Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT
114
Permit#: MST2019-00193
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/19/2019
TIGARD Parcel: 2S107AA03100
Jurisdiction: Tigard
Site address: 14230 SW 169TH AVE
Subdivision: ROSHAK RIDGE Lot: 31
Project: Polygon at Roshak Ridge, Lot 31
Project Description: New SF,
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 625 sf Basement: sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1017 sf Garage: 418 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 1642 sf Value: $214,475.30 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
0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 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!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 1642
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: $33,095.08
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 'N.__ !�'\ Permittee Signature:
F(S7k3Lk �CS'--
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.
L 0-\----- e---).. \
Building Permit Application
Residential REC,E1VED FOR OFFICE USE ONLY
City of Tigard FEB 0 6 2019 ReceivedDateB : D. ' S. Permit No..A' \et_ C
It v 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review y1
Phone: 5017182439 Fax: 503.598.1960t, DateB : 5 �� .4* Other Perm, 7J( `�-�U It
Inspection Line: 503.639.4175 ' t OF TIGARD Date Ready/By: Tuns: H See Page 2 for
TIGARD SU DIVISION Notified/Method: SupplementalInformation
Internet: www.tigard-or.gov
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ a l -7c -
Number of bedrooms:
1k
111 Accessory building ❑Multi-familY
❑Master builder 0 Other: Number of bathrooms: 9)
JOB SITE INFORMATION AND LOCATION Total number of floors: 7... Zp(0 0
Job site address: t -A ) JD
* ) 'W /1 New dwelling area: (tow)._ square feet ` O t
City/State/ZIP: ------\-A(/�0tl�//� 11� (Tl Garage/carport area: q I v square feet / _2,,,s—
Suite/bldg./apt.
s
Suite/bldg./apt.no.: Iv\ v Project name:Polygon at Roshak Ridge Covered porch area: ic;co square feet Li
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.: , 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.
I\ j t 1 Valuation: $
'CJ�� Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Polygon WLH LLC Type of construction:
Address:703 Broadway Street Ste 510 Occupancy groups:
•
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360)695-7700 Fax:(360)693-4442 New:
APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH LLC (Please refer tojeeschedule)
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
Amount received:
Phone:(360)695-7700 Fax::(360)693-4442
E-mail:permitsubmittals@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic 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 A Fax:(360)693-4442
State surcharge(12%of permit fee): $21.60
CCB lie.:2072 7 Total fee due upon application: $201.60
-------
Authorized signature: , � This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Amand. Gavin Date: ` I a(1 f 11
*Fee methodology set by Tri-County Building Industry
f `I Service Board
I:\Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
g Date/By: Permit No.:" "�e�{ot_ .' q�
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ��V, `
, I` • Phone: 503.718.2439 Fax: 503.598.1960Other Permit:
Date/By:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE*SCHEDULE—USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
zl.1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
j Multi-family 0 Master builder 0 Other: Description Qty. _ Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
� Air conditioning 1 46.75
Job site address: l Lt�Q S(&) t .pQ-t\.. I J, r 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.: 31 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
t\Y n�5T UM--co tQ.3 fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
.4 PROPERTY OWNER 0 TENANT Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
equipment 33.39
Address:703 Broadway St.,Ste.510 Clothes dryer exhaust 33.39
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:Polygon WLH,LLC Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Range
E-mail:permitsubmittals@polygonhomes.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: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:...j— * Fee methodology set by Tri-County Building Industry Service Board
Print name:Tim Hay Date:04/08/2019
tPBuilding\Permits'MEC_PermitApp 040113.doc 440-4617T(11/02/COM/WEB)
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Receiveg PlanDate/B Review IIE__
. .'• 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : IMEDIMall
Related Permit#.
Inspection Line: 503.639.4175 Ready Date/By: kris: El See Page 2 for
111-i,4N:Lr Internet: www.tigard-or.gov Notified/Method; Supplemental Information
. TYPE OF WORK PLAN REVIEW
Z New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building �i
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 ❑Emergency system. larger separately derived
Job#: Job site address: 11{'2,�0 ) t l0 ❑Addition of new motor load of system. 2
_`�"�, 100HP or more. ❑"A","E" 'I_••,"1-3", i
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Roshak Ridge 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision:Roshak Ridge Lot#: 31 Includes attached garage.
1,000 sq.ft.or less i 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion Z 33.92 1
DESCRIPTION OF WORK
Limited energy,residential
s-r +z�(-j`9 ,—bt eV5 (with above sq.ft.) 75.00 2
N
t Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
r ❑ TENANT Renewable Energy 0 See Page 2
►+ PROPERTY OWNER 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
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 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 CONTACT PERSON Branch circuits-c 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
service or feeder fee,first
Address:703 Broadway St,Ste.510 branch circuit 56.18 2
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'nodular 67.84 2
Email:permitsubmittals@polygonhomes.com dwelling,service and/or feeder
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 0 See Page 2 2
panel,alteration,or extension. b
City/State/ZIP:Vancouver,WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(I 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 min) 78.18/hr
5 Inspections for which no fee is 90.00/hr
CCB Lie.: 194066 Electrical Lie.: C760 Suprv.Lic.;, 'C310specifically listed(t/hr min)
� CA ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: l�t� tx �, Subtotal:
Print name: Alex Sbalya Date: 04/08/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: AMie,,,a_kc izt,k, TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: MISHCHIJK.,SERC Y Date: 04/08/2019 days after it has been accepted as complete.
• Number of inspections allowed per permit.
❑\Building\Permits\ELC PermitApp E.R_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB ''I
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received Permit No. /
,
_
II
q 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: k\'�-C'X.)\Ci-( kc1'�
. Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: tura: Ed 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 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
tgr 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building Multi-family SFR(3)bath 0 500.32
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:
`LA 23O 6,W `t.Dtk'Th Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: l 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.: 31 Fixture or item:
Tax map/parcel no.: Backflow preventer l 31.27
DESCRIPTION OF WORK Backwater valve ( 12.51
_Clothes washer l 25.02
m'' �tq.-'OO VS Dishwasher l 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER 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 1 25.02
City/State/ZIP:Vancouver,WA 98660 Hose bib 2 25.02
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
Cs 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/tavatory 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 '3 25.02
Water heater 37.52
Business name:G&B Plumbing&Sons Inc Water piping/DWV 56.29
Address:P.O.Box 92 Other: _ 25.02
City/State/ZIP:St.Paul,OR 97137 Subtotal
Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: $72.50 ,
CCB Lic.: 184372 Plumbing Lic.no.:ph634 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: ... TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days
Print name:Steve Fowler Date:04/08/2019 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
i:+Building`Permits\PLMU-PermitApp.doc 10/01,09 440-46l6T(10i02CONVWEB)
City of Tigard
■ a COMMUNITY DEVELOPMENT DEPARTMENT
ill
T 1 c A R D Building Permit Review — Residential
IN;
Building Permit #: SrLq_ \C,e>
Site Address: 1-2,3O SW' Wit-'-'
Project Name: 'Polrg,!2 al- I k RA 4- Lot #: 31
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review rr
Pro sal: 'J41.J J? J Pia,. 'M z.
Verify address/suite#active in Accela. [t In River Terra e: ❑ No Yes,River Terrace Review Addendum
Sit9lan Elements: Ltd'Er ion Control
Q'3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper rained trees with drip line and tree protection measures
[4awn to scale(standard architect or engineer scale) �tprint of new structure(including decks)and FFE
orth arrow .. locations&easements(required for new and additions)
EKte address,project or subdivision name and lot number C! idewalk/driveway approach
4pplicant information(name and phone number) rA1 . ation of wells/septic systems
�d
t dimensions and building setback dimensions
;pet tree size,type and location
lam°'° are footage of buildings to be demolished ELet names
sting structures on site L torner elevations(2'contours if more than 4'differe al)
of area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? Wes ❑No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑YNo
Clean Water Services—Service Provider Letter of platted prior to 9/10/1995): L. 4 'j1
�R quired: 1=I Yes,applicant was notified No Received: ❑ Yes ❑ No '-'� 1
VPublic Facilities provement(PFI) Permit: 114-es
_,_,� 10,4 A
_ Required: applicant was notified CI No Applie For: Ltd' Yes El No,stop intake
lIX nd Use Case#: r r)f 2 j S—fi(-)44.-- _ [ " Zoning: .-i 1 CeO'
2 'equired Setbacks: Front: 12- Rear: Side: 3 Street Side: A' Garage: 3
J ding Height: Max. Height: Actual Height: z_ ��rch
Landscape Area: 20 % LU'Lot Coverage Max: 0 0/0
Iri , ntrance ❑ Set back no more than 8'from street-facing wall El Parallel to street or offset 45 degrees or less
J Windows ❑ Minimum 12%of area of all street-facing facades
Garage ❑ Garage door is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
Riv4r. ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
'( ❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
15 t ❑ Garage door width is ❑ 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ��91 Window trim ❑ Window recess ❑ Window projection ❑ Balcony
E Visual Clearance L'1 Urban Forestry an
Sensitive Lands: ❑ Yes PI
No Type:
Con ons met prior to issuance of b ding rmit
otes: 11-11)",s TI 14 fit- erne-- y (VIAi j f ztn ' 1 ✓ nLc-
❑ Approved By Planning: 1 Date: S/21 l 9
Revisions (after Building Submittal on Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\Building\Forms\BldgPernutRvw_RES_022819.docx
Building Permit Submittal
Original Submittal Date: I
Site Plans: #
Building Plans: #
Building Permit#: 2/Enter s [building permit#above. g/
Workflow Routing: Planning Engineering [3/Permit Coordinator ( Building
Workflow Sign-off: [ " ign-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.
IL/Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: \___\2L. Date:
Engineering Review
,Slope at building pad: c7
.- 7°
2 Conditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes .T No
Assess Water Quantity Fee in-lieu: ❑ Yes in No
LIDA Facility on lot: El Yes .0''No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
la'Approved by Engineering: At,l 1G it-- w i Date:
Revisions (after Building Submittal only) Reviewer 44 ate
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:
P6C Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: GO4es ❑ N A
LIDA ❑ YesA
OK to Issue Permit C,�/
Approved by Permit Coordinator: /0/Date: ./��0 i
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
City of Tigard
114r COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #: cc-C \G-. ()11vCt)
Site Address: 1'1'60 Su/ k.6(11. kg-
Project Name: F,(ygiA. al' tc L4 r-4 Lot #: 31
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Distfict Design Standards (18.640.070.I.):
Is the project subject to the plan district design standards? TrYes ❑ No
1.0
Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional
ement 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
P CI CI X Cl
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: 2LS 7
3. E trances:At least one entrance must meet both of the folio g standards: O 'ho a c_f
M Max. 8 ft. s tback from lon est street- facin wall [ Parallel to street,angle no more than 45° from street,
gg or open onto porch
En : ce .ens to a porch: [ Yes ❑ No
If y, , the following apply: L ' 5-sq.ft.min.
Gne str--t facing entry Lf_l"r2 ft.max. roof above floor of porch
A [5 ft. depth min. cO%min.porch roof coverage
4.Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
❑
_l vered porch min. 5 ft.wide x 5 ft. deep 111 Recessed entry area min. 5 ft.wide x 2 ft. deep
LfLall offset min. 16 inches ❑ Dormer min. 4 ft.wide
I Roof eave min. 12 inch projection Illycoof offset min. of 2 ft.
❑ Roof shingles either tile or wood LJ Gable,hip or gambrel roof design
❑ : •of pitch oriented south min. 500 sq. ft. ❑yorizontal lap siding min. 3-7 inches wide
tY Accent siding min. 40%of street facade Ef Window trim min. 2'/2"wide by 5/8"deep
❑ Window recess min. 3 inches for all street facing ❑ B*window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access LldAttached garage is 35% or less of street facade
( - .-T. Garages and Carports:May face the front or side lot line on a corner lot.
l 0 Setbacks:
No closer to front or side lot line,than longest street-facing wall. CIYes CINo. If No (Check one):
/�
�` l l e7- ❑ May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
WI/_,.i P/ CIMay extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
1�% above the garage that faces the street with a min. area of 12 sq.ft.
,f Width: (Check one)
❑ 12-foot-wide garage door El 40%max. of street facade
O 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: C7 Date: 5/22
I:\Buildin\Forms\Bld PermitRvw_RES_RT_121417.docx
B B
Electrical Permit Applicatiol; -c I~ , t T . FOR OFFICE USE ONLY •
City of Tigard Received N /�l- '\Plan Review
Date/B : \. 1\Cc Perm": IL ,� V\"
14 n. Phone:13125 SW Hall Blvd.,Tigard,OR 97223 .10 i- 1. 2919
g Related Permit#:
Phone: 503.718.2439 Fax: 503.598.19,§0 Date/B
Inspection Line: 503.639.4175 ✓ 3 .. Ready Date/By: Juris: El See Page 2 for
TIGAKD : I *,. Notified/Method: Supplemental www.tigard-or.gov �a Information
TYPE OF WORK A "i a PLAN REVIEW"
I ®New construction 0 Addition/aiteration/replacemen ,:'' (�
Please check all that apply(submit 2 sets of plans w/items checked):
\(, �. `) 0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 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 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
❑Addition of new motor load of system.
Job#: I Job site address: t,k'5o 5(.1....) U(4-' H-1.70. looHP or more. ❑"A',"E","i-2","t-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑"Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Polygon At Roshak Ridge 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description - I Qty. l Each l Total I o-
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge 1 Lot#: 31 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1
a I DESCRIPTION OF WORK Limited energy,residential
75.00 2
Q (withtne ge smq.multi
v` 't' dLer•r CY\ 1 `ST 1b 1 tt—i0 k Ct )
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0
See Page 2
® PROPERTY OWNER
0 TENANT Services or feeders installation,alteration,and/or relocation
Name:William Lyon Homes,Inc. 200 amps or less 100.70" 2
Address:703 Broadway St Suite 510 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2
Phone:(360)695-7700 Fax:(360)693-4442 Over 1,000 amps or volts 552.26 2
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
0 APPLICANT 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,
each branch circuit 7.42 2
Contact name:Nichole Thorpe B.Fee for branch circuits without
sAddress:703 BroadwaySt Suite 510 branche it feederitfee,first 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Each add'I 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 Reconnect only and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
�usmess name:Alameda Electric Sign or outline lighting `" 57.84' —"---2—
Address:3415 NE 44th Signal circuit(s)or limited-energy 0 See Page 2 2
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.Lie.: 487 specifically listed CA hr min)
p � ' ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: Subtotal:
Print name: Kile Rood Date: 03/08/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
�� This permit application expires If a permit is not obtained within 180
Print name: Kile Rood Date: 03/08/2019 days after It has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\PermitslELC_PennitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB