Permit rl - Plumbing Permit L.:NED
Building Fixtures FOR OFFICE USE ONLY
Rece ivv
City of Tigard AUG 2 0 2020 �j Permit N
n 13125 SW Hail Blvd.,Tigard,0'14, 2�'i, s__f r ,I R D Pardee: O/Z�O/�i�} -S T--2,074.-001 33
g 8 i1- !P'-'11R7 til Plan Review
3111 I : Phone: 503.718.2439 Fax: 50 hfl 1 6 Other Permit No.:
,� �.,> Pardee. 31�?v AGIn -----
TIGAAP Inspection Line: 503.639.417-j! {,(, ( i+'��-2 { f!J)`.� pare Ready/R / U J 'SJ rq�
2 �W�, �/f lads 0 See Page 2 for
Internet: www.tigard-or.gov Notated/Ste ed/Mc hod: 7/ I Supplemental Information
(llY0E o w9pi _ 4a14-' 7tporioi ':. IEE* SClJLE
KNew construction ❑ Demolition W - __ For special information use c/hecklisl.
----- --- - --- Description I Qty. 1 Ea_ I Total
❑Addition/alteration/replacement ❑ Other: New I-2-family dwellings(includes 100 fi.for each utility connection)
CATEGORY OF CONSTRUCTION. SFR(I)bath 312.70
l-and 2-family dwelling ❑ Commercial industrial SFR(2)bath 437.78
-- __--- SFR(3)bath 500.32
❑Accessory building ❑Multi-family -
____- __ - - ---- --- -- Each additional bath .i •-n 25.02
❑Master builder ❑Other: _ Fire sprinkler( par meq.ft.) Page 2
.108 SITE INFORMATION AND LOCATION _Site utilities:
Job site address: V4 23?..., a a D �1� - Catch basin or area drain 18.76
Drywe--- - ^--� O - -- Footing
1,leach line,or trench drain age 2
City/State/ZIP. (� e ---
-__-- Fooling dram(no.linear 0.: ) Page 2
Suite/bldg./apt.no.: 1`\ Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
---- -It ^ , t t 1 Sanitary sewer(no.linear ft.: ) Page 2
.. 111 ''' A4�3L,la � -- Storm sewer(no.linear ft.: ) Page 2 -
__.____ _____ __ Water service(no.linear Il.:_) Page 2
Subdivision: Lot no.: Fixture or item: _
Tax map/parcel no.: ---- Back flow preventer .---- _.I31.27----
DESCRIPTION OF WORK Backwater valve - _-_ 12.51_--__
Clothes washer 25.02
Dishwasher 25.02
QC) c yci:in V-.1) �t Drinking fountain _-_ i_25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT r Expansion tank 12.51
\ 1--C1- � x Flodl cap 25.02
--- -------- Fl000rr drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) 1 Ice maker 12.51
APPLICANT: 0 CONTACT PERSON I Interceptor/grease trap 25.02
--
'_`---___ __ -- .- - - Medical gas(value:$ ) Page 2
Business name: -- - ---
-- ----- - -- - - ------ Pruner 12.51
Contact name:
_.___ ___-___-- _... _ _ _ Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
I City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
- ---- - - -- -- - - Urinal 25.02
E-mail:
-- - --- -- Water closet 25.02
CONTRACTOR --- -
. n �. -= - 4 - Water heater 37.52 I
Business name: vel. •, ofti-.._IAA) atm woRutl �t Water plping/DWV 56.29
Address: tinS Lalst Other. 25.02
City/State/ZIP•. gt(1'\ `I 1 • (�� Ci 40(0O _ _ ___ _ Subtotal
Phone:( Il3ICJ i� C?,- Fax:( Gln Q q ._._._--__. - Minimum permit fee: S72.50
/' J Plan review (25/u of permit fee)
CCB Lie: It 2�_ Plumbing Lic_no_:: Z O.. _ - - ----
LU State surcharge(12%of permit fee)
Authorized signaturj•� TOTAL PERMIT FEE
I Print name_ (�Y.N i a Q {�Qe Date_ / /L A this permil application expires if a permit Is not optatncd witKin 180 days
���lll I-rGVI after it has been accepted as complete.
"Fee methodology sd by To-County Building Industry Service Board.
I'Aullding,l'crnuis,PLMU-PermitApp doe 10/01:09 4-00-4616T(10,112,(Dm WI-B)
CITY OF TIGARD MASTER PERMIT
1 2 t COMMUNITY DEVELOPMENT Permit#: MST2020-00133
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/09/2020
TIGARD Parcel: 2S107AA11100
Jurisdiction: Tigard
Site address: 14238 SW GOLD COAST TER
Subdivision: ROSHAK RIDGE Lot: 111
Project: Polygon at Roshak Ridge, Lot 111
Project Description: New SFA
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 78 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 34 Bathrooms: 3 Second: 684 st Garage: 613 sf Front: 12 Smoke
Dwelling Units: 1 Third: 673 sf Right: 3
Detectors: Yes
Total: 1435 sf Value: $210,085.67 Rear: 5
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: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
BckBw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywall-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvoes 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 addl 500 sf: 3 201-400 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: 0 801+amp-1000v: 0
1000+amplvolt: 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 1435
Owner: Contractor:
POLYGON WLH LLC POLYGON WLH,LLC 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: PHONE: 360-695-7700
FAX: 360-693-4442
Total Fees: $26,544.23
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 952-001-00 O. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2`322,1987 or 1.800.332.2344.
��Issued By: Cam. l;ic_2 /ass-� Permittee Signature: �"'" PG/ C+�
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.
J Building Permit ApplicatioB E C E I VE D
Residential FEB 0 3 2020 FOR OFFICE USE ONLY
City of Tigard CITY OF TIGARD n iBy: /2 Y a sad Permit Wf �O�IJ 1017/33
III • 13125 SW Hall Blvd.,Tigard,OR �,��LDING DIVISION Pin Rer' �,Q OtherP
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: dD ?�� AA ertni //.4-7(J(J4J Q0.e,
Inspection Line: 503.639.4175 Dare Ready/By: cure, El See Page 2 for
TIGARD Notified/Method: Supplemental www.tigard-or.gov Information
TYPE OF WORK REQUIRED 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
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF C ONSTRUCTION work indicated on this application. Q�
El 1-and 2-family dwelling ❑Commercial/industrial Valuation $ l Di b iJJ
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other. Number of bathrooms: r , I{]
JOB SITE INFORMATION AND LOCATION Total number of floors: 3 abL D
Job site address:1 42,58 CvoLo exAs-r Tig.e. New dwelling area: 1i4 square feet (i13
City/State/ZIP:Tigard,OR 97224 Garage/carport area: (.013 square feet U 99
Suite/bldg./apt no.: Project name:Roshak Ridge Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
64kdt41iiggiarea: 12 square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Roshak Ridge Lot no.: I( ) 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: $
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 St.,Ste 510 Occupancy groups:
City/State/ZIP:Vancouver WA 98660 Existing:
Phone:(360)695-7700 Fax:( ) New:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH,LLC (Please refer to fee schedule)
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
Amount received:
Phone:(360)695-7700 Fax::( )
E-mail:permitsubmmittals®polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEESx.
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic 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%61P: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: $201.60
Authorized signature: . This permit application expires if a permit is not obtained
�, Q within 180 days after it has been accepted as complete.
Print name:Tonja Morris " D•D4/17l2019 *Fee methodology set by Li-County Building Industry
Service Board
T-\Rnildine\Permits\RTSP-RRcPerrnitAnn rine 02/24/2011 440-461'ITN 1J02/COM/WEBI
Mechanical Permit Applicati-RECEIVED FOR OFFICE USE ONLY
City of Tigard Received Permit
'I 13125 SW Ha11 Blvd., D
Tigard,OR 97223 FEB 0 3 2020 Date/By: ryadae �/33
Pl
Phone: 503.718.2439 Fax: 503.598.1960 an Review Other Permit:
I:; /_, Inspection Line: 503.639.4175 CITY OF TIGARD Date By:
Date Ready/By: /mom: 0 See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE USE!CHECKLIST,
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit
Value:$
CATEGORY OF CONSTRUCTION . RESIDENTIAL EQLIPMENT/SYSTEMS FEES*.
ig 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist
Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE LNFORMATION AND LOCATION ' ' � Heating/cooling:
Job site address: 14{7,3E5 (i.. Ch'c4ST Air conditioning 46.75
-1t�o LT Furnace 100,000 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.: l I Other 23.32
-- Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER Other. 23.32
OTENA_'VT Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
Address:703 Broadway St..,Ste.510 equipment 33.39
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 [] CONTACT PERSON Other. 23.32
Business name:Polygon WLH,LLC Fuel piping:
S14.15 for first four;54.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
Wall/suspended/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
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 lie.:209001 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
oI 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
IABuilding\Pemiits C PermitApp_o4ot 13.doc 440-461 7T(11/02/COM/WEB)
RECEIVED
Electrical Permit Apmlicatio� 4 : ; f' o" o s 3 - r;�>f,� ar a ::r--<
EB 0 32020 _ yr.� . 2-- . r>City of Tigard Received Permt --Cre12-0o2C, i V pl VV// J
d
y igard,OR 9 Y OF TIGARD Date/By:
cBy:
Plan Review
74
13125 SW Hall Blvd_,T
Phone: 503.7182439 Fax: 503�j)@�91NG DIVISION Date/By: Related Permit tl:
T1GIil2.1� Inspection Line: 503.639.4175 ReadyDateBy: r Er See Page for
- - c Internet www.tigard-orgov Notifed/Method: Supplemental Information
' TYPE OF:WORK
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans whams checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
_ -:,:..•-: ..'r _;.:CAT,RGORY._OF-CONSTRUCTION. ..: ::'. ;i...:...... .. . .. • exceeds 10,000 amps at 150 volts or ❑Floating buildings.
El I-and 2-family dwelling El Commercial/industrial ElAccessory building less to ground o exceeds la,000 ❑Commercial-use agricultural
amps for all other installations buildings.
❑Multi-family ❑Master builder
❑Other ❑Fire pump. ❑Installation of 150 KVA or
.._f:`.:`: SOB SI1-a•:1NFo ATION"AND LOCATI,OTT;'=, : .. ❑Emergencysystem larger separately derived
,, 0 Addition of new motor load of system.
14.235
Job#: Job site address: 4. Goa) CvRET T£ - 100EF or more. ❑ A""E "1-2""1-3"
City/State/ZIP:Tigard,OR 97224 ❑Six or moreresidentialtmi occupancy,
❑Health-care facilities. ❑'Recreational vehicle parks.
Suite/bldg./apt#r`- _ I 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 SCu DILE
Description I Qty. I Each I Total 1 .
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: 11 ' Includes attached garage.
1,000 sq.ft or less 168.54 4
Tax map/parcel#: Ea add'l 500 sq.ft.or portion 33.92 1
DESOF2IP.TION OF WORK Limited energy,residential
(with above sq.ft) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft)
Renewable Energy LI See Page 2
la PROPERTIs 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 to400 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 55226 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 i 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 I . 0 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
service or feeder fee,fist
Address:703 Broadway St Suite 510 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Each acid')branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 Fax :(360)693-4442 Each mannfertured or modular 67.84 2
dwelling,service and/or feeder
Finail: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
panel,alteration,or extension ❑ See Page 2 2
City/State/ZIP:Portland OR 97213 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 6625/hr
Phone:(503)319-2192 I Fax:( ) Investigation(1 hr min) 90.00/hr
)~:mail'solarpda@me.com Industrial plant(Ihrmin) 78.18/hr
•
Inspections for which no fee is 90.00/)u
CCB Lie.: 199188 Electrical Lie.: c923 Suprv.Lic.: 48715 . spexificallylisted(hhrmin)
Suprv.Electrician signature, EI ECTRII Ai PERMIT FEES
required Subtotal
Print name: Kile Rood Date: 03/08/2019 ❑Plan Review Required(25%of permit fee):
•
fj�/ State surcharge(12%of permit fee):
Authorized signature: y l -�� 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.
r
Plumbing Permit Application Building Fixtures RECEIVED
FOR OFFICE USE ONLY
City of Tigard FEB 0 3 2020 Received
■ 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit No s`r'7_r 7.,-.40/3
Phone: 503.718.2439 Fax: 503.59a�t(ARP OF TIGARD Plan Review
l' +v Date/By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 iTin niNG CIVISION DateReady/By: runs H See Page 2for
Internet: www.tigard-or.gov Notified Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
E New construction 0 Demolition For special information use checklist.
Description I Qty. Ea. I 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 ❑Commercial/industrial SFR(2)bath 437.78
ElAccessory building El Multi-family
SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 4N 7j� l�+g-r 1,a2 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 fl.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision:Roshak Ridge Lot no.:
Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
V Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
E PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:Polygon WLH,LLC FixtureJsewer 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
E APPLICANT ❑ 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 12.51
E-mail:permitsubmittals@polygonhomes.com Urinal 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: $72.50
CCB Lie.: 184601 --41 ifIcl' Plumbing Lic.no.:PB732
Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:RobertDlshman Date: This permit application expires If a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:Building'Permits1PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
i COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: /f,.S j p a 0 — 'e'/3 3
Site Address: H 117 3 Sin/ bold Cx-r 1errac2
Project Name: g05 - (-kt -e,. ._ _ _ _ , - Lot #: L 1 1
Planning Review - U
Proposal: ,J Q A Rowhougt, IAIA Et-
sgi Verify address/suite#active in Accela. vi, In River Terrace: 0 No 1S( Yes,River Terrace Review Addendum
SitePlan Elements: ,F4Erosion Control
Y_'AS copies of site plan on 8-1/2"x 11"or 11 x 17"paper (detained trees with drip line and tree protection measures
Drawn to scale(standard architect or engineer scale) footprint of new structure(including decks) and FFE
SEffi orth arrow Utility locations&easements(required for new and additions)
,Site address,project or subdivision name and lot number Midewalk/driveway approach
Applicant information(name and phone number) /V4 ocation of wells/septic systems
iv�1Lot dimensions and building setback dimensions Street tree size,type and location
Square footage of buildings to be demolished x$treet names
xtsting structures on site Comer elevations(2'contours if more than 4'differential)
N t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? I i 0—Ago
II area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es No
)N" Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified k No Received: ❑ Yes ❑ No
Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yesj a cant was notified K No Received: ❑ Yes 0 No
SDC Exe> erF or U �j -fer.- ❑ Yes g No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified y No Applied For: ❑ Yes 0 No,stop intake
CELLand Use Case#: j)(De2aM-0Duo2— ix Zoning. P. I2
Required Setbacks: Front B Rear: Side: j 8.S—
.IN—Building Street Side: 3 Garage:
Building Height: Max. Height: N/(ft Actual Height 34
TkLandscape Area: 2n % g Lot Coverage Max: g(7
Entrance I1 Set baci
o m re than 8'from street-facing wall 0 Parallel to street or offset 45 degrees or less
Windows ■I Minim12°/ of. -a of all street- acing facades
Garage ■I a . ageor i b:., d widest strf�unll ❑ Yes ❑ No,one of the following is met:
Ili r to . o more than 5'from wall and ere i a c vered or exten ' beyond garage.
❑ r t- .s o more than wall and t ge on 2°d floor.
II Garage .oo wi this 0 12'or 1'ss 50%or 1 ss o a a e 60%or less and includes 7 of following:
❑ Cove d porch ❑ Recessed entrance 0 Wall offset 0 1'Roof eave ❑ Roof offset
❑ Fire shingles 0 Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
(Visual Clearance idUrban Forestry Plan
X Sensitive Lands: ❑ Yes X No Type:
;4, Conditions met prior to issuance of building permit
Notes: �� /
Approved By Planning: Date: i3
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: ?�o2p
Site Plans: # �/
Building Plans: # `3
Building Permit#: 117rEnter building permit#above.
Workflow Routing: l'Planning Engineeringrmit Coordinator �Bnilding
Workflow Sign-off: Ja Sign-off for Planning(include notes from planning review)
Route Application Documents: ('Engineering (1)copy of permit application, (1) site plan, (1)building plan and
al plan review routing form.
Ihr Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: 49 .e -' Date: /.2-y`346
Enflineeting Review
Slope at building pad: /J I
Conditions"Met"prior to issuance of building permit //Al
Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes l7Y No
Assess Water Quantity Fee in-lieu: 0 Yes VNo
LIDA Facility on lot: 0 Yes 'No
0/Final Plat Recorded:
0 NOT Approved by Engineering: Date:
Notes:te
E Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved 0 Not Approved
Permit Coordinator Review
lik-Condidons "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:
SDC Exemption: 0 Received Does not apply
14. SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: EYes 0 N/A
LIDA 0 Yes IX N/A
-OK to Issue Permit J�
Approved by Permit Coordinator: � � Date: `[IZA 12'0
1:\Building\Forms\BldgPermitRvw_RES_122419.docx
City of Tigard
11111 q COMMUNITY DEVF.T OPMENT DEPARTMENT
C .
TIGARD River Terrace Building Permit Review Addendum
e
Building Permit #:
Site Address: `4Z�jg SW Gold Ccxi.C+ T Y-
Project Name: IRoSva,K Rto{o�C, Lot #: i 1 l
(New dwelling=subdivision nar- Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.070.1):
Is the project subject to the plan district design standards?4 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 Gabled dormer
ft. deep min.2ft.,5 ft.wide min. 2 ft., 6ft.wide
K 0 0 0
2. Eyes on the street: a minimum of� 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: F..a� /y o {2'. (3`,v
3. Entrances:At least one entrance must meet both of the following standards:
tl`jMax. 8 ft. setback from longest street- facing wall Parallel to street angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: .1(Yes 0 No
If yes,all the following apply: 25 sq.ft.min.
AOne street facing entry 14-12 ft.max.roof above floor of porch
N " ft depth min. Z30%min. porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facade
Covered porch min. 5 ft wide x 5 ft. deep _Recessed entry area min. 5 ft.wide x 2 ft. deep 'r
JJ Wall offset min. 16 inches 12.—_ ❑ Dormer min. 4 ft.wide
[Roof eave min. 12 inch projection -1 12-- 0 Roof offset min. of 2 ft. n
CI Roof shingles either tile or wood Gable,hip or gambrel roof design f'I R.
0 Roof pitch oriented south min. 500 sq. ft. 0 Horizontal lap siding min. 3-7 inches wide
Accent siding min.40%of street facade Window trim min. 2 t/"wide by 5/8"deep Fig_
0 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 F 0 Attached garage is 35% or less of street facade
5. Garages and Carports:May face the front or side lot line on a corner lot.
Setbacks:
No closer to front or side lot line,than longest street-facing wall. 0 Yes'No. If No (Check one):
.81--May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story
above the garage that faces the street with a min. area of 12 sq.ft.
Width: (Check one)
i2-foot-wide garage door ❑ 40%max. of street facade
O 50%max, of street facade with 7 detailed design elements
Notes: 411.03
{ ��
Approved By Planning: Date: 4/ /. /X
\R I: uiId g\Forms\BldgPermi[Rvw_RES_RT_1214I7.docx �`�