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Permit Plumbing Permit Applilago "'c i , 'i . !L..,t...p'.,, L. Building Fixtures AUGp q FOR OFFICE USE ONLY G 2 d 2020 Received �i City of Tigard pate/B is Permit Nl 5 g 41 13125 SW Hall Blvd.,Tigard, 97223 -T-1,--, y. - �� ����� " g R'f Plan Review Phone: 503.718.2439 Fax 503.598-1960 + .3+" t Date/By: �.IJ A ..4 Other Permit No.: TIGARD Inspection Line: 503.639A175 01v 13 K:1 Date i d/Mc ho 1 .Iii.... ® See fags 2 nn' Internet: www.hgard-or.gov Notified/Me hod: �/2/7 G5 'W O {,CT Supplemental Information TYPE OF WORK ..- FEE* SCHEDULE `2�tJtra'v K New coma-ruction ❑ Demolition For special information use checklist. - --- .- ----- - - Description I Qty. I Ea. I Total ❑Addition:alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath - 312.70 - AfI-and 2-family dwelling f❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 I 0 Accessory building I ❑Multi-family -- ----- Each additional bath/kitclisia. 25.02 ❑Master builder I ❑Other Fire sprinkler( js .ft.) /t�35 Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: ) ___ Job site address: V.A.7 2_ e9ilJ �.--1 1) w \�� Catch basin or area drain 18.76 City/State/ZIP: f L�' �� c 'q`iAc) Drywall,leach line,oar trench drain 18.76 1 Footing drain(no.linear ft.:_) -�I Page 2 Suite/bldg./apt.no.: 0'�- Project name: ?._.,c)Sh Manufactured home utilities I 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 ` 5 _Ux- 1 A o- -Sanitary sewer(no.linear B.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Lot no.: Fixture or item: "fax map/parcel no.. Back flow preventer - 31.27 DESCRIPTION OF WORK Backwater valve 12.51 -- ------ -- ' ' Clothes washer 25.02 (�� _ Dishwasher 25.02 ham_ n)C ; A 4 1C.L) c>-kloVDrinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑>-TENANT. Expansion tank 12.51 Name: � ' .i V - IZASC6 - Fixmrc/sewer cap 25.02 - -Floor dram/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 0 APPLICANT ,0 CONTACT PERSON ' Interceptor/grease trap 25.02 - ---- Business name: Medical gas(value:$ ) Page 2 --- -- 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) I E-mail --Urinal 25.02 - - --- -.---- --- Water closet 25.02 CONTRACTOR -- -- ' . -- Water heater 37.52 Business name: ; 4D0) Or 1 ��lti). 6.1..4\ `f Water piping/DWV 56.29 n Address: VVV{CCC ��j,� � `� , rn� `n/�`, Other: 25.02 - City/State/ZIP: 1�1. dSr (�' 20 _ _.. _ _--_ Subtotal Phone:( sG71G' 171.61s� Fax:O tOb9- C O+ 1 .__-__ _ Minimum permit fee: $72.50 --- q • Plan review (25%of permit fee) CCB Lic.: [ lZlZ. Plumbing Lic.no.: 2- 1sa�4) -- ---- State surcharge(12%of permit fee) Authorized signature. TOTAL PERMIT FEE f ` � Date: This permit application espires if a permit is not obtained within 180 days [Print name_ Jul w I after it has been accepted as complete. �,. .. . Lam. l J WJ.-.'.i `Fee methodology set by Tri-County Building Industry Service Board. 1.AluddmgAPcrmhs,PLMILPerm,App do, 10/01/09 440-461611111,02)(OM WEB) p CITY OF TIGARD MASTER PERMIT a' COMMUNITY DEVELOPMENT Permit#: MST2020-00129 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/09/2020 r(C A I D 9 Parcel: 2S 107AA10700 Jurisdiction: Tigard Site address: 14272 SW GOLD COAST TER Subdivision: ROSHAK RIDGE Lot: 107 Project Polygon at Roshak Ridge, Lot 107 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 sf 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 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 SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add.'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: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: V 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 98680 VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: 360-693-4442 Total Fees: $26,665.73 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specially 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 throu AR 952-001-0090., ✓L_You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / Issued By: t lam �i(at Permittee Signature: ®`✓ '2--�,Z.-1 C e4// 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. IF • / �a 7_ ( 7 diS/2 o V Building Permit ApplicationREDEIVED Residential FEB 0 3 2020 FOR OFFICE USE ONLY City of Tigard Received: // / �Q P7daO-aa/ 5, 13125 SW Hall Blvd.,Tigard,OR 97223CITY OF TIGARD Plan Rev �% �d P°naitN°i`�-s Phone: 503.718.2439 Fax: 503.598.1�ILDING DIVISION Dam iewLJ $ 2� rmirc0g 26at, -ado 7, y 7!a Other Pe TIGARD Inspection Line: 503.639.4175 Date Ready/By: saris: el See Page 2 for Internet: www.tigard-or.gov Notified/Method: �0 Supplemental Information — f 1.4/L re ftf 7 - TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El I-and 2-family dwelling [3Commercial/industrial Valuation: $ 21 O 0435 0 Accessory building 0 Multi-family Number of bedrooms: 3 0 Master builder 0 Other. Number of bathrooms: ]`3 JOB SITE INFORMATION AND LOCATION . Total number of floors: 3 9by q Job site address: 1421 Z, Gaue. CST 1-1.-eV New dwelling area: (4• ,5 square feet Ii13 City/State/ZIP:Tigard,OR 97224 Garage/carport area: (13 square feet ()Qj4 Suite/bldg./apt.no.: S Project name:Roshak Ridge Covered porch area: square feet Cross street/directions to job site: Deckec area:` q'� square feet temL't'stet O . square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Roshak Ridge Lot no.: 10, 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.: ti(I 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 ❑ 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 ❑ 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 City/State/ZIP:Vancouver WA 98660 Total fees due upon application: Phone:(360)695-7700 Fax::( ) Amount received: E-mail:permitsubmmittals@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted 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/DP: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 lie.:204238 Total fee due upon application: i $201.60 Authorized signature: This permit application expires if a permit is not obtained p� within 180 days after it has been accepted as complete Print name:Tonja Morris Date 04/17l2019 *Fee methodology set by Tri-County Building Industry Service Board. A TARmidimr\Permitc\RI iP-RRSPerrnitAnn don 02/24/2011 440-4613T(i1/02/COM/WEB) Mechanical Permit Application FOR OFFICE LSE ONLY City of Tigard RECEIVED Received Pe mitN DateBy: c°/ST� —aa/.29 " 13125 SW Hall Blvd.,Tigard,OR 97223 plan Review Phone: 503.718.2439 Fax: 503.598.1960 FEB U 3 2020 Date/By: Other Permit: 1'1 ;A I'_l i Inspection Line: 503.639.4175 Date Ready/By. Juris: RI See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information BUILDING DIVISION TYPE.OF WORK COMMERCIAL FEE* SCHEDULE-USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES* ig 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total 3013 SITE INFORMATION AaNT) LOCATION Heating/cooting: ir conditioning 46.75 Job site address: 1442,12 (1i0(XJ C,DAST T Furnace00 �G�� 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.: I.CY1 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 beater 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 ❑ TENANT Other: 23.32 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 ts APPLICANT ❑ 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 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®poiygonhomes.com Barbecue 'lyl 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($90.00) Plan review(25%of permit fee) Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee) CCB lie.:209001 TOTAL PERMIT FEE This permit application expires if la permit is not obtained within 180 QA� days after it has been ccepted as complete. Authorized signature: "'tea baILCUZ., * Fee methodology set by Tn-County Building Industry Service Board Print name:Elia Duran Date:04/08/2019 1:1Buildmg\Pe[mits\MBC PennitApp_040113.doc 440A617r(11/02/COMRVEB) Electrical Permit Applicati ECEIVED „ ,� r��,�4 O0OFFfakUSEO,I,V4 City of Tigard FEB 0 3 2020 Received Date e 13125 SW Hall Blvd.,Tigard,OR 97223 BY: Permit pe yf� � ��� 9 Phone: 503.7182439 Fax: 503.598.1My OF TIGARD DatelBy: Related Permit 6: TIGA- Inspection Line: 503.639.4175 rusts: BUILDING DIVISION Ready l)atelBy E1 See Page2for c. Internet www.tigard-or.gov Notified/Method: Supplemental Information . . . .. .•'. TYPE OF.WORK '":'.` ? • . .. sP Nr-REV[E ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories where the available fault current ❑Marinas and boatyards. "` •• '' `r''..::CATEGORY_OF:CONSTRUCTION,. ,,.-' •:,.:i..•.;�1.', .. exceeds 10,000 amps at 150 volts or 0 Floating buildings. El1� `and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground or exceeds 14,Oo0 ❑Commerc al-vse agr ca coal amps for cell other installations buildings. ❑Multi-family ❑Masten builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or •-i-1 • JOE SITEi'7NFO$MATION 1ND tOCATIOIV;=: i. ❑Emergency system. larger separately derived Job#: I Job site address: I -11,12 (�____,F t O Addition mf oew motor load of system. ��•� `J.I;i�I l'F� I OOIiP or more. ❑••A" "E'"1.2"•,13„ City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy. ❑Healtb-care facilities. ❑fRerreational vehicle pads. Suite/bldg./apt#: _ I Project name:Polygon At Roshak Ridge 0 Hazardous locations. ID 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 I Qb'. 1 Each I Total 1 New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: l01 Includes attached garage. 1,000 sq.R or less 168.54 4 Tax map/parcel#: Es..add'I 500 sq.R or portion 33.92 1 DESCRIPTION OF'WORK Limited energy,residential 75.00 2 (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) _ ®.PROPERT Y,OWNER-':.`..:. • • Renewable Energy a See Page 2 . 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 I 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 - , -...E.APPLICANT El CONTACT.PERSON Brandt circuits—new,alteration,or extension,per panel A.Fee for branch 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 branc ircu fee,first branch circuit 56.18 2 h t City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 I 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 circnt(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) 6625/hr Phone:(503)319-2192 I Fax( ) Investigation(1 hr min) 90.00/hr • Email:solarpdx@me.com Indvst al plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: 48735 specifically listed(F 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): ,,-,r - State surcharge(12%of permit fee): -Authorized signature: PERMIT FEE: /� TOTAL , �/ This permit application expires if a permit is not obtained within 186 Print name: Kile Rood Date: 03/08/2019 days after it has been accepted as complete. * Number of inspections allowed per permit Plumbing Permit ApplicatiOECEIVED Building Fixtures FOR OFFICE USE ONLY City of Tigard FEB 0 3 2020 Received n 13125 SW Hall Blvd.,Ti DateRev Permit N 7 gard,OR 9722 � ���0�z9 Phone: 503.718.2439 Fax: 503.598.1 �LD TY OF TIGARD Plan Review Inspection Line: 503.639.4175 BUUUUUUILDING G)VISION Date/By: OtherPermtNo.: TIGARD Date Ready/By: Anis: H 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. 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 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 0 Accessory building [El Multi-familySFR(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: l 1.41,12, C e0,:, C sT -tJZ Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 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 Lot no.: 101 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 • • ® PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name:Polygon WLH,LLC Fixture/sewer cap 25.02 Address:703 Broadway St.,Ste 510 Floor drain/floor siuk/hub 25.02 Garbage disposal 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone:(360)695-7700 Fax:( ) Ice maker 12.51 ® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name:Polygon WLH,LLC Medical gas(value:$_) Page 2 Contact name:Tonja Morris Primer 12.51 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 - CONTRACTOR Water closet 25.02 Water heater 37.52 Business name:Alliance Plumbing Water p i ' P 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 Lic.:184601j��� Plumbing Lic.no.:PB732 Plan review (25%of permit fee) State surcharge of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Robert Disltnl8n 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:1Buildinewermits\PLMU-PeemitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) City of Tigard 11111 ■ COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential t.,,,,a� Building Permit #: n-S f 4,34 20 -e9C 429 Site Address: 42-72- 5vJ Gold C ct 1-c-1rrace Project Name: IZCZSh � }2Ado�.e, _ _V , - Lot #: �,Q7 Planning Review U Proposal: po/hOJ Ki Llh IT stz. Verify address/suite# active in Accela. ti4, In River Terrace: ❑ No N( Yes,River Terrace Review Addendum Site,,/, Plan Elements: , `E' rosion Control I ;S copies of site plan on 8-1/2"x 11"or 11 x 17"paper PORetairted trees with drip line and tree protection measures Drawn to scale(standard architect or engineer scale) ,KPootprint of new structure(including decks)and FFE ,Korth arrow Utility locations&easements(required for new and additions) Site address,project or subdivision name and lot number idewalk/driveway approach [pplicant information(name and phone number) V Location of wells/septic systems ,LElLot dimensions and building setback dimensions KStreet tree size,type and location Square footage of buildings to be demolished Street names (VExisting structures on site .Comer elevations(2'contours if more than 4'differential) gLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? li I: o impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Y es No N- Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified No Received: O Yes ❑ No ,Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs Required: ❑ Yes,ap 'cant was notified ,''No Received: ❑ Yes ❑ No SDC Exe e ❑ Yes ( No Received: ❑ Yes ❑ No Public Facilities Improvement(PFI)Permit: Required: ❑ Yes,applicant was notified 'No Applied For. ❑ Yes ❑ No,stop intake Land Use Case#: pal22c IG,—e�-vc32 (S1 foning. P. `2- Required Setbacks: Front: E5 Rear: 5 Side: 0' l 1 Street Side: N I A- Garage:IS.S Building Height: Max. Height: N I Pr Actual Height r 3 4 Landscape Area: 20 % XLot Coverage Max: P)(0 Entrance II Set back o m re than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows II Mir 12°/ of.rea of all street- acing facades Garage ■I a. aged or i b:.� d widest str fen l ❑ Yes ❑ No,one of the following is met: Mi Do r to . o more than 5'from wall and ere i a c vered or exten beyond garage. ❑ •No r t- .s o more than ' wall and t arage on 2nd floor. ti Garage .oo wit this ❑ 12'or 1 ss 50%or 1 ss o a a e 60%or less and includes 7 of following: ❑ Cove porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof cave ❑ Roof offset ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding ❑ Window trim ❑ Window recess 0 Window projection ❑ Balcony Visual Clearance 9 Urban Forestry Plan Sensitive Lands: 0 Yes jgf No Type: pro Conditions met prior to issuance of building permit Notes: y Approved By Planning: 7�?.! -i .9 Date: 419 (20 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Fotms1BldgPennitRvw_RES_1224I 9.docx Building Permit Submittal Original Submittal Date: cV3, ZO Site Plans: # 3 Building Plans: # -3 Building Permit#: E'Enter building permit#above. Workflow Routing: Planning Qr'Engineering Permit Coordinator l Building Workflow Sign-off: [Sign-off for Planning(include notes from planning review) Route Application Documents: Er Engineering. (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: �4-k&L�� Date: yr2-Y/Zt3 En-;veering Review f, Slope at building pad: LS, /� 1;1/Conditions "Met"prior to issuance of building permit /V�/2 ,_,, /Easements (encroachments) per engineering conditions of approval and plat 1!d'Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes I,..�'/No Assess Water Quantity Fee in-lieu: ❑ Yes LE7 o LIDA Facility on lot: ❑ Yes L� No LI Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: 0 Approved ❑ Not Approved Permit Coordinator Review Conditions "Met"prior to issuance of building permit ❑ Approved, NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: • Revision Notice 2: Date Sent to Applicant: SDC Exemption: 0 Received 11 Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: '6 yes El N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: - Yes ❑ N/A LIDA ❑ Yes sO N/A XOK to Issue Permit Approved by Permit Coordinator: VCa Date: 412.42o I:\Building\Forms\BldgPermitRvw_RES_1224I 9.docx a City of Tigard q COMMUNITY DEVELOPMENT DEPARTMENT 11114 River Terrace Building Permit Review Addendum TIGARD Building Permit #: Site Address: 1 4272 5W Gold C c+ Tr Project Name: I2©Slr K P.- Lot #: 107 (New dwelling=subdivision n 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?,14 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 2. Eyes on the street: a minimum of 12% of each street facing façade must include windows or entrance doors. Percentage Shown: F a,,C)[0 /Q... (3 to 3. Entrances:At least one entrance must meet both of the following standards: . Max. 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:,R Yes ❑ No If yes, all the following apply: 1425 sq.ft.A-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: ,a;Covered porch min. 5 ft.wide x 5 ft. deep.P 12'Recessed entry area min. 5 ft.wide x 2 ft. deep F -Wall offset min. 16 inches F l ❑ Dormer min.4 ft.wide .. Roof cave min. 12 inch projection 'FI (L Roof offset min. of 2 ft. Z. ❑ Roof shingles either tile or wood ,g Gable,hip or gambrel roof design FIR., ❑ Roof pitch oriented south min. 500 sq. ft. 0 Horizontal lap siding min. 3-7 inches wide ❑ Accent siding min.40% of street façade Window 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 igI,Balcony min. 5 ft.wide x 3 ft. deep with inside access(Z ❑ 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 Yes0No. If No (Check one): . 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) ❑ 12-foot-wide garage door Z40%max. of street facade ❑ 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: , Date: 4-l�'l l20 Ii\BuildinglFormslBldgPamitRvw_RES_RT_121417.docx V