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Permit (184)
A CITY OF TIGARD MASTER PERMIT R COMMUNITY DEVELOPMENT , ,,;& Permit#: MST2019-00038 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/25/2019 '\ L(4\° Parcel: 2S107AA11900 Jurisdiction: Tigard Site address: 14204 SW GOLD COAST TER Subdivision: ROSHAK RIDGE Lot: 119 Project: Polygon at Roshak Ridge, Lot 119 Project Description: New SFA. 8/28/2019: REPRINT to add fire sprinkler system. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 562 sf Basement: 97 sf Left: 0 Parking Spaces: 0 Height: 34 Bathrooms: 3 Second: 562 sf Garage: 456 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 1221 sf Value: $169,483.45 Rear: 10 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 Drywell-Trench Drain: 0 Other Fixtures: 1 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'I 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 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 1221 Owner: Contractor: POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) A38R£L►t WAYS ST€5#0- - &TR€€T,SU T€5418 s 1 - t icE -R4Q)-1 _ _f VANCOUVER,WA 98660 VANCOUVER,WA 98660 Ceiling 2 Ersn Cntrl 503-639-4175 PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: Total Fees: $24,772.99 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: �� -,\,..,' ......_ Permittee.Signature: ‘-- t,C_ C'VA C -<-- Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application RECEIVEDh‘L`�rL, k4 Building Fixtures AUG 1 3 2019 FOR OFFICE USE ONLY C11y of Tigard Received �G • 4. 13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGARD Date/By: /�(o/// � l/ Permit No.: MST2019-00038 i/ p . Plan Review Phone: 503.718.2439 Fax: 503.598.1°r�11LDING DIVISION gt��/iS Qom/ Other Permit No.: Date/By: +w� Ti GA RD Inspection Line: 503.639.4175 Date Read/B Y y: Juns: H See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental information Tyr* O W M,. - R*$ t�P ®New construction ❑Demolition For special information use checklist. Description Qty. Ea. Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTIOI�I SFR(1)bath 312.70 ® I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 0 Accessory building ❑Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kilchen 25.02 ❑Other: Fire sprinkler(1221 sq.ft.) Page 2 '.JOB,SITE INFORMATION.:AND LOCATION Site utilities: Job site address:14204 SW Gold Coast Terrace 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.:.-k Project name:Roshak at River Terrace 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 at River Terrace(Townhomes) 1 Lot no.: 119 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 D SCRIPTION-OF WOK Backwater valve 12.51 Clothes washer 25.02 MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 >®>-PROP RTY OWNER [ 'pE lyT Expansion tank 12.51 Name:Polygon NW Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:703 Broadway St.Suite 510 Garbage disposal 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone:(360)695-7700 Fax:( ) Ice maker 12.51 It APPLICANT 0 CONTACT P1l114sQN Interceptor/grease trap 25.02 Business name:Polygon NW Medical gas(value:$ ) Page 2 Contact name:Jennifer Lopez Primer 12.51 Roof drain(commercial) 12.51 Address:703 Broadway St.Suite 510 Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700- -z----- Fax::( ) Tub/shower/shower pan 12.51 E-mail:jennifer.lopez@polygonhomes.com Urinal 25.02 ONT c GI Water closet 25.02 37.52 56.29 25.02 Water heater Business name:Alliance Plumbing,LLC Water piping/DWV Address: 146 W Historic Columbia River Hwy Other: City/State/ZIP:Troutdale,OR 97060 Subtotal Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50 CCB Lie.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee) g ;-----7Z-----) �� State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Gavin Thomes Date:8.07.2019 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. (:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-46167(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Ttilit es 1 y:', Fee(ea ©tat S uai ':Footage: .-Permit dee: " Footing drain-1"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 ;aluaos.-..< e • Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees 90,- Fee(ea) Total each additional$100.00 or fraction thereof,to �., and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Other Fixtures: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantil by Fixture Type Fixture Typefor Replacer Plan Review fair PlumbingI1r;Esxallaticl,>as Work Perforated: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Bath -Tub/Shower Please check all that apply. Jacuzzi/Whirlpool ❑ Any new commercial building with water service 2"and Car Wash -Each Stall greater,except systems designed and stamped by licensed -Drive Thru engineer. Cuspidor/Water Aspirator 0 New exterior plumbing site utilities for any complex structure Dishwasher -Commercial as defined in OAR918-780-0040. -Domestic ❑ Medical gas and vacuum systems for health care facilities. Drinking Fountain ® Any multipurpose fire sprinkler system. Eye Wash 0 Any complex structure as defined in OAR918-780-0040. Floor Drain/sink -2" 3» Submit 2 sets of plans with any of the above. Car Wash Drain Isalmetrik"or Riser Diagram Garbage -Domestic-non-food Disposal -Domestic-food related 0 Isometric or riser diagram is required for new buildings -Commercial-food related that meet the qualifications above. -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Comments regarding fixture work: Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter Washer-Clothes *Note: If the fixture work under this permit results in an Water Extractor Water Closet-Toilet increase of sewer EDUs,a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the https://allianceplumbing-my.sharepoint.com/personal/gavin_alliancepluml5G5ng_net/Documents/Documents/Fire Sprinklers/RT/PLMF_PermitApp (3).doc CITY OF TIGARD MASTER PERMIT 11 ; COMMUNITY DEVELOPMENT Permit#: MST2019-00038 13125 SW Hall Blvd.,Ti Date Issued: 04/25/2019 Ti C;;1[.:L and OR 97223 503.718.2439 9 Parcel: 2S107AA11900 Jurisdiction: Tigard Site address: 14204 SW GOLD COAST TER Subdivision: ROSHAK RIDGE Lot: 119 Project: Polygon at Roshak Ridge, Lot 119 Project Description: New SFA. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 562 sf Basement: 97 sf Left: 0 Parking Spaces: 0 Height: 34 Bathrooms: 3 Second: 562 sf Garage: 456 sf Front: 12 Smoke DwellingUnits: 1 Detectors: Yes Third: 0 sf Right: 0 . Total: 1221 sf Value: $169,483.45 Rear: 10 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 0 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 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'l 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 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 1221 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 1 Hour Fire Rated Roof/ VANCOUVER,WA 98660 VANCOUVER,WA 98660 Ceiling 2 Ersn Cntrl 503-639-4175 PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: Total Fees: $24,636.46 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 95 01-0090 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: '���/ jr �1 �'�.._-_., Permittee Signature: G��(/- /�J�/�'Ge7j�--%'7d/l/1 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. • Building Permit Application gig . Residential FOR OFFICE USE ONLY - City of Tigard Received Permit No " 13125 SW Hall Blvd.,Tigard,OR 9722 ' �` Date/B : r �� 1 ' — ��' _ V Phone: 503.718.2439 Fax: 503. 8 Plan Review 5g ? A/ Other Perini q- "r Inspection Line: 503.639.4175 �0� t � 'F-1�S ) Date/B : � t TIGARD p BUILDING DateReady/By: � ' F3 SeePage2for Internet: www.tigard-or.gov . DIVISION Notifed/Method: / (� 44SR Supplemental Information 6---7.9/c— 7'0c/6c 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. 1�i , 4( 3 1-and 2-family dwelling 0 Commercial/industrialValuation: $ ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other Number of bathrooms: JOB SITE INFORMATION,AND LOCATION Total number of floors: 3 ( Le'-7c1 ^� Job site address: I I '7 0 u1 b v V /J+, cogs; ��//n New dwelling area: a a- J square feet 17(9L- City/State/ZIP: ` m a). �_t. /U•�� (.4( square feet 90� T(9911(6 �,�� �/ '�/r� Garage/carport area: Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: square feet 9 7 Cross street/directions to job site: Deck area: square feet Otherowcilire erc4v4tf l square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Polygon at Roshak Ridge Lot no.: lig Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the . DESCRIPTION OF WORK work indicated on this application. Valuation: $ Existing building area: square feet /1 New building area: square feet C./ El PROPERTY OWNER 0 TENANT Number of stories: Name:Polygon WLH LLC Type of construction: Address:703 Broadway Street Ste 510 Occupancy groups: City/State/ZIP:Vancouver,WA 98660 Existing: Phone:(360)695-7700 Fax:(360)693-4442 New: ® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name:Polygon WLH LLC (Please refer rolceschedule) Contact name:Amanda Gavin Structural plan review fee(or deposit): Address:703 Broadway St.Ste 510 FLS plan review fee(if applicable): City/State/ZIP:Vancouver WA 98660 Total fees due upon application: Phone:(360)695-7700 Fax::(360)693-4442 Amount received: E-mail:permitsubmittals@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM EEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Submit two(2)sets of roof plan with connection details Business name:William Lyon Homes,Inc. Address:703 Broadway St Ste 510 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 and administrative fees): $180.00 Phone:(360)695-7700 Fax: 360)693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Amanda Gavin Date: J /� *Fee methodology set by Tri-County Building Industry Service Board I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/0 /COM/WEB) Mechanical Permit ApplicatiTTECEIVED FOR OFFICE USE ONLY City of Tigard Received g Date/BPermit No.: 13125 SW Hall Blvd..,Tigard,OR 97223 APR 9 2019 Plan Rview Phone: 503.718.2439 Fax: 503.598.1960Date/By: Other Permit: Y 1 Vii:s 1.I i Inspection Line: 503.639.4175 CITY OF TIGAR ate Ready/By: 7uris: H See Page 2 for Internet: www.tigard-or.gov BUILDING I-yw\PI g otified/Method: Supplemental Information TYPE OF"WORK 1 J Y1A,1 COMMERCIAL FEE* SCHEDULE- USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY.OF CONSTRUCTION, RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist. ®Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total Heating/cooling: +�"�JLLO`B�� SITEINFO�R_MATION AND LOCATION _ ��L� s� �OL� Air conditioning 46.75 Job site address: ,.1 \�Vc}5� T.f2.&-. Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name:Roshak Ridge Heat pump 61.06 Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:Roshak Ridge Lot no.: i 1(i Other: 23.32 1 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION ©F WORK Oras fireplace/insert 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 I PROPERTY OWNER ❑ TENANT - Other: 23.32 • Environmental exhaust and ventilation: Name:Polygon WLH,LLC Range hood/other kitchen equipment 33.39 Address:703 Broadway St.,Ste.510 Clothes dryer exhaust 33.39 City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32 ® APPLICANT. 0 CONTACT PERSON Other: 23.32 Business name:Polygon WLH,LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Tonja Morris Furnace,etc. Address:703 Broadway St.,Ste 510 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace Range E-mail:permitsubmittals®polygonhomes.com Barbecue CONTRACTOR • Clothes dryer(gas) Business name:Pro Heating&Cooling Other. MECHANICAL PERMIT FEES* Address: NW Alociek Dr,Ste.1104 Subtotal City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee) CCB lic.:209001 TOTAL PERMIT FEE . This permit application expires if a permit is not obtained within 180 V WQi bn, days after it has been accepted as complete. Authorized signature: A * Fee methodology set by Tri-County Building Industry Service Board Print name:Elia Duran Date:04/08/2019 I:\Building\Pernvts\MBC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) Electrical Permit ApplicatioiL FOR OFFICE USE ONLY City of Tigard Received Permit#: 20 qq9 t 11 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review .. Phone: 503.718.2439 Fax: 503.598. y pt ry�q Related Permit#: Inspection Line: 503.639.4175 �✓t 1 t! Ready Date/By: lulls: H See Page 2 for 111-14"1-1-3. w . Internet: ww.tigard-or.gov 8IJILD NG DIVISIO • Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. Z 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural ❑Multi-family 0 Master builder 0 Other: Fie form all other installations. Inbustallation 0 Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION�t ❑Emergency system. larger separately derived '4� 6U)Goa) CAIN''T QQ ❑Addition of new motor load of system. Job#: Job site address: 104HP or more. ❑"A",•'E","1-2",`•1-3^, City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:Roshak Ridge 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I New residential single-or multi-family dwelling unit. Subdivision:Roshak Ridge Lot#: 1 V9 Includes attached-garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.It or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 ® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name:Polygon WLH,LLC 200 amps or less 100.70 2 Address:703 Broadway St,Ste510 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2 Phone:(360)695-7700 Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or 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 APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name:Polygon WLH,LLC above service or feeder fee, 7 42 2 each branch circuit Contact name:Jolene Smith B.Fee for branch circuits without Address:703 Broadway St,Ste.510 service or feeder fee,first 56.18 2 branch circuit City/State/7.IP: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:permitsubmittals@polygonhomes.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Portland Electric Sign or outline lighting 67.84 2 Address:1915E 5th St,Ste D Signal circuit(s)or limited-energy panel,alteration,or extension. 0 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) 66.25/hr Phone:(360)314-4945 Fax:( ) Investigation(1 br min) 90.00/hr Email:paW@portlandelectric.biz tit Industrialplant(1 hr min) 78.18/hr 5 Inspections for which no fee is CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lic.:-.490.208 specifically listed(''/hr min) 90.00/hr A9_%.1 ELECTRICAL PERMIT FEES alt. ...Electrician signature,required: QSubtotal: Print name: Alex Shalya Date: 04/08/2019 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: } n" TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: MISHCHUK,SERC Y Date: 04/08/2019 days after it has been accepted as complete. _._ ___ . _ _.,____,_ * Number of inspections allowed per permit. Plumbing Permit ApplicationE` ED KEC Building Fixtures ""�� FOR OFFICE USE ONLY City of Tigard APR 9 2019 Received - Date/By: Permit No.: v 13125 SW Hall Blvd.,Tigard,OR 97223 III Phone: 503.718.2439 Fax: 503.5 ,� OF I� I�Q Plan ReviewDate/By: Other Permit No.: TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: Juris: H See Page2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑Demolition For special information use checklist. Description Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ®Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: W 204 5 W GOLD CO A-s-r - 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.: 1 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 1 Lot no.: 1 19 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I 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 Business name:Polygon WLH,LLC Medical gas(value:$ ) Page 2 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 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name:G&B Plumbing&Sons Inc Water piping/DWV 56.29 Address:P.O.Box 92 Other: 25.02 City/State/ZIP:St.Paul,OR 97137 Subtotal Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: $72.50 CCB Lic.:184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee) A : -- State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Steve Fowler Date:04/08/2019 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(l0/02/COM/WEB) City of Tigard III 4 aCOMMUNITY DEVELOPMENT DEPARTMENT lG -„ , ,,, Building Permit Review — Residential Building Permit #: �: ,r, _� . ... — a3k:�'i:'C:, Site Address: ri 101 SL' C-70161 Ce-a ju-rat Project Name: br ening n a} gak � ' i Lot #: 11 li g subdivision name;A 'Qtion or Alteration=last name of owner) Planning Review Al, Chil Proposal: 1Jtt,l 5\(. etVerify site address/suite#exists and active in permittem. pr River Terrace Neighborhood: 0 No g; Yes,See River Terrace Review Addendum Attached S' e 'Ian Elements: Cr. ee(3)copies of site plan . E�settng structures on site it�tte plan mu t Ig on 8-1/2”x 11"or 11 x 17"paper Mb,rawn to scale(standard architect or engineer scale) oot elinati nsw structure(including decks)with finished PIET prth arrow lity locations&easements(required for new and additions) [:D) address,project or subdivision name and lot number idewalk/driveway QV approach •plicant information(name and phone number) Ir• . ation of wells/septic systems it •t dimensions and building setback dimensions L ' xisting trees to be retained with drip line,and tree ware footage of buildings to be demolished •rotection measures &Lot area,buildingcoveragearea,percentage �'' of coverage and �4/,, et tree size,type and location rs ....pervious area(applicable if R-7,R-12,R-25&R-40) L+ treet names Il,l roperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? T Yes ❑No 4 foot differential) If yes,is a storm water quality facility shown? ❑ ]No Clean Water§trvices—Service Provider Letter(lot platted prior to 9/10/1995): /Required: t ❑ Yes,applicant was notified 0 No Received: �� (-414\1 Public Faciliti Improvement(PFI)Permit: Yes 0 No aired: Yes,applicant was notified 0 No Applied For. 0 Yes 0 No s 144Olt d Use Case#: OW. _ , top intake � IsOOOv2 Zoning g-IL required Setbacks: Front t/I L Rear I D Side 0/3 Street Side --' Garage required Requirement Lo �/o / �g•S ❑.,/Lot Coverage Maximum: W % ..( :uilding Height Maximum Height 3S Actual Height Py V -sual Clearance t jzSensitive Lands: 0 Yes ,,_,/ (3-: 4d No Type Urban Forestry Plan eConditions "Met" rior to issuance of building permit otes: 'C4111 qi .6 it r j P �- i fla AU (17( I itt C1,4yL, Approved By Planning: Date: 2--L.1-(1 Revisions (after Building Submittal only) Revision 1: 0 Approved 0 Not Approved ReviewerDate Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved I:\BuildineForms\BldgpermitRvw RES_061417.docx swift Building Permit Submittal Original Submittal Date: Q1-A-I t C', Site Plans: # Building Plans: # Building Permit#: Enter building permit#above. 8/Building 8/Engineering ee ['Permit Coordinator g Workflow Routing: 13/Planning � rin' g Workflow Sign-off: d 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. and [2-Building original permit application,site plans,building plans,engineer beam calculations and trust details,if applicable,etc. Notes: - By Permit Technician: �‘) Date: ,a 1` ‘A (\c{ Engineering Review I o .�S1ope at building pad: ❑ 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: 0 Yes D No Assess Water Quantity Fee in-lieu: 0 Yes Er No LIDA Facility on lot 0 Yes D No ❑ Final Plat Recorded: Date: ❑ NOT Approved by Engineering: 1/5`74fNotes: t.✓A ( ? N P i 144 ' obi!N)tl'P.Q'I '' In'Approved by Engineering: 14,.. (4--"' Date: J7.6./1 r 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 Permit Coordinator Review Conditions"Met"prior to issuance of building permit 0 Approved,NOT Released: Date: - --- Notes: Revisions(after Building Submittal only) Revision Notice 1: Date Sent to Applicant Revision Notice 2: Date Sent to Applicant R sion Notice 3: Date Sent to Applicant: SDC 7Fees Entered Wash Co Trans Dev Tax: Yes 0 N/A Tigard Trans SDC: I"Yes 0 N/A Parks SDC: t(Yes ❑, /A LIDA 0 Yes 11 N/A IVi OK to Issue Permit 316/1, Approved by Permit Coordinator: 4 , Date: it LtL1 (� I:\Building\Forms\gldgPermitRvwRES 010118.docX :11111 City of Tigard r COMMUNITY DEVELOPMENT DEPARTMENT 1 1 GK n River Terrace Building Permit Review Addendum Building Permit #: --\- \CA G am( Site Address: 41 )9 ,„ G,,, ( ,„F -,L-rra€i Project Name: Pals a a1' jt1y1L- itligc Lot #: lig (Nok dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of River Terrace Plan Dist 'ct Design Standards (18.640.070.1.): Is the project subject to the plan district design standards? POI Yes 0 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�ft. deep Gabled dormer [�/ ft. deep 0 min.2ft.,5 ft.wide min. 2 ft.,6ft.wide 0 0 0 2. Eyes on the street: a minimum of 12%of each street facing façade must include windows or entrance doors. Percentage Shown: 111 /J L1-1.7 3. Entrances:At least one entrance must meet both of the follo • g standards: g/Max. 8 ft. setback from longest street- facing wall Parallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porch: IYes 0 No / Iff y s,all the following apply: 1sq.ft.min. V519ne street facing entry IVV ft.max.roof above floor of porch D'5 5 ft. depth min. V30%min.porch roof coverage 4.Detailed Design:All buildings shall include a min. of five of)he following elements on all street-facing facades: Covered porch min. 5 ft.wide x 5 ft. deep F Recessed entry area min. 5 ft.wide x 2 ft. deep F 070 offset min. 16 inches [ Dormer min. 4 ft.wide S g Roof eave min. 12 inch projection F/S ❑ oof offset min. of 2 ft. ❑ Roof shingles either tile or wood ,5 F S able,hip or gambrel roof design Lid ❑ oof pitch oriented south min. 500 sq. ft. Horizontal lap siding min. 3-7 inche wide S LTJ Accent siding min.40%of street facade F 0 Window trim min. 2'/2"wide by 5/8"deep ❑ Window recess min. 3 inches for all street facing ❑yay window min. 5 ft.wide by 2 ft. deep O Balcony min. 5 ft.wide x 3 ft. deep with inside access IJ Attached garage is 35%or less of street facades 5. Garages and Carports:May face the front or side lot line on a corner lot. Setbacks: Nozeloser to front or side lot line,than longest street-facing wall. 0 Yes LtiYNo. If No (Check one): 'LJ' May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch. O May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story above the garage that faces the street with a min. area of 12 sq.ft. Width: (Check one) ❑ Jr2-foot-wide garage door 0 40%max. of street façade 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: ( Z'L Date: 2-'0--I 9 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 \RI) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: V Ilt;Y UIQ ) [A I Ll DATE RECEIVED: 2 z5-1q DEPT: BUILDING DIVISION RECEIVED • FROM: A-�n� ? �/Vou (EivIA FEB 252019 Vc COMPANY: ()' in V Q 1� CITY OF TIGARD BUILDING DIVISION PHONE: J� — T1 DO By: Sr RE: r-i�W 1 � la. Vt/!SI—Fey VC A/1 STUr. 00 02)6 (Site Address) (Permit Number) �Uk o� t- -r /ICA HI (Project\me 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. r _ Engineer's calcul ions. Other(explain): A toI,/ )t V O ' V (A V 1 V�S . �% REMARKS: C D V lr�V -eu2 (2L tl Q V\S QVC- Sit Routed to P- it Technician: Date: (,(e ( Initials: Fees Due: 0 Yes ❑No Fee Des ptio : Amount Due: i/Z l G141 rico. yc $ (i$ �o ( r Special Instructions: Reprint Permit(per PE): jjYes El ❑ Done Applicant Notified: ate: Initials: I:\Building\Forms\TransmittalLetter-Revisions_061316.doc Plumbing Permit Application BuildingFixtures t:1.,_, I : "'`-" `' r FOR OFFICE USE ONLY City of Tigard 1 6 "l 1(:; Received \15 t kg \ �`(\�T?�J�G- 114 - v O, Date/By: Permit No. 1 (.:_,W- , 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review Phone: 503.718.2439 Fax: 5034-5? -1,960•t Other Permit No.: Inspection Line: 503.639.4175 :.°-;'," '' Date/By: TIGARD p Date Ready/By: Juris: PI See Page 2 for Internet: www.tigard-or.gov . .l L L ,'.4 s • ` .I ,' ' E `+'° Notified/Method: Supplemental Information TYPE OF WORK , FEE""SCHEDVTLEG ,,, r_ s ®New construction ve ❑Demolition e {: For special information use checklist G� Description ElAddition/alteration/replacement ❑Other. Qty Ea. Total -'-5,, New 1-2-family dwellings(includes 100 ft.for each utility connection) , , '; CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ®Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 14 Z Q t . �'sT `-'c . Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 11 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: �- I 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 I Lot no.: liefFixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF.WORK Backwater valve 12.51 `tet I` 2�y Clothes washer 25.02 "/ 1 1' �� ` 2.01Ct,"U v 63 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNERI 0 TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixture/sewer cap 25.02 Address:703 Broadway St.,Ste 510 Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone:(360)695-7700 Fax:( ) Ice maker 12.51 El APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Polygon WLH,LLC Medical gas(value:$ ) Page 2 Contact name:Tonja Morris Primer 12.51 Roof drain(commercial) 12.51 Address:703 Broadway St.,Ste 510 Sink/basin/lavatoty 25.02 City/State/ZIP:Vancouver,WA 98660 Solarill*stPotabk willf4 {, Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:permitsubmittals@polygonhomes.com Urinal 25.02 CONTRACTOR' Water closet 25.02 Water heater 37.52 Business name:Alliance Plumbing Water piping/DWV 56.29 25.02 Subtotal Address: 146 W Historic Columbia River Hwy Other: City/State/ZIP:Troutdale,OR 97060 Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50 CCB Lic.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days Print name:Robert Dishman Date: after it has been accepted as complete. *Fee methodology set by Tri-County Building industry Service Board. l:\Building\Permits\PLMLI-PertnitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Electrical Permit A PPlicati©i< r�r li FOR OFFICE USE ONLY City of TigardReceived /`C,, ( j �C� ('1 Date/B : k \i t J' Permit#\('�' .`�\q_Q.\. .. 't 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.196Q Date/13 : Related Permit#: TIGARD Inspection Line: 503.639.4175 Ready Date/By: Juris: 13 See Page 2 for a. Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK -`r '- ryt -'PLAN REVIEW ®New construction ❑Addition/alteration/replacement "`�''' ''' " Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Buildingover three stories. ❑Demolition ❑Other: VC\��f--' where the available fault current 0 Marinas and boatyards. -- CATEGORY �, — '` �' exceeds 10,000 amps at 150 volts or ❑Floating buildings. ® 1-and 2-familydwellingAccessory less toground,or exceeds 14,000 0Commercial/industrial ❑Accessory building 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑ Other: _ 0 Fire pump. 0 Installation of 150 KVA or JOB SITE:INFORMATIONWAND`LOCATION ,':. - ❑Emergency system. larger separately derived ` ❑Addition of new motor load of system. Job#: Job site address:l�2.1)4 6,0“) (O E-c '44 10011P or more. ❑ `A `E",`1-z", '1-3", City/State/LIP:Tigard,OR 97224 �� 0 Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: _ Project name:Polygon At Roshak Ridge 0 Hazardous locations. 0 Supply voltage for more than • 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description - I Qty. j Each L Total I . New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: ,`Ok Includes attached garage, Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential c;�� (with above sq.ftJ 75.00 2 "'"'— — �� �� ��r�b� Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 ® PROPERTY OWNER 0 TENANT. Services or feeders installation,alteration,and/or relocation Name:William Lyon Homes,Inc. 200 amps or less 100.70 2 Address:703 Broadway St Suite 510 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2 Phone:(360)695-7700 Fax:(360)693-4442 Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 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 Branch circuits-new,alteration,or extension,per panel ® APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with Business name: William Lyon Homes,Inc. above service or feeder fee, 7.42 2 each branch circuit Contact name:Nichole Thorpe • B.Fee for branch circuits without Address:703 Broadway St Suite 510 service or feeder fee,first 56.18 2 branch circuit 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:permitsubmittals@polygonhomes.com Reconnect only 67 ga . ____ 2. CONTRAt:i ult . . Pump or irrigation circle 67.84 2 r Business name:Alameda Electric Sign or outline lighting 67.84 2 Address:3415 NE 44th Signal circuit(s)or limited-energy panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP:Portland,OR 97213 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)319-2192 Fax:( ) Investigation(1 hr min) 90.00/hr • Email:solarpdx@me.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lie.: 4871/S specifically listed ehhr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Kile Rood • Date: 03/08/2019 0 Plan Review Required(25%of permit fee): - State surcharge(12%of permit fee): Authorized signature: - TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Kile Rood Date: 03/08/2019 days after it has been accepted as complete.