Permit (137) CITY OF TIGARD BUILDING PERMIT
11 ,
S COMMUNITY DEVELOPMENT Permit#: BUP2019-00115
Date Issued: 05/20/2019
T i G AR o 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107AA26300
Jurisdiction: Tigard
Site address: 14450 SW RIVER TERRACE BLVD
Project: Polygon at Roshak Ridge Swim Center Subdivision: ROSHAK RIDGE Lot: U
Project Description: Swim center.
Contractor: POLYGON WLH, LLC Owner: POLYGON WLH LLC
703 BROADWAY STREET,SUITE 510 703 BROADWAY ST STE 510
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX: 360-693-4442
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: NEW Type of Const: Permit Fee-COM-New Construction 05/20/2019 $1,397.61
Occupancy Grp: B Occupancy Load: 20 12%State Surcharge-Building 05/20/2019 $167.71
Plan Review 05/20/2019 $908.45
Dwelling Units: 0 DC Provision Review,COM New-Bldg 05/20/2019 $194.00
Stories: 2 Height: 25 ft Plan Review-Fire Life Safety 05/20/2019 $559.04
Bedrooms: 0 Bathrooms: 2 Metro Const.Excise Tax 05/20/2019 $277.16
Value: $230,964 Tig-Tual School CET-Non Residential 05/20/2019 $1,291.55
Info Process/Archiving-Lg$2.00(over 05/20/2019 $48.00
11x17)
Floor Areas: Info Process/Archiving-Sm$0.50(up to 05/20/2019 $52.50
Total Area: 1987 11x17)
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $4,896.02
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet: 1 Special Inspection(see plans)
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
l
Issued By: `
( Pjermittee Signature: e,v ,..,,....,0,0, c 77 0„,v/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
ResidentialE FOR OFFICE USE ONLY
Received.
City of Tigard \>\..X\a Sj-- Permit No. k7. 1C(–�tt`-3
`J g � Date/By: �..
1 III Ill 13125 SW Hall Blvd.,Tigard,OR 9722$/1 ��a 2 1919 Plan Review
Q Other Permits/
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: �' 8 1 �C/ 9� QL7��
T I G A R D Inspection Line: 503.639.4175 (�r,)"�f t j - p I l Aj-( Date Ready/By: Jugs: 1Z1 See Page 2 for
Internet: www.tigard-or.gov , m `` {{Np� o�^qi1viSI s Notified/Method'. / Supplemental Information
�U�L�[la� tl,.diV4�,�11.1�; a
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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 1 1-and 2-family dwelling xi Commercial/industrial Valuation: $
ElAccessory building 0 Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1o5Q sW V JC2 -(74..(1-(102_, '131 V b New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Roshak Ridge Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Roshak Ridge Lot no.: u 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.
S(A)1 r1(\. 02Pit(\, Valuation: $ 230 I /6,9.36
Existing building area: 1,11/4 square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories: 2
Name:Polygon WLH,LLC Type of construction: V-1?,
Address:703 Broadway St.,Ste 510 Occupancy groups: j' lj--2-
City/State/ZIP:
City/State/ZIP:Vancouver WA 98660 Existing: it 1p P/A
Phone:(360)695-7700 Fax:( ) New: fJ/G7/ 4114
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH,LLC (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Tonja Morris
FLS plan review fee(if applicable):
Address:703 Broadway St.,Ste 510
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Amount received:
Phone:(360)695-7700 Fax: :( )
E-mail:permitsubmmittals@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:Polygon WLH,LLC 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.
Permit Fee(includes plan review
City/State/ZIP:Vancouver WA 98660 $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:204238 N 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.
�– ` `` 1 *Fee methodolojy set by Tri-County Building Industry
Print name-.Thula Morris Dec. 17/2819 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
71COM■
MUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - With Land Use
Building Permit #: _axP,. v1C-t- Oakes
Site Address: / 4/2(5( 5 It) g'ue,-- 7 ./.,-4,,e. ,B/ej Suite/Bldg#:
Project Name: gcshak Cw,rn Ch-7/e�
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: /00u/ .S2,V,inm; pc o/ Gm( ‘o: .y
erisite address/suite# exists and activepermit system.
�/� fY Y
4d pver Terrace Neighborhood: dd Yes ❑ No
nd Use Case#: 'p7R ac./--0000 I
LSI Plan Match Approved Land Use:
[tUUite Plan CI Landscape Plan ❑ Other:
rban Forestry Plan ❑ Elevation Plan
C'Building Height: Maximum Height 35' Actual Height )5
Conditions Met: ❑ Prior to Submittal Irior to Permit Issuance
Er Business License:
Exists: El Yes �NO,applicant notified to obtain business license
Er-Public Facilities Improvement(PH) Permit:
Required: 173-...Yes,applicant was notified El No Applied For: Ig4es ❑ No,stop intake
Notes:
Approved by Planning: 9J? Lrft, Date: c.../...1 i
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date:
Site Plans: #
Building Plans: #
Building Permit#: ❑ Enter building permit#above.
Workflow Routing: ❑ Planning ❑ Engineering ❑ Permit Coordinator ❑ Building
Workflow Sign-off: ❑ Sign-off for Planning(include notes from planning review)
Route Application Documents: ❑ Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date:
I:\Building\Forms\BldgPernutRvw_COM_WithLandUse_060116.docx
Engineering Review /
'"Slope at building pad: 50 70 s C�7n .'"/ �(/J �`,1
CJ--PFI Permit#: C
u-Conditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat(not typical on SDR/CUP)
�-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes Er No
Assess Water Quantity Fee in-lieu: ❑ Yes Er No
LIDA Facility on lot: ❑ Yes No
❑ 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
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
��Revision Notice 3: Date Sent to Applicant:
" SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ,_,� /A
Tigard Trans SDC: 0 Yes Il�d A
Parks SDC: ❑ Yes Ld'N/A
EK3K to Issue Permit
Approved4(71-
by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse 070915.docx