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Permit CITY OF TIGARD MASTER PERMIT I', 111. 'n COMMUNITY DEVELOPMENT ''i Permit#: MST2019-00204 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 >k Date Issued: 07/01/2019 ftCatl `'> V Parcel: 2S107AA11200 Jurisdiction: Tigard Site address: 14232 SW GOLD COAST TER Subdivision: ROSHAK RIDGE Lot: 112 Project: Polygon at Roshak Ridge, Lot 112 Project Description: New SFA. 9/9/19: REPRINT to add fire sprinkler system. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 646 sf Basement: 101 sf Left: 0 Parking Spaces: 0 Height: 37 Bathrooms: 3 Second: 633 sf Garage: 547 sf Front: 8 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 1380 sf Value: $194,005.20 Rear: 5 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 Drains: 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Other Fixtures: 1 Drywell-Trench Drain: 0 Other Fixture Units: Fire sprinkler system 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'I 500 sf: 2 201-400 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 SFA VB R-3 1380 Owner: Contractor: POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) - - --TWEROADWMf-STITefttY— -? -5Uf 5`Tfi F €€srtC1 X41 -_ _# - VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 1 Hour Roof/Ceiling PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: Total Fees: $25,455.58 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 ora1.800.332.2344.—�� Issued By: Permittee Signature: t �� \1L Y- 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. , tar .), ki Plumbing Permit Application Building Fixtures RECEIVED FOR OFFICE USE ONLY City of Tigard Received n Date/By: P1 l�t Permit No: MST2019-00204 II w 13125 SW Hall Blvd.,Tigard,OR 97223AU G 2 9 2019 Plan Review d _ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: '/7/it2 r Other Permit No_ TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Read /B Y Y: Juns ® See Page 2 for Internet: www.tigard-or.gov L111 DING DIVISION Notified/Method t~A L Supple TYPE QK WOE 1 . ., -r-E* $CIIIgDULE Supplemental entallnformatwn �ti. .,.. _...,,, _.rte.. ®New construction 0 Demolition For special information use checklist Description Qty. Ea. Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 0 Accessory building 0 Multi-family SFR(3)bath 500.32 0 Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler(1380 sq.ft.) Page 2 JOB''SITE IN'F'ORMATION AND LOCATION Site utilities: Job site address:14232 SW Gold Coast Terrace Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: �g I Project name:Roshak at River Terrace Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision:Townhomes at Roshak 1 Lot no.: 112 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION•• OF WORTI Backwater valve 12.51 Clothes washer 25.02 MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 >;( PROPERTY OWNER • ' I 0 TENANT Expansion tank 12.51 Name:Polygon Northwest Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ►;4 APP ;ICANT C] CONTACT PERSON Interceptor/grease trap 25.02 Business name:Polygon Northwest Medical gas(value:$ ) Page 2 Contact name:Jennifer Lopez Primer 12.51 Roof drain(commercial) 12.51 Address:703 Broadway St.Suite 510 Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 ==-1- _--- ---__�s_- r C - -Pflone:(3611)6135:7/011` -ax: :(360)816-7817 Tub/shower/shower pan 12.51 E-mail:jennifer.lopez@polygonhomes.com Urinal 25.02 CONTRAC 'OR Water closet 25.02 Water heater 37.52 Business name:Alliance Plumbing,LLC Water piping/DWV 56.29 Address: 146 W Historic Columbia River Hwy Other: 25.02 City/State/ZIP:Troutdale,OR 97060 Subtotal Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50 CCB Lie.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee) /�� _ State surcharge(12%of permit fee) Authorized signature: F�--�-� TOTAL PERMIT FEE Print name:Gavin Thomes Date:8.27.2019 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. 1:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty Fee tea) Total Square Footage: Permit Fee: Footing drain 151 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Pernit:Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for ^, Fee(ea) Total each additional$100.00 or fraction thereof,to Other Inspections or Feesand including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: Other Fixtures: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type Fixture Type for Replace/ Plan Review for Plumbing Installations Work Performed: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Bath -Tub/Shower Please check all that apply. -Jacuzzi/Whirlpool ❑ Any new commercial building with water service 2"and Car Wash -Each Stall greater,except systems designed and stamped by licensed -Drive Thru engineer. Cuspidor/Water Aspirator ❑ New exterior plumbing site utilities for any complex structure Dishwasher -Commercial as defined in OAR918-780-0040. -Domestic ❑ Medical gas and vacuum systems for health care facilities. Drinking Fountain ® Any multipurpose fire sprinkler system. Eye Wash ❑ Any complex structure as defined in OAR918-780-0040. Floor Drain/sink -2" _ _Submit a sets of plans with any of the above. 4,, Car Wash Drain Isometric or Riser Diagram Garbage -Domestic-non-food El or riser diagram is required for new buildings Disposal -Domestic-food related -Commercial-food related that meet the qualifications above. -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Comments regarding fixture work: Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter Washer-Clothes *Note: If the fixture work under this permit results in an Water Extractor Water Closet-Toilet increase of sewer EDUs,a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the https://allianceplumbing-my.sharepoint.com/personal/gavin_alliancep1uml2ng_net/Documents/Documents/Fire Sprinklers/RT/PLMF PermitApp (3).doc CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT III Permit#: MST2019-00204 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/01/2019 TIGARD 13125 2S107AA11200 Jurisdiction: Tigard Site address: 14232 SW GOLD COAST TER Subdivision: ROSHAK RIDGE Lot: 112 Project: Polygon at Roshak Ridge, Lot 112 Project Description: New SFA. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 646 sf Basement: 101 sf Left: 0 Parking Spaces: 0 Height: 37 Bathrooms: 3 Second: 633 sf Garage: 547 sf Front: 8 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 1380 sf Value: $194,005.20 Rear: 5 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 Drains: 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 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: 2 201-400 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 SFA VB R-3 1380 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 1 Hour Roof/Ceiling PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: Total Fees: $25,274.05 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: \.• Permittee Signature: .----77)—Vit:-..L,-, t'., T -\f+. } '-LLx\\ 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 t�(�, ��_-U.\-- \ \ ;.-- Residential 1°`,�; l J` FOR OFFICE USE ONLY City of Tigard Received Date/By Permit No. 114 13125 SW Hall Blvd.,Tigard,OR 97223 -EB 0 7 20 1y y ( � �� TI�q -C� Plan ReviewI - p� Phone: 503.718.2439 Fax 503.598.1960 DateBv: l.� �1 Other Perm`--1q_0`Ltti TIGARD Inspection Line 503.639.4175 ;I-fl/OF. r §'"( Supplemental Date Ready/By: Juni El Internet: www.tigard-or.gov 6 See Page for I.11l �}��If' F Notified/Method: 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. ® 1-and 2-family dwellingValuation: $ ` \�I i�1� y DCommercial/industrial V D Accessory building ❑Multi-family Number of bedrooms: Z 1=1Master builder 0 Other: Number of bathrooms: JOB SILL INFORMATION AND LOCATION Total number of floors: 11C7 Job site address: I. I� //1(� fifl i/h/// /)c New dwelling area: I square feet�33 City/State/ZIP:Tigard,OR 97224 t 1 U 1 ) It V V (�l l Garage/carport area:51 square feet wit, Suite/bldg./apt.no.: U Project name:Polygon at Roshak Ridge Covered porch area square feet l Cross street/directions to job site: Deck area: �� Z square feet tner Ostr cTure area: -t square feet REQUIRED DATA:COIVIMERCL4L-USE CHECKLIST Subdivision:Polygon at Roshak Ridge Lot no.: 1 2 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 (7 a DESCRIPTION OF WORK work indicated on this application. New SEXValuation: $ } Existing building area: square feet J New building area: square feet � 0 ® PROPERTY OWNER 0 TENANT Number of stories: �' Name:Polygon WLH LLC Type of construction: j) Address:703 Broadway Street Ste 510 Occupancy groups: City/State/ZIP:Vancouver,WA 98660 Existing: Phone:(360)695-7700 Fax:(360)693-4442 � APPLICANT New: P-- . ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name:Polygon WLH LLC (Please' fee name:Amanda Gavin Structural plan review fee(or deposit): Address:703 Broadway St.Ste 510 FLS plan review fee(if applicable): City/State/ZIP:Vancouver WA 98660 Total fees due upon application: Phone:(360)695-7700 Fax: :(360)693-4442 Amount received: E-mail:permitsubmittals(a�polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of 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 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60 CCB lie.:207247 Total fee due upon application: $201.60 Authorized signature This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Ama a Gavin Date: 1 *Fee methodology set by Tri-County Building Industry �/ („0/ Service Board. I:ABuilding\Permits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB) if Mechanical Permit Applicat' g A � M #V ` _ "' Received _. City of Tigard PermitNo.im�—r\'mos_(y 4 '1 13125 SW Hall Blvd.,Tigard,OR 97223 y Plan Review ! 1 Phone: 503.718.2439 Fax: 503.598.1960 JUN 9 g DatelBy. Date/By: Other Permit: T i{i+alta Inspection Line: 503.639.4175 y gg Date Read/B : loris: El See Page 2 for — Internet: www.tigard-or.gov CITY OF rIGARLJ Notified/Method: Supplemental Information 'BUILDING DIVISION - TYPE.OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction E Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ • CATEGORY.OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*:. cg 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist i j Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOE SITE INFORMATION AND LOCATION Heating/cooling: — Air conditioning I 46.75 Job site address: t2, Z Ciatz (,oPrST 'rgeg, Furnace 100,000 BTU(ducts/vents) 46.75 City/State/LIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: U_ 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.: ' ( Other. 23.32 I, 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 1M,ST ZCt`nn 1+d O7.C)Lk 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 ® PROPERTY OWNER- ❑,TENANT Environmental exhaust and ventilation: Name:Polygon WLH,LLC Range hood/other kitchen equipment 3339 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 ❑ CONTACT;PERSON Other: 23.32 = Fuel piping: Business name:Polygon WLH,LLC $14.15 for first four;$4.03 for each additional Contact name:Tonja Morris Furnace,etc. Address:703 Broadway St.,Ste 510 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace Range E-mail:permitsubmittals@polygonhomes.com Barbecue CONTRACTOR . Clotheser(gas) (g ) Business name:Pro Heating&Cooling Other. MECHANICAL;PERMTT FEES*, Address: NW Alociek Dr,Ste.1104 Subtotal City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee) CCB lic.:209001 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 QAi�a 1udays after it has been accepted as complete. Authorized signature: .' Fee methodology set by Tri-County Building Industry Service Board Print name:Elia Duran Date:04/08/2019 Electrical Permit Applicat* FOR OFFICE USE ONLY City Of Tigard Received DateB : IIMMHAIMEME ° 13125 SW Hall Blvd.,Tigard,OR 9722 1 2019 Plan Review d - Phone: 503.718.2439 Fax: 503.598.15MN 9 Date/B : Related Permit 4: Inspection Line: 503.639.4175G.rF't ' Ready Date/By: H loris: See Page 2 for IIURLI.L) Internet: www.tiaard-or.00v CITY5 �_� �� Notified/Method: Supplemental Information NISION TYPE OF WORK PLAN REVIEW 0 New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition El Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. El 1-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: 1., 2 ()Lb ° jAc c �n re"' ❑Addition of new motor load of system. Z3 • 100HP or more. ❑•,A„ "E„ ..1_�•, .•1.3•, City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Hazardous locations. 0 Supply voltage for more than Suite/bldg./apt.#: ...9_ Project name:Roshak Ridge 0 600 volts nominal. ❑Service or feeder 600 amps or more. Cross street/directions to job site: FEE SCHEDULE Description I Qq'. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision:Roshak Ridge Lot#: t rz, Includes attached garage. 1,000 sq.ft.or less ` 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 1 33.92 1 DESCRIPTION OF WORK Limited energy,residential 'n,� dr —k-2vt q —bO7o,"11 (with above sq.ft.) 75.00 2 Y` _ Limited energy,multi-family 75.00 2 residential(with above sg ft.) Renewable Energy 0 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 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—new,alteration,or extension,per panel A.Fee for branch circuits with Business name:Polygon WLH,LLC above service or feeder fee, 7.42 each branch circuit Contact name:Jolene Smith B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address: 703 Broadway St,Ste.510 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 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. 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 min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 194066 Electrical Lic.: C760 Suprv. Lie.;,.. /P/}5 specifically listed(Ye hr min) Suprv.Electrician signature,required: nn ,A,- G ELECTRICAL PERMIT FEES t � fLQ�I�A� Subtotal: - Print name: Alex Shalya Date: 04/08/2019 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): I Authorized signature: ��1�4 .CJ/t-!�(-k. TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 I"-- Print name: MISHCINK,SERAY Date: 04/08/2019 days after it has been accepted as complete. * Number of inspections allowed per permit. 1:\Building\Permits'ELC_PermitApp ELR ERE.doe Rev 06/17/2015 440-46151111/05/COM/WEB Plumbing Permit ApplicatiO ,- .� �. BuildingFixtures ,, E `°'FOR OFFICE.USE,ONLY City of Tigard jtiN 1 9 2019 Received PermitNo.��-�� '_�` �"C '� 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: ��+l ' r Phone: 503.718.2439 Fax: 503.5 rw -'g Plan Review 995 a,� 971 1 Date/By: Other Permit No.: TIGARD D Inspection Line: 503.639.4175 1 � ( �� I )�€ Internet: www.tigard-or.gov ��_ Date Ready/By: Juris: El See Page 2 for Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑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 tg 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath _ 437.78 0 Accessory building Multi-family SFR(3)bath ' 500.32 0 Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: i tk,32.. C'.10 Lb C'_ppl Si 'rte 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.: '1‘.=w 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.: A 12 Fixture or item: Tax map/parcel no.: Backflow preventer ` 31.27 DESCRIPTION OF WORK Backwater valve r 12.51 � n S.� ,�,et- 002.04 Clothes washer , 25.02 11 ' Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER ____I 0 TENANT Expansion tank 12.51 Name:Polygon WLII,LLC Fixture/sewer cap 25.02 Address:703 Broadway St.,Ste 510 Floor drain/floor sink/hub 25.02 Garbage disposal r 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib Phone:(360)695-7700 Fax: _ 25.02 ( ) Ice maker t 12.51 ® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Polygon WLH,LLC Medical gas(value:$ ) Page 2 Contact name:Tonja Morris Primer 12.51 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 a... 12.51 E-mail:permitsubmittals@polygonhomes.com Urinal 25.02 CONTRACTOR Water closet '''525.02 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 Lie.: 184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee) '' State surcharge(12%of permit fee) Authorized signature: !►P4: -1vy.-�� " .� `� TOTAL PERMIT FEE Print name:Steve Fowler Date:04/08/2019 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building-Permits`PLMU-PermitApp.doc 10/0109 440-4616T(10/02.%CONLWEB) City of Tigard a COMMUNITY DEVELOPMENT DEPARTMENT , G. „4'.;;T Building Building Permit Review — Residential TIGAtD r i - - ® , per,; ru__ _ __ - _ z L�� .r{�� -, ,.t � f, ,, _ _ . .# . _ Building Permit #: N\ST —' ' ()C' ' Site Address: /212%4Q Qt) 620ke d nz Project Name: 0✓ , ,, •7) fAx -4_ Kl J Lot #: iii ew d -1, • =subdivision name;Addition or Alteration= name of owner) Planning Review eJ`' ' t•t 13 t Iq: Slit ?‘..P iN caftv.�rta '-eic...V- Pro I a sal: A•244) --QP �� &. Verify address/suite# active in Accela. VG In River Terra e: ❑ No ll/J Yes, River Ten-ace Review Addendum Sit Plan Elements: IJQEr•sion Control 3 opies of site plan on 8-1/2"x 11"or 11 x 17"paper '1 ained trees with drip line and tree protection measures X ! awn to scale(standard architect or engineer scale) Y.Aotprint of new structure(including decks) and FFE ✓ orth arrowity locations&easements (required for new and additions) ' Sie address,project or subdivision name and lot number VSid-walk/driveway approach 1 aplicant information(name and phone number) a1 r,+ •tion of wells/septic systems • .t dimensions and building setback dimensions 01 l'i eet tree size,type and location U ..uare footage of buildings to be demolished rE 4treet names it .. 'sting structures on site OCorner elevations(2'contours if more than 4'diffe tial) ✓ of area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replace ? Yes ❑ • impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown?1 Yes IP o lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): equired: ❑ Yes,applicant was notified VJ No Received: ❑ Yes ❑ No UTA Public Faciliti (Improvement(PFI) Permit: 'equired: [7 Yes,applicant was notified ❑ No Applie For: Yes ❑ No, top intake and Use Case#: �Gl• '�o1�= (, lld "coning. — __ Pb Setbacks: Front: Rear: Side: /� Street Side: Garage: 2P C �equired � (./ g Euilding Height: Max. Height: 10 Actual Hei ht: :79" 0 Landscape Area: 4 0 % Lot Coverage Max: Entrance ! et back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows ❑ Minim °_, of area of all street-facing facades t street-facingwall ❑ Yes ❑ No, .. . t e followingis met: Garage ❑ Garage door is behin. _ N ❑ Door extends no more than :.. wall and there is a covere. •: extending beyond garage. ❑ Door extends no more than 5'from wall an. . - - . sq ft.window above garage on 2nd floor. ❑ Garage door width is ❑ 12'or less -I'/o or less of fac • 60%or less and includes 7 of following: ❑ Covered porch • ' - essed entrance ❑ Wall offset ❑ 1' ' i. --.ve ❑ Roof offset tl' ❑ Fire .'.-: -s ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambre ro. D Dormer a Accent siding It. Window trim ❑ Window recess ❑ Window projection I . ,. 0V isual Clearance If Urban Forestry an 011'0sensitive Lands: CIYes No Type: rA Conditions met prior to issuance of building permit N es: Approved By Pla 'ng: .. - -- C\-^' a Date: Revisions (after B •• ding Submittal only) Revie D to Revision 1: Approved ❑ Not Approved _ a Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_0228I 9.docx I Building Permit Submittal Original Submittal Date: I--1 IC1 Site Plans: # Building Plans: # Building Permit#: 12(Enter building permit#above. Workflow Routing: [+Planning 2/Engineering l Permit Coordinator Com' Building Workflow Sign-off: [( Sign-off for Planning(include notes from planning review) Route Application Documents: 2c Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Et Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: .�.A .A...",_ Date: thrr4l pt or, Atil" Engineering Review 4o Slope at building pad: An Conditions "Met"prior to issuance of building permit Elf-Easements (encroachments) per engineering conditions of approval and plat j'Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes .Q No Assess Water Quantity Fee in-lieu: ❑ Yes Er No LIDA Facility on lot: ❑ Yes L'No Z Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: :DApproved by Engineering: 4, Date: SW 19. Revisions (after B ylding Submittal only) Reviewer Date Revision 1: Ig Approved ❑ Not Approved 8 6//7//7 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 ❑ N/A Tigard Trans SDC: [j�/y ❑ N/A Parks SDC: Yes �❑ �A J LIDA ❑ Yes L(YN/A � / / '� OK to Issue Permit / ;/ 1 / / Approved by Permit Coordinator: / Date: I:\Building\For ms\BldgPermitRvw RES 022819.docx I City of Tigard " COMMUNITY DEVELOPMENT DEPARTMENT 1 G A R' River Terrace Building Permit Review Addendum TBuilding Permit #: T�1.Act- C: 4. Site Address: /2-/-23 .2— - Q1() co/o1 6&c-- 77r�r er Project Name: f- / n r ,i* Lot #: /1� (Nev�� % ing=subdivision name;Addition or Alteration= name of owner) Planning Review of River Terrace Plan Dist t Design Standards (18.640.070.1.): Is the project subject to the plan district design standards?ICi Yes ❑ No 1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft.of frontage.An additional element required for lots with over 60 ft. of street frontage shall be provided every 30 ft. Porch min. 5 t. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dormer ft.c517f min.2ft., 5 ft.wide min. 2 ft.,6ft.wide 2.Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors. Percentage Shown: F: >A.2oh : > j % 3. E trances:At least one entrance must meet both of the folio • g standards: vt Max. 8 ft. setback from long street- facing wall Parallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porch: Yes ❑ No If s,all the following apply: [)5 sq.ft.min. ip ne street facing entry t.max.roof above floor of porch 1101 5 ft. depth min. 30%min.porch roof coverage eC4 . etailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades: overed porch min. 5 ft.wide x 5 ft. deepf 0 Recessed entry area min. 5 ft.wide x 2 ft. deep 0/Wall offset min. 16 inches 0 Dormer min. 4 ft.wide fRoof eave min. 12 inch projection f ❑ :oof offset min. of 2 ft. O Roof shingles either tile or wood Vable,hip or gambrel roof designPR----.Q_ O ' .of pitch oriented south min. 500 sq. ft. rizontal lap siding min. 3-7 inches wide I— ; Accent siding min. 40%of street facade" L1Q Window trim min. 2'/2'wide by 5/8" deep f--11?---- ❑}�7indow recess min. 3 inches for all street facing 0 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. Garages and Carports:May face the front or side lot line on a corner lot. Setbacks: • loser to front or side lot line,than longest street-facing wall. 0 Yes No. If No(Check one): May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch. O May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story above the garage that faces the street with a min. area of 12 sq.ft. Wid : (Check one) 12-foot-wide garage door 0 40%max. of street facade O 50%max. of street facade with 7 detailed design elements Notes: Approved :;y Planning: � � '- .j Date: - 1:\Building\Forms\B1dgPermit RvwRESRT_]21417.docx FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City Of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT IIIii _ Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: , DATE RECEIVED: DEPT: BUILI?FNG DIVISION IPRECEIVED FROM: S• JUN 1/n019' 014-. -Tr CITY OF TIGARD COMPANY: 0 i BUILDING DIVISION PHONE: -150 I 41 -9 5 --7-70 0 By ,� : ' NF RE: 11-122- 51A) Ccf -mg- � o�n M57WI9 - 602-0 ite Address) (Permit Number) a elb s -k ' ' -- Lgi 7 I I Z (Project name or subdivisio OF e and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. X Revisions: i 7E -P(_e+nJ Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: 6I -Pcg-,,, -bI'b J 07 ciat L ciA.-7— ZN is Fttra- FOIA OFFICE USE ONLY Routed to Permit Technician: Date: 4)11,1 i 1 1 Initials: f Fees Due: in Yes ❑No Fee Description: Amount Due: '; $ k (>.rr Qt 1r a—.Av,',c�J $ 1 0 o� $ $ Special Instructions: Reprint Permit(per PE): [1 Yes ❑ No ❑ Done Applicant Notified: Date: Initials: I:\Building\Forms\TransmittalLetter-Revisions_061316.doc i" Plumbing Permit Application Building Fixtures $ ` � FOR OFFICE USE ONLY City of Tigard 1 Received }``�i , 1 Permit No. IIII " 13125 SW Hall Blvd.,Tigard,OR 9723 7 �11 v, Date/By: j �� `__ Phone: 503.718.2439 Fax: 503.5,9f4960- Plan Review Inspection Line: 503.639.4175 a r. d r. ` , Date/By: Other Permit No.: TIGARD p i. .,t k Date Ready/By: Juris: See Page 2 for Internet: www.tigard-or.gov ,,,1 i 1 t .i ,r,!:Q I:' Notified/Method: g y ,, Supplemental Information �, °TYPE OF-WORK . :FEE* SC;REDULE "� "' ®New construction 0 Demolition „ . For special information use checklist. ❑Addition/alteration/replacement 0 Other \� Description I Qty. I Ea. Total C New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑ Accessory building 0Multi-family ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: t Lk-z..5 5 Z GaCOPrST Tr-Q-Q Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 , r� Footing drain(no.linear ft.:_) Page 2 �X' 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.: 1 I Z Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK> Backwater valve 12.51 h �� ,,,, -i Clothes washer Ut/IA. 7 4A UYZ � kc\-ob2o� 25.02 Dishwasher 25.02. Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER l ?; 0 TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixture/sewer cap 25.02 Address:703 Broadway St.,Ste 510 Floor drain/floor sink/hub 25.02 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 Contact name:Tonja Morris Primer 12.51 Roof drain(commercial) 12.51 Address:703 Broadway St.,Ste 510 Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 (potable : ,- 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:Alliance Plumbing Water piping/DWV 56.29 Address:146 W Historic Columbia River Hwy Other: 25.02 City/State/ZIP:Troutdale,OR 97060 Subtotal Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50 CCB Lic.:184601 / Plumbing Lic.no.:PB732 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Robert Dishman Date: 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. rra,,;i,r;nnmar,n;tckcrnnrr_n..,.,:te....,r,,,. rn/nvn9 mn-4AIATI ninlicnnstwcat Electrical Permit Applicatidilf `' t ' �� FOR OFFICE USE ONLY,` , 't City of Tigard i Recetved �� ICEMBINIMmi t '( 13125 SW Hall Blvd.,Tigard,OR 97223 `� DanR : �" Phone: 503.718.2439 Fax: 503.598.19601111 Plan Review Date/B : Related Permit#: T1GA1.. Inspection Line: 503.639.4175 Ready Date/By: Juris: El See Page 2 for e Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK . ®New construction D Addition/alteration/replacement . , Please check all that apply(submit 2 sets of plans w/items checked): 0 Demolition ❑Other. ,i c\"� ,l ❑Service or feeder 400 amps or more 0 Building over three stories. , ) where the available fault current . . : .. ,:CATEGORY.0E-CONSTRUCTION A� -- ❑Floating and boatyards. ?,'.. . exceeds 10,000 amps at 150 volts or 0 Floating buildings, ® 1 and 2-family dwelling 0 Commercial/industrial ❑AccessClry-bi ldirig less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. 0 Multi family 0 Master builder ❑ Other: ❑Fire pump. 0 Installation of 150 KVA or . JOB SITE:INFORMr1 TIONAND LOCATION ❑Emergency system, larger separately derived Job#: I lob Site address: �4Z3'z `�'"" ❑Addition of new motor load of system. Gab Cu as rap_ 100HP or more. ❑"A , E, '1.2 , `1.3 , City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy. ❑Health-care facilities. d Recreational vehicle parks. Suite/bldg./apt.#: _ I Project name:Polygon At Roshak Ridge 0 Hazardous locations. 0 Supply voltage for more than Cross street/directions to job site: ElService or feeder 600 amps or more. 600 volts nominal. FEE SCHEDULE Description I Qty. L Each f Total j + New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge I Lot#: t 12.— Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 DESCRIPTION OF WORK Ea.add'l 500 sq.ft.or portion 33.92 1 Limited energy,residential tsY‘. OST 47T — 6 62O (with above sq.ft.) 75.00 2 Limited energy,multi-family residential(with above sq.ft.)_ 75.00 2 PROPERTY-OWNER`.:.., I ❑ TENANT Renewable Energy ❑ See Page 2 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 City/State/ZIP:Vancouver,WA 98660 _ 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:(360)695-7700 I Fax:(360)693-4442 Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 59.36 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps1 to 400 amPs 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 Branch circuits-new,alteration,or extension,per panel ® APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with Business name:William Lyon Homes,Inc. above service or feeder fee, Contact name:Nichole Thorpe each branch circuit 7.42 2 • B.Fee for branch circuits without Address:703 Broadway St Suite 510 service or feeder fee,first branch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98660 Each add'1 branch circuit 7.42 2 Phone:(360)695-7700Miscellaneous(service or feeder not included) Fax: :(360)693-4442 Each manufactured or modular Email:permitsubmittals of dwelling,service and/or feeder 67.84 2 @P Ygonhomes.com ,- . Reconnect pri1Y — �7 - COITTRACTOR Pump or irrigation circle 67.84 2 Business name: Alameda Electric Sign or outline lighting 67.84 2 Address:3415 NE 44th Signal circuit(s)or limited-energy ❑ 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 I 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 CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lie.: 4871%5 specifically listed(%hr min) 90.00/hr Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES 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: / rf/5� • --- TOTAL PERMIT FEE: Print name: Kile Rood ." Date: 03/08/2019 This permit application expires if a permit is not obtained within 180 * :days after it has been accepted as complete.