Permit (160) CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2019-00073
13125 SW Hall Blvd.,Ti Date Issued: 05/02/2019
TEC�a1R.0 and OR 97223 503.718.2439 9
Parcel: 2S 107AA00500
Jurisdiction: Tigard
Site address: 14249 SW 168TH AVE
Subdivision: ROSHAK RIDGE Lot: 5
Project: Polygon at Roshak Ridge, Lot 5 •
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 1119 sf Basement: 140 sf Left: 3 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1062 sf Garage: 422 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2321 sf Value: $295,094.05 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 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'I 500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2321
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 Eaves
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 Geo Tech Report Required
Prior To Pour
3 Ersn Cntrl 503-639-4175
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $34,750.18
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 503.232.198877 or 1.800.332.2344.<,i)
Issued By: _—� Permittee Signature: 0/i/ c✓ice�� ��,w
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
LO-1-
- Residential RECEIVED FOR OFFICE USE ONLY
Cityg of Tigard
Received
PermitNo.:„„ �DDate/By: _ ”
III v -
13125 SW Hall Blvd.,Tigard,OR 9722 EB 0 6 2019 Plan Review ligyzwa
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit.C`,
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD DateReadyBy: L. El See Page2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: / a2 /' .••t—llill Supplemental Information
� a-- ,'ni-/6"t'
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ 1.
5–'
I D°114
LI❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms: aj
JOB SITE INFORMATION AND LOCATION Total number of floor(3 .2-7 Lil
Job site address: I LI?)(--I. 5-1#., t(si f A � f(eNew dwelling area: ` square feet lZ
b(Q
City/State/ZIP: �1 �i 0 111 0, '72. Garage/crport area: 2'i! square feet
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: square feet ,V b
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.: 5 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.
1A " " i' Valuation: $
Existing building area: square feet
New building area: square feet
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:
Il APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH LLC (Please refer rofee 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
Phone:(360)695-7700 Fax::(360)693-4442 Amount received:
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 :(360)693-4442
i' State surcharge(12%of permit fee): $21.60
CCB lie.:207247 AI �le Total fee due upon application: $201.60
Authorized signature: 44This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Amanda Gavin Date: (l gy`/11 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPemiitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
1
Mechanical Permit Apphcatl TIECE`V FOR OFFICE USE ONLY
City of Tigard �.�dj Received
"II - Date/By:RePermit No 5��/9_ vtI
I 13125 SW Hall Blvd.,Tigard,OR 97223 n 201 GK/(!73
Phone: 503.718.2439 Fax: 503.598.1960 APR Plan Review
Date/By: Other Permit:
T I GARD Inspection Line: 503.639.4175 �y F q+ Date Ready/By: 7u H See Page 2 for
Internet: www.tigard-or.gov CITY 11 ��� Datified/Ivlethod: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
cgi.1_and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
ti Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
� Air conditioning 46.75
Job site address: 1I{�J.k S W t(19(6—M Pr) Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Roshak Ridge 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.:
5 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTIONOF WORK Gas 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
® PROPERTY OWNER 0 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
Fuel piping:
Business name:Polygon WLH,LLC
$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:Apex Air LLC Other:
MECHANICAL PERMIT FEES*
Address:18004 NE 72nd Ave Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee)
CCB lic.:203034 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Tim Hay Date:04/08/2019
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Electrical Permit ApplicationRECEl Y ED FOR OFFICE USE ONLY
City of Tigard APR 12 2019 Received
Date/By: f PemutS%ao/'C-wa 73
13125 SW Hall Blvd.,Tigard,OR 97223
I Plan Review
Related Permit#:
Phone: 503.718.2439 Fax: 503.598.1
eITY OF` IGARD Date/By:
Inspection Line: 503.639.4175 pp + t' n n Ready DateBy: luris: H See Page 2 for
111it'al.O. Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: l 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):
❑Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-family ❑Master builder 0 Other: ❑Fires for other installations. Inbustallation p ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: 1 u[j ��n �+ 1,t /� ❑Addition of new motor load of system.
1-IZt �7 W IlpV Tti he 100HP or more. ❑ A", E> 1_2, 1_3 ,
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Roshak Ridge ❑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
New residential single-or multi-family dwelling unit.
Subdivision:Roshak Ridge Lot#: 5 Includes attached-garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: _
Ea.add'1500 sq.ft.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.)
ED 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
r�;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,
7A2 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/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 67.84 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 ❑ See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Vancouver,WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 lir min) 66.25/hr
Phone:(360)314-4945 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:pawl@portlandelectric.biz c= Industrial plant(1 hr min) 78.18/hr
I -5 Inspections for which no fee is
CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lic.:-4 18,23' specifically listed(%hr min) 90.00/hr
� ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: (Tilt,
Subtotal:
Print name: Alex Shalya Date: 04/08/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: ft f,,kse. TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: MISHCHUK,SERG Y Date: 04/08/2019 days after It bas been accepted as complete.
* Number of inspections allowed per permit
1
Plumbing Permit Applicatio ECEIVE
Building Fixtures N FOR OFFICE USE ONLY
City of Tigard APR 9 2019
Rece/By:ive Permit No./-7S7;20
a 13125 SW Hall Blvd.,Tigard,OR 97 /?+&o'�
2. Phone: 503.718.2439 Fax: 503.598 OF TIGARD Plan Review
Date/By:
Other Permit No.:
Inspection Line: 503.639.4175 BUILDING DIVISION DateReady/By:TIGARD
Juris: ECJ See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist
Description Qty. Ea. Total
0 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
X1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 'arMulti-family SFR(3)bath 500.32
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: ti' q 5(A.) I N 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.: 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.: 5 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 ❑ 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/DW V 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
Plan review (25%of permit fee)
CCB Lic.:184372 Plumbing Lic.no.:pb634
,, State surcharge(12%of permit fee)
e
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(10/02/COM/WEB)
City of Tigard
•.10/
i a COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c A R D Building Permit Review — Residential
r
Building Permit #: \`(\c-,T-QC_ OCn
Site Address: 1 L4L 9 S I Ungtilkiei
Project Name: `Q'O� (a, CZ( R Lot #: 5
(New dw g=subdivision name;Addition or Altera =last name of owner)
Planning Review
Proposal: 3V� C�L
AVerify address/suite#active in Accela. ,X In River Terrace: ❑ No 1(Yes,River Terrace Review Addendum
Site Plan Elements: ''rosion Control
Xi copies of site plan on 8-1/2"x 11"or 11 x 17"paper Atetained trees with drip line and tree protection measures
Drawn to scale(standard architect or engineer scale) ootprint of new structure(including decks)and FFE
North arrow tility locations&easements(required for new and additions)
Mite address,project or subdivision name and lot number >Sidewalk/driveway approach
Applicant information(name and phone number) I:1 ocation of wells/septic systems
I., .t dimensions and building setback dimensions "Street tree size,type and location
Pi.quare footage of buildings to be demolished .Street names
xisting structures on site ILCorner elevations(2'contours if more than 4'differential)
a Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? gYsip No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? EN.. 1111 No
V Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified .tel No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified JRr No Applied For: ❑ Yes ❑ No,stop intake
g Land Use Case#: PDP-2015-ccoo2. gi.,Zoning: P.-12(PD)
.Required Setbacks: Front: S Rear: 40 0 Side: '3 Street Side: NA Garage: 3'
Building Height: Max. Height: N A- Actual Height: t 2-9
Landscape Area: 20 % Lot Coverage Max: 80
ntranc ❑ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
WI s ❑ Minimum 12%of area of all street-facing facades
rage ❑ Garage door is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
o,�A ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
S `f l `i0,1\
� ❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
�
v❑ Garage door width is CI 12'or less CI 50%or less of facade ❑ 60%or less and includes 7 of following:
9-/C.��Q ❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
1\0'9A.
l' ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
P. Visual Clearance ,iR Urban Forestry Plan
M Sensitive Lands: ❑ Yes 14 No Type:
ill) onditions met prior to issuance of building permit
otes: Cry ttt tyis (( 1uc51- bt, W1C+ pnor-10 t s vconce .
XApproved By Planning: ?d"- Date: 3_1241
Revisions (after Building Submittal o ) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved 0 Not Approved
I:\Building\Forms\BldgPermitRvw RES 022819.docx
Building Permit Submittal
Original Submittal Date: cis l L I I C/
Site Plans: # '
Building Plans: #
Building Permit#: R1 Enter building permit#above.
Workflow Routing: [3/Planning RrEngineering COY Permit Coordinator Building
Workflow Sign-off: E71/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.
g Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: \ '4-k._) _)‘----, Date: kA.. ‘ koi
Engineering Review
lope at building pad: V) 420
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
;I.-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes n' No
Assess Water Quantity Fee in-lieu: El Yes No
LIDA Facility on lot: CI Yes No
Final Plat Recorded:
❑ NOT Approved ,�AbyEngineering: Date:
Notes: Ir)iR't'r ft- (yJti1rl v 4. f li (lei. f
2r Approved by Engineering: Date: ?j i 41 1 7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
n tions "Met"prior to issuance of building permit
�fJ A roved NOT Released: a3/i t /q
PP � 41'ite: J
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revisi Notice 2: Date Sent to Applicant:
Re ision Notice 3: Date Sent to Applicant: —/
SDC Fees Entered: Wash Co Trans Dev Tax: ��i,T/Yes ICI N/A
Tigard Trans SDC: CVYes ❑ N/A
Parks SDC: es ❑ N/A
LIDA ❑ Yes Eiv /A
KOK to Issue Permit ����
Approved by Permit Coordinator: A-6-"Oe'e/L
Date: 4 1 i 1 iq
I I
I:\Building\Forms\BldgPermitRvw_RES 022819.docx
•
City of Tigard
1111iCOMMUNITY DEVELOPMENT DEPARTMENT
i
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #: cT 2- ,\C\- 0 ,671.3
Site Address: 142_491 SW ikp5i-h Phsv.p�
Project Name: PC.ILiGOn C , KrCshG1.k t2 Lot #: S
(New dwe ' g=subdivision name;Addition or Alteration last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.070.1):
Is the project subject to the plan district design standards?'Yes ❑ 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.
Porch min. 5 ft. deepBalcony w/ access 2 Window Projection Vertical Wall Offset a
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide Gabled dormer
t2( ❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: 2.-SIO
3. Entrances:At least one entrance must meet both of the following standards:
Yi.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: 156 Yes ❑ No
If yes,all the following apply: 25 sq.ft. min.
IS(One street facing entry 12 ft. max.roof above floor of porch
545 ft. depth min. 030%min.porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
ICovered porch min. 5 ft.wide x 5 ft. deep KRecessed entry area min. 5 ft.wide x 2 ft. deep
❑ Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide
Vs.goof eave min. 12 inch projection tg Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
❑ Accent siding min.40%of street facade ❑ Window trim min. 2 1/2"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
5. Garages and Carports:May face the front or side lot line on a corner lot. l 1
Setbacks: A-
I
No closer to front or side lot line, than longest street-facing wall. ❑ Yes ❑ No. f No (Check oh �
e)
❑ May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
❑ 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)N
❑ 12-foot-wide garage'door ❑ 40%max. of street façade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: Date: 3/7/ 19
IABuilding\Forms\BldgPermitRvw RES RT 121417.docx
ti it
Electrical Permit Applica Ii ih. . . v. . FOR OFFICE USE ONLY
13125 SW Hall Blvd.,Tigard,OR 972 3 Received,
City of Tigard X 7 1
�� I. t7 Date/B :
g Plan Review
1 Phone: 503.718.2439 Fax: 503(598}1960 ,, t - ;.J Date/B : Related Permit#:
k 3
Inspection Line: 503.639.4175 _ X' Ready Date/By: Juris: EJ See Page 2 for
TIGARD Internet: www.tigard-or.gov 5 9_ '_2' Notified/Method: Supplemental Information
TYPE OF WORK R'� , .r,. k; PLAN REVIEW
®New construction 0 Addition/alteration/replacement }}, Please check all that apply(submit 2 sets of plans w/items checked):
v S 0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other: •
t .,..t.,,,�A where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
I ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations, buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
- JOB SITE`,INFORMATION AND`LOCATION 0 Emergency system. larger separately derived
1'2ft c ` S t ` ,W \1 - P
O Addition of new motor load of system.
i Job#: Job site address: �P 100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: 1 Project name:Polygon At 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 f Qty. 1 Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge 1 Lot#: 5 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 1
' DESCRIPTION'OF WORK Limited energy,residential
... _ ,�` sx-�� ►\`I �ynk of—0001-5 (with above sq.ft.) 75.00 2
V`-'t'K 1 Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 PROPERTY OWNER I ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name:William Lyon Homes,Inc. 200 amps or less 100.70• 2
Address:703 BroadwaySt Suite 510
201 amps to 400 amps 133.56 2
401 amps to 600 amps200.34. 2
P
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
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being on made that I own which is not 200 amps or less 1 59.36 1
property
and 701. 201 to 400 125.08 2
intended for sale,lease,rent,or exchange,accordingto ORS 447,449,670,
g � ampsamps
Owner signature: Date: 401 amps to 599 amps 168.54 2
APPLICANT " 0CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
II'
0i
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
sAddress:703 BroadwaySt Suite 510 branchrace or feeder fee,first 56.18 2
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 67.84 2
dwelling,service and/or feeder
rmi submittals of onhomes.com
Email:pe t @p yg Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Alameda Electric Sign or outline lighting -` 67.84 2
Signal circuit(s)or limited-energy 0 See Page 2 2
Address:3415 NE 44th panel,alteration,or extension.
Ci /State/ZIP:Portland OR 97213 Each additional inspection over allowable in any of the above
ty ' Additional inspection(1hr 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) 78.181 hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 199188 Electrical Lic.: c923 Suprv. Lic.: 4871)% , specifically listed(%hr min)
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):
TOTAL PERMIT FEE:
Authorized signature: I�
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.
' Number of inspections allowed per permit.
C\Building\Permits\ELC PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB