SYSTENISIEES'::•,'.
0 i-arid 2-6mily dwelling 0 Commerciallinduktrkil 0<Accemny building I Far special infaratatiaa ase cheat&
' El Multi-family El Magri-builder 0 Othm: ' DeTilMon I Qty. 1, •Ea__ I Toed
- .' . . -- - — - ---- ' -• --- licatiocooling:
..-,..-..,..- , 1':-4: .4::- _-:-.;:i7:',;; ;:400.,:WE,,•:i:tii'E.OR.litATtifityr,--8NCY.I.:t.,0C-4411t:W:V;T-7 --4:7:-:;;;:i:,!,..:i:::::„:::::,...-.;::::,.-- -
- . . Air conatiorrizza I 1 ..t.75
Job site a',0.&esst 191"11\ al ' II Al Furnace 100_000 Fn.]Muco..4-eet...0 1 46175
(--) 54_94 City/StateiZIP:Tigard,OR.97224 Furnace 100.0004 6Th ktoct$:;-,Atnts) -
i 1
pump , 61_06 1
, Suitelb14/apt-no.; r 1 i,
- project..:-RI y,ylott MsW , Duct work 23.32 1 1
. _ .
Ccoss streettdireetions to jOb site: °Vol ' 1-lvdrortic hot water system
Residential holier(ratfiator or
hydronic) 13,32I
,
Unit heaters(fuel-type, at eleark), • t
in-wall,in-dttet sospeaded,etc. 46.75 I
IFluelvent for any of above •. I , 2132
Other: 23.31
Subdi'visiaa: N uf...r- Tecr-ace ECA-S f. Lot no.: .
OS I Other feel appfiancer.:
Tax mapipaccei no.: Water.heater . .:. 23_32
-...7..;4 . . ge.iiii.f.idier-:titiO.:eiiiki.r,1737.t.,.112:i.:..::; Z';,T;r5r,7.;.:::: 1': ' Ga5 ruePlaceti f' i t
Flue vent far water heater or- gas
. fireplace 23.32
,,. . . Log lighter(gas) 23.32 I
' Wood'pellet stove I 33.19 I
Wood Freolace,rtrexert 23.32
. ClainutevA liter/flue/vent , 73.31 I
-..-. Other _ 2332
i;.4Rigiiiikrii5W4 :5..!, :t:',-ii:::';''.:".: ;1.: :'..'1..:'''.12' S ;F :s:!''':: -1,.:. - .,
POI UOlikd VOkili UtiL ' Ranee hoadiather Lischen
1 1 1 13_39
Addons—,.1 fp r
W IP ei i AA LSEkfQ SID I
eau:in-merit
0i:ides drver exhaust I 1 1 33.39
1 CitylState17-1P. Va v\,(A)Gt v,,e,v VUOt, , (s1 OD I Sinale-duct exhaust(hathromns, i i to ,."
ad comportments,utility rooms) 1 " .!...,,....t-z.„
1 Phr"= ';te 0 (00‘S 1/1l2 0 .. : .F:Ix'''.( 0()(tO(t 1411 41/ ArtieferErwl space fans 't j23.32
A1'iiii1ek.4f::-.,!:!-:;.-,.::::..-,':,::.-!. ::, ;47..::-.:,:;-. ..,:.E1....t.ciitia,ilik-istyk:...:,.:;:. ',..;,.;.,:. Other I 23.32
Fuel piping:
Busirsess name:Polnon WLE.,LLC
SI 4.1S for first fear:..c.-4.,03 for oath atidirmuat
Coat. .name-, YYjiAlACkfiL elrAV. FtraCe.e'' . , 1
.. .
Addr 1 D 3 --€)roarAu.)c Ske- 510, Gas heat pump .
, Wallisttspendedknit heater 1 1
City/StateIZIP:Vancouver,WA 98660 Waterbeater
•
Phone:(360)695-77r1 i Fax;:(360)693-4442 Fireplace
i .
•
E-mut-lt-... e_rifY %A-Sk.,0:::•Ty;.WOASra-DRO\ SOVVVOneN-e,5.az rn i Barbecue 1 1
;:j2;!:'..i.i1;qr:':• -,.;.!:jiir;,i. ,..,•-, .i.;,..•: :'..]#.2f7:'..,:, F:•:;:::-.671R804:00 ..., , 5.7.:.N7•::: .:•;:_5.9ilf: t'.4t1 aathC3 dryer(PS) i 1
Other: 1 .
Business mune:Apex Air LLC .
'AIICA..8g-:„Atzt .:T:CF;5'. ....:::
Add....,--ss:18904 NE 726d Ave Subtotal
.
CkylStakIZIP:Vancouver,WA 98686 Minimum petutil fee es9(Lom I I
Plau.review(25%of permit fm) I
Phonm 060)3,0-11.119 . I Fax:(MO)326-1769 State surcharge(12%of permit Teel i
Etc::203034 TOTAL PERMIT FEE i
•
Astimrized sir.riature:
fr/I qnFri
Plot Itain=. 1 4” /
4
.„,,,:sti,,,i,„:::::.„,,:rpri.imcimpit.iya peavro:Ltai:elnedtultybtaistritelictscidiai:if:a
slays after it tars bent accepted e&eauiplete.
1-V4Iii6,47,',P.A.-Las'ME-r.l.tattrseirAtTiNC 1:,dae 44D-k<1 77(1-1,13:147614NSII.;
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
.-.111 - ' Date/B
a Permit#:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
- Phone: 503.7182439 Fax: 503.598.1960 DateBy: gEntraMIMEN
Inspection Line: 503.639.4175 Read Date/ lurk:
TIGARD Y Y Q See Page 2 for
• •a Internet: www.tigard-or.gov Notilled/Method: Supplemental Information
•. -t_:,.-- _ ' PLAN R�VIE�Y
®New construction []Addition/alteration/replacement Pleasecheck all that apply(submit a sets of plans w/items checked):
❑Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three strides.
where the available fault current ❑Marinas and boatyards.
g ._.:`* _ ,.ti_ C T_Ecolz_ Ole Ca_Ax g rC N -y_
_ ., exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling I=1Commerciallindlistrial µE Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi family El Master builderamps for all other installations. buildings.
❑Other: 0 Fire pump. 0 Installation of I50 KVA or
-r_ JOB SITE 7Mtr 3A.`ITON AND.LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
'1.
Job#: I Job site address: 'L11 ¶v3 ,u v rA l f u�,� l OOHP or more. ❑"A»`5" I-z» I-3»
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy.
❑Iieaith-rare facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project
name: hO 1 ❑Hazardous locahons 0 Supply voltage for more than
l o ►j ��� KVJ�U� g
U ❑Sernce or feeder 600 amps or more 600 volts nominal
Cross street/directions to job site:
pouf t rA-A - _ _E_SCRoDULE - '" _
Description I Qty. Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: V.,1 v,e y to y yot(J,q Y�/i s,c 1 Lot#: sS Includes attached garage.
Tax map/parcel#: 1,000 sq.ft or less I 168.54 4
x'm Ead'l ad500 sq.ft.or portion , 33.92 1
IESG 210000 0,'W AFW
Limited energy,residential 75.00 7
(with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
PIiOPE1tIflWEI0 h Renewable Energy ❑ See Page 2 l
�` - `" " `,� :TENAi T -- Services or feeders installation,alteration,and/or relocation
Name: PO 11VA` O'' ,/l/ 1/1/G
] (i 200 amps or less 10030 2
Address:' �O ✓ 9 V V 1V�t 1'W)(A (J ('0 201 amps to 400 amps 133.56 2 -
Vl J 401 amps to 600 amps 200.34 2
City/State/ZIP: VM V)w v/ve 01(j(,I e I) 601 amps to 1,000 amps 301.04 2
Phone: 3,(() tocky-n[X) 1 Fax:(JO) (o6P)4ylJ', Over 1,000 amps or volts 552.26 2
!`i-5�1 w ,1 1' 6) ,, , -t Temporary services or feeders installation,alteration,and/or
Email: YJ �yit !(��t DNi(OS. CCj{il,(.,,reiocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. - 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
arA a' - A S ON, _ Branch circuits-new,alteration,or extension,per panel
•"" _.- ._ .-_... - _ A.Fee for branch circuits with
Business name: p I 'l, / , 1 L � above service or feeder fee,
�� Vl, _11�� each branch circuit 7.42 2
Contact name:i. Y✓Ia/V/l.( 6-tai,'L B.Fee for branch circuits without
Address: -7(.„--.-2- � service or feeder fee,fust
J '✓�C>Q GCir' _c >1 D branch circuit 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2
Miscellaneous(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 ?V/ (40{til 0tMIVrt ',--Y
JIVOI /MV�VReconnec
t only 67.84 2
r , 3 +�'_ COSZX14QR F _ i - �: .l
Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC - Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:6101 NE St Johns Rd panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 6625/hr I
Phone:(253)320-1657 Fax:( ) Investigation(1 hr mitt) 90.00/hr 1
Email:bdaniels@gweusa.com Industrial plant(I hr min) • 78.18/hr
I Inspections for which no fee is
CCB Lic.: C1158 Electrical Lie.: 208174 J Suprv.Lie,: 4496S specifically Listed(%hr min 90 001 hr 1
t -7.----'
f � " ELET'FR1wtrAi��) EtB4I'I?*-01, ." .-,:�
Suprv.Electrician signature,required: - /1/ . C... ., .. Y Subtotal:
Print name: Joan P Albert •- Date: _)2-I 4//y 0 Plan Review Required(25%of permit fee):
�-�,, __—___ 7/ - State surcharge(12%of permit fee): 1
Authorized signature: w - TOTAL PERMIT FEE;
This permit application expires if a permit is not obtained within 180 '
Print name: Bill Daniels Date: 10_I z.///gdays sifter it has been accepted as complete.
* Number of inspections allowed per permit
:1:1Building1PermitslELC Pe rnitApp_ELR ERE_doe Rev 06/17/2015 440-461ST(11/05/coM/wEB
Plumbing Permit Application
Building Fixtures
City of Tigard Received
Penult No.:
v 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
1111111 11 Plan Review
Phone: 503.718.2439 Fax: 503.598:1960Other Permit Noot V1US"Vl1713
Datc,B :
T I GA R D Inspection Line: 503.639.4175 Date Ready/By: 3vsis: F1 See Page 2 for
Internet: www.tigard-or.gov Noti5ed/Method: Supplemental Information
:TYPE-OF WORK FEE*:SCHEDULE,.
`A4 New construction Q Demolition For special information use checklist.
Description ( Qty. I Ea. 1 Total
0 Addition/alteration/replacement 0 Other New 1-2-family dwellings(includes 100 ft.for each utility connection)
' CATEGORY-OF CONSTRUCTION SFR(1) 312.70
SFR(2)bath 437.78
A O 1-and 2-family dwelling ❑Commercial/industrial
SFR(3)bath 1 500.32
❑Accessory building Multi-family
Each additional bathAdtchen 25.02
❑Master builder 0 Other Fire sprinkler( sq.ft.) Page 2
SOB SITE.EsTFOR'1G7.AT1ON"AND LOCATION Site utilities:
Job site address: 11-1q11
(`-I"1 L``l Ile fit- p V J Catch basin or area drain 7.8.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suitetbldg.lapt.no.: Project name: 7Q l"Ary,�� b& n o d Manufactured home utilities 50.03
Cross street/directions to job site: "J PK-eLt t\. Manholes 18.76
I Rain drain connector 18.76
Sanitary sewer(no,linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
�A `CAS* Water service(no.linear ft.:_) Page 2
Subdivision: v,ey T-eV-V (.�. Lot no.: 53 c Fixture or item:
Tax map/parcel no.: Backflow preventer 131.27
Backwatervalve
DESCRIPI'IQ11IOF WORK =_ j 12.51
Clothes washer
25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
®!l,PROPERTY OWNER. ,. .0 TENANT Expansion tank 1251
/ Fixture/sewer cap 25.02
Name: pot ovk vow, VW
Floor drain/floor sink/huh 23.02
Address / \0 Garbage disposal 25.02
City/State/ZIP: Vpi V1 U)0,V,e,Y' 11.)01. 01 (.12 to() Hose bib 25.02
Phone:# ?Jbp g S 'M t,h Fax ( )lo6t2, Li Li L Ice maker 12.51
.APPLICANT--., CONTA.CT:PERSON
Iskerceliiurlgrease tr 25.02
Business name: I 1 ` A 1/ tAl( Medical gas(value:S ) Page 2
I Primer 12.51
Contact name Roof drain(commercial) 12.5I
Address:l '1017 I V l)(A( i ` m (Jy c`D Sink//basirttlavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360):695-7700 Fax::(360)693-4442" Tub/shower/shower pan 1251
E-mail: ?CVey�/ylk ,i\pWl. OILS I/,mo" Ol�� n ht11tiQS 1,DV(,E Urinal 25.02
,_. a t:
F N33tACTOit.>
ter aset 25.02
_.-. Water heater
3752
Business name: G4-L.6 \k 1 �c Waterpiping/DWV 56.29
Address: 4). . $.0F4 ata Other: 25.02
City/State/ZIP: 5' `', e4,4,4 1 ot" - cl tsi Subtotal
Phone:(z,3 -"y98y - nil"" Fax:.(ell t.»-7g„1-47-110n review
permit fee: 7?5{i
CCB Lie.: Jt� f 3 7 L Plumbing Lie.no. Plan rc arg (25%2of peewit fee)
State surcharge(12%of permit.fee)
Authorized signature: 1:11304, TOTAL PERMIT FEE
Print name; Date:` {1 This permit application expires if a permit is not obtained within 150 days
s 1 Z "leo 1 after it has been accepted as complete.
*Fee methodology set by Tri'Couuty Building industry Service Board,
l:;aur tP lPLMtt p .pp:aoc tautens 440461.61Xtomr OMAVEB)
r
City of Tigard
71 41.,
COMMUNITY DEVELOPMENT DEPARTMENT
T1 G M n Building Permit Review — Residential
Building Permit #: S 0Cc- (.\k;,233?)
Site Address: 1 q1 '9-1 ) /( 9,L4 ,,
Project Name: P*on 0-1– ,�� 4� Lot #: gs—
(Ne lung=subdivision name;Addition or Alteration a t name of owner)
Planning Review {q�
Proposal: Ale& c7 ill
- ° --
/'
erify site address/suite#exists and active in permit stem.
UJ River Terrace Neighborhood: ❑ No ICJ Yes,See River Terrace Review Addendum Attached
SitPlan Elements:
,�,PIMA�ree(3)copies of site plan �J':,�:sting structures on site
raplan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
ven to scale(standard architect or engineer scale) O or elevations
rth arrow 'ty locations&easements(required for new and additions)
gal
to address,project or subdivision name and lot number S'dewalk/driveway approach
�J. .plicant information(name and phone number) P 'L4 ation of wells/septic systems
rA • dimensions and building setback dimensions I :l sting trees to be retained with drip line,and tree
11,v.uare footage of buildings to be demolished , otection measures
RI Lot area,building coverage area,percentage of coverage and M treet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street names
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replace ? Yes ❑ o
4 foot differential) If yes,is a storm water quality facility shownA0 ❑Yes No
0 �can Water Services—Service Provider Lettet^(lot platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified 0No Received: ❑ Yes CI No
Public Facih Improvement(PFI)Permit: P�/�dlee..-.0O/OS
equired: Yes,applicant was notified ❑ No Applied For: IllYes ❑ No,stop intake
d Use Case#: P2)e s^-0000, Q &a, s 06
nh'g IQ- pD) '
Re uired Setbacks: Front Rear Side Street Side lye Garage q � � � �I�I'1 g
rickandscape Requirement: 2Q
.t Coverage Maximum:
A Building Height Maximum Height 01,pr Actual Height go
II ! isual Clearance
!] •,ensitive Lands: ❑ Yes 1 No Type
J Urban Forestry Plan
❑ Conditions "Met" or toissuance of building e t L )
Notes: Q-oncC l 7 U'N� �1a iyuc-/ pY7(h— 77� 171- >Ss j/6?,A
❑ Approved By Planning: /ji/ Date: A-I&//c"))
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
I:\Building\Forms\BldgPennitRvw RES 061417.docx
Building Permit Submittal
Original Submittal Date: Via.\tIS
Site Plans: #
Building Plans: # �"
Building Permit#: 101 Enter building permit#above.
Workflow Routing: Planning 2/Engineering E'Permit Coordinator C`-Building
Workflow Sign-off: RI Sign-off for Planning(include notes from planning review)
Route Application Documents: [Engineering: (1) copy of permit application, (1) site plan, (1)building plan and
original plan review routing form.
[ "Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: � �� Date: a
Engineering Review �J�
ki Slope at building pad: J "
❑ Conditions"Met"prior to issuance of building permit
O Easements (encroachments)per engineering conditions of approval and plat
2 Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 8"No
Assess Water Quantity Fee in-lieu: 0 Yes E. No
LIDA Facility on lot: 0 Yes Q No
,a-Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
ja-Approved by Engineering: i K LAI • Date: 11- / l re
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 ❑ Not Approved
Permit Coordinator Review
Oonditions"Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes: O1--}o14 9nC/ r VI It( W rtikt VA UMW* etvatOtivi bl 114S loldo Mc),liGt.6
Revisions (after Building Submittal only) m0 ( Vl)n'es
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
I►; SDC Fees Entered: Wash Co Trans Dev Tax: kS Yes 0 N/A
Tigard Trans SDC: RT Yes 0 N/A
Parks SDC: tgr Yes 0 N/A
LIDA 0 Yes N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: t 2 111 [ LS
I:\Building\Forms\BldgPermitRvw_RES 010118.docx
R
City of Tigard
1111 a COMMUNITY DEVELOPMENT DEPARTMENT
C
T I G A R D River Terrace Building Permit Review Addendum
6', ...-1./i2 1,4s ie :%5i3 d - 'e+ :34. c a 'k - "Qiasrg.ti iltte --A€_ F.,WWg s,&Win]
Building Permit #: \-`(\ -v (A, C� 3`
Site Address: MO 91 9k) //e9. /.v
Project Name: �t p %i - ✓�lS - ' Lot #: S
(New dwe .e.-- bdivision name;Addition or Alteration=last nam- ./owner
Planning Review of River Terrace Plan Dist4ef Design Standards (18.640.070.1.):
Is the project subject to the plan district design standards?VYes El No
1.Articulation:a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional
element required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 deep ft. deep min. 2ft.,5 ft.wide min. 2 ft.,6ft.wide Gabled dormer
ClCICI ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: r/S—: (Q 0
0
3. trances:At least one entrance must meet both of the foll.. - g standards:
►A Parallel to street,angle no more than 45° from street,
Max. 8 ft. setback from long street- facing wall
or open onto porch
Entr nce opens to a porch: Yes CINo
If es,all the following apply: 5 sq.ft. min.
ne street facing entry ft.max.roof above floor of porch
17, 5 ft. depth min. 30%min.porch roof coverage
4. P tiled Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
iVA overed porch min. 5 ft.wide x 5 ft. deep CI Recessed entry area min. 5 ft.wide x 2 ft. deep
all offset min. 16 inches ❑ Dormer nun. 4 ft.wide
Roof eave min. 12 inch projection ❑ f offset min. of 2 ft.
❑ Roof shingles either tile or wood PeGable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. El Hyrizontal lap siding min. 3-7 inches wide
F ❑ Accent siding min.40%of street facade Vtindow trim min. 2'/2"wide by 5/8"deep
❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35% or less of street facade
. • : , es and Carports:May face the front or side t line on a corner lot.
Setbacks: �Pr
No closer to front or side o - an longest street-facing wall. ❑ Yes ❑ No. ',. Check one):
❑ May extend up to 5 ft.if there is a cover-. font porch and gars.- .:-s not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is part of a . r -• •r building and there is a window at the second story
above the garage that faces the street with , •-.. area of 12 sq.ft.
Width: (Check one)
❑ 12-foot- :,- •.rage door ❑ 40%max. of street facade
PI i'o max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: - Date: ph,
ko
I:\Building\Forms\BldgPermitRvw_RES_RT_121417.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.
�,,, City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
► = Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Prt� ( S t) I Ar nn S o y DATE RECEIVED:
DEPT: BUIL13ING DIVISION
FROM: OMO \C(CL eiRV\V1 JAN 3 2019
COMPANY:
V l o -ito
Ca
PHONE: ( voj1tts-1100 BY:
RE: L� e) – cqLp s J Ro I v'�,u�J Mci \�—bO�J��(Site Adress (Permit Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. -C Revisions: 0 Ira)rtr
Cross section(s) and details. Wall bracing and/or lateral analysis. pi-1-
Floor/roof framing. Basement and retaining walls. V12-
1A
�Beam calculations. Engineer's calculations. \
Other(explain): IY`S atm) 2
REMARKS:
FO 0 ICE USE ONLY
Routed to Permit Technician: ate: Initials:
Fees Due: ❑Yes Fee Desc ipt' n: Amount uD e:
$
Special
Instructions:
Reprint Permit(per PE): _ ❑ YesNo n Done
Applicant Notified: Date: // / Initials: p1
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
Plumbing Permit Applicata
Building Fixtures H 1 r `- l ' FOR OFFICE USE ONLY
i , Received
City of Tigard I ;1 1 2019 Date/By:�t��,iC{S Permit No T &_� �"
. 's 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �_
Phone: 503.718.2439 Fax 50 rSQ$i9C�4 4 i t # _rt< o Date/By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 t I ,-,2-:,, fl+f`, r-,i ,, Date Ready/By: Juris: RI See Page 2 for
Internet: www.tigard-or.gov44-� _ •i""' Notified/Method: Supplemental Information
`. TYPE OF WORK ' FEE* SCHEDULE " ' '
®New construction ❑Demolition For special information use checklist.
�� aescri tion
i s - p Qty. Ea. Total
❑Addition/alteration/replacement 0 Other: = a. N ew 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION 'Ir\s k" SFR(1)bath 312.70
El1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
El Accessory buildingSFR(3)bath 500.32
®Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND.LOCATION. Site utilities:
Job site address: t 44-11 1V13(1-44 Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:Roshak Ridge Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision:Roshak Ridge ( Lot no.: 48'. Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK ' Backwater valve 12.51
Clothes washer 25.02
���t �''6055.5
Q`� �� � iK. Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PRQPERTY,OWNER 0 TENANT : Expansion tank 12.51
Name:Polygon WLH,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:703 Broadway St.,Ste 510
Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:Polygon WLH,LLC
Primer 12.51
Contact name:Tonja Morris
Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
E-mail:permitsubmittals@polygonhomes.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:BDL Plumbing LLC Water piping/DWV 56.29
Address:PO Box 85 Other: 25.02
City/State/ZIP:Corbett,OR 97019 Subtotal
Phone:(503)351-3903 Fax:( ) Minimum permit fee: $72.50
CCB Lic.:180345 PlumbingLic.no.:PB1582
Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: 1 /4,..6.,...40„„.- TOTAL PERMIT FEE
Print name:Brandon Laster Date: This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)