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Permit (53) Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY RECEIVED City of Tigard Received Date/By:/212-?//f� // Permit No.: MST-2011-00223 - ii 13125 SW Hall Blvd.,Tigard,OR 97223 II Phone: 503.718.2439 Fax: 503.598.10EC, 1 7 2019 Plan Review ^, Date/By: / K. 6 Other Permit No.: TIGARD Inspection Line: 803.63 8.4175 F TIGARD Date Ready/By:� n,..,/� _ Juris: 0 See Page 2 for Internet: www.tigard-or.gov oV ��TY U� �����©� Notified/Metho ''G •4�7"t- Supplemental Information TYPE OF WO> ) -DtNG D FEE* SCHEDULE G T/+zj%/L- r et y6e , ®New construction 0 Demolition For special information use checklist. Description Qty. Ea. 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 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen /,, 25.02 ❑Master builder 0 Other: Fire sprinkler(1214 sq.ft.) i.V Page 2 � JOB SITE .1:'1147:1A !s Ii r, • Site utilities: Job site address: 14233 SW 169th Ave 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.: 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 Lot no.:63 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WOE Backwater valve 12.51 Clothes washer 25.02 \1U'LTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 /:1 PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: Polygon Northwest Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 L1 APPLICANT ❑,CONTACT PERSON Interceptor/grease trap 25.02 Business name: Polygon Northwest Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Jennifer Lopez 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 Phone:(360)695-7700 Fax::(360)816-7817 Tub/shower/shower pan 12.51 E-mail:jennifer.lopez@polygonhomes.com Urinal 25.02 CONTRACTOR Water closet 25.02 -•-u Water heater 37.52 Business name:Alliance Plumbing,LL(' Waterpip r m 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 Lie.no.:PB732 Plan review (25%of permit fee) / -� State surcharge(12%of permit fee) Authorized signature: 1` �� C! TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days Print name:Gavin Thornes Date: 12.16.2019 after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\PLMU-PermitApp.doc 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(ea) Total Square Footage: Permit Feer Footing drain-151 I 00• 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: Permit 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 Other Inspections or Fees Qty`. Fee(ea) Total each additional$100.00 or fraction thereof,to Ii and 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 (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Other Fixtures: I i 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/ Fin Review for Plumbing Installations Work Performed: Capped Added Relocate Baptistry/Font Plan review is required for any of the following. 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" 3" Submit 2 sets of plans with any of the above. -4" Car Wash Drain Isometric or Riser Diagram Garbage -Domestic-non-food Disposal -Domestic-food related ❑ Isometric or riser diagram is required for new buildings -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 Water Extractor *Note: If the fixture work under this permit results in an 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_allianceplum13�1ng_net/Documents/Documents/Fire Sprinklers/RT/PLMF_PermitApp (3).doc �z CITY OF TIGARD MASTER PERMIT 11:, ' COMMUNITY DEVELOPMENT Permit#: MST2019 00223 Date Issued: 09/10/2019 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 TIGARD 9 Parcel: 2S107AA06300 Jurisdiction: Tigard Site address: 14233 SW 169TH AVE Subdivision: ROSHAK RIDGE Lot: 63 Project: Polygon at Roshak Ridge, Lot 63 Project Description: New SFA. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 562 sf Basement: 90 sf Left: 0 Parking Spaces: 0 Height: 37 Bathrooms: 3 Second: 562 sf Garage: 430 sf Front: 8 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Total: 1214 sf Value: $164,352.30 Rear: 0 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF RainStorm 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: 1 Backwater Value: 1 Other Fixtures: 0 Drywall-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'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 1214 Owner: Contractor: POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) 703 BROADWAY ST STE 510 703 BROADWAY S i xtt T SUITE 510 -1 EPBR t - - -, 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: $24,534.23 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.1.00 .2, Issued By: 4---A.—I1/4..... �— Permittee Signature: (A)70t--AC-41 —N\ Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. .� Building Permit Application lte1�, �' ' ...._k_ei.--..\—\--- U-3 Residential " "" ... �,1 d ( FOR OFFICE USE ONLY - Cityof Tigard Received g > 0 Q DateBy: �` { Permit No. -^y } • 13125 SW Hall Blvd.,Tigard,OR 97223' '- t -0'J Plan Review } �G J ��ra j-�� � Phone: 503.718.2439 Fax: 503.59$.��4 o i Date/By. ��� �� Other Permi[ jct.- \= Mechanical Permit Application,r�f s — FOR OFFICE USE ONLY City of Tigard d ,, ,,,fi .,,.Q. .,,h . Received Date/By: Permit No.. (`�t V�ry e� 'I 13125 SW Hall Blvd.,Tigard,OR 97223 �� "i �.1ti3}-�'-J t i r , e U 1(♦ Plan Review Phone: 503.718.2439 Fax: 503.598.1960 I t I i\ l Other Permit: DateBy: k {r�a i,17 Inspection Line: 503.639.4175 Date Read B ]oris: Internet: www.tigard-or.gov a I"4Yr ;- k „ Ready/By: See Page 2 for >e 1 3 k 1, a Notified/Method: _ Supplemental InCnrmatinn Urt r N "q l\t/SiC y TYPE.OF WORK COMMERCIAL FEE* SCH.LDULE'— USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition D Other: mechanical materials,equipment,labor,overhead,and profit. Value CATEGORY OF CONSTRUCTION $ RESIDENTIAL EQUIPMENT./SYSTEMS FEES* 1 1-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building For special information use checklist i j Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Beating/cooling: Air conditioning I 46.75 Job site address: it-12.b 3 I(eq-n-4 Pru/ Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: ‘\ Project name:Roshak Ridge Heat pump 61.06 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 Lot nOther. Subdivision:Roshak Ridge o.: /_;L 23.32 W Other fuel appliances: Tax map/parcel no.: Water heater 23.32 • DESCRIPTION OF WORK Gas fireplace/insert 33.39 yin S 1 10�� -615 2Z 3 Fluevent for water heater or gas I� � 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. ®, PROPERTY OWNER TENANT 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 Fuet 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 Walls usvended/un t heater__., T ,-4 EitigP9t lf- I'6gA1$606 Water heater Phone:(360)695-7700 Fax: :(360)693-4442 Fireplace Range E-mail:permitsubmittals@polygonhomes,com Barbecue .. CONTRACTOR Clothes dryer(gas) Business name:Pro Heating&Cooling Other. MECHANICAL PERMIT FEES* Address: NW Alociek Dr,Ste.1104 Subtotal. City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00) Phone:(360)270-1590 Fax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lic.:209001 TOTAL PERMIT FEE s.A: This permit application expires if a permit is not obtained within 180 &CZ1u � days 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 Applicatigri r ,� a , ,- u Y ' FOR OFFICE USE ONLY- City of TigardReceived . /( '' Dan R : " Permit#: -� 13125 S W Hall Blvd.,Tigard,OR 97223' ` , Plan Review Phone: 503.718.2439 Fax: 503.59$1960 Date/B : Related Permit#: TIGARI3 Inspection Line: 503.639.4175 a Ready Date/By: Juris: H See Page 2 for o Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition ❑Other: 0 Service or feeder 400 amps or sabre 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION - exceeds 10,000 amps at 150 volts or 0 Floating buildings. N 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. 0 Multi-family 0 Master builder 0 Other: ❑Fire pump. ❑Installation of 150 KVA or - - JOB.SITE INFORMATION AND-LOCATION ' ' 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: t Lk-z3 3 .51,,, t b9-n-j 100HP or more. ❑"A","E","i-2","1-3", City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy. 0 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. I- Each _ Total j * New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: l,e 5 Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK ' Limited energy,residential (with above sq.R) 75.00 2 �/1 rn� a' DU 2:1-5 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 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 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:William Lyon Homes,Inc. above service or feeder fee, 7.42 2 each branch circuit • Contact name:Nichole Thorpe B.Fee for branch circuits without Address:703 Broadway St Suite 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 S�S?NTRACTOR 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 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.Lic.: 487115 specifically listed(%hrmin) 90.001 hr 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: ,_...„....--/------ ,,,--- r 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. 1•\Buildinu\Permitc\FT r PPnnit Arm FT R FRC a-- o ncii•rnn,< ..n _.__.__.—_ 1 Plumbing Permit Application Building Fixtures ,1L/ 1 '` ' ' FOR OFFICE USE ONLY City of Tigard Received '� 13125 S W Hall Blvd.,Tigard,OR 972231 U L1 7 ?l) Date/By: w 1.1� S Vic Plan Review Permit No, o ' 11 Phone: 503.718.2439 Fax: 503.598 1960 Date/B Other Permit No.: TIGARD Inspection Line: 503.639.4175 (j''''i)y Df,,--. i €r !v�)il 1>°, Date Ready/Bo Juris: BSee Page 2 for Internet: www.tigard-or.gov t�[,�� lil ( �i 1�t 1' Notified/Method: Supplemental Information TYPE OF WORK , , " ETILE :2 ,,,, ,y ° F� "SD ®New construction ❑Demolition For special information use checklist Description I Qty. I Ea. 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 0 Commercial/industrial El 1-and 2-family dwellingSFR(2)bath 437.78 ElAccessory building ®Multi-family SFR(3)bath 500.32 ❑ 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-`,'2,6.6 Std `U)q'1-F Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 i Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: t\ 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.: (03 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Backwater valve 12.51 �� ���DES,,C,,RIPTION OF.WORK \J:JYe/J7K bY\ ` 22 C-b0vl�j Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 in 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 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone:(360)695-7700 Fax:( ) Ice maker 12.51 IEI-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:Vancouver,WA 98660 j +Solar unitalaotable water) _£2 # z___-,, Phone:(360)695-7700 Fax: :(360)693-4442 Tub/shower/shower pan 12.51 E-mail:permitsubtnittals@polygonhomes.com polygonhomes.com Uel 25.02 Water closet 25.02 CONTRACTOR 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 Plan review (25%of permit fee) CCB Lic.:184601 / Plumbing Lic.no.:PB732 AI State surcharge(12%of permit fee) Authorized signature: 4 /I 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. t:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) City of Tigard a COMMUNITY DEVELOPMENT DEPARTMENT C T 1 c n K n Building Permit Review — Residential Building Permit #: S-Vt4 - n2- Site Address: /fie, k) /7,06]-A /917-e— Project Name: Pj/1 �n �+�a,,C �--/ Lot #: (2� (New( ling=subdivision name;Addition or Alteratioly3 ast name of owner) Planning Review Pro sal: f-eA) ltd Verify address/suite# active in Accela. In River Terra e: ❑ No /Yes,River Terrace Review Addendum Sit Plan Elements: t►, rosion Control copies of site plan on 8-1/2"x 11"or 11 x 17"paper 20',#,tained trees with drip line and tree protection measures VI!prawn to scale(standard architect or engineer scale) 1•F otprint of new structure(including decks)and FEL rth arrowVt . 'ty locations&easements(required for new and additions) r5ite address,project or subdivision name and lot number h Sidewalk/driveway approach V .plicant information(name and phone number) Ii cation of wells/septic systems Y4Lot dimensions and building setback dimensions ►S eet tree size,type and location Aare footage of buildings to be demolished feet names 1.1 A.ting structures on site VComer elevations(2'contours if more than 4'differ tial) • .t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? es ❑NN impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shownIYes Mo i can Water Services—Service Provider Lette of platted prior to 9/10/1995): gaited: ❑ yes,applicant was notified I� No Received: ❑ Yes El No Ikr Public Faciliti mprovement(PFI) Permit: equired: Yes,applicant was notified ❑ No Applied For: /Yes ❑ o,st p intake and Use Case#: �/ Old 600 0 Zoning: i—/`a-�� 0--1.--)--) _ equired Setbacks: Front: E5 Rear:____;41......_Side: 0 Street Side: 9v� — Garage: _ i :uilding Height: Max.Height: Actual He- ht: . ..c Ir Landscape Area: �6 % Lot Coverage Max: 0/0 Entrance ill _- .ack no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows ❑ Minimum •' area of all street-facing facades Garage ❑ Garage door is behind . ,eet-facing wall ❑ Yes ❑ No,one o •- .1 owing is met: ❑ Door extends no more than 5' r. . and there is a covered .o • ending beyond garage. ❑ Door extends no more than 5'from wall an. i sq ft.window above garage on 2nd floor. ❑ Garage door width is ❑ 12'or less • :'o or less of faca.• ! 60%or less and includes 7 of following: ❑ Covered orch ■ --, sed entrance ❑ Wall offset 0 1'Roo -s:-3 _ ____ _II_Roof offset ❑ Fire s..•: ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roo ■ Dormer a Accent siding • Window trim ❑ Window recess ❑ Window projection ❑ a .• 110° isual Clearance T Urban Forestry pen 14.-nsitive Lands: ❑ YesTr No Type: it! Conditions met prior to issuance of building permit Not : Approved By Planning: .) Date: (--, Lj______ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_022819.doex Building Permit Submittal Original Submittal Date: `tel.1 \tC Site Plans: # Building Plans: # 7 Building Permit#: 21/Enter building permit#above. Workflow Routing: D Planning 12/Engineering ["Permit Coordinator R Building Workflow Sign-off: 1.I Sign-off for Planning(include notes from planning review) Route Application Documents: 12/Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. L3/Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: �;� Date: Engineering Review Slope at building pad: C Conditions "Met"prior to issuance of building permit 12' Easements (encroachments)per engineering conditions of approval and plat +r Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes .1 No Assess Water Quantity Fee in-lieu: ❑ Yes B'No LIDA Facility on lot: ❑ Yes J;4' No Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: ,Approved by Engineering: kr e4, (,v Date: iy Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review 0 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: (2 SDC Fees Entered: Wash Co Trans Dev Tax: e-Yes ❑ N/A Tigard Trans SDC: s ❑ N/A Parks SDC: Me-Yes ❑ N/A LIDA ❑ Yes C /A OK to Issue Permit 7 10 / , �/14r Approved by Permit Coordinator: Date: !� I:\Building\Fonns\BldgPermitRvw_RES_022819.docx City of Tigard 11111 COMMUNITY DEVELOPMENT DEPARTMENT C TIGARD River Terrace Building Permit Review Addendum - lW,.`�� a^.t s:..:�big�.,..,_�:: ,.. .�»-. � , __•�_: ._.�,. ..e�a,....?b-o�vs.n wto- ,:.aas�...a ;r.a_.,�s.�a.-,.�.��&..+::.-�.,�s�.c;.,,aax,w��. i s.,c.{...:,.-,as Building Permit #: \( - - - K Site Address: 1 ( ) 1i OA five_ Project Name: /it , : + , 4 ' e <_',, _ r, �� r ,� Lot #: '-) ew.( IR g=subdivision name;Addition or Alteration= .t name of owner) Planning Review of River Terrace Plan Dist 'ct Design Standards (18.640.070.1.): Is the project subject to the plan district design standards? N� 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 ft. deep ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide Gabled dorm ❑ ❑ ❑ ❑ 2. Eyes on the street: a minimum Qf 12%of ch street facing facade must include windows or entrance doors. Percentage Shown: �%.2 3. trances:At least one entrance must meet both of the folio g standards: Max. 8 ft. setback from longest street acing wall Parallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porch: ❑ Yes No If yes,all the following apply. ❑ 25 sq.ft. min. ❑ One street facing entry ❑ 12 ft. max.roof above floor of porch ❑ 5 ft. depth min. ❑ 30%min.porch roof coverage 4.Detailed 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 �❑ essed entry area min. 5 ft.wide x 2 ft. deep ❑ ll ld offset min. 16 inches Dormer min. 4 ft.wide VRoof eave min. 12 inch projection ❑ oof offset min. of 2 ft. ❑ Roof shingles either tile or wood V Gable,hip or gambrel roof design ❑,coof pitch oriented south min. 500 sq. ft. ❑ Ijarizontal lap siding min. 3-7 inches wide Accent siding min.40%of street facade VWindow 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. Garages and Carports:May face the riont or side to ' on a corner lot. No closer to ro : 'se lot line,than longest street-facing wall. ❑ Yes ❑ I. e.. No (Check one): ❑ May extend up to 5 ft.if there ' ; • ered front porch and i 1.- •oes not extend beyond the front porch. ❑ May extend up to 5 ft.where the garage is par • =•.•o-story building and there is a window at the second story above the garage that faces the street wi . . n. area of 12 sq.-. Width: (Check one) Cl 12-foot- :-• I. age door ❑ 40%max. of street facade i• i•o max. of street facade with 7 detailed design elements Notes: Approved By Planning: / Date: c-7jg 1:\Building\Forms\BldgPermitRvw_RES_RT_121417.docx