Permit Plumbing Permit Armliaa 5CENSYJ
Building Fixtures 1 7 2(l�,(l FOR OFFICE USE ONLY
�u� l 1'(1'�J 'i
CityofTigard �z/n p Date/BP: C/ 1-00
1111 • 13125 SW Hall Blvd.,Tigarr a,• 'vy27i TI A� , Y' / V Permit Nglys°f'� ! t�v" 't 7
�� Plan Review` A//
Phone: 503 718.2439 %''�,$P) S r lo S N Date/By CPI i S t7 �1'�-C7) Other Permit No.
Inspection Line: 503.639'44 ` -..,•-'I -' IIIJJJ l V ----
TIGARD Date oohed/Method
/j�� _/) J ia: I RI See Page 2 for
Internet: www.ligard-or.gov Notified/Method I� ICY 1 Supplemental Information
TYPE OF WORK `: . 76A/079-.- FEE* SCHEDULE
New construction ❑ Demolition For special information use checklist.
--- - -- ---- Description I Qty I La. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi family
Each additional bath/kit n _!vet/ 25.02
❑ Master builder ❑Other: Fire sprinkler(I sq.ft.)! 525 41 Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
/_ -- -- - --
C - -
Job site address: i420 � i lC�1-I f Catch_ basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: �, Q ----
C
Footing drain(no.linear fl.: ) Page 2
Suite/bldg./apt.no.: ' Project name: a 2Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
ad-
f+7 i /� �.* ^� Sanitary sewer(no.linear ft.: ) Page 2
4Nt 7Lt� l L �29 ? "1�------- _------ Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: 1,ot no.- Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
- -- -_---- Backwater valve 12.51
DESCRIPTION OF WORK '..
-- - --- - -- Clothes washer 25.02
I_ Etain
25.02
- ump 25.02
0 PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
------ ---- Floor drain/floor sink/hub 25.02
Address:
_-___ ___ _ Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:
- ----- --- Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62 54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: I Water closet --- 25.02
CONTRACTOR -----
__ Water heater 37.52
Business name: wool enA003 A bpi tocAco.f Water piping/DWV 56.29 __
Address: 10`4-S Lk) (s,__a)Lit AbiA, 26,1€1 CI )-f Other: _ 25.02
City/State/ZIP: ' ..o11 A(Iop_ afro Subtotal
Phone:(16.03 Gc,:,,; • i--4.15\ Fax:(6'03 (0; , Q O`7' .-. Minimum permit fee: $72.50
2 • r Z� SD(APb Plan review (25%of permit fee)
CCB Lic.: Plumbing Lic.no.
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: /� Date: Q t na This permit application expires if a permit is not obtained within 180 days
/U� �y I I� after it has been accepted as complete.
--' "Fee methodology set by Tri-County Building Industry Service Board
I i301ldmg1PermirrPLMU-PermllApvloc 10/01/09 440-4616T(I0i02/COM:WI'H1
t CITY OF TIGARD MASTER PERMIT
' ! I COMMUNITY DEVELOPMENT Permit#: MST2019-00327
Date Issued: 02/27/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107AA07100
Jurisdiction: Tigard
Site address: 14297 SW 169TH AVE
Subdivision: ROSHAK RIDGE Lot: 71
Project: Polygon at Roshak Ridge, Lot 71
Project Description: New SFA.
BUILDING
Floor Areas Reauired Setbacks Reauired
Stories: 3 Bedrooms: 2 First: 646 sf Basement: 103 sf Left: 0 Parking Spaces: 0
Height: 28 Bathrooms: 3 Second: 633 sf Garage: 532 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 0
Detectors: Yes
Total: 1382 sf Value: $195,164.08 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
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel'Noes Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Fumy=100K: 0
ELECTRICAL
Residential Unit Service Feeder Tema 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:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA VB R-3 1382
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 NFPA 13D Sprinklers
Required
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $25,031.43
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..232.19877 or 1..800.332.2344.
Issued B . Permittee Signature: CA/ ref r1 /'Lf 4770N
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.
t
•
, 1--Aiktt_. ), lk-A , ‘..,_,C‘' '
Building Permit Application
Residential ; 14 ( '°- " FOR OFFICE USE ONLY
- Received 13 ,Q c T ^(�� j.
City of Tigard Date/By: ! Permit No.,"
13125 SW Hall Blvd.,Tigard,OR 97223 FEB V P, 9 Plan Review �1•;�y\f, ��('\^�
Phone: 503.718.2439 Far: 503.598.1960 Date/By: '� ' / ' Other Permict- So�
TIGARD Inspection Line: 503.639.4175 f _,<-s Date Ready/By: saris El See Page 2 for
Internet: wwryv.tieard-or ,�el ' Notified/Method:0/' 9��`1 -r / Supplemental Information
TYPE OF WORK REQUIRED DATA I-AND 2 FAMILY DWELLING
®New construction El Demolition Permit fees*are based on the value of the work performed.
' Indicate the value(rounded to the nearest dollar)of all
❑Addition alteration/replacemen[ ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® ❑CommerciaV ndustrial v'I-and 2-family dwelling Valuation: $ '9 C `L4
❑Accessory building El Multi-familyNumber of bedrooms r
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: `( 19
Job site address: ( LI 7 211 cr /1 / I t�ti trA New dwelling area: _&$'�,� square feet �33
City/State/ZIP:Tigard,OR 97224 V v Garage/carport area:5 square feet lo4U
Suitelbldgiapt.no.: `a Project name:Polygon at Roshak Ridge Covered porch area: square feet t 03
Cross street/directions to job site: Deck area: / square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Polygon at Roshak Ridge Lot no.: 11 Permit fees*are based on the value of the work performed.
I 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.
New SFA Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Polygon WLH 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 ❑ CONTACT PERSON BUILDING PERMIT FEES`
Business name:Polygon WLH LLC (Please refer mceschedule)
Structural plan review fee(or deposit):
Contact name:Amanda Gavin
FLS plan review fee(if applicable):
Address:703 Broadway St.Ste 510
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Phone:(360)695-7700 Fax: :(360)6934442 Amount received:
E-mail: permitsubmittals@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYS 1 Eh!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 lic.:207247 Total fee due upon application: $201.60
Authorized sift e: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Amanda Gavin Date:/(/(€7) *Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
t
Mechanical Permit Applicati0RECEIVED FOR OFFICE USE ONLY
City of Tigard Received ���
g Date/By: Permit No. T�,}yl,-,
'i 13125 SW Hall Blvd.,Tigard,OR 97223 AUG 2 9 2019 Plan Review ` !JV
' - Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Pemtit:
1tfrA1tI) Inspection Line: 503.639.4175 CITY OF TIGARD DateReadyBy: Iucis: 0seePage2for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE-USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
rg 1-and 2-family dwelling ❑ Commercial/indushial ❑Accessory building For special information use checklist.
Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cabling:
Pt�/FJ Furnace
Job site address: litre 1 5w lD \1VI Air 100,000conditioning 46.75
ce BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: 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.: 1 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
^^ __11 � -- -_ t �y h Flue vent for water heater or gas
(t N��YC4.Fi-v g '� MST 1 JT W lC-100�jZ71 fireplace 23.32
Log lighter(gas) 23.32
. Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
El PROPERTY OWNER 0 TENANT Other: 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 Fuel 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
WalVsuspended/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
ilitk 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)
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
0'- ihl days after it has been accepted asi complete.
Authorized signature: `^' ' u�'�'�T • Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:04/08/2019
1:\Build!no 1P.rn,il.\UFr P...,91 e....nent 1 a A.... .,,, ..,....................-...
Electrical Permit ApplicationR EC E I VE D Received
FOR OFFICE USE ONLY
City of Tigard Date/By:
Permit amS`�\p-� �
13125 SW Hall Blvd.,Tigard,OR 97223 A U G 2 9 2019 Plan Review
y Phone: 503.718.2439 Fax: 503.598.1960 Date/By:: Related Permit#:
'1 Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: Jude: I Ei See Page 2 for
TIGARI)
a Internet wwmtigard-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.
❑ 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 ❑ Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations, buildings.
0 Multi-family 0 Master builder ❑ Other: 0 Fire pump,
0 Installation of 150 KVA or
JOB SITE D4FORMA.TION AN]) LOCATION 0 Emergency system. larger separately derived
n �} `W � 0 Addition of new motor load of system.
Job#: Job site address:
y ✓'1 1 J 1 100HP or more. ❑••A" ••E"••I.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
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description 1 Qty. I Each I Total I •
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: -11 Includes attached garage.
I,000 sq.ft.or less i 168.54 4
Tax map/parcel#: Ea add'l 500 sq.ft.or portion , 33.92 1
DESCRIPTION OF WORK Limited energy,residential
,L,� A_f� C"t' ' 5 1 (with above sq.ft.) 75.00 2
vim' e�� J t �� ` ^ �� L 1 Limited energy,multi-family
residential(with above sq.ft) 75.00 2
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
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 0 CONTACT-PERSON Branch circuits—new,alteration,or extension,per panel
A Fee for brooch circuits with •
Business name:William Lyon Homes,Inc. above service or feeder fee,
each branch circuit 7.42 2
Contact name:Nichole Thorpe - B.Fee for branch circuits without
Address:703 Broadway St Suite 510 service t feetfee,first
branch circui 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each add'1 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
dwelling,service and/or feeder
Email:permitsubmittals@polygonhomes.com 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 ❑ 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) 6625/hr
Phone:(503)319-2192 Fax: ( ) Investigation(1 hr min) 90.00/hr
•Email:solarpdx@me.com Industrial plant(1 hr m n) 78.18/hr
Inspections for which no fee is 90.00!hr
CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lie.: 4871,E$ specifically listed(h 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: /� r— TOTAL PERMIT FEE:
\ This permit application expires if a permit is not obtained within 180
Print name: Kile Rood I Date: 03/08/2019 days after it has been accepted as complete.
Plumbing Permit Application
Building Fixtures ECEIVED FOR OFFICE USE ONLY
City of Tigard AUG 2 9 2019 Received M
Date/By: PermitNo.MSSr XCI_a:PjA
13125 SW Hall Blvd.,Tigard,OR 9722 v vv CC
1 a fTY DING
TIGARD Plan Review
Phone: 503.718.2439 Fax: 503.598 CLL Other Permit No.:
boi, DING DIVISION Date/By:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Auras: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist
Description Qty. 1 Ea. 1 Total
❑Addition/alteration/replacement ❑ 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
ElAccessory building ®Multi-family SFR(3)bath 1 500.32
0 Master builderEach additional bath/kitchen .C5 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 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.: 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.: Fixture or item:
Tax map/parcel no.: Backflow preventer i 31.27
DESCRIPTION OF WORK Backwater valve 1 12.51
W\ tI W� 2.-CA Clothes washer tl 25.02
t I �, - ,- b b' 2.-� Dishwasher 125.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:Polygon WEAL 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 t 12.51
® 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 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 3 12.51
E-mail:permitsubmittals@polygonbomes.com Urinal 25.02 a
CONTRACTOR Water closet 25.02
Water beater 1 37.52
Business name:Alliance Plumbing Water Pi tping/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)
44itien-•"-- State surcharge(12%of permit fee)
Authorized signature: ( TOTAL PERMIT FEE
Print name:Robert Dishman Date: ✓ op.
` lel This permit application expires If a permit Is not obtained within ISO days
` I after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:1Building\Permits/PLMU-PemsitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
, 1
City of Tigard
rillg COMMUNITY DEVELOPMENT DEPARTMENT
i
T I G A R D Building Permit Review — Residential
Building Permit #: CrS- 7A:2ACt- tp3a�
Site Address: 14"q 9- S)&) lhp 9-744 t9lit-_
Project Name: Ppl h a¢ -L , Lot #: 91
(New: I g=subdivision name;Addition or Alteration st name of owner)
Planning Review
Proposal: /LILit) Rry9-
Il/ Verify address/suite#active in Accela. ZIn River Terr.ce: 0 No lYes,River Terrace Review Addendum
Site Plan Elements: iv:Erosion Control
424 opies of site plan on 8-1/2"x 11"or 11 x 17"paper 1, hit::
rained trees with drip line and tree protection measures
raven to scale(standard architect or engineer scale) !F otprint of new structure(including decks)and FI h
I9orth arrow V' •ty locations&easements(required for new and additions)
ite address,project or subdivision name and lot number ►Sidewalk/driveway approach
ail +plicant information(name and phone number) ,61 0',cation of wells/septic systems
iti • dimensions and building setback dimensions MI 5fteet tree size,type and location
it, uare footage of buildings to be demolished LVSigeet names
I!'% 'sting structures on site VComer elevations(2'contours if more than 4'diff ntial)
i"4 Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ISQYes ❑I'
impervious area(applicable if R-7,R-12,R-25&R-40) If es,is a storm water •uali facili shown? 1:i es o
Dt* lean Water Services-Service Provider Lettey(lot platted prior to 9/10/1995):
Required: 0 Yes,applicant was notified V'No Received: 0 Yes 0 No
NJ Public Facih s Improvement(PFI) Permit:
quired: Z Yes,applicant
tt}waas notified 0 No Applie For: Yes 0 o,stop intake
�and Use Case#: o/� cow,/ IG Zoning: —
equi �G1red Setbacks: Front: l� Rear: t1 Side: 0 Street Side: Garage: ,(5
wilding Height: Max. Height: II
Actual H ", ht:
Landscape Area: ....- 0 % Lot Coverage Max: e C) %
Entrance t back no more than 8'from street-facing wall 0 Parallel to street or o degrees or less
Windows 0 Minim %of area of all street-facing facades
Garage 0 Garage door is be • widest street-facing wall 134( 0 0 No,one of the following is met:
❑ Door extends no mor 5'from wall an they covered porch extending beyond garage.
❑ Door extends no more than 5' ere is a 12 sq ft.window above garage on 2"d floor.
0 Garage door width is 0 12'or le 5 o ess of facade 0 60%or less and includes 7 of following:
❑ Covered porch 0 essed entrance 0 W et 0 1'Roof eave ❑ Roof offset
❑ Fire shin C] Lap Siding 0 Roof pitch ❑ ,or gambrel roof 0 Dormer
O nt siding ,Ll Window trim ❑ Window recess ❑ rojection 0 Balcony
1 .sual Clearance Urban Forestry an
O� ensitive Lands: 0 Yes Q No Type:
Co ditions met prior to issuance of building permit
No /�� '
Approved By Planning: '—' Date: L�7I
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
1:\Building\Forms\BldgPemritRvw_RES_022819.docx
Building Permit Submittal
Original Submittal Date: 1( - Iq
Site Plans: # 3
Building Plans: #
Building Permit#: 5 Enter building permit# above.
Workflow Routing Er Planning ['Engineering [-Permit Coordinator Er-Building
Workflow Sign-off: El Sign-off for Planning(include notes from planning review)
Route Application Documents: [r Engineering. (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
ii/Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: g I Ig
Engineering Review
IV Slope at building pad: z
❑ Conditions "Met"prior to issuance of building permijI
Easements (encroachments)per engineering conditions of approval and plat
Ct
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes LNo
Assess Water Quantity Fee in-lieu: 0 Yes tNo
LIDA Facility on lot: 0 Yes 4/No
I Final Plat Recorded:
0 NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: 73 /�
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
Permit Coordinator Review
0 Conditions"Met"prior to issuance of building permit
0 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: es 0 N/A
zy
Tigard Trans SDC: ss ❑ N/A
Parks SDC: L� Yes ❑0 N/A
LIDA 0 Yes hJ N/A
OK to Issue Permit �'�j� 1 cj
Approved by Permit Coordinator: /6l'/ ' Late:U / �3 �/
I:\Building\Forms\BldgPerniltRvw_RES_022819.docx
City of Tigard
11111 COMMUNITY DEVELOPMENT DEPARTMENT
C
T 1 c ARD River Terrace Building Permit Review Addendum
Building Permit #: hc\Syjct_ p(33a----A-
Site Address: g2 449 ) /jp 471/ j ,e
Project Name: 0/ op - P-0- i ,`,>, ' Lot #: f
(New ng=subdivision name;Addition or Alter a =last 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?2.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 ft. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dorm
ft. deep min. 2ft., 5 ft. wide min. 2 ft., 6fy.wide
❑ ❑ ❑
2.Eyes on the street: a minimum of 12%o each street facing facade must include windows or entrance odors.
Percentage Shown: >l2 ° °
3. trances:At least one entrance must meet both of the folio g standards:
11Ll Max. 8 ft. setback from longest street- acingwall 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:
❑ overed porch min. 5 ft.wide x 5 ft. deep 0 %ebessed entry area min. 5 ft.wide x 2 ft. deep
it )7Vall offset min. 16 inches [ Dormer min.4 ft.wide
IIVRoof eave min. 12 inch projection 0 lye6of offset min. of 2 ft.
❑ Roof shingles either tile or wood IG Gable,hip or gambrel roof designfrC
O 'oof pitch oriented south min. 500 sq. ft. ❑ orizontal lap siding min. 3-7 inches wide
D5 Accent siding min.40%of street facade'ek-c= Ed Window trim min. 2 1/2"wide by 5/8" deep f
❑ 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 facade
5. and Carports:May face the front or side lot line S2tga co er lot.
Setbacks:
No closer to front or side lot , longest street-facing wall. 0 Yes 0 No. heck one):
O May extend up to 5 ft.if there is a covere orch and gara e not extend beyond the front porch.
O May extend up to 5 ft.where the garage is part of a building and there is a window at the second story
above the garage that faces the street with a . area of 12 sq.ft.
Width: (Check one)
❑ 12-foot- ' age door ❑ 40%max. of street facade
a max. of street facade with 7 detailed design elements
Notes:
�� i/i
Approved By Planning: .� ,„ ,� Date:
1:'3uilding\Fotms\BldgParmitRvw_RES_RT_121417.docz