Permit .
CITY OF TIGARD F . f ' MASTER PERMIT
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s COMMUNITY DEVELOPMENT z/?ff2{ �f�j Permit#: MST2019-00279
T t G A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/09/2020
Parcel: 2S107AA13200
Jurisdiction: Tigard
Site address: 16817 SW SUNSHINE COAST ST
Subdivision: ROSHAK RIDGE Lot: 132
Project: Polygon at Roshak Ridge, Lot 132
Project Description: New SF. 2/25/21: REPRINT to add (1)lay to primary bathroom.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 948 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1130 sf Garage: 380 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2078 sf Value: $272,989.28 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 3 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: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 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: 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&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Ecom asin Y
Other: N Other Description: p 9
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2078
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 Geo Tech Report Required
VANCOUVER,WA 98660 VANCOUVER,WA 98660 Prior To Pour
2 Ersn Cntrl 503-639-4175
3 1 Hour Fire Rated Eaves
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $34,260.35
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 calling 503.232.1987 or 1.800.332.2344.
'et/
T
Issued By: � ' Permiftee Signature: �/ �'' ei
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.
Plumbing Permit Applicati E. o r s
Building Fixtures FOR Oil (( I: t'si: ON1.1
FEB 2 4 202 i City of Tigard Received 2IA 5 /,,Zj i�l' .'i' . S7�U'7YJc 9
ilh 'r 13125 SW Hall Blvd.,Tigard,OR 972�';� Date/By:
Phone: 503.718.2439 Fax: 503.598.19b0 OFTY �IGA Plan Review
• a Date/B Other Permit No.:
Inspection Line: 503,639.4175 BUILDING DIVILI ' . Date Ready/By: raris: ® See Page 2 for
T 1 G A R TJ Internet: www.tigard-orgov ovo l
g 8 Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist
Description 1 Qty. I Ea.J 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
Xl-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building %-Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler(__sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16817 SW SUNSHINE COAST ST 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/bldgJapt.no.: Project name ''olygon at 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.: 132 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
5th lavatory added after plan review Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:Polygon WLH,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:703 Broadway St.,Ste 510
Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
�4 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Polygon WLH,LLC Medical gas(value:S ) Page 2
Primer 12.51
Contact name:Tonja Morris
Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 Sink/basi avatorr / 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units a 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:G&B Plumbing&Sons Inc Water €�t m DWV 56.29
P P�
Address:P.O.Box 92 Other: 25.02
City/State/ZIP:St.Paul,OR 97137 Subtotal
Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: S72,50
` CCB Lic.: 184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee)
_ State surcharge(12%of permit fee)
Authorized signature: .: - TOTAL PERMIT FEE
Print name:Steve Fowler Date:
10/30/20 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:tnuildanetPermvslPl.MU-PermitAnn.dnc 10,01/04 440-46I6Ti I0/02ICOM/WEB)
it CITY OF TIGARD MASTER PERMIT
'' ' COMMUNITY DEVELOPMENT Permit#: MST2019-00279
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 1 210 9/2 0 2 0
T I �'�R T3 9 Parcel: 2S107AA13200
Jurisdiction: Tigard
Site address: 16817 SW SUNSHINE COAST ST
Subdivision: ROSHAK RIDGE Lot: 132
Project: Polygon at Roshak Ridge, Lot 132
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 948 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1130 sf Garage: 380 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 st Right: 3
Detectors: Yes
Total: 2078 sf Value: $272,989.28 Rear: 10
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
0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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
Fum>=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: 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&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 2078
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 Geo Tech Report Required
VANCOUVER,WA 98660 VANCOUVER,WA 98660 Prior To Pour
2 Ersn Cntrl 503-639-4175
3 1 Hour Fire Rated Eaves
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $34,232.33
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 throughOOAR(�.J 1- CI952-001-00990. 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: Vk7 W Permittee Signature: Da a2pi n- o ('
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
r' ___ -
Building Permit Application
RRECEIVEDl . .
Residential FOR OFFICE USE ONLY
City of Tigard FEB 0 6 2019 Received �1 O�1 ��� Permit No.t,^t�-2,,1p
III 't 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review r� o her Pe m
=: Phone: 503.718.2439 Fax: 503.598.19�QITY OF TIGARD Date/By ���I �� ` 1-OM�
Inspection Line: 503.639.4175 BUILDING DIVISION DateReadyBy: runs: El See Page2 for
TIGARD
Internet: www.tigard-or.gov Notified/Method. r igi j ,�o Supplemental Information
&M�"iv 17�n/,T-/-
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
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling Valuation: $ 2��(� D 1
❑Commercial Indus ria
❑Accessory building ❑Multi-family Number of bedrooms: ;
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 PLJ V
Job site address: W D I'} S W(V I VI c V I rnL Y 1 Q, CO( y� 3\ New dwelling area: 'R'1 , square feet ` l 3t
1 �
City/State/ZIP: ' O �� Garage/carport area: Jb" square feet i
Suite/bldgJapt.no.: 1 r �� l7' j Project name:Polygon at Roshak Ridge Covered porch area: square feet
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.: I 9i2../ Permit fees*are based on the value of the work performed.
value(rounded
o the
st dollar)of all
Tax map/parcel no.: Indicate
the
materials labor,overhead,
equipment, the profit for the
P t,
DESCRIPTION OF WORK work indicated on this application.
i\fel00 F 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 Street Ste 510 Occupancy groups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360)695-7700 Fax:(360)693-4442 New:
❑ APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer ro fee schedule)
Business name:Polygon WLH LLC
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
Amount received:
Phone:(360)695-7700 Fax::(360)693-4442
E-mail:permitsubmitffils@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR 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)6934442 _ State surcharge(12%of permit fee): $21.60
CCB lie.:207247 Total fee due upon appl cation: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
LPrint name:Amanda 'n Date: ll I l°1 *Fee methodology set by Tri-County Building Industry
Service Board.
I:1BuildinglPemuts\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
' Mechanical Permit A
City of Tigard pplicaEIVED FOR OFFICE USE ONLY
Received
'Date/By: Permit Nok, _ACV.
13125 SW Hall Blvd.,Tigard,OR 97223FR 2 5 2019 Plan Review
I Phone: 503.718.2439 Fax: 503.598.196 Other Permit:
Inspection Line: 503.639.4175 OF TIGARD
Date/By:
TIGARD C,� Date Ready/By: Idris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
1-and 2-family dwelling ❑CommerciaUindustrial El Accessory building For special information use checklist.
Multi-family ❑ Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heatingrno0ng:
Air conditioning 46.75
Job site address: 11,08 i'1 S W Suns 1-tl N E ( -t S T 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
13Z Other: 23.32
Subdivision:Roshak Ridge Lot no.: 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
Other. 23.32
® PROPERTY OWNER ❑ TENANT 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:
$14.15 for first four;$4.03 for each additional
Contact name:Ton]a Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
WalUsuspended/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
Cyr CONTRACTOR Clothes dryer(gas)
Business name:Apex Mr LLC Other.
MECHANICAL PERMIT FEES*
Address: 18004 NE 72°0 Ave Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
' Phone:(360)342-8109 Fax:(360)326-1769 Plan review(25°%of permit fee)
State surcharge(12%of permit fee)
CCB lie.:203034 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Tim Hay Date:04/08/2019
I:\Building\Pamits\MEC PermitApp 040113.doc 440-4617T(t 1/02/COM/WEB)
, , RECEDED
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard MAR 1 7 2020 Received ..
Date/B : - �� -
- 13125 SW Hall Blvd.,Tigard,OR 972 7-y OF HGARD Plan Review
;.
Phone: 503.7182439 Fax: 503.59 0 ' Date/B : Related Permit ft:
Line: 503.639.4175 r8 LUNG DIViSl1O.N Ready Date/By: Auris: Id See Page 2 for
T I G A K U Internet: www.tigard-or.gov 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):
O Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#: lob site address: 16817 Sunshine Coast St. 100HP or more. ❑"A","E","I-2","1-3",
O Six or more residential units. occupancy.
City/State/ZIP: ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Roshak Ridge ❑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 leach I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: Roshak Ridge Lot#:132 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea add''500 sq.ft.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.)
Renewable Energy 0 See Page 2
U PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: Polygon Homes WLH, LLC 200 amps or less 100.70 2
Address: 703 Broadway St., Ste 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:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:permitsubmittals@taylormorrison.com relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 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
Branch circuits—new,alteration,or extension,per panel
® APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with
Business name: Polygon Homes WLH, LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Tonja Morris B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: 703 Broadway St., Ste 510 branch circuit
City/State/ZIP: Vancouver WA 98660 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360 )816-7800 Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: permitsubmittals@taylormorrison.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Portland Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: 1915 E 5th St., Ste D panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: Vancouver,WA 98661 Additional inspection(I hr min) 66.25/hr
Fax:( ) Investigation(1 hr min) 90.00/hr
Phone:( 360)314-4915 Industrial plant(1 hr min) 78.18/hr
Email:paul@portlandelectric.biz Inspections for which no fee is
90.00/hr
CCB Lie.: 194066 Electrical Lie.: C760 Suprv.Lie.: 49205 specifically listed(Y hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Q.ix Subtotal:
Print name: Alex Shalya Date: 3/17/20 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
_Q '�]�� : - Q Q r, L TOTAL PERMIT FEE:
Authorized signature: XJ f t LtiWLC/ft fa.R.
This permit application expires if a permit is not obtained within 180
Date:3/17/20 days after it has been accepted as complete.
Print name: SergeV Mishchuk * Number of inspections allowed per permit.
I:\Building\Permhs`,ELC Pem,itApp_ELR_EREdoc Rev 06/172015 440-4615T(il/05/COM/WEB
Plumbinz Permit Auvli ,. '
Building Fixtures MAR 1 7 2020 IIIIIIIIIIIIMIIII
Received 5
City of Tigard lxiwsr: PmmitNo.: S j r;�» �7
Tt' "i
13125 SW 1Ta11'BIvd.,Tigard, Plea Review
Si
Phone 503.718 2439 Fax . Me, LM /L i iD 7u Aar�t;r Other Permit No.:
laspmtion Line 503.639.4175 Date p gY lease �e See Page 2 for
Internet: www.tigardror.gnv Noufind Matbod Supplemental Information
TYPE OF WORK FEE' SCHEDULE
®New construction 0 Demolition _ For eetal iafornvatfon lase che.:kti t
Description I 4ty ( Fa. [ Total
❑Addition(a)teration/replacemcnt 0 Other. New I-2-family dwellings(includes 100 ft for each utility connection),
CATBGORY OF CONSTRUCTION SFR(1)bath 312_70
la 1-and 2-family dwelling 0 Commercial/Industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other Free sprinkler(__sq.ft) Page 2
JOB Srra INFORMATION AND LOCATION Site utilities:
lob site address: 16817 Sunshine Coast St. oraresdrain 18.76
City/Stattl/1P:Tigard,OR 91224 Drywall,(mach line,or march drain 18.76
— footing drain(no.linear ft-:_) Page 2
SuitabldgJa t.no.: 1 Project name Roshak Ridge _ Manufactured home utilities 50.03
Cross streeedireetions to job alto Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft:_,._) Page 2
Storm sewer(no.timer ft.: ) Page 2
Water service(no linear ft:_) Page 2
SUbddrisime Roshak Ridge Lot no.: 132 Fud:reeritem:
Tax map/parcel no.: Bankfiow prevents, 3127
DESCRIPTION OF WORK Backwater verve 12.51
Clothes washer 25.02
1 Dishwasher 23.02
Drinking fountain 25.02
' eetonlsump 25.02
l[S2 PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name Polygon WLH,LW { F xturdacwer cap 25.02
Flora drain/floor sink/hub 25.02
Address:703 Broadway Sty 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
El APPLICANT 0. CONTACT PERSON a Imp 25.02
1 Medical gas(value Ste) Paget
Business name:Potygas WLH,LLC
Primer 12.31
Contact name:Tetaja Morrie Roof drain(t ommdcial) 123 L
Address:703 Broadway St.,Ste 510 S 25.02
City/Stae/ZH':Vancouver,WA 98660 1 Solar units(potable water) 62.54
Phone(360)6954700 Fax::(360)693-4442 Tntvishowerishower pan 12.51
H ma[ coat Urinal 25.01
Wad closer 25.M
1 CONTRACTOR Water Meter 37.52
Bushman eamek,691:)e P J;Ci A _ Water piping/DWV 56,29
Address / 40X' !f Other 25.02
Cfty/StatePIIP; (at he,'t ' % / Subtotal
Phone: W) 2)f Q (,' 1 Fax: Minimumpamit fee: 372.50
CCII Lac.: /t0 t' Plumbing Lie no. i3LL. Plan review (25%of Record fee) .
Stare surcharge(12%of permit fee)
k»Oarited signature: 1 TOTAL PERMIT FEE
Point more:S lIVIPs lw� (t / Date. 3/17/20 I TM permrt.pptwtloa Ma We .accepted
at me o plate. otitis tan eisy,
_J ,net ft Ma bwe utly od in complete.
'For eaetlt°dobry M try Trifioaaty Podding industry Service Board.
L doe 16e1404 44046 e5Ttl0A7/COMEWEal
City of Tigard
1111 ■ COMMUNITY DEVFT OPMENT DEPARTMENT
T I G A K D Building Permit Review — Residential
Building Permit #: N\S-T au -01i51-61
Site Address: \t. B 1 Sys! Sunshtn. { S-f St.
Project Name: ppi.gal @ Posi k k Rickkei Lot #: i37_
(N ew elling=subdivision name;Addition or Alt -ation=last name of owner)
Planning Review
Proposal: NOW 'P—
Verify address/suite# active in Accela. it,In River Terrace: ❑ No X Yes,River Terrace Review Addendum
Site Plan Elements: iNZrosion Control
'S,3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper NARetained trees with drip line and tree protection measures
fawn to scale (standard architect or engineer scale) Footprint of new structure(including decks)and FFh
orth arrow Utility locations&easements(required for new and additions)
ite address,project or subdivision name and lot number Sidewalk/driveway approach
Applicant information(name and phone number) T .cation of wells/septic systems
NILot dimensions and building setback dimensions '_•F treet tree size,type and location
Square footage of buildings to be demolished '6treet names
( Existing structures on site Corner elevations(2'contours if more than 4'differential)
IA
of area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Y s No
XClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: El Yes,applicant was notified jlit,No Received: ❑ Yes ❑ No
V.Public Facilities Improvement(PFI)Permit:
Required: ❑ Yes,applicant was notified lit No Applied For: ❑ Yes ❑ No,stop intake
. Land Use Case#: PD9.2-01a (Dome, ,g Zoning: 42-I2
Required Setbacks: Front: la]et Rear: IC) Side: 3 Street Side: Pc Garage:
Bolding Height: Max.Height: N Actual Height: i/
Landscape Area: 2� % El Coverage Max: %
Entrance II Set back no ore th 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows li Minimum 12'o of a of :1 street-facing facades
Garage II .. .rage doo.is b ' d wi;-.. street-facing wall ❑ Yes ❑ No,one of the following is met:
k Door -xten no . an 5'from wall and there is a covered porch extending beyond garage.
❑ ►.o exten s no • i', 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
■I Garage do r wi is • 12' . less ❑ 50%or less of facade 0 60%or less and includes 7 of following:
❑ Covered orch ❑ Reces--d entrance 0 Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shin es ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent s ding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
iCKVisual Clearance X Urban Forestry Plan .
ensitive Lands: 1 Yes ❑ No Type:GINS VP.-amid or-1 trig tiott ...LI
Conditions met prior to issuance of building permit hot l'rtr1.1
Notes:
Approved By Planning: Date: JIo/t
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved El Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
I:\Building\Fors\BldgPemitRvw_RES_022819.docx
l , .
Building Permit Submittal
Original Submittal Date: a(k.i,tq
Site Plans: #
Building Plans: #
Building Permit#: [ Enter building�pe t#above.
Workflow Routing: SY/Planning [ 'Engineering Ierm tit Coordinator .' uilding
Workflow Sign-off: [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
oigi°al plan review routing form.
LW Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: -41t0 i ICI
Engineering Review
Er-Slope at building pad: 2
Mr-Conditions "Met"prior to issuance of building permit yAc,
a Easements (encroachments)per engineering conditions of approval and plat
Er Water Quality/Quantity Facility:
Assess Water
QualityFee in-lieu:
❑ Yes ErNo
Assess Water Quantity Fee in-lieu: 0 Yes , [No
LIDA Facility on lot: 0 Yes Er No
3 Final Plat Recorded:
O NOT Approved by Engineering: Date:
Notes:
j,/
E Approved by Engineering: te,V j r Date: 7 bpi l 9
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: ❑ Approved 0 Not Approved
Permit Coordinator Review
O Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
i❑13DC Fees Entered: Wash Co Trans Dev Tax: f�Yes 0 N/A
(/ Tigard Trans SDC: E"Yes 0 N/A
Parks SDC: ,eYes 0 ,N/A VLIDA ❑ Yes G�/N/A
OK to Issue Permit /
Approved by Permit Coordinator: / 1/ Date: d 1 i g
L:\Building\Forms\BldgPennitRvw_RES_022819.docx
. ,. i
f
74 City of Tigard
COMMUNITY DEVET OPMENT DEPARTMENT
T[G A K D River Terrace Building Permit Review Addendum
r
Building Permit #: 1\—C- 'Gl—CY`S1)
Site Address: llob 11 an1 Sunsht .� ,g} a:
Project Name: n Rc - 9-le z Lot #: \3
(Newll @ ing=subdivision name;Addition or raticm=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? M,Yes 0 No
1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional
element required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 ft. deep ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide Gabled dormer
3a 0 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: i 3 pip
3. Entrances:At least one entrance must meet both of the following standards:
,'Max. 8 ft. setback from longest street- facing wall �lParallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: 14,Yes ❑ No
If yes,all the following apply: 31,25 sq.ft. min.
',One street facing entry . 12 ft.max.roof above floor of porch
i05 ft. depth min. ..Er30%min. porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
Covered porch min. 5 ft.wide x 5 ft. deep.g,
Recessed entry area min. 5 ft. wide x 2 ft. deep
Wall offset min. 16 inches 0 Dormer min. 4 ft.wide
koof eave min. 12 inch projection Roof offset min. of 2 ft.
O Roof shingles either tile or wood KGable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. 0 Horizontal lap siding min. 3-7 inches wide
O Accent siding min. 40%of street facade glyVindow trim min. 2 1/2"wide by 5/8"deep
❑ 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. 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.%Yes 0 No. 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 ❑ 40%max. of street facade
X.50%max.of street facade with 7 detailed design elements
Notes:
Approved By Planning: /, Date: •//Q/j
1:`,Building\Forms\Bld5PamitRvv.,RES RT_t214 17.docx