Permit CITY OF TIGARD MASTER PERMIT
712 COMMUNITY DEVELOPMENT Permit#: MST2019-00197
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/27/2019
Parcel: 2S107AA04400
Jurisdiction: Tigard
Site address: 14117 SW RIVER TERRACE BLVD
Subdivision: ROSHAK RIDGE Lot: 44
Project: Polygon at Roshak Ridge, Lot 44
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 1119 sf Basement: 140 sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1062 sf Garage: 422 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2321 sf Value: $295,094.05 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 1 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!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 2321
Owner: Contractor:
POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 Geo Tech Report Required
Prior To Pour
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $34,700.18
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or( 1.800.332.2344. (�
Issued By: \ c�J.k Permittee Signature: ���
\ `--��.•Pt�C 1
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.
. , ,.
\\___\
Application
L 0 \ \
Building Permit
Residential RECEIVED FOR OFFICE USE ONLY
Cityof Tigard Received -
111 a 131SW Hall Blvd.,Tigard,OR 97223 FEB 0 6 2019 Plan Review permit�o `� �
Phone: 503.718.2439 Fax: 503.598.1960 Dan R s�� � Other Perm w� AG_00 CD
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD DateReadyBy: Iuris: H SeePage2for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
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. (�5
Valuation: $ 2q r 00)(401-and 2-family dwelling ❑Commercial/industrial
14❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms: $
JOB SITE INFORMATION AND LOCATION Total number of floors: 5 D-'7 Lf
Job site address: q 1 \' W1A) Y2-1,\g}C- y'Y'Cu.. . j`uOt New dwelling area: 2_2)94 square feet I b 6 Z
City/State/ZIP: 1\O'V V, Ole- (71'--1 'r/'
'IL ' 1�L Garage/carport area: 2-9 square feet t t t 9
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: square feet 146
{6
Cross street/directions to job site: Deck area: square feet l
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Polygon at Roshak Ridge Lot no.: LiLl 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.
^A ) c Valuation: $
K/V v c? Existing building area: square feet
New building area: square feet
el PROPERTY OWNER 0 TENANT Number of stories:
Name:Polygon WLH LLC Type of construction:
Address:703 Broadway Street Ste 510 Occupancy groups:
•
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360)695-7700 Fax:(360)693.4442 New:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer 1nfee schedule)
Business name:Polygon WLH LLC
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:
Amount received:
Phone:(360)695-7700 Fax::(360)693-4442
PHOTOVOLTAIC SOLAR"PANEL SYSTEM FEES*
E-mail:permitsubmittals@polygonhomes.com
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
CCB lic.:207247
Total fee due upon application: $201.60
Authorized si This permit application expires if a permit is not obtained
within 180 days after it has been as complete.
1�/1� *Fee methodology set-byafter Tit has a acceptedh,scom _
Print name:Amanda avin Date: �l/'� Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46131(11/02/COM/WEB)
r .
•
Mechanical Permit Applications C`
FOR OFFICE USE ONLY
Received
- City of Tigard Permit No.IN g 2 Date/BY: 1 _(:::(....)M_
" 13125 SW Hall Blvd.,Tigard,OR 97223 A P�R h 2019 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY OF IGAR j `Date Ready/By: J 0 See Page 2 for
Internet: www.tigard-or.gov BUILDINGDIVISI tified/Method: Supplemental Information
TYPE OF WORK i 6 �! 9 NCOMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
1;41-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 Heating/cooling:
111 Air conditioning 46.75
-1
Job site address: Slip A . --\--41-%0 �j ac,e ,\V t) 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.: 1414 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
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
WallWauspeeded/unit hater
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 721'd Ave Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee)
CCB lic.:203034 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
-_ days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Tim Hay Date:04/08/2019
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
,
Electrical Permit ApplicationEGFIVED,FIVEFOR OFFICE USE ONLY
City of Tigard s t Received
Date/B
13125 SW Hall Blvd.,Tigard,OR 97223 Plan R : ��
Plan Review
. . Phone: 503.718.2439 Fax: 503 598i:1491ty OF TIGARDDate/B : Related Permit 4:
Inspection Line: 503.639.4175t� t�, y Ready Date/By: Juris: ® See Page 2 for
'ill.i�"-Li Internet: www.tigard-or.gov ±3til�, °' i DIVISION Notified/lvlethod:
Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction . ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑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 ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family El Master builder ❑Other: ❑Fireum .
p p ❑Installation of 150 KVA or
JOB SITE IN1 OR1KA. TIOI11 Alin LOCATION ❑Emergency system. larger separately derived
Job#: Job site address: 0 Addition of new motor load of system.
11!11 �.�`-�0eQ —� 3�VO100HP or more. ❑"A" "E" "I-2> "1-3"
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Roshak Ridge 0 Hazardous locations. ❑Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCFIEDULE
Description ,..I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision:Roshak Ridge Lot#: ( 4 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
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.)
131, TENANT Renewable Energy ❑ See 2
PROPERTY OWNER Services or feeders installation,alteration,Page 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 x Cl CON1ACT PERSON Branch circuits-e 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:permitsubmittals@polygonhomes.com Reconnect only 67.84 2
! ',..,--7.:_,-,;.:!:. R Ay z 0 .._01.f,l. ^v.
pump or ittigetten 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 ❑ See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Vancouver,WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 lir min) 66.25/hr
Phone:(360)314-4945 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: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.:.A 23'4310S specifically listed(Az hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: cit,,, � Subtotal:
Print name: Alex Shalya I Date: 04/08/2019 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: A f / Lt.dift�ll.,i�. TOTAL PERMIT FEE:
_ -_ _4 _ This permit ezplrestfa permits no/obtained within 180
Print name: MISHCHUK,SERC 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
Plumbing PermitApplicat' ( '
4,7
Building Fixtures FOR OFFICE USE ONLY
APR Z019
City of Tigard R ! jew
. PermitNo.v 13125 SW Hall Blvd.,Tigard,OR 97 1 '` ,�
Phone: 503.718.2439 Fax: 503.54 '1 6 Other Permit No.:
Inspection Line: 503.639.4175 ' e i�° G D I\l,-,,") Date/By:
T I G A R D Date Ready/By: Juris: H 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
54 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:
i4(Al. 1 t OCR_ ^� r,Ot e e \ v Catch basin or area drain 18.76
Job site address: 1
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.: 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.: LH 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
0 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:Pa ver,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
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)
,tState 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 timrbeeaaeeeptedaseompleter
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
III COMMUNITY DEVELOPMENT DEPARTMENT
C
TIGARD Building Permit Review — Residential
Building Permit #: MST -c Ac _GG\C1-4
Site Address: /2N/9- _SP/v -Throa give;
Project Name: fo(gx-y1 #6/ Lot #:
(Neug=subdivision name;Addition or Alteration= name of owner)
Planning Review
Proposal: A,261) &)P
/
Fre Verify address/suite#active in Accela. 0 In River Terra e: ❑ No dYes,River Terrace Review Addendum
Siy Plan Elements: 'LA r• ion Control
icopies of site plan on 8-1/2"x 11"or 11 x 17"paper 1`-a '' ained trees with drip line and tree protection measures
awn to scale(standard architect or engineer scale) �1 otprint of new structure(including decks)and FFErth arrow ty locations&easements(required for new and additions)
Ve address,project or subdivision name and lot number Sid alk/driveway approach
111/11 iplicant information(name and phone number) I A,ation of wells/septic systems
Y Lo dimensions and building setback dimensions rf-et tree size,type and location
IPA ‘ re footage of buildings to be demolished O eet names
■'-' -sting structures on site Corner elevations(2'contours if more than 4'diff ntial)
7 .t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replace ? YJ es ❑ o
imp•rvious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown. Yes CL/JNo
V' lean Water Services—Service Provider Lett of platted prior to 9/10/1995):
�equired: ❑ Y ,applicant was notified No Received: ❑ Yes ❑ No
ublic Facili . s Improvement(PFI)Permit:
Vquired: Yes,applicant was notified ❑ No Applie For: YJ Yes ■ No stop intake
nd Use Case#: t42 . Ai' req ' 1� Zoning le.-/2_ ��
Front: —Garage:Setbacks: _ - Rear: Side: Street Side: A.G. Garage:
Z(F:.. ding Height: Max.Height: ,r _ Actual Height:
rA Landscape Area: 2O % M Lot Coverage Max: g 0 0/0
Entrance iii -t back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees s
Windows ❑ Minim %of area of all street-facing facades
Garage ❑ Garage door is be"ii •dest street-facing wall 0 ❑ Yes No one of the following is met:
❑ Door extends no more . :• 5'from wall and ere is a co porch extending beyond garage.
❑ Door extends no more than 5'fro .11 and is a 12 sq ft.window above garage on 2°a floor.
❑ Garage door width is ❑ 12'or less_ i 50%o - of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch • ' -cessed entrance ❑ Wall o ❑ 1'Roof cave ❑ Roof offset
❑ Fire s .•_ - ❑ Lap Siding ❑ Roof pitch ❑ Gab e, :- or gambrel roof ❑ Dormer
r. ccent siding Window trim ❑ Window recess ❑ Wins o•• •'ection LIBalcony
•1,t isual Clearance d rban Forestry Plan
, _
Sensitive Lands: r. Yes ❑ No Type: iO''1,C41�i.j1 fl-- ..
Conditions met prior to issuance of building permit
No s•
Approved By Planning: I i ' Date:4_44_
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES 022819.docx
4
Building Permit Submittal
Original Submittal Date: aLL I tq
Site Plans: #
Building Plans: #
Building Permit#: ElEnter building permit#above.
Workflow Routing. C'Planning Engineering Permit Coordinator Building
Workflow Sign-off: 12/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.
Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: .4i...— Date: F P \Qi
ANOWNIIMINZIONESNIMINIA
Engineering Review
)"Slope at building pad: 5-0 7o
Aff Conditions "Met"prior to issuance of building permit
.1 Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes fd' No
Assess Water Quantity Fee in-lieu: ❑ Yes ti No
`
LIDA Facility on lot: ❑ Yes "LJ No
.2"Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes: /
ZlApproved by Engineering: 4'i (1 i Date: s keli,
Revisions (after Building Submittal only) Reviewer 'f3oate
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:
SiSDC Fees Entered: Wash Co Trans Dev Tax: 1r/Yes ❑ N/A
Tigard Trans SDC: [ ' s ❑ N/A
Parks SDC: '+��"Yes ❑ ��/A
LIDA ❑ Yes 7 N/A
, ---
OK to Issue Permit Or]
QApproved by Permit Coordinator: ate: 4 f-1
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
l .
City of Tigard
IR- k COMMUNITY DEVELOPMENT DEPARTMENT
a
River Terrace Building Permit Review Addendum
Building Permit #: -c- kq- (�C is
Site Address: /1/11-9-— ) , /'�� r�^�ee ,619
Project Name: p7/ ,4 fid . Lot #: 2-P/(Newt 4f g=subdivision name;Addition or Alteration ast name of owner)
Planning Review of River Terrace Plan Distr;et Design(((S///tandards (18.640.070.I.):
Is the project subject to the plan district design standards? V 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 deep ft.deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide Gabled dormer
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12')/0 of each street facing facade must include windows or entrance doors.
Percentage Shown: e/e
3. E ances:At least one entrance must meet both of the follo • g standards:
Max. 8 ft. setback from longe street- facing wall Parallel to street,angle no more than 45° from street,
or ope. onto porch
Entrance opens to a porch: Yes ❑ No
If s,all the following apply: 1, 25 sq.ft. min.
ne street facing entry Tr2 ft.max. roof above floor of porch
5 ft. depth min. Ila 30%min. porch roof coverage
4. etailed 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 0 Recessed entry area min. 5 ft.wide x 2 ft. deep
El all offset min. 16 inches 0 Dormer min. 4 ft.wide
/Roof eave min. 12 inch projection 0 ' .of offset min. of 2 ft.
CI Roof shingles either tile or wood I. able,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. rizontal lap siding min. 3-7 inches wide
O Accent siding min. 40%of street façade la Wuidow trim min. 2 1/2'wide by 5/8" deep
❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35%or less of street facade
5. . . and Carports:May face the front or side lot ' a c er lot.
Setbacks:
No closer to front or side lot ft ..n longest street-facin w . Yes ■ ' .. If No (Check one):
❑ May extend up to 5 ft.if there is a covere. ,.t .orch and r. .t e does not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is part of . -.,o- :+ building and there is a window at the second story
above the garage that faces the street with . - .i . area of 12 sq.ft.
Width: (Check one)
❑ 12-foot-...- :. age door ❑ 40%max. of street facade
1'/o max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: - _ / Date: _-- If MEI -
I:\Building\Forms\B1dgPermitRvw_RES_RT_121417.docx
Electrical Permit Application--;' - i , Y 4 ,, FOR OFFICE USE ONLY
City of Tigard i Date/BReceivea �1 cy I,`'1 S Permit#:M\1
,11 'a 13125 SW Hall Blvd.,Tigard,OR 97223 1 li i_ .1 to 2 t t"I Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
TIGAKD Inspection Line: 503.639.4175 ' ' ' 4 Ready Date/By: Juris: el See Page 2 for
ro Internet: www.tigard-or.gov i ' ,, e . Notified/Method: Supplemental information
TYPE OF WORK u, y* "'PLAN REVIEW,
New construction 0 Addition/alteration/replacement „,,,,:i-,,,,.,_,:„.,-;,,, Please check all that apply(submit 2 sets of plans w/items checked):
kn> 0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION a'�C �.,:�^`”"-- exceeds 10,000 amps at 150 volts or 0 Floating buildings.
1-and 2-familydwellingCommercial/industrial "'f less to ground,or exceeds 14,000 0 Commercial-use agricultural
® 0 0 Accessory building
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB S1'I'J ;INFORMATION AND-LOCATION 0 Emergency system. larger separately derived
Job#: I Job site 1 1 address'. (�`1, ,.,,,(2.. d/-vt.y ❑Addition100HPor of new motor load of more. system.
❑
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy.
0 Health-care facilities. ❑'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 I Lot#: 41.\- 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 I
DESCRIPTION OF WORK Limited energy,residential
6Y QYl 'J7 L� pots
-1 (with above sq.ft.) 75.00 2
~��� Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
e PROPERTY OWNER 0 TENANT, Renewable Energy ❑ Sg2
Services or feeders Installation,alteration,
eePaande/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
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 I
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 El 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,
each branch circuit 7.42 2
Contact name:Nichole Thorpe B.Fee for branch circuits without
sAddress:703 BroadwaySt Suite 510 brancheaice or feeder fee,first 56.18 2
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 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: adElecIrle _ - ------ .--Signnroutlineitglldng 117`8* ..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(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
hr min)
CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: 487/S specifically listed(''A
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\Pemits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(1 MI5/COM/WEB