Permit (45) CITY OF TIGARD MASTER PERMIT
11.0„..
'
.;. . . 2COMMUNITY DEVELOPMENT Permit#: MST2019-00216
T IGAFt D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/19/2019
Parcel: 2S 107AA03000
Jurisdiction: Tigard
Site address: 14244 SW 169TH AVE
Subdivision: ROSHAK RIDGE Lot: 30
Project: Polygon at Roshak Ridge, Lot 30
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: 23 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 8 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
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 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!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 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: $33,609.42
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 R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 5503..-232.19877 oror1.800.332.23444.
��E-t
Issued By: Permittee Signature: . 1t1.�t—ic \1CC
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.
Is.
i Building Permit ApplicationOT 0
Residential RECEIVED FOR OFFICE USE ONLY
Cityof Tigard Received
III - g FEB 0 6 2019 C S Permit No. lS , ` CLN.
" 13125 SW Hall Blvd.,Tigard,OR 97223 DateB
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960CITY OF TIGARD Date/B : Awl,
Other . -
Inspection Line: 503.639.4175
TIGARD
p BUILDING DIVISION DateReadyBy: Juris: H SeePage2for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
• 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.
® I-and 2-family dwelling 0 Commercial/industrial Valuation: $ /) _l.�O'Q �
❑Accessory building E.:1 Multi-family Number of bedrooms: �/ L 1 v
❑Master builder [1]Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:2 2221.5-
Job site address: 14 2 Uj /' � I � i e New dwelling area: I{j`(b square feet .c f 1
City/State/ZIP: - c VrVi f 1� ✓�� 6?- Garage/carport area:. 2-)".?
� square feet (6c9
Suite/bldg./apt.no.: Project name:Polygon at 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:Polygon at Roshak Ridge Lot no.:30 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
DFSCRIPTION OF WORK work indicated on this application.
)-?)\A) Valuation: $
Existing building area: square feet
New building area: square feet
Isi PROPERTY OWNER 0 TENANT Number of stories:
Name:Polygon WLH LLC Type of construction:
Address:703 Broadway Street Ste 510
Occupancy•
p y groups:
City/State/ZIP:Vancouver,WA 98660
Existing:
Phone:(360)695-7700 Fax:(360)693-4442
� APPLICANT: New:
0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH LLC tP1oR�refertnfceschedule)
Contact name:Amanda Gavin
Structural plan review fee(or deposit):
Address:703 Broadway St.Ste 510 FLS plan review fee(if applicable):
Cit}/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* •
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name:William Lyon Homes,Inc. Submit two(2)sets of roof plan with connection details
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.:207247A _
Total fee due upon application: $201.60
Authorized signature: ` This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Amanda Ga
Date: 1 1.9,1ii
*Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Applica ( 1ED FOR OFFICE USE ONLY
City of Tigard Received
Permit No.
Date/By:
III I , g , y' ��
Phone:13125 503.718.2439SWHallBlvd. Ti
Fax:ard503.598.1960OR97223 6 APRnig Plan Review Other Permit:
Date/By:
TIGARD Inspection Line: 503.639.4175 cri�� �-yy,C� } Date Read/B kris:
Internet: www.tigard-or.gov BUILDING+ I1..4 c �� >��� �6� y y: H See Page 2 for
DIVISION
U g i`3 Notified/Method: Supplemental Information
TYPE OF WORK 611 COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,
equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTIONValue:$
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
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
uu JOB SITE INFORMATION AND LOCATION Heating/cooling:
_t 2�� 5 ((Q� 1 Air conditioning 46.75
Job site address: \/r�i 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
hydmnic) 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.: 30Other: 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
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:Apex Air LLC Other:
MECHANICAL PERMIT FEES*
Address:18004 NE 72nd Ave
Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Phone:(360)342-8109 Plan review(25%of permit fee)
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_040!13.doc 440-4617T(11/02/COM/WEB)
Electrical Permit Applicata l /ED FOR OFFICE USE ONLY
City of Tigard Received
Date/By: permit�X`1 "\oV\"1
111/ - IUL
..'II 13125 SW Halt Blvd.,Tigard,OR 97223 D D 9) J 9 01 (4 Plan Review
• Phone: 503.718.2439 Fax: 503.598.19 ' Date/By: Related Permit#:
Inspection Line: 503.639.4175 -1 Ready Date/By: Juris: H See Page 2 for CgOF IGAR
Internet: www.tigard-or.gov Notified/Method: I Supplemental
Information- U� iNG DIVISION PLAN
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition ❑Other: 0 Service or feeder 400 amps or more 9 Building over three stories_
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONS'I'RUCTI-ON exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder 0 Other:
❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Job#: Job site address: 1,L ❑Addition of new motor load of system.
It 2tL \ �( j I00HP or more. ❑ A» E» l_2> l_3>
City/State/ZIP:Tigard,OR 97224 El Six or more residential units. occupancy.
0 Health-care facilities, ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Roshak Ridge ❑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. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision:Roshak Ridge Lot#: 30 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
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ 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
be APPLICANT 1 ❑ CONTACT PERSON Branch circuits-c new,alteration,or extension,per panel
A.Fee for branch circuits with I
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'!branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 Fax: :(360)693-4442 Each manufactured or modular
Email:permitsubmittals@polygonhomes.com
dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
,'"V1,- a.. ..; r s. ',,„,.e,_t ij .i ,,1,11'.-1`;',,', . _.-, ,_,.t.:. a Pump or irrigation circle 67.84 2
Business name:Portland Electric Sign or outline lighting 67.84 2
th 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(1 hr mitt) 78.18/hr
Inspections for which no fee is
CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lic.:.,...0a./.143,0.5, specifically listed(V2 hr min) 90.00/hr
F1 FCTI2ICA1 PERMIT FEES
QSuprv.Electrician signature,required: �x j;( 1/1...a.11.0..., Subtotal:
Print name: Alex Shalya I Date: 04/08/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: AILik, TOTAL PERMIT FEE:
* . This permit application expires If a permit is not obtained ctrthin ISO
Print name: I ISHCHUK,SERG Y Date: 04/08/2019 days after it has been accepted as complete.
I
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
•
4 „ ,
Plumbing Permit Application
Building Fixtures �°,,.. �-' FOR OFFICE USE ONLY
City of Tigard Received Permit No.: c �'
n 13125 SW Hall Blvd.,Tigard,OR 97223 h
PR '� Date/By: J� �i
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
1(.-P H.;
Date/By: Other Permit No.:
TI GA R D Inspection Line: 503.639.417CITY OF �` tote Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov 13t I%LD D VI°-3�"•Notified/Method: Supplemental Information
TYPE OF WORK FEE*SCHEDULE
®New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
NI 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler(-sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: I Lk 2.14.4 S�� I lock-Z-1A Pt 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.: 3 0 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
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:G&B Plumbing&Sons Inc WaterPIP �in 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: $72.50
CCB Lic.:184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Steve Fowler Date:04/08/2019 This permit application expires if a permit is not obtained within 180 days
-- -- - after It has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLM[J-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c A R o Building Permit Review — Residential
IN
Building Permit #: M�T?1L C�- co)AlQ
Site Address: Iy2„1-1L\ SW Itoci
Project Name: �jj, Posira�- Lot #: -30(New d g=su ivision name;Addition or Altera n=last name of owner)
Planning Review
Proposal: NeW Gj L
8—Verify address/suite# active in Accela. &In River Terrace: ❑ No )4.Yes,River Terrace Review Addendum
Site Plan Elements: 1$Erosion Control
copies of site plan on 8-1/2"x 11"or 11 x 17"paperetained trees with drip line and tree protection measures
rawn to scale(standard architect or engineer scale) *Footprint of new structure(including decks)and FFE
North arrow VJUtility locations&easements(required for new and additions)
bite address,project or subdivision name and lot number %sidewalk/driveway approach
kpplicant information(name and phone number) h[ .kocation of wells/septic systems
/Scot dimensions and building setback dimensions Ktreet tree size,type and location
Yquare footage of buildings to be demolished XStreet names
existing structures on site Xcorner elevations(2'contours if more than 4'differential)
Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? L 4/[ No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? L�l ,, s1No
Clean Water Services-Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified X No Applied For: ❑ Yes ❑ No,stop intake
Land Use Case#: S)13 zot S�-cc O(D 4 Zoning: — 2
At Required Setbacks: Front: g Rear: 3 Side: 3 Street Side: NA- Garage: 31
Building Height: Max. Height: IJ / ,Pt Actual Height: �3
Landscape Area: 2-0 ra..Lot Coverage Max: Cap
Entrance U Set ba k no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows 1\ . ' um 120/ of area of all street-facing facades
Garage N . arag; door is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
1'oor ext nds no mor- an 5'from wall and there is a covered porch extending beyond garage.
❑ ,.or ext ds no more . 5'fr•m wall and there is a 12 sq ft.window above garage on 2nd floor.
❑ Garage .oor wi th is ❑ 1''o ss ❑ 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered p rch ❑ ' . esse. ; trance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingl 0 La. Siding 0 Roof pitch 0 Gable,hip,or gambrel roof 0 Dormer
❑ Accent si ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
Visual Clearance ,C Urban Forestry Plan
'Sensitive Lands: ❑ Yes Z No Type:
R'Conditions met prior to issuance of building permit
Notes:
Approved By Planning: G Date:
Revisions (after Building Submittal only Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
Building Permit Submittal
Original Submittal Date: t;,kC-1
Site Plans: # j
Building Plans: # S
Building Permit#: 7'Enter building permit#above.
Workflow Routing: [2'Planning 2/Engineering g"-Permit Coordinator [Building
Workflow Sign-off: 2r 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.
R/Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: . 11%\..„\L\JA -� Date: c�I e \\C\
Engineering Review 7
.� Slope at building pad: ` C9
,12"Conditions "Met"prior to issuance of building permit
2r Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 21"No
Assess Water Quantity Fee in-lieu: ❑ Yes -Er No
LIDA Facility on lot: ❑ Yes No
,2 Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
fd' Approved by Engineering: 4t1 /CA Date: `J /.7
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
D 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:
LISDC Fees Entered: Wash Co Trans Dev Tax: pYes ❑ N/A
Tigard Trans SDC: Y Y ❑ N/A
Parks SDC: es ❑
LIDA ❑ Yes ����
OK to Issue Permit
l
Approved by Permit Coordinator: /friDater /9"
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
t
City of Tigard
RI
1,1 COMMUNITY DEVELOPMENT DEPARTMENT
T I G ARD River Terrace Building Permit Review Addendum
Building Permit #: M' 7" ck- )A kit
Site Address: 1424'4 cvJ I lecliyx k,e✓
Project Name: %ILIA°1 ) a Q9Skta k R e Lot #: ' 0
(New dwe g=subdivision name;Addition or Alteration= t name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.070.I).
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.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 ft. deep Gabled dormer
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
❑ El El ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: '1.3°10
3. Entrances:At least one entrance must meet both of the following standards:
x Max. 8 ft. setback from longest street- facing wall '�1 Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: X Yes ❑ No
If yes,all the following apply: 1 25 sq.ft.min.
One street facing entry y 12 ft.max.roof above floor of porch
a 5 ft. depth min. Z30%min.porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing façades:
2jCovered porch min. 5 ft.wide x 5 ft. deep .T Recessed entry area min. 5 ft.wide x 2 ft. deep
X Wall offset min. 16 inches ❑ Dormer min.4 ft.wide
X Roof eave min. 12 inch projection El Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood X Gable,hip or gambrel roof design
El 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 El 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 façade
5. Garages and Carports:May face the front or side lot line on a corner lot. �f
( �^����
Setbacks: A
o c •set front or side lot line,than longest street-facing wall. ❑ Yes ElNo. If No (Check one):
11 41,:y t up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
II ay x en 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) '/�� (
❑ 1 - t- Ede garage door '"�"t�I D�" f� ❑ 40%max. of street facade
❑ 50 A axl of street facade with 7 detailed design elements
Notes:
Approved By Planning: ,`, Date: 512.8 119
1:\Building\Forms\BldgPermitRvw_RES_RT_12141 7.docx
Electrical Permit Applicatio i: I" t' . i p FOR OFFICE USE ONLY
City of Tigard ReceiDate/B a, ( Permit ii \ 'J VAC—(M' U
III
'1 13125 SW Hall Blvd.,Tigard,OR 97223 I 01 1. 8 10 19 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 i ! f t, • Ready Date/By: Juris: 0See Page 2 for
TIGARD Internet: www.tigard-or.gov ,t 3 ,. , ,t Notified/Method: Supplemental Information
3 a ,
TYPE OF WORK - f ,. , PLAN REVIEW ,,,"` .
®New construction 0 Addition/alteration/replacement q A. Please check all that apply(submit 2 sets of plans w/items checked):
'a+F `^C\❑Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other: , " ^c 1 ))) where the available fault current
0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION 1 ,--"'- exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling 0 CommerciaUindustrial 0 Accessory 1 ding 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
' 4U( Sw I(d ---f ❑100Addition of new motor load of system.
Job#: I Job site address: tooHP or more. ❑"A","E","l-z'•,"t-3^,
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I 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 - I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: 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
(with above sq.ft.)
1 r�� v- bn t�(15'C�0 6 _002,„, Limited ever
Ugy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable
® PROPERTY OWNER 0 TENANT Servic es or feedersinstallation,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
Temporary services or feeders installation,alteration,and/or
Email: 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
El APPLICANT ❑ CONTACT PERSON Branch circuits-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
seAddress:703 BroadwaySt Suite 510 branche it feederitfee,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 67.84 2
dwelliEmail:permitsubmittals@polygonhomes.com Reconnectne, onlye and/or feeder
67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Alameda Electric ----Sign or outline lighting— -61.84 2
Signal circuit(s)or limited-energy 0 See Page 2 2
Address:3415 NE 44th panel,alteration,or extension.
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 90.00/hr
CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: 4871/S, 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):
/.s - State surcharge(12%of permit fee):
Authorized signature: 1� -..e'''/ TOTAL PERMIT FEE:r 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.
I:\Building1Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB