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Permit City Of Tigard • COMMUNITY DEVELOPMENT DEPARTME 1111 Request for Permit Action T 1 Ci A li I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ® Applicant n Contractor n City Staff Check(V)one REFUND OR Name: INVOICE TO: (Business or Individual) Polygon Homes WLH LLC Mailing Address: 703 Broadway St., Ste 510 City/State/Zip: Vancouver, WA 98660 Phone No.: 360-695-7700 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): V] CANCEL/VOID PERMIT APPLICATION. ❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). n INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). Permit#: MST2018-00352 Site Address or Parcel #: 16870 SW Rockhampton Ln Project Name: Polygon at Roshak Ridge Subdivision Name: Polygon at Roshak Ridge Lot #: 236 EXPLANATION: Plan renamed and updated Signature: %6 C� d4.iud Date: 1/6/2021 Print Name: Tonja 4(llorris Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. FOR OFFICE USE ONLY Route to Sys Admin: Date By Route to Records: Date • / "I( By 'V Refund Processed: Date By Invoice Processed: Date /f.20-/ By Mr Permit Canceled: Date/�i?'O// By Parcel Tag Added: Date By 1:ABuilding\Forms\RegPcrmitActiorr 120518.doc 1 V___C-1-- a .. U.) Building Permit Application fit ECEIVE Residential FOR OFFICE USE ONLY City of Tigard ��yy DatReceived -�� ` �, Gr 2018 Date/B : Permit No. ��a '" 13125 SW Hall Blvd.,Tigard,OR 97223 1Plan Review Phone: 503.718.2439 Fax: 503-598.19 Date/By: 1� Oilier Permt '� u�_ , Inspection Line: 503.639.4175 .1I I OF TIGARD DateReady/By. tur;s: ® See Page 2for I'IGAIZI� Internet: www,tigard-or.gov MUtt}f1N{C [ill(i 1 otified/Method: Supplemental Information TYPEO .......................i . �7: RFQUIItEA DATA AND�FAMII7'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 CONSTRUCTION workindicated on thisapplication. b0� ' d' � Valuation: a(9t-1� ® 1-and 2-family dwelling ❑Commercial/industrial - ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: Total number of floors: 2 5- j :JOB STI'E IIV FORMATIQN AND LOCATION � p` Job site address: 1 W c51 D SW Cat-lGe,V1417-1-bV\. tzt,AA New dwelling area: 'Lb ]% "square feet ( 1 City/State/ZIP:Tigard,OR 97224 Garage/carport area: 3SD ) square feet CI4 g Suite/bldg./apt.no.: Project name:NIUMO'VVA 'M\,/lbt, M-StJ Covered porch area: . square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet l REQI)AREA DATA COMM RCIAL-'USE CHECI LIST Subdivision: V.We i:L Y I att, (A I Lot no.: 23(p 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 `DECRIPTION OFWORK ;.- work indicated on this appli cation. M,w Valuation: $ Existing building area: square feet New building area: square feet I PROPERTY OWNER ❑ TENANT Number of stories: Name:Polygon WLH,LLC Type of construction: • Address:1% -1 077 1Jv1.) We StD Occupancy groups: City/State/ZIP:Vancouver WA 98660 Existing: Phone:(360)695-7700 Fax:( ) New: ® APPLICANNT .❑ CONTACT PERSON BUILAING.PERMIT:FEES* (Please rerertn fee sch'er7ule) Business name:Polygon WLH,LLC Structural plan review fee(or deposit): Contact name:, Awavkaa...obtv to, �,.g t FLS plan review fee(if applicable): Address:11O '/OINA1 � �t �j, re�1v 1 Total fees due upon application: City/State/ZIP:Vancouver WA 98660 (0 { q U t, Amount received: Phone:(360)695-7700 1,, 1 Fes::( ) 1,, "t E-mail: r� 1 Y/VVl, 1 tc f' U`l ov1 1 o ru-S . of PIIooroyc mo I ARPANEL SYSTEiVI FES' ercial ns. CONTRACTOR :, roof-top op mounted Phot Voi ax'SolarrPanel System. Business name V -)I\ 12 WX 1, f-Cj \A O V\kQ S . Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: : 102, jAf-b(k \ C(.k,J Sk' S"tQ, C t,0 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 lie.: ldlyl a,L1 A Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. f' (V K( ,t e ,V`t A i I i-'I Q *Fee methodology set by Tri-County Building industry Print name: V V` Date: (� Service Board. 1:1Building\Permitsll3lJP-RESPcrmitApp.doc 02/24/2011 440-4613T(11/02ICOM/WEB) ... , , . „ IVED migE Mechanical Permit Appli . FOR OFFICE ESE ONIA City of Tigard Received 1 Faith No.: 114 13123 SW Hall Blvd.,Tigard.OR 97411:C 1 2 "z 0 18 D.c_43,: • Plan= 503.718.2439 Far. g13.598.1960 Plan Review it tiv.:Wny: tklm-Pr= TIGARD ItsPMti"Li3'' „.5°_,_,34•39•4175 CITY OF TIGARD Osie Re:oh:My: look 621 Stc Page I for- • humid,: ww*,v.orou-or.gov Supplemental Information pVILDING DIVISION 14miti.0.4...4a _._ *i::-_--7:7:Pi..!'i;:.-e-Yiii--i•-iiVVT,--.1:•:2. ,7t7.4;1i.--::t.,;?:-:'tg7 FL':::7t.f;0-4**-?7,,!i• f-.:*ii.P*-it:i.. 1iLii*-fki:ISti7: Mechanical permit fc.._s''are based on the value of the work Now cOnstructiOn 0 Addifionialierrti iorLfreplatterderd performed.Indicate the cable(rounded to die nearest dollar)oral! 0 Demolition 0 other trimbanical mmerials.cquipment,labor.ex-erlieat and mom. Value:S ,,_:;..,,,r,,I-.,.._ - -t-A--t.4-140-.0.i,Afi• i,•i§„,*• i •-.640,,---;t7:.4.f. t--if.„,:.•-..-,,,,--1;:_•.::.%:,!:;; ;:-,.;•--- :---.,--....--- ---i.,-,,.- --.--,-- _ —_ . .... -,. . .... __ . 13 1-and 2-fami1y&aim Er ComractriaVinduktri-t1 El Arrzsgory builcfink rar veciat information use ckerldist A Mufti-faraily 0 Master backs 0 Other; Desmiption 1 Qty. 1 -Er I Total 7.2.f4--.B,7-i. 1*-.00-inirikiiiti'01:6041;0:664.iiiir0f.;*7i-Orn:,-.::::::,:fc liergoecuoUng: __ -•- Air conditioning . 1 , 46.75 Job sn addri.ssf VVArl 0 5 IN. V-OCV-1/17AMOMA UVli Fmasce I-00.000 BTU ranc.-mi'venis) 1 _ 46175 City/Slatara.P..:Tigard,OR 97224 Fru-gace 100.000+13Th(dirosaits) • 54_91 , Snitefulde.%pt.no.: • Project name!.p01, ,,,,,,+. v64,4, Heat pump 6 1_06 1 Onct work 23,32 I Cress strceildireedons to job 11 site: tit —7 livdrenic hot wrier sestem 23.32 O Residential boiler(radiator or hydronie) 2:3,32 Unit heaters(fuel-type,not eitrie), in-wall.in-duct.faf,pmcieti,e , 46 75 Rureent for any of above 2.3,32 Other StihdietiOtr%0 ex -verface. Er.,,L64., 49 Lot go.: ?)12(0 • \ /14 r fuel upplianms: _ 23.32 Tax map/sestet no.: Water beater . - , 2332 1 , ; "(P: : :-.•03tigifitiefildkOtiNiC- ..L.:t Gas rirePieln9cri 39 I 1. ; 33_ Flue vela for Av-m-r hmterpir E.as i Frreplace , 23.32 ,_Log lighter(gas) 23.32 - - r__ ___ - Wood/pellet Mow 33.39 Wood fireptaedirisert 23.32 ChiumewlinerlflueNcin 23.32 I , *iittilk;•:-.L?:-7.- - 4 7::::kfZ''.t Z ;'... i'3rtNAS*!7:1;:,: :!;:f Other 2332 . - i Envirrountotal exhaust and A-moldier! , flIc i Dtimovk wtAi 1,1,u Range ha:Aim-her kithen I • ectuipment I I 13....W Address: l(f5i VD(Arkt_ )1/_4/1 Yc (YU- I 0 Chrbm-cirver cdiand 1 33.39 CStateiliP: ,` IA GU(A,Ve, VIA, 01, ((i te Q -- VA ' . I. 5ingle-duct exhaust(bathrooms, totlet comparraaints,utility rooms) 23.32 Phci= Lli.e0(Q Ot. 11 00 I Attiejerawlsrm=fans . 23.32 . r:W,47:;:..01.63.174:k6f:PrOf;4 fii'i - :7.--i'f: Other 23.32 I Fuel piping: Desire=name:_Polygon WJ.14,LLC • S14.1S for first four:S;4:03 for each additionalCclite4 n6mc Am a vac, &lot vjo . F.. ,..e . 1 . , .A..iare i D S R)roari.u.D0,_ St-. t 5A-e- 5 k0• Gas limi pump . . Wallitsmocridcdianit healer i 1 city/State./ZIP:Vancouver,WA 98660 Water-beater I Mane:(360)695-7700 1 Fax::(360)693-4442 Fireplace Rmrge 1 E-•=tal:Recrev‘r54Tyc.kkaAS/22- 5.-nes ..az ni Barbecue i 17,.:-g''Zt_::!:XQINTR-f!,#-0) ;1 ", -=-7 r,;-,.::74.,-, ,'. J a°41e5'I'M 1-451 I Other: Buriness Amur Apes Air LIZ 1:1_nr,-:‘T,••"":'[fr-,•Aik!:;*1/440ihltiESIOX015r-t;::-.., ',..-i !.:-f". Airl&ms:t MU NE 72nd Ave Subtotal Cry/5121CDP:Vartmdrver,WA 98186 Minimum permit fee(S9OA)i Plan xvicw(25%of permit fee) Pho=MP 342-8109 . I Fur,(30)326-170 State surcharge(12.%&permit fee) tt , Ca3 Etc:.203034 TOTAL PERMIT FEE I i / This permit eppliention tnpirm Ira permit is not obtained winrin inn daysaner ir lam been at4 as complete. AlatIxtrized signature; — * pet menu:doh:Le Achy Tei-Cranny&tal Industry&r,nce awed F - Print nnmel ,......„.......„,„..,,,_"3,.der •Nil—ti477 rivricaiiiwan , EIVEDElectrical Permit , ➢icat' Y--OF1�ICEUS .ONL City of Tig dud Received t FC 1 2 2018 DateB : 1 it 13I25 SW Hall Blvd.,Tigard,OR 9722I-' Plan Review M • Phone: 503.718.2439 Fax: 5034941.950 (� DateB : w • TIGARD Inspection Line: 503.639.4175 OF T(VA D ReulyDatW y Ju is. I1 See Paget for 1 e, Internet: wnvW tigard or.goV �r Noti0edlMethod Supplemental information TYPE 01? DIVISION •. PLAN RE'4 CYV l. ®New construction ❑Addition/alteration/replacement Please check all that apply(submit sets of plans w/items checked): Demolition ❑Service or feeder 400 amps or more ❑Building over three stories. ❑ El Other whereboatyards. 't'the available fault current ❑Marinas and I 'GATEtIORY OF CONSTRUCTION- exceeds 10,000 amps at 150 volts or ❑Floating buildings. ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural I amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or JOB'SITE INFORMATION'AND::LOCAT ^ION 0 Emergency system. larger separately derived r Job#: Job site address: t(Q i'10 S i) Y/(�('�/ll(l Ii I 1 A 0 Addition of new motor load of system. l It�Jvr"r rY I, l�l/1 IOOHPormore, ❑ •A",••b",••l_Z•',"t_3,,, ❑Six or more residential units. occupancy. City/State/ZIP:Tigard,OR 97224 ❑Recreational vehicle parks. ` ❑Health-care facilities.�j Hazardous locations El Supply voltage for more than I Suite/bidg,/apt#: Project name: r Ol In /) �/J�I,�rl 11� ❑ 600 volts nominal. 1 JQ" '�"'✓V AtI ❑Service or feeder 600 amps or mole. Cross street/directions to job site: 1 :TEE SCIIEDULE , Description I Qty. I Each f Total I ' 1 n New residential single-or multi-family dwelling unit. Subdivision: VVe (/l f/ cuA( m�� jJ 4 Lot#; 1V40 Includes attached garage. V v � 1,000 sq.ft.or less 1. 168.54 4 I Tax map/parcel# i Ea.add'l 500 sq.ft.or portion I 33.92 1 1 _ DESCRTP140I',.;OR WOR Limited energy,residential 1 (with above sq.ft.) 75.00 2 t Limited energy,multi-family 75.00 2 residential(with above sq.ft.) ti Renewable Energy ❑ Sec Page 2 PROP 7RTY OWNER D::'I'ENANT Services or feeders installation,alteration,and/or relocation Name:Polygon WLH,LLC 200 amps or less 100.70 2 �10 3 I,nl cMjit3 („(r S (ID 201 amps to 400 amps . 133.56 2 Address: I V ►V I JI .]� 1J 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 552.2E 2 1 rn�V1'J„„ � V 0 t 1V 0 in+ � c,CD1 A d Temporary services or feeders installation,alteration,and/or I Email: t I 1 Y�/�/6( �/� U�/i/t� relocation i Owner?firm This installation is being ma a on operty that I own which is not 200 amps or less 59.36 1 h intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 tl Owner signature: Date: 401 amps to 599 amps 168.54 2 ® Nrrr ttcA (` .';Cl rroxacv:imRsor.i.-.;:. Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name:Polygon WLH,LLC above service or feeder fee, 7.42 2 each branch circuit Contact name:.MarIA,CIA_ VI V—, B.Fee for branch circuits without Address:. 1022 y>y U() wQ� ,(a CA- c I/0 service or feeder fee,first brands circuit 56.18 2 v -` `"`� City/State/ZIP:Vancouver,WA 98660 Bach 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 Email 7 L��/) V,OV/I,L Its O1IA TV11/1f1 1 (�wy Reconnect r � l.1 Y W 4 Reconnect only 67.84 2 i, CONTRACTUIt " -. Pump or irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2 Address:6101rIYE St JohnS Rd Signal circuit(s)or limited-energy IA See Page 2 2 panel,alteration,or extension. City/State/ZIP:Vancouver WA 98661 Each additional inspection overallowable in any of the above Additional inspection(I lnr min) 66.25/hr Phone:(253)320-1657 Fax:( ) Investigation(1 lir thin) 90.00/hr Email:bdaniels@gweusa.com Industrial plant(1 hnnin) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: C1158 EIectrical Lic.: 208174 Suprv,Lie.: 4496S specifically listed('/_hr min) .�— -- �f/ � � ...,(_. �— ELECTRICAL PERKS FTES Suprv.Electrician signature,required: fll d-.V /.P . 9 ty i J i�l Subtotal: Print name: Joan P Albert Date: 10)I I O' I ❑Plan Review Required(25%of permit fee): State surcharge(12%of penult fee): Authorized signature:'' -.. .a-' TOTAL PERMIT FEE z '""— This permit application expires if a permit is not obtained within 180 Print name: Bill Daniels/ Dates I�I (2)1 10 days after it has been accepted as complete. 1 * Number of inspections allowed per permit. t'lnuldinglPcrmirslELC_PernritApp ELR_ERE.doc Rev 06/17/2015 440-4615T(11105/COMtwts'B ED Plumbing Permit Applica r EIV Building Fixtures 0E1: 12 2018 City of Tigard Received Permit 13125 SW Hall Blvd.,Tigard,O v. Plan Review • 2 Phone: 503.718.2439 Fax: 5 5.ti6� J'(j`A Date/By Other Perini[No.��( j��i � T l i ;�I:p Inspection Line: 503.639.41 f U 1Lfl f C DIVISION Date Ready/By: luris: la See'Pag'e5 2 for Internet: www.tigard-or.gov Notified/Method: tai Information Supplemental x sri "" ' 1Y E'OF'WORT ' r . .. :!f:$0 EDCII checklistttl . ?.��i , �..New construction CI Demolition Porspe ' in ormation use Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) d 4 : 'X`� -'.'7 x SFR(1)bath 312.70 �� �'Q. �,'� n' aHY.UY?�iiG,TRIICT[ON -. 7 78 �� SFR(2)bath 43 17 i and 2-family dwelling er, ❑Commercial industrial SFR(3)bath ' 500.32 ❑Accessory building ❑Multi-family Each additional bath/icitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 ;3 JOBS INFORMATi42tl A'31D LO ATIOi5i�" Site utilities: d e \ fl() S) 3C1 ' CW lV � Catch basin or area drain 18.76 Job site address: 5 1(_�"/�` I ell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name:. Jl O v,i G tt O S t (, Manufactured home utilities 50.03 Cross street/directions to job site: J(I Q,C _Manholes 18.76 „[J/�' Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear IL: ) Page 2 Subdivision: _.\Ue.V�'€ 'c V.iL(t, � Lot no.: -Fixture or item: Tax map/parcel no.: I L a Backflow preventer ' 31.27 t[.n...a�in. rlT - ' f1S-7 Backwater valve . -, �s4 � a �� a� A M, 1 12.51 "ix.. .wtM:S � • tia ,_,nw. .,,., k u :,. i . Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 q " Expansion tank 12.51 Fixture/sewer cap 25.02 �p � -:�usx tm, s Name:. olycm)rt W L ..l.L Floor drain floor sink/hub 25.02 Address: 'II0 27 Garbage disposal 25.02 0 te U Hose bib 25.02 City/State/ZIP: Vet�DU�V1/� t,, ✓f/. Phone: "3(90 (pas `7-Tao Fax ( b)(O� j 11 u 0 l Ice maker 12.51 r u S Interceptor/grease�p APLIA ._ ;CONTACT PERS©N._.. in 25 0 "'� Medical gas(value: ) Page Business name: FM H ck o in V\CIA`(^t,C. Pr imer 12.51 Contact name:. yv,ry\(A,M a.„ G-) k V l Roof drain(commercial) 12.51 -J Address: n�. 5 � r� �� co Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Y \ Solar units(potable water) 62.54 Fax::(360)693-4442 Tub/showerishower pan 12.51 Phone:(360)yy 695-77001nn In��p ' �/y-�j 1�, 'n n n r +q E-mail: L ll V` �/�Y/V V v �IS�i V V �V L�V Y lit I�V IJI Urinal 25.02 Water closet 25.02 1 : A . -r,.�s r 4 .N1 RAC'O$ ;,' Water heater 37.52 Business name: (3±J 4 A.WJ01Vt, .d 11V ' Water piping/DWV 56.29 T Address: .11• cp. Other: 25.02 City/State/ZIP: 5T. C oft, i1 t31 Subtotal �t r�1 Minimum permit fee: 572.50 Phone: 5b3•-•2s�-- KO F (q1 Q--la 1-1. / Plan review (25%of permit fee) CCB Lie.: IQ t 3 , . Plumbing Lic.no.:P) al State surcharge(12%of permit fee) Authorized signature: cs C t. `+-� TOTAL PERMIT FEE L tiv� ppy n� This permit application expires if a permit is not obtained within 180 days Print name:Eth Date:- di L91 f I yl after 3t has been accepted as complete. E bbll *Fee methodology set by Tri County Building Industry Service Board. U • L•\1uitdinglPmeils\PLMO•Pami1App.d°c 10/01/09 440-4616T{10102/COM/WEB) kl a City of Tigard r COMMUNITY DEVELOPMENT DEPARTMENT ■ T I G n K D Building Permit Review — Residential Building Permit #: ( <\ST"a , kg- a Site Address: zee -Yi ) v " / -n_- Project Name: PO/ " „n to--71- , 6,1" hey Lot #: ,:� (Ne fI' g=subdivision name;Addition or Alterati last name of owner) Planning Review Proposal: A)--Cl) a Z4 Z ral bi pyrift'site address/suite# exists and active inpermit sem. River Terrace Neighborhood: ❑ No V Yes,See River Terrace Review Addendum Attached Siy"Plan Elements: 0/Three(3)copies of site plan sting structures on site Dil,�,,je plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished ]LJ rawn to scale(standard architect or engineer scale) fl or elevations orth arrow 1JU; 'ty locations&easements(required for new and additions) e address,project or subdivision name and lot number Pro;dewalk/driveway approach ciplicant information(name and phone number) 111 :r ation of wells/septic systems M Lot dimensions and building setback dimensions listing trees to be retained with drip line,and tree 111 l't uare footage of buildings to be demolished rotection measures area,building coverage area,percentage of coverage and OPitreet tree size,type and location pervious area(applicable if R-7,R-12,R-25&R-40) 110iStreet names V.11Property corner elevations (2 foot contour lines if more than >1,000 sf of impervious area created or replaced? I IJ Yes ❑ 4 foot differential) If yes,is a storm water quality facility shown? 3trYes WJNo clean Water Services—Service Provider Lette of platted prior to 9/10/1995): equired: CI Yes,applicant No ofwas notified l) Received: El Yes CI No Public Facili ' s Improvement(PFI)Permit: PF1 QJ -00103 a uired: Yes,applicant was notified ❑ No Applied For: 4t7 Yes ❑ No,stop intake ) /,2 and Use Case#: Pbie,2 )> C L%�/ .2Q/ 000C�q- oning: — Ph) equired Setbacks: Front Rear /0 Side Street Side /3I ,arage -2C.c /L landscape Requirement: /) G ot Coverage Maximum: t y oi ` �+l Building Height: Maximum Height 1v ( 2 Actual Height (..Q/ )I leA isual Clearance III k.ensitive Lands: ❑ Yes 2rNo Type I Urban Forestry Plan ❑ Conditions Met"prior to issuance of b .ding permit Notes: �� y 4:proved By Planning: .-- Date: J,D- /-q- /6 Revisions (after B ding Submittal only) evie er Date Revision 1: Approved CD Not Approved 3 , i Revision 2: ❑ Approved El Not Approved Revision 3: El Approved ❑ Not Approved I:\Building\Forms\BldgPennitRvw RES 061417.docx i Building Permit Submittal Original Submittal Date: Qlval1S. Site Plans: # 3 Building Plans: # Building Permit#: CJ'Enter building permit#above. Workflow Routing: Er Planning Er Engineering ["Permit Coordinator Building Workflow Sign-off: El/Sign-off for Planning(include notes from planning review) Route Application Documents: V Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. 2'Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: 14Av-\f Engineering Review I o Slope at building pad: ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 21 No Assess Water Quantity Fee in-lieu: ❑ Yes 2 No LIDA Facility on lot: ❑ Yes 0'No 2 Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: (AP-A 17r - 6,1 N t--)4 12‘' N I AJCS IC /5 5 0 E ,©'Approved by Engineering: MM. I La- 40 ate: 4/ , 9 Revisions (after Building Submittal only) Reviewer at Revision 1: ,Er Approved ❑ Not Approved A..CJ . SA lti. (.1511/1. /4 AGA E 3 1 Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑17eonditions"Met"prior to issuance of building permit 3 h/`�• Approved,NOT Released: t,(4 ,`��/1i v Date: a! �!? Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Re ion Notice 3: Date Sent to Applicant: glir SDC Fees Entered: Wash Co Trans Dev Tax: 'Yes ❑ N/A Tigard Trans SDC: p es ❑ N/A Parks SDC: Yes ❑ /A LIDA 0 Yes N/A ❑ OK to Issue Permit Approved by Permit Coordinator: Date: I:\Building\Forms\BldgPernutRvw_RES_010118.docx • City of Tigard Ill a COMMUNITY DEVELOPMENT DEPARTMENT ■ T 1 G A R D River Terrace Building Permit Review Addendum Building Permit #: S; .c) \S,- C5 `--Se. Site Address: /( -,C2k) /�' ,'/A )0; 4, e_ Project Name: Pa `)h r, - —0j,J r Lot #: c•2 (NJv elling=subdivision name;Addition or Alteratior}f last name of owner) Planning Review of River Terrace Plan Disttrit Design Standards (18.640.070.1.): Is the project subject to the plan district design standards? III/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 deep ft. deep min. 2ft.,5 ft.wide min. 2 ft., 6ft.wide Gabled dormer El ❑ ❑ ❑ 2. Eyes on the street: a minimum of 12°/ of each street facing facade must include windows or entrance doors. Percentage Shown: / /j 3. E rances:At least one entrance must meet both of the follo ng standards: Max. 8 ft. setback from longe street facing wall Parallel to street,angle no more than 45° from street, or open onto porch Entrance opens to a porch: Yes ❑ No If s,all the following apply: sq.ft. min. ne street facing entry ft.max.roof above floor of porch IS 5 ft. depth min. %min. porch roof coverage 4. P etailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades: �a overed porch min. 5 ft.wide x 5 ft. deep ❑ Recessed entry area min. 5 ft.wide x 2 ft. deep all offset min. 16 inches ❑ Dormer min. 4 ft.wide Roof eave min. 12 inch projection Vjhoof offset min. of 2 ft. ❑ Roof shingles either tile or wood Of Gable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. Erporizontal lap siding min. 3-7 inches wide ❑ Accent siding min. 40%of street facade Window trim min. 21/2'wide by 5/8" deep ❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft.deep ❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35%or less of street façade 5. Garages and Carports: May face the front or side lot line on a corner lot. Setbacks: No oser to front or side lot line, than longest street-facing wall. ❑ Yes 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) ❑ -foot-wide garage door ❑ 40%max. of street facade 50%max. of street façade with 7 detailed design elements Notes: Approved By Planning: 4Date: AQii 7-//e) I:\Building\Forms\BldgPermitRvw_RES_RT_1214I 7.docx