Permit (219) CITY OF TIGARD BUILDING PERMIT
IN COMMUNITY DEVELOPMENT Permit#: BUP2019-00197
Tigard OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 08/14/2019
T[(�;OR[7 9
Parcel: 2S107AA25600
Jurisdiction: Tigard
Site address: 14301 SW RIVER TERRACE BLVD
Project: Polygon at Roshak Ridge Neighborhood Park Subdivision: ROSHAK RIDGE Lot: N
Project Description: Shelter for a neighborhood park.
Contractor: POLYGON WLH, LLC Owner: POLYGON WLH LLC
703 BROADWAY STREET, SUITE 510 703 BROADWAY ST SUITE 510
VANCOUVER,WA 98660 VANCOUVER,WA 97223
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX: 360-693-4442
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: IIA Permit Fee-Additions,Alterations, 08/14/2019 $377.90
Demolition
Occupancy Grp: U Occupancy Load: 0 12%State Surcharge-Building 08/14/2019 $45.35
Dwelling Units: Plan Review 08/08/2019 $245.64
Stories: Height: ft DC Provision Review,COM TI-Ping 08/14/2019 $102.00
Bedrooms: Bathrooms: Info Process/Archiving-Sm$0.50(up to 08/14/2019 $17.50
Value: $19,492 11x17)
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $788.39
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
- -_- -P€etGOrridors:-
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 cop of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permiftee Signature: Sr l f ��""7
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. l it
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
Residential FOR OFFICE USE ONLY
City of Tigard ' Received / / P( A ,
13125 SW Hall Blvd.,Tigard,OR 97223 4 Date/By: / s/ {V,t ,' �7//`Yl
Plan Review' '' Phone: 503.718.2439 Fax: 503.598.1960 A 4 i`7 - a ! s 19Date/By: _ - �' j Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: � , , 7kris
H See Page 2 for
www.tigard-or.gov .. ? No• d/Method:/' G G� SupplementalInformation
. `r. DIVISION ,,'",'�/›.
TYPE OF WORK RE i HIRED 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
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUC TION work indicated on this application.
1-and 2-family dwellingValuation: $
0 Commercial/industrial
TillAccessory uildin bNumber of bedrooms:
g ❑Multi-family
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: r1..‘ o k k,),) --R,06k -i-e ac ---:,\ ki b New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Roshak Ridge Covered porch area: square feet
Cross street/directions to job site: TRACTis1 Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Roshak Ridge I 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.
PSK S t-teem*. Valuation: $ )C‘ 'I-' 1e2,.6`dExisting building area: NA square feet
New building area: —I 00 square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Polygon Type of construction:
Address: I '' ' I Occupancy groups:
City/State/ZIP:Vancouver WA 98660
Existing:
Phone: .I 6' II
New:
0APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* •
(Please refer to fee schedule
PolygonBusiness name:
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:
Phone:(360)695-7700 Fax::( )
Amount received:
E-mail:permitsubmmittals@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.
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.:204238 ,
Total fee due upon application: $201.60
Authorized signature: l. This permit application expires if a permit is not obtained
�_ �� • 111111within 180 days after it has been accepted as complete.
Print name:Tonja Morris Date:04/17/2019 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
.1114 q COMMUNITY DEVELOPMENT DEPARTMENT
T1cAlzD Building Permit Review — Commercial - With Land Use
r.
Building Permit #: /&/(, 62 /?'-' 6? /7
Site Address: i D 1 SIAI Riva 1Fe-nrAce 1 )vid Suite/Bldg#:
Project Name: ra " U+�1 � - �IAC, PWk: �'
(Name o ommee al business occupying the spMe.. If vacant,enter Spec Space.)
Planning Review
Proposal: pal r & C(
Verify site address/suite#exists and active in permit system.
;River Terrace Neighborhood: ZK Yes El No
*Land Use Case#: VI)Q OY rWO0 2
*Plans Match Approved Land Use:
1LSite Plan Ngli Landscape Plan El Other:
--Urban Forestry Plan Elevation Plan
Building Height: Maximum Height Ni R- Actual Height ta:..S
Conditions Met: Prior to Submittal Prior to Permit Issuance
Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
]Public Facilities Improvement(PFI) Permit:
Required: El Yes,applicant was notified egrNo Applied For: El Yes El No,stop intake
Notes:
Approved by Planning: ilii i u r Date: S f 'f19
Revisions (after Building Submittal ,ly) Reviewer Date
Revision 1: ❑ Approved Cl Not Approved
Revision 2: El Approved El Not Approved
Revision 3: ❑ Approved El Not Approved
Building Permit Submittal
r --- ---- - - ---- -- - ---- --
Original Submittal Date:
Site Plans: #
Building Plans: #
Building Permit#: ,► nter building prmit#above.
Workflow Routing: ri Planning Engineering yI4ermit Coordinator uilding
Workflow Sign-off: er ign-off for Planning(include notes from planning review)
Route Application Documents: Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
lipA
__ZZeZ(7
By Permit Technician: :cdi� - ���1i� �� / Date:
/
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse_060116.docx
En ineering Review
IV Slope at building pad:
❑ PFI Permit#: 4'
❑ Conditions "Met"prior to issuance of building permit /iY
❑EEasements (encroachments) per engineering conditions of approval and plat(not typical on SDR/CUP)
[/Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes lNo
Assess Water Quantity Fee in-lieu: E Yes 22/No
LIDA Facility on lot: ❑ Yes PrNo
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: /110111.. Date: /
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 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:
VADC Fees Entered: Wash Co Trans Dev Tax: 0 Yes ,ISN/A
Tigard Trans SDC: ❑ Yes L"N
Parks SDC: ❑ YesN/A
OK to Issue Permit 4117
Approved by Permit Coordinator: Date: c�/7-11/L9
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse_070915.docx