Permit (66) CITY OF TIGARD BUILDING PERMIT
li
' • COMMUNITY DEVELOPMENT Permit#: BUP2019-00186
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/07/2019
T I t; 1 R 0g Parcel: 2S107AA23600
Jurisdiction: Tigard
Site address: 16870 SW ROCKHAMPTON LN
Project: Polygon at Roshak Ridge Subdivision: ROSHAK RIDGE Lot: 236
Project Description: Ramps and porticos for sales trailer across(2)lots at site addresses: 16870&16882.
Contractor: POLYGON WLH, LLC Owner: POLYGON WLH LLC
703 BROADWAY STREET, SUITE 510 703 BROADWAY ST STE 510
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: 360-695-7700 PHONE:
FAX: 360-693-4442
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VBPermit Fee-Additions,Alterations, 08/07/2019 $149.75
Demolition
Occupancy Grp: B Occupancy Load: 10 12%State Surcharge-Building 08/07/2019 $17.97
Dwelling Units: Plan Review 07/31/2019 $97.34
Stories: Height: ft DC Provision Review,COM New-Ping 08/07/2019 $203.00
Bedrooms: Bathrooms: Info Process/Archiving-Sm$0.50(up to 08/07/2019 $8.00
Value: $4,500 11x17)
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $476.06
Required Items and Reports(Conditions)
Required:
Fire Sprinkler: Parapet:
Fire Alarrrt` — Prbtec[ed Cor rlUors`
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: .,g--el t mittee Signature: � -- ``L(�i
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
. /j47This 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
Residential FOR OFFICE USE ONLY
City of Tigard Received 1 ,\r ,
I'' Permit Noj\j \
Date/By:
r 13125 SW Hall Blvd.,Tigard,OR.97223 . i, /(i t� Plan Review
1. , ' o Other Permit: n �,
11 a Phone: 503.718.2439 Fax: 503.598.1960 e Date/By: O•- • — J � C DQ.)\`1,�i 1j
TI GARD Inspection Line: 503.639.4175 Date Ready/By: �' i�i / t r : 0 See Page 2 for
Internet: www.tigard-or.gov a Notifies J.'od - ,- , Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
I j New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
E 1 1-and 2-family dwelling ❑Commercial/industrial
ixf Accessory building ElMulti-familyNumber of bedrooms:
-
0 Master builder 0 Other: Number of bathrooms:
.
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:, Q 503"-- lrieltkpk_.n I�. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 1 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Roshak Ridge Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Roshak Ridge 1 Lot no.: jay 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.
Valuation: $S1Ksivrk. "Pepsi1),(z► e-0-5
Existing building area: %g square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories: I
Name:Polygon WLH,LLC Type of construction:
Address:703 Broadway St.,Ste 510 Occupancy groups:
City/State/ZIP:Vancouver WA 98660 Existing:
Phone:(360)695-7700 Fax:( ) New:
El APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Polygon WLH,LLC
Structural plan review fee(or deposit):
Contact name:Tonja Morris
FLS plan review fee(if applicable):
Address:703 Broadway St.,Ste 510
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amouni receives?
Phone:(360)695-7700 Fax: :( )
E-mail:permitsuhmmittals@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:Polygon WLH,LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:703 Broadway St.,Ste 510 Solar Installation Specialty Code checklist.
Permit Fee(includes plan review
City/State/ZIP:Vancouver WA 98660 $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:204238 , Total fee due upon application: $201.60
Authorized signature: 111111' t. This permit application expires if a permit is not obtained
4 ih within 180 days after it has been accepted as complete.
�� " 4 *Fee methodology set by Tri-County Building Industry
Print name:Tonja Morris Date:04/17/2019 Service Board.
L:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
III COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - With Land Use
Building Permit #: k...�� AC\-ONCAU
Site Address: tg ca r(, UKMOn tale Suite/Bldg#: 26
Project Name: Jµ1, 1'701te^ pd i- )0s,-l- 5
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review ,'pp
Proposal: S�11e3 J ��
i kr 10j ' A 4
1G Verify site address/suite# exists and active i permit system.
Cg/River Terrace Neighborhood: Yes 04 ❑ No 1 'V7cai 'rail G<'
band Use Case#: 7-6(1°,2/,/q -- U 6 0 / 3
Plans atch Approved Land Use:
11 Site Plan ❑ Landscape Plan ❑ Other:
�❑ Urban Forestry Plan CIElevation Plan
[D' ding Height: Maximum Height 3S Ac5ial Height 1,6.
[ Conditions Met: ❑ Prior to Submittal IC/Prior to Permit Issuance
d Business License:
sts: ❑ Yes ❑ No,applicant notified to obtain business license
Public Facilities Improvement(PFI)Permit:
Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake
Notes:
Approved by Planning: 2---- Date: -7- )-(13'
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: --1-1')O,k Ot
Site Plans: # S
Building Plans: # a
Building Permit#: 2'Enter building pet#above.
Workflow Routing: R Planning LSI'Engineering [ 'Permit Coordinator R/Building
Workflow Sign-off: NI'Sign-off for Planning(include notes from planning review)
Route Application Documents: R"Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: kck
I:\Building\Fonns\BldgPermitRvw_COM_WithLandUse_060116.docx
Engineering Review
Slope at building pad: 7 `ale
❑ PFI Permit#:
(''Conditions "Met"prior to issuance of building permit
3/Easements (encroachments)per engineering conditions of approval and plat (not typical on SDR/CUP)
L Vater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes EYNo
Assess Water Quantity Fee in-lieu: ❑ Yes 3/No
LIDA Facility on lot: ❑ Yes E/No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: %„d 1.4 Date: 7/?),//'
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
O 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:
rd SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes 1E N/A
Tigard Trans SDC: 0 Yes
Parks SDC: ❑ Yes N/A
K to Issue Permit
Approvedby Permit Coordinator: Date: / 'Ji
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse_070915.docx