Permit CITY OF TIGARD MASTER PERMIT
iiii4
it COMMUNITY DEVELOPMENT Permit#: MST2019-00278
T FGAR D, 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/16/2019
Parcel: 2S107AA05100
Jurisdiction: Tigard
Site address: 16880 SW SUNSHINE COAST ST
Subdivision: ROSHAK RIDGE Lot: 51
Project: Polygon at Roshak Ridge, Lot 51
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 1 First: 809 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 4 Second: 1049 sf Garage: 437 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 1858 sf Value: $248,825.69 Rear: 0
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: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 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'I 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 1858
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
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $33,687.50
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 R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calli-•503.2 .19 •Zsr,.. .332.2344.
r,
., r
Issued By: '' .. Permittee Signature: -,:`�►��.`s .. A 2.I*
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.
, , \_____(....)—\—' \
RE
Bolding Permit Application
Residential FOR OFFICE USE ONLY
Received
Cityof Tigard DECermit No.
g C l L 1 0 2 I P Date/By: �`% 1 k SF Mc
III13125 SW Hall Blvd.,Tigard,OR 97223 PlanReview I t/I N S` `� ��1(1
mit. p....,„,,.c 5-,,-.,-,,T(
Phone: 503.718.2439 Fax: 503.598.1960 Il : 4,rk Other PermiL.)W�
I,I'r'1 J1 IIGAI y I
Inspection Line: 503.639.4175 Ready/By: Juris: ® See Page 2 for
TIGARD $IJPLDING l)A Y IS!<R u Iemental Information
Internet: www.tigard-or.gov ��u')11R\T"'•.ethod:�� Z//�/ G PP
Y 66J
„., TI'PE OF WORK / ... REQUIRED DATA 1-AND 2 FAI13f"LYD:. G
P„ .._. :' /7 % ,,,,,,494:02.'W%-
®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 CONS �t s MONl k work indicated on this application.
Valuation: $
® 1-and 2-fancily dwelling 0 Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: a ,2-2-q5'
.lob site address: (o(6 E V V Svc viS ' k st, New dwelling area: 1 Ca S f , square feet
City/State/ZIP:11 (>r. b all 2ZL Garage/carport area: i 1,b1 square feet
Suite/bldg./apt.no.:J Project name:Polygon at Roshak Ridge RY'gc L Covered porch area: . •9er. square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIREDDATA COINIMERC' <' CKLIST <
Subdivision: V4 ut1i t? �� Q,t4i(t Lot no.: 51 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: ""�' ` �►t Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
work indicated on this a lication.
Valuation: $
6//9 ; & �c -,vs
Existing building area: square feet
�E D 12-(GC 1/V4-L. /ex./ile 70 iz v/ / . New building area: square feet
® PROPERTY OWNER '_ 140 TENANT i Number of stories:
Name:Polygon WLII 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,..,,,,'..:0,1;4„W„1 ., ❑.CONTACT ii:aN BUILDIN� ;FIIT FEES* y 7. i✓
Business name:Polygon WLH LLC ''" ,�iK (P .e r$o schedule) 4,1„ ,,..
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
P t t ..--Ic SO , BYS x
E-mail:permitsubmittals@polygonhomes.com . - .- j e.. .-F� �,,
/�z / voiy,, 'iii Commercial and residential prescriptive installation of
\ •, ,?.'",`,-,/,;4 .;,1.;;, 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 lic.:207247
Total fee due upon application: $201.60
Authorized sign.� This permit application expires if a permit is not obtained
� within 180 days after it has been accepted as complete.
'I/1/2,1 , *Fee methodology set by Tri-County Building Industry
Print name:Amand: Gavin Date: Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440 4613T(11/02/COM/WEB)
Ilk k
Mechanical Permit Application RECEI F(}R OFFICE USE ON LN
City of Tiga rd .iter..civcd '
: . 13125SW Hall Blvd.,Tigard.OR 97223
I
)i:I: 0 6 20
Dim-Peutit:
' Phone: 3.71g.2439 Fax; 913,598.1900 Ilaresr.
Itspok.,^tiongr3.6.39A175
TAk'D CITY-OF TIG, ,., I.°YitY: ioro . Pi See Pag=e 2.tor
Interact www-tigard-or.gav ;,..I.,e0.4ettiod.: Supplemental iXtformatiwa
BUILDING DIVISION 1 ,
7 ,-iiii-k7:77:::7•::7:77,2i3i.;-.77,5.-,-47-z.T.,,a7.7.-,T;7,77 9,-;kotoo.', -;7-rci4E000
Mechanical permit leas',are based on the value or the work.
El New COuStruCtiOrt 0 Addition:Tata atiOnteptaCernent r4017ted.Indicate tise Take Ovum,134 to the nearest dollar)of all
0 Demolition 0 Otha: mechanical materials.equipment.labor.overhead.and profit. 1
: ...-,:„ _ _ -_-• • _ •- Value:$
.A!•7-::1 -47'-'- ::.':.::. :7---::',:-::;:: ;•:'•.;;-.F.C.i0E0f),..RV.:•i*ciiiti.'g liktietif*;-ie% ':,- "'"::'-'; '*--- LTJSTEMSFES
'---."---''''.--,'"-•''' ' "-""•--'- '"''.'' -- -- :
•v,
0 l-arid 2-finnity clwelline 0 Commexciallindusnial 0 Accessory building r..r-special information use riterliist
El Multi-fmily 0 Maud balider 0 Other Descrirgion 1 Qty. 1 -F"._ 1 Tot'al
•';-.1':';:'',::' --i-;-::'•1.q40*ii:0i*EaFi:i4iTi*4(,*i$:Iiia4-1&:;;;.'-: ,; :!.: :.:t
Air conditioning
9.b S tiV.StA„Vic.inAMb COW661- ci-- 1 1 , 46,75
Fume=100.1100 BTU kkterlivents) i I 46-75, I
....)
City/StateZIP:Tigard,OR 97224 Furnace 101000+8Th(ditcts'vets) i , 54_91
Saiteiblitinpt.no.: ,. Project nama,V0 V1/1,oti-06w4, ,..,, Heat pump
Dort work ___ 61.06 1
23.32 I I
t
,
Cross streetidirecdons to job site: A Irea I*droll ic hal water mtem 23,32
Residential boiler(radiat)r or
, bydronie) I 23,32
Unit heaters(foal-type,roat eleetrk),
in-well.in-duct sur,peaded,etc, 46,75
Flue'vent for awe of above i 23.32
Othea7
Subdivi31:M ‘•U ex Terrace exxs 4z 1.°1 11'1.: _ Other fuel spurns- um=
Tax rraipiparcel no.: Water heater ' 2332 1
1 . . ilii-::b.ftiiiiaiikt:i":7-,11, :!,',.-::.::::-::'.!,!.:: ::, 'F.1::. .!;i:...,,,,'", Gas fireFileeelasert I
Flue Writ fin-water heater er Vls
fireplace 23.32
Log lighter(gas) 2132
- .- Wooepellet stove I 33.39 I
Wood fireolacerinisco 23.32 ,
, Claininev A inerlfluthent • 2132
23.32
4'*giiiikin -: iE-,..f-:,' ' -,0'ft. -,,iii.,te:.F-' '.i.:.;: 5:-7: Other:
Name• f I . I (DIAUli__ Range 1100(11m-her kitchen
etruipuient 1 11 33_39
1=3111r.4.15 42)- V* 4.." A A A . A - I Clothes-dryer exhaust j 1
1 C"Y'SLat VC 4 COU-Ver WCA) atk(ele0 1 Single-duct exhaust(bathrooms, 1 1
i tojit compartruents utility romns) J 1 2132
1 Moog: t%0 7ay1-I(20 , -Frac:( ) I ArtieleravvIspam fans j 23.32
:..., ::•••:,1*,::::EE!.dEtA1'r.Lic.i.L.NT-:--,i,!:::.:-.1,.7:, .::::,,:r.:,:::.pit..:42: Ek.::e.cro,:wr:taLSON:?;;:: ?-,•.,,;!,, 1 Other . 23.32
1 Furl pipint
: Boasingss name:Poly-goo W1.1.4,LLC SI 4.1S for first four:$4113 for each uileafinalit
CwIt aarr44- r‘-yv\ot,wA A, CI.CM l'it
Address: -1 D3 -Ryroatiu-D Cl_ S4t-- t 5A-e, 10, , Cit'ts heat puma
T '
, Weilistzuentindfartit heater
City,StztaZIP:Vaneriterer,WA 98660 Waterheater i
.
_
Mona:(360)695-7700 i Fax:-..(368)693-4442 Fireplace -
EingaRefr A-SO.:von,Icko‘kS u•-/WvsorN WAry\-65.CZ rY1 i
i Barbecue
tii -..;:i-S:7. ..',1;: :?.:Tg'.-7.i.,-. ,.T. l*,.:11.,f4.0i)(0 -:::;': i::?,...:.::- :; t;_q:ir..., I rhes drm-(nes1 1 I
Other.
Busirrm name:Apra Air LLC
ti;11L.ANICArkititileS ::::::. ,:! ,:,::,.:•,.':,,.
Address:13004 NE 72 Ave Subtotal
CkylStatelZIP:Vancouver,WA 9S686 Minimum permit-1e($96,(ab I
— Plea review(25%of riconit fee) ,
Phona(360)3424109 I Fox:(360)326-1769 State sura
1
av,ge(12%of permit Tee) ,
CCB Licz 283034 ITOTAL PERMIT FEE
_ „ 1
Tlie• permit atiplientinn et.pircs ir 1 ren161 iN wit ubtainvi within 1St(
days after it has hmii acerpted as-toutpitte.
Authorized signature; — * Pee reinhodategy w by Tli-cminty Blinding Industry Seviw seard
MEd BMW. i Ces. I Dat*: III:I Li I 18 1
1-Irgiitbci-,Petffits,m.E.1:-_Pamr.htsp_e46{la dt. 4:%-4(47-rni,VICillt.17WEIII,
Electrical Permit Application vasf > At 4 �,.-0'''•74' - .ark xa�c, S%`
P tion RECEIVEC ,r 4-1,,,,f.„., 0110u 0 It, -� l 1° 4. .
of Tigardeceived 7�
City e Permit#H677,20,9_0(9,22„iiiaux '" 13125 SW Hall Blvd.,Tigard,OR 97223 DECD�� 12 2019 Date/By:Plan Review Related Permit#:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
CITY O TIGARD
��s3F ;` Inspection Line: 503.639.4175 Ready Date/By: Jars: H See Page 2 for
Cv,xARD Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: 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.
0 Demolition 0 Other: • where the available fault current 0 Marinas and boatyards.
_ CATEGORY_OF-CONSTRUCTION , - exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 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.
❑Multi-family 0 Master builder ❑ Other: 0 Fire pump. 0 Installation of 150 KVA or
'
JOB SITE-INFORMATION"AND'LOCATION;'..c 0 Emergency system. larger separately derived
#: Job site address: ❑Addition of new motor load of system.
Job
I00HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑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 I Total I *
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: 51 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.addl 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
VUllat
— (with above sq.ft.) 75.00 2
Limited energy,multi-family
MSTzoi c, „-0o 1 '7e residential(with above sq.ft.) 75.00 2
I `tom LN t Renewable Energy 0.See Page 2
® PROPERTY OWNER':: . _ ❑ 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
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 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
sAddress:703 BroadwaySt Suite 510 branchranice or feeder fee,Srst 56.18 2
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:Alameda Electric Sign or outline lighting 67.84 2
Address:3415 NE 44th Signal circuit(s)or limited-energy 0 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(I 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 90.00/hr
CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: 48715 specifically listed(LA hr min)
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: J (> ®e TOTAL PERMIT FEE:
�; This permit application expires if a permit is not obtained within 180
Print name: Kile Rood Date: 03/08/2019 I days after it has been accepted as complete.
Plumbing Permit Application RECEIVED
Building Fixtures
0 6 2 018 Received
City of !TEC y: Pelt No.:M.. G-LL`
$ 13125 SW Hall Blvd..Tigard,OR 972'23c0ITY OF 1 rGAR Ian. Rev.i°w
Phone: 503.7182439 Fax: 503.598..1 Iyp g;Ll�l7� rate-33y: LlehkrPcrcnicAo:
TIGARD Inspection Lige: 503.639.4175 1LD1NG DIVISI Asi it- ReadylBy: Ivris: fry See Page 2 for
Internet www.tigard-or.gov tifaed/Method: Supplemental Information
TYPE OF WORK" .. . "..` FEE*.SCHEDLTi E
For special information use cited:list.
®New construction t.��--}7 1 Demolition diDescription ( Qy. 1 Ea. ( Total.
❑Addition/alteration/replacement El Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
SFR(2)bath 437.78
1-and 2-family dwelling ❑Commercial/industrial
SFR(3)bath I 500.32
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
El Master builder U Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE' INFORMATION ANI? LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address: 1 0(a(6D S '� tA,0�1/1.4.45_, CD& St S well,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224vu v >1
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: N I101.014* �� 1 Manufactured hame utilities 50.03
Cross street/directions to job site: AKA 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:l' v_1 Ver-c-Q,Y Y VLI.V mss- Lot no.: 5' _Fixture or item:
Tax map/parcel no.:
Backflow preventer X71''"" 31.27
Backwater valve ` 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectoresurnp 25.02
i! PROPERTY OW IER I. 0 TENANT `.
Expansion tank 12.51
: ill' Fixture/sewer cap 25.02
Name:
titu ( Floor drain//Iloor sink/hub 25.02
Address:'. 1 I Va��� 7} Cp 1 V''ll Garbage disposal 25.02
City/State/ZIP:c v r(I1 w(Lvov 0 S(O op Hose bib 25.02
Phone:I +nR J'M D D Fax:(A00) (0C12 l4 Lj L1Z Ice maker 12.51
APPLICANT • 0 cOrrrwr PER,SOi�i e
Tnterceptorigrea.s trap 25 tl
Business name: Fol Y1 1)L4 arim
Primer
gas(value:5 ) Page 2
V Primer 1.2.51
Contact name: {,�i, CiI� j A - Roof drain(counufereial) 12.51
er
Address: 102D(/ ,�1✓ ctiUt 9- (itSID Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)69S-7700 Fax::(3611)6934442 Tub/shower/shouter pan 1251
Email:. o"419(lSr°I�1,�ro1 Qs•c
- - Urinal
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: G4...:_.. 1W �1'Lk, , '£jam,-O AJ ,f1,-y?k, "" Water pipingfl3WV 5629
Address: ) Q,. $ (; '_t Other: 25.02
City/State/ZIP: 51",. e 4.4 arc. 4111131
_ Subtotal
Minimum permit fee:
Phone:Ls-b...13A t'461 Fax:(G. V..,-7g:1-4r ii/ " Plan review (25%of permit fee)
CCB Lie.: f Plumbing��f� Lie.na. State surcharge(12%of permit fee)
—
Authorized signature: t" +Orv" -- TOTAL PERMIT FEE
Print name: ,j `t.Ug ' I Date: i 3)rt:'liii• 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.
lBuiittingWamits\PLMU-PermitApp.doc.10i0l1l9 4404616T(ltl/o2tcOMPVEn)
City of Tigard
114 COMMUNITY DEVELOPMENT DEPARTMENT
■
T l c n lz n Building Permit Review — Residential
Building Permit #: k\k\5--1--NACt_ c W\
/(-C�
Site Address: e ��(, � ,C2mg i vl_P (3 gq- S72.
Project Name: Pd i fri .all- ,i5c120.k ea 7 Lot #: __1
(Ne a il' g=subdivision name;Addition or Alteration illf t name of owner)
l
Planning Review
Py.
�royosal: i cFE
[ Verify address/suite# active in Accela. In River Terrace: ❑ No Lld Yes,River Terrace Review Addendum
SitPlan Elements: E‹,r.osion Control
11Z copies of site plan on 8-1/2"x 11"or 11 x 17"paper V 1,,-tained trees with drip line and tree protection measures
V)rawn to scale(standard architect or engineer scale) &F otprint of new structure(including decks)and FFE
1Yu� rth arrow mU:d ty locations&easements(required for new and additions)
4�J address,project or subdivision name and lot number 5Sidewalk/driveway approach
VI plicant information(name and phone number) 1111':,.cation of wells/septic systems
Lot dimensions and building setback dimensions FA eet tree size,type and location
uare footage of buildings to be demolished L�✓J S et names
S. sting structures on site tomer elevations(2'contours if more than 4'diffe tial)
1P .t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced 1/Yes ❑
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown?0 Yes No
1-lean Water Services—Service Provider Letttte of platted prior to 9/10/1995):
quired: ❑ Yes,applicant was notified M No Received: ❑ Yes ❑ No
M Public Faciliti'a mprovement(PH) Permit:
equired: M Yes,applicant was notified ❑ No rlpplie For: yes ❑ No,stop intake
4ndUseCase#: � Q1 S` 0000 If L� Zoning: £` )1 e Front: Rear: ®
uired Setbacks: Side:
q �� Street Side: e Garage: .,"
u ding Height: Max. Height: Actual Height:
Landscape Area: .z.--Q0 % Lot Coverage Max: 16 cyo
Entrance i. _- back no more than 8'from street-facing wall ❑ Parallel to street or o . '5 degrees or less
Windows ❑ Minimum °• .f area of all street-facing facades
Garage ❑ Garage door is behin. '.:- street-facing wall \\..) kc'
❑ - ❑ No,one of the following is met:
❑ Door extends no more than ••• wall and the - ' a covered porch extending beyond garage.
❑ Door extends no more than 5'from w. . : .-- - is a 12 sq ft.window above garage on 2nd floor.
❑ Garage door width is ❑ 12'or -: ❑ 50%or less of ac..- ❑ 60%or less and includes 7 of following:
❑ Covered porch P 'ecessed entrance ❑ Wall offset ❑ 1 ' .. -.ve ❑ Roof offset
❑ Fire s '.: s ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambre .. ❑ Dormer
■ ccent siding VA Window trim ❑ Window recess ❑ Window projection ■ ony
Clearance rban Forestry PlanA� ,,�JJr % �+4isual
• ensitive Lands: es ❑ No Type: ,�l�(.t`CKl/�/,I6°l/l/NO 1/o2/UJ A l
• Conditions met prior to issuance of building permit
Not
Approved By Planning: "if -- Date: .9/)OA
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.docx
Building Permit Submittal
Original Submittal Date: t 1, It
Site Plans: #
Building Plans: #,,_a_
Building Permit#: ffil Enter building permit#above. �/
Workflow Routing: Planning Q'Engineering liPermit Coordinator 12/Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: E .-1 gineering: (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: Date: -1, IG' \q
Engineering Review
2"-Slope at building pad: 4,
❑ Conditions "Met"prior to issuance of building permit n AR-
R'Easements (encroachments)per engineering conditions of approval and plat
1Z-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ErNo
Assess Water Quantity Fee in-lieu: ❑ Yes ErNo
LIDA Facility on lot: ❑ Yes 12r.No
21/Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
CKApproved by Engineering: 7:,........e4-4 Date: ilia,
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
❑ 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:
Re ision Notice 3: Date Sent to Applicant: ,/
SDC Fees Entered: Wash Co Trans Dev Tax: L/ Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes El /A
LIDA El Yes L✓f N/A
OK to Issue Permit �
Approved by Permit Coordinator: 0Da /�te: ;/ l/J ' /
I:\Building\Fonns\BldgPermitRvw_RES_022819.docx
• •
City of Tigard
111
COMMUNITY DEVELOPMENT DEPARTMENT
lig
C
T l G ARD River Terrace Building Permit Review Addendum
o
Building Permit #: Pc\ T -a-�I\C;_ 01, 1
1/
Address: 1 O Q&) J" t:t a
Project Name: O/. - ,)7 ..1,71- ,L 1,/,. Lot #: -/
(New. igg=subdivision name;Addition or Alteration= .iname 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? 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 f. deep Gabled dormer
ft. deep min. 2ft.,5 ft.wide min. 2 ft.,6f wide
0fe,te
0 q4 , 1112. Eyes on the street: a minimum of 12%of each
/stree facingfaçade must include windows or entrance doors.
Percentage Shown: F.-2 % z '!2 0 0
3. Entrances: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 open onto porch
Entrance opens to a porch: Yes 0 No
If ys,all the following apply: 4 sq.ft.min.
girine street facing entry NJ 1 ft.max.roof above floor of porch
Aa 5 ft. depth min. 30%min.porch roof coverage
4. tailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
Wovered porch min. 5 ft.wide x 5 ft. deep" ❑ ecessed entry area min. 5 ft.wide x 2 ft. deep
all offset min. 16 inches fel" i Dormer min.4 ft.wide'
VJ Roof eave min. 12 inch projection" 0 : .of offset min. of 2 ft.
O Roof shingles either tile or wood I%9able,hip or gambrel roof design/
❑ Roof pitch oriented south min. 500 sq. ft. orizontal lap siding min. 3-7 inches wide
❑ Accent siding min.40%of street façade UtWindow trim min.2'/2"wide by 5/8" deep s
❑ Window 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 0 Attached garage is 35% or less of street façade
. . . . .es and Carports:May face the front or side 1 t line on a corner lot.
Setbacks: 1Cs'
No closer to front or sue e,than longest street-facing wall. ❑ Yes ❑ ► o. f No (Check one):
❑ May extend up to 5 ft.if there is a co •: -d front porch and y. ; e .oes not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is part •►: o-story building and there is a window at the second story
above the garage that faces the street wi . ; . area of 12 sq. .
Width: (Check one) •
O 12-foot- garage door ❑ 40%max. of street façade
• i'o max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: , ." Date: j1(
I:\BuildingWorms\BldgPermitRvw_RES_RT_121417.docx