Permit (167) CITY OF TIGARD MASTER PERMIT
,IN,,,....
2 . COMMUNITY DEVELOPMENT Permit#: MST2019-00131
13125 SW Hall Blvd.,Ti Date Issued: 05/02/2019
TtCtLR.D and OR 97223 503.718.2439 9
Parcel: 2S107AA02900
Jurisdiction: Tigard
Site address: 14252 SW 169TH AVE
Subdivision: ROSHAK RIDGE Lot: 29
Project: Polygon at Roshak Ridge, Lot 29
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 809 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 1858 sf Value: $240,968.70 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 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
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvoes 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: 4 201-400 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 1858
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
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $33,614.92
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 O'- •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: I AMP Permittee Signature: e/I /9-74/° 1e- ,77e/
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.
., , .. .
ac--A
Building Permit Application
Residential RECEIVED FOR OFFICE USE ONLY
- Cityof Tigard C �+ Received
111 131SW Hall Blvd.,Tigard,OR 97223r EB o V 20 19
Date/By: \`\ri \�' PermitNo. Sv\C1_�` r�
Plan Review �A /
Phone: 503.718.2439 Fax: 503.598. Date/By:
9 (� h I Other Permit\j \CI-(11
Inspection 503.639.4175Y OF TIGARD
TIGARD p DateReadyBy: 7uris: See Page 2for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method. 7/„..i/V/.7 . F&A Supplemental Information
TYPE OF WORK REQUIRED DATA:i-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 0 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: $ /).C1 0' Q
❑Accessory building ❑Multi-family Number of bedrooms: /(!
❑Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors:2 L1-1 S
Job site address: 1 y 2S2 'VA) I tOq-C-ti PC� New dwelling area: ) Asquare feet t Q9l
City/State/ZIP: f11t V1/ `Or— C71 (/_ _Lt Garage/carport area: 416-1 square feet ��l
Suite/bldg./apt.no.: JI Project name:VPolygonat Roshak Ridge Covered porch area:--psquare feet
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.: V` 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
�A/m/.� �. lc DESCRIPTION OF WORK work indicated on this application.
eV\/ J = Valuation: $
Existing building area: square feet
New building area: square feet
ID PROPERTY OWNER ❑ 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 tofee schedule)
Structural plan review fee(or deposit):
Contact name:Amanda Gavin
FLS plan review fee(if applicable):
Address:703 Broadway St.Ste 510
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 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
L. lic.:207247 Allik Total fee due upon application: $201.60
Authorized signature: 11111.1141ki This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Amanda Gavin , Date: l'�(�'�
*Fee methodology set by Tri-County Building Industry
L ( / Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
•
Mechanical Permit Applicatiett-
r—CE FOR OFFICE USE ONLY
City of and Received I/
Ti _
y
Tigard Date/By: Permit No. C,(1 iJ3
13125 SW Hall Blvd.,Tigard,OR 97223 APR 2 b 2010
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960Date/By: Other Permit:
T I G ARD Inspection Line: 503.639.4175 CITY OF T AR Date Ready/By: I I H See Page 2 for
Internet: www.tigard-or.gov BUILDING NG DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
la'1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
{ Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heatinglcooling:
Air conditioning 46.75
Job site address: I M 25 2 5 W L loci 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.: "2.1
Other. 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF 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
Address:703 Broadway St.,Ste.510 equipment 33.39
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 72"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 lit.: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)
VEElectrical Permit Application 1 H` FOR OFFICE USE ONLY
City of Tigard h 0 ) L Received
A R 2 '' Date/B : Permit#: ' �",--^e .. 4)/'7
13125 SW Hall Blvd.,Tigard,OR 97223 _ Plan Review tJG J
I Phone: 503.718.2439 Fax: 503.598.196&" i I.# Date/B : Related Permit#:
Inspection Line: 503.639.4175 9'�!�lt^�pp � try r a tsgead DateB Saris:
•L.LLIALI-L7- Internet: www.tigard-or.gov BU1IDiN 0!VIS1( lNotified/Method: See Page I2 nr
Supplemental Information
�, - , !: • TYPE OF WORK PLAN REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition ❑Service or feeder 400 amps or more 0 Building over three stories.
0 Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family D Master builder ❑Other:
❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
I�^ ,'^� ❑Addition of new motor load of system.
ns
Job#: Job site address: ` W V/ 100HP or more.
City/State/ZIP:Tigard,OR 97224 ElSix or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Roshak Ridge ❑Hazardous locations. ❑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#: 'z/ 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 I
DESCRIPTION OF WOE Limited energy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
® PROPERTY OW ItRenewable Energy ❑ See 2
0 TENANT Services or feeders installation,alterationPage,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
e APPLICANT ❑ 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/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:permitsubmittais@polygonhomes.com Reconnect only 67.84 2
_.��x s ,w,5 , . s --5; 4 ,, ,,, cZ, „--.>. , ,-;,-..-1',;!...':. Pump or irrigation circle 67.84 2
Business name:Portland Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 1915 E 5'St.,Ste D 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 hr min) 90.00/hr
Email:paul@portlandelectric.biz Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lic.: 05 specifically listed(A hr min) 90.00/hr
/� �� �� ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: cit,,, Subtotal:
Print name: Alex Shalya Date: 04/08/2019 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: }72) ML.„,1f1.0//141.4, TOTAL PERMIT FEE:
This permit application expires ifs permit Is not obtained within 180
Print name: MISHCHUK,SERG Y Date: 04/08/2019 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
1
Plumbing Permit Application .'',_ �
Building Fixtures t.�. I FOR OFFICE USE ONLY
City of Tigard A P R 2 •J 2019 Received
- Date/By: Permit No.: 7 C
'I 13125 SW Hall Blvd.,Tigard,OR 97223 �/�.Si cG�// "�l1�3/
v Plan Review
Phone: 503.7182439 Fax: 503.598.1901r '' -1jTi v1A Other Permit No.:
to/By:
T I G A R D
Inspection Line: 503.639.4175 G to Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov ���-�E ��yp ��
Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist.
Description Qty. I Ea. I 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
Igi 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: 141 7, SA 1(19.A. 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 1 Lot no.: 21 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
WaterPmPin 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)
6 SJ 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(10/02/COM/WEB)
141.'
City of Tigard
li
.111 COMMUNITY DEVELOPMENT DEPARTMENT
i 111
Building Permit Review — Residential
TIGARD
Building Permit #: K\M--c \CA- LON
Site Address: 14 2- 1- ` kikl 161th Avt
Project Name: 1)'1-7i:ik A 17•03114L Kije Lot #: 2..'T
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Prpposal: IdtW St:.
rill Verify address/suite# active in Accela. In River Terr e: El No UKes,River Terrace Review Addendum
i - Plan Elements: E1El, 5sion Control
• .pies of site plan on 8-1/2"x 11"or 11 x 17"paper P ' ained trees with drip line and tree protection measures
0)0/pawn to scale(standard architect or engineer scale) H. "ootprint of new structure(including decks)and FFE
r*Nyorth arrow L'A *ty locations&easements(required for new and additions)
gSte address,project or subdivision name and lot number Sidewalk/driveway approach
IIVXplicant information(name and phone number) rf,' • ation of wells/septic systems
2t dimensions and building setback dimensions D-:ireet tree size,type and location
WS..are footage of buildings to be demolished15ErpeE't names
P : "sting structures on site irComer elevations(2'contours if more than 4'differ7fial)
E et area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? [ es LI No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? 0 4.85A1 No
/Clean Water Services—Service Provider Lettezr(lot platted prior to 9/10/1995): L?Alle1v41 Si14`
quired: CI Yes,applicant was notified IP'No Received: 0 Yes E No
dIlt-
D4tublic Facilitieyimprovement(PFI)Permit:
equired: 'Yes,applicant was notified E No Appliid For: CI Yes CI No,stop intake
V, and Use Case#: 19K2X1S-00002— di Zoning: K-12- (.?0
Ir_Vequired Setbacks: Front:1 2—_ Rear: 0 Side: 3 ,
Street Side: PA Garage: ..)
Wkiilding Height: Max.Height: Actual Height: 2..S.5
VLandscape Area: f.,0 °/.3 Lot Coverage Max: d %
KAA.' 'Entrance 0 Set back no more than 8'from street-facing wall 0 Parallel to street or offset 45 degrees or less
d Windows El Minimum 12%of area of all street-facing facades
R44,- Garage 0 Garage door is behind widest street-facing wall 0 Yes 0 No,one of the following is met:
CI Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
Itrrita. 0 Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
E Garage door width is CI 12'or less 0 50%or less of facade 0 60%or less and includes 7 of following:
O Covered porch CI Recessed entrance 0 Wall offset 0 1'Roof eave 0 Roof offset
O Fire shingles 0 Lap Siding 0 Roof pitch 0 Gable,hip,or gambrel roof 0 Dormer
CI Accent siding Window trim 0 Window recess 0 Window projection CI Balcony
V
isual Clearance
Rkrban Forestry P)an
S2.1-
EV/ensitive Lands:
0 Yes OWN() Type:
p Conditions met prior to„issuance of buildin*permit
I /es: C414(1-11IN +1) IX (.J.- pr ‘,0 kn
IA
reN.I
----
Approved By Planning: _____ ---
— 7A._ Date: '1111.1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved El Not Approved
Revision 2: 0 Approved CI Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
**Iir
Building Permit Submittal
Original Submittal Date: .\U-\kG1
Site Plans: # `
Building Plans: # �_
'
Building Permit#: Enter building permit#above.
Workflow Routing: Planning C /Engineering C'Permit Coordinator CI Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: Di Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
NI'Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ...94- i.i Date: 4 tk\\‘q
Engineering Review
lope at building pad: T l D
Conditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat
V Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes of No
Assess Water Quantity Fee in-lieu: ❑ Yes V No
LIDA Facility on lot: ❑ Yes 7 No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
X Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
XSDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: k Yes ❑ N/A
LIDA ❑ Yes tg N/A
OK to Issue Permit
Approved by Permit Coordinator: A/OlvV) pa).-- Date: 4-___\\_1
I:\Building\Forms\BldgPermitRvw_RES 022819.docx
----Air
a
City of Tigard
IR COMMUNITY DEVELOPMENT DEPARTMENT
Ill ■
T 1 G A R lJ River Terrace Building Permit Review Addendum
Building Permit #: Mc- - 7'G1cA-WeD t
Site Address: N 7-- 2- S'w 1M f.-1) AA,
Project Name: P4tyAc1 ski- I- i*Nak. 1Z ,1Q Lot #: 2,61
(New Melling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Dispict Design Standards (18.640.070.I.):
Is the project subject to the plan district design standards? Pi 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 dee Balcony w/access 2 Window Projection Vertical Wall Offset a
P ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide Gabled dormer
1=1 ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: 2.6,O^/
3. Entrances:At least one entrance must meet both of the folio g standards:
11 ax. 8 ft. setback from longest street- facing wall 'tel arallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: 112<s ❑ No —/
If ye all the following apply: Ltd sq.ft.min.
tE9ne street facing entry Lri ft.max.roof above floor of porch
LU'5 ft. depth min. LfY30%min.porch roof coverage
4.Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
❑ Covered porch min. 5 ft.wide x 5 ft. deep ❑ Recessed entry area min. 5 ft.wide x 2 ft. deep
❑ al offset min. 16 inches ❑ D�ermer min.4 ft.wide
Roof eave min. 12 inch projection [/R,faof offset min. of 2 ft.
El Roof shingles either tile or wood [ Gable,hip or gambrel roof design
❑ : .of pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
F Accent siding min.40%of street facade ❑ Window trim min. 2 I/2"wide by 5/8"deep
❑ Window recess min. 3 inches for all street facing ❑Itay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access IIG 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.
Setbacks:
11/44A; o closer to front or side lot line,than longest street-facing wall. ❑ Yes ❑ No. If No (Check one):
4,- ❑ 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.
aft 7 Width: (Check one)
❑ 12-foot-wide garage door ❑ 40%max. of street facade
50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: -p— //�� Date: •
I:\Building\Forms\BldgPennitRvw REs RT 1214I7.docx
Electrical Permit Applicatioi 4,. F f n' 1 a r FOR OFFICE USE ONLY
City of Tigard Received y� ��,` _ i
. JUL2 Q
Date/By: 1� �\� Permit#:`. 1S\ JV\i("C tZitD i
" 13125 SW Hall Blvd.,Tigard,OR 97223 �l' 2 1 i 1. 3
Plan Review
Phone: 503.718.2439 Fax: 503.598 196Q Date/By:Ili
Related Permit#:
TIGARI) Inspection Line: 503.639.4175 ( t Ready Date/Ey: Auris: I EI See Page 2 for
ca Internet: www.tigard-or.gov --"t Notified/Me.•.: J Supplemental Information
TYPE OF WORK �S *
�\ .'.PLAN`REVIEW;
El New construction 0 Addition/alteration/replacement /` V tl Please check all that apply(submit 2 sets of plans w/items checked):
❑SerOice or feeder 400 amps or more ❑Building over three stories.
0 Demolition 0 Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION I ', sexceeds 10,000 amps at 150 volts or 0 Floating buildings.
El 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: El Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION - " ' ;; -' ❑Emergency system. larger separately derived
G L 0 Addition of new motor load of system. -
Job#: Job site address: 1 LI Z5 Z 5 WI i 17�1 1/G 100HP or more. ❑"A","E","1-2 "1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Polygon At Roshak Ridge 0 Hazardous locations. 0 Supply voltage for more than
El Service or feeder 600 amps or snore. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
•
Description I Qty. I Each l Total I *
q New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: i 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
75.00 2
Ilk
--01 'AA 1--
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
El Renewable Energy ❑ See Page 2
PROPERTY OWNER El: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 I 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
APPLICANT I 0.CONTACT PERSON Branch circuits-c new,alteration,or extension,per panel
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 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
81.E4——_- 2 __ _
Business name:Alameda Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:3415 NE 44th panel,alteration,or extension. ❑ 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(I hr min) 78.18!hr
Inspections for which no fee is 80,00/hr
CCB Lie.: 199188 Electrical Lie.: c923 Suprv.Lic.: 4871/S specifically listed(lb hr min)
ELECTRICAL 'PERMIT._FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Kile Rood Date: 03/08/2019 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: �,'. ----
TOTAL PERMITFEE:
�' 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.