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Permit (177) CITY OF TIGARD �"y MASTER PERMIT k r' R '> COMMUNITY DEVELOPMENT Permit#: MST2019-00032 G�' " Date Issued: 04/25/2019 T I GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 \TD�\ Parcel: 2S 107AA 12400 Jurisdiction: Tigard Site address: 14144 SW GOLD COAST TER Subdivision: ROSHAK RIDGE Lot: 124 Project: Polygon at Roshak Ridge, Lot 124 Project Description: New SFA. 9/3/2019: REPRINT to add fire sprinkler system. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 562 sf Basement: 240 sf Left: 0 Parking Spaces: 0 Height: 35 Bathrooms: 3 Second: 560 sf Garage: 294 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 1362 sf Value: $178,823.70 Rear: 5 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: Fire sprinkler system MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 2 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SFA VB R-3 1362 Owner: Contractor: POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) F me BROA VIAY$T•S#E f48 ,SLHTE 51O -4 4440w-Fire-Rated-Soffits- VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 Ersn Cntrl 503-639-4175 PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: Total Fees: $25,084.99 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.8000 � 1.800.332.2344. Issued By: �k \. !� � V_, Permittee Signature: 3 orlWV:A.0 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. Plumbing Permit Application Building Fixtures RECEIVE • FOR OFFICE USE ONLY City of Tigard AUG 1 3 2019 Received �7 �� E 'I 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: fJ��% �` 7 l rrtit No.: MST2ol9-00032 _ Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD Plan Review / / Inspection Line: 503.639.4175 ate By: !3 77 1 G Other Permit No.: TIGARD P BUILDING DIVISIOIDateRead/B Juris: ® See Page2 for Internet: www.tigard-or.gov y o Notified/Method: Supplemental Information s."', 11J1E ', ®New construction D Demolition For special information use checklist Description I Qty. Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility tea, Y g connection) ` " ' CA.TVG Y' CONSTRUCTION '.'- SFR(1)bath 312.70 ® I-and 2-famildwelling 0 Commercial/industrial SFR(2)bath 437.78 ElAccessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Firesprinkler(. 'sq.ft.) !3 ca Page 2 JOB`.SI E INFORMATION ANTI LOCATION ,' Site utilities: Job site address: 14144 SW Gold Coast Terrace 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 at River Terrace 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 at River Terrace(Townhomes) 1 Lot no.: 124 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Backwater valve CI#I SN rF.CORK = 12.51 Clothes washer 25.02 MULTIPURPOSE FIRE SPRINKLER SYSTEM Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ®'PRO Err- OWNN ❑ TENANT Expansion tank 12.51 Name:Polygon NW Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:703 Broadway St.Suite 510 Garbage disposal City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone:(360)695-7700 Fax:( ) Ice maker 12.51 e;® 4 FLIT ,.""; D ,'NTACT P ON." Interceptor/grease trap 25.02 Business name:Polygon NW Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Jennifer Lopez Roof drain(commercial) 12.51 Address:703 Broadway St.Suite 510 Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 'Fax`::1 ) 6.-S ower s ower pan 12.51 E-mail:jenniferJopez@polygonhomes.com Urinal 25.02 CO RACTOR Water closet 25.02 Water heater 37.52 Business name:Alliance Plumbing,LLC 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 Lic.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee) �7 State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Gavin Thomes Date:8.07.2019 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'Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Fee(cal .Tota Site' tilies l Scuare. ottae; ?`errnlllt: Footing drain-151 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 V1Iu o> ' Per1l> t Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for z Qty. Fee(ea) lltal each additional$100.00 or fraction thereof,to 'Other Inspections o r' foe and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: Other Fixtures: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type Fixture Type for Replaee/Rl / PiRer�><ew"for-:I'Ium6>ing Instillations Work Perfoied: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Bath -Tub/Shower Please check all that apply. -Jacuzzi/Whirlpool ❑ Any new commercial building with water service 2"and Car Wash -Each Stall greater,except systems designed and stamped by licensed -Drive Thru engineer. Cuspidor/Water Aspirator ❑ New exterior plumbing site utilities for any complex structure Dishwasher -Commercial as defined in OAR918-780-0040. -Domestic ❑ Medical gas and vacuum systems for health care facilities. Drinking Fountain ® Any multipurpose fire sprinkler system. Eye Wash 0 Any complex structure as defined in OAR918-780-0040. Floor Drain/sink -2" 3» -Submit 2 sets of plans with any of the above. -4" Car Wash Drain I gllmetric Magialn, Garbage -Domestic-non-food Disposal -Domestic-food related 0 Isometric or riser diagram is required for new buildings -Commercial-food related that meet the qualifications above. -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Comments regarding fixture work: Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter Washer-Clothes *Note: If the fixture work under this permit results in an Water Extractor Water Closet-Toilet increase of sewer EDUs,a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the https://allianceplumbing-my.sharepoint.com/personal/gavin_alliancepluml52'ng_net/Documents/Documents/Fire Sprinklers/RT/PLMF_PermitApp (3).doc CITY OF TIGARD MASTER PERMIT Pri s. COMMUNITY DEVELOPMENT Permit#: MST2019-00032 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/25/2019 TiC .A P.i 9 Parcel: 2S107AA12400 Jurisdiction: Tigard Site address: 14144 SW GOLD COAST TER Subdivision: ROSHAK RIDGE Lot: 124 Project: Polygon at Roshak Ridge, Lot 124 Project Description: New SFA. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 562 sf Basement: 240 sf Left: 0 Parking Spaces: 0 Height: 35 Bathrooms: 3 Second: 560 sf Garage: 294 sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 1362 sf Value: $178,823.70 Rear: 5 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 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: 1 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 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: 2 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SFA VB R-3 1362 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 1 Hour Fire Rated Soffits VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 Ersn Cntrl 503-639-4175 PHONE: 360-695-7700 PHONE: 360-695-7700 FAX: Total Fees: $24,851.62 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR;.--001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19988.,7oor 1.800.332.2344. Issued By: s� Permittee Signature: o / �/ we--le,.-7O, 1 Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. ... 1 ( ,---\--- \ -- ..k.-\ Building Permit Applicatio , _ tom- -II Residential t ,,,„,,, ,,,, EtcFOR OFFICE USE ONLY Cityof Tigard FEB0 d 209 Received Date/By. 1 t t Ilq 5 Permit No.1c.l '- � C�v" ✓ III Z '° 13125 SW Hall Blvd.,Tigard,OR 972,, ,3, Plan Review Phone: 503.718.2439 Fax: 503.59 (1 s , ,$''i- DateBy: p1/t - j /Alt' Other Permit � T I GARD Inspection Line: 503.639.4175 E�n `, !a E Date Ready/By. p rJ — auris: I H See Page 2 for Internet: www.tigard-or.gov Notified/Method: 7 l4 /c l 1 Supplemental Information - 1�ii- -oe.yreAl 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. ❑Addition/alteration/replacement ❑Other: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ (\"')%/ b 4 ❑Accessory building ❑Multi-family Number of bedrooms: 2 11 ❑Master builder 0 Other: Number of bathrooms: 77 JOB SITE INFORMATION AND LOCATION Total number of floors: 3 l (.49 Job site address: (t4 I q-1 O_ ((X71Tf 5t� New dwelling area: I'jfpZ square feet s�City/State/ZIP: ►xj(.....10 \)- G 12---?--' Garage/carport area: ✓w square feet (02, Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: square feet 0 Cross street/directions to job site: Deck area: 7 D.. square feet Subdivision:Polygon at Roshak Ridge Lot no.: ''LL\ 0th strut ear a: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK" work indicated on this application. 0 Valuation: $ / r Existing building area: square feet i New building area: square feet LP El PROPERTY OWNER 0 TENANT Number of stories: Name:Polygon WLH LLC Type of construction: ..--) Address:703 Broadway Street Ste 510 Occupancy groups: e ... City/State/ZIP:Vancouver,WA 98660 Existing: ,.. Phone:(360)695-7700 Fax:(360)693-4442 New: 1 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name:Polygon WLH LLC (Please refer la fee schedule) Structural plan review fee(or deposit): Contact name:Amanda Gavin FLS plan review fee(if applicable): Address:703 Broadway St.Ste 510 Total fees due upon application: City/State/ZIP:Vancouver WA 98660 Phone:(360)695-7700 Fax::(360)693-4442 Amount received: E-mail:permitsubmittals@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 and administrative fees): $180.00 Phone:(360)695-7700 Fax:(360)6934442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 Total fee due upon application: $201.60 Authorized Signa.i e: , This permit application expires if a permit is not obtained 1 / within 180 days after it has been accepted as complete. Print name:Amanda GI 'In ‘ Date: I I d//' 7 *Fee methodology set by Tri-County Building Industry / l` Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application RECEIVE .. eived FOR OFFICE USE ONLY Cityof Tigard Date/By: gPermit No.: 't 13125 SW Hall Blvd.,Tigard,OR 97223 h P R 9 2019 Plan Review Phone: 503.718.2439 Fax: 503.598.1960111 /1 t� Date/By: Other Permit: v .6�,�_� Inspection Line: 503.639.4175 T y�ate Ready/By: Jur s: LTJ See Page 2 for Internet: www.tigard-or.gov CITY Y OFTIGA 46otified/Method: Supplemental Information BUILDING DJVlSle TYPE,OF WORD COMMERCIAL FEE*SCBEDITLE—USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction D Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION. RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist ®Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: ILit il(.I, Su.) GOI-D CdRsT -re,e2.. 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)Z* Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OE"WORiZ 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 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name:Polygon WLH,LLC Range hood/other kitchen equipment 33.39 Address:703 Broadway St.,Ste.510 Clothes dryer exhaust 33.39 City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32 El 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/L P: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: e_ MECHANICAL PERMIT FEES* Address: NW Alociek Dr,Ste.1104 Subtotal City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee) CCB lic.:209001 TOTAL PERMIT FEE This permit aa permit is not obtained within 180 A� days afterpplication itexpires has beenif accepted as complete. Authorized signature: W * Fee methodology set by Tri-County Building Industry Service Board Print name:Elia Duran Date:04/08/2019 I:\Building\Permits\ME.C_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) Electrical Permit Application FOR OFFICE USE ONLY City of Tigard A P R 1 2 Z019 Received Date/ Permit#: ', 13125 SW Hall Blvd.,Tigard,OR 97223 yti Plan Review — Phone: 503.718.2439 Fax: 503.598.196 ��- IRelated Permit#: n�i DateB Inspection Line: 503.639.4175 3U LDING D vISi•, adyDateBy: turis: l See Paget for 'L1U.i14N-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): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Other; where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 1-and 2-familydwellingCommercial/industrialless to ground,or exceeds 14,000 ❑Commercial-use agricultural ® 0 0Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: OA tk G� --ipa' ["'r 100HP or more. ❑"A","F',"1-2", 1-3", City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:Roshak Ridge ❑Hazardous locations. 0 Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nominaL Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision:Roshak Ridge Lot#: i2,41 Includes attached-garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 1 DESCRIPTION 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 0 See Page 2 10 PROPERTY OWNER 1 0 TENANT Services or feeders installation,alteration,and/or relocation Name:Polygon WLH,LLC 200 amps or less 100.70 2 Address:703 Broadway St,Ste510 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: 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 El APPLICANT ❑ CONTACT PERSON- Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name:Polygon WLH,LLC above service or feeder fee, 7A2 2 each branch circuit Contact name:Jolene Smith B.Fee for branch circuits without serAddress:703 Broadway St,Ste.510 branche circuit fee,first 56.18 2 branch circuit City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 Fax: :(360)693-4442 Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:permitsubmittals@polygonhomes.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Portland Electric Sign or outline lighting 67.84 2 Address:1915 E 5th St Ste D Signalnel, circuit(s)alteration, or extension. 0 See Page 2 2 � panel,alteration,or extension. City/State/ZIP:Vancouver,WA 98661 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(360)314-4945 Fax:( ) Investigation(1 hr min) 90.00/hr Email:paul@portlandelectric.biz /%k. . Industrial plant(I hr min) 78.18/hr / Inspections for which no fee is 90.00/hr CCB Lic.: 194066 Electrical Lie.: C760 Suprv.Lie.: 49117r specifically listed(tV2 hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: (lit, A � Subtotal: Print name: Alex Shalya Date: 04//08/2019 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: ,' TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: MISHCHUK,SERC Y Date: 04/08/2019 days after it has been accepted as complete. 0 Number of inspections allowed per permit. Plumbing Permit ApplicatioRECEIVED Building Fixtures APR 9 2019 FOR OFFICE USE ONLY City of Tigard Received - rr♦� Permit No.: 114 a 13125 SW Hall Blvd.,Tigard,OR 972�3TY OF TIGARD Date/By: Phone: 503.718.2439 Fax: 503-WADING DIVISION Plan Review Other Permit No.: T I G ARD Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑Demolition For special information use checklist. Description I Qty. Ea. I 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 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ®Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinlder( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: pi'vjI_ 51,A) �'�OLD OAST f Q Catch basin or area drain 18.76 Job site address: /� �7 City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name:Roshak Ridge Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision:Roshak Ridge I Lot no.: '24 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK` Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I ❑ 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 ® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Polygon WLH,LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Tonga 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 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name:G&B Plumbing&Sons Inc WaterPip g/r in DWV 56.29 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: $72.50 Plan review (25%of permit fee) CCB Lic.:184372 Plumbing Lic.no.:pb634 State surcharge(12%of permit fee) Authorized signature:• TOTAL PERMIT FEE Print name:Steve Fowler Date:04/08/2019 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\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) ifq , City of Tigard '. COMMUNITY DEVELOPMENT DEPARTMENT Ti CAM)• Building Permit Review — Residential Building P2-e) ermit #: It'1 2- 1 .. r. Site Address: Project Name: , d, / / to J.__ i �,_ Lot #: Q. (New`;t P, g=subdivision name;Addition or Alteration orat name of owner) Planning Review Proposal: / i F I P6.fit-rify site address/suite#exists and active inermit s Ia River Terrace Neighborhood: p m. �ghborhood: ❑ No V Yes,See River Ten-ace Reran.Addendum Attached Site 'lar Elements: it ee(3)copies of site plan gJ.►f:sting structures on site m e plan m3 st bg on 8-1/2"x 11"or 11 x 17"paper L Footprint of new structure(including decks)with finished wn to scale(standard architect or engineer scale) i.•r elevations >, •rth arrow IP: .1•ty locations&easements(required for new and additions) K Ce address,project or subdivision name and lot number %Si•ewalk/driveway approach ®' pplicant information(name and phone number) 10:+cation of wells/septic systems 51 •• dimensions and building setback dimensions a. Il ' . otection meacare footage of buildings to be demolished �� •sig trees ao be retained with drip line,and tree I�Lot area,buildingcoveragesures area,percentage of coverage and IIS eet tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) treet nam 16Property comer elevations(2 foot contour lines if more than >1,000 ses 4 foot differential) f of impervious area created or replaced? C es❑ iktumIf es,is a storm water uali ._._ shown? Yes L✓INo ,lean Water Services—Service Provider Lettot platted prior to 9/10/1995): equired: 0 Yesapplicant was notified Qf ®/ No Received: ❑ Yes 0 No Public Fatxliti provement(PFI)Permit: 12:r;Required: Yes,applicant was notified 0 No Applied For: yeS 0 No,stop intake L'and Use Case#: M oning i) .��614 1, -• �,. t S rim jequired Setbacks: LFront 13 Rear �— Side dscape Requirement _ / /o Street Side l�1 Garage a �— ot Coverage Maximum: ' g % V B •ding Height Maximum HeightAy. a ' isual Clearance Actual Height Aysensitive Lands: VYes 0 No yp Pg Urban Forestry Plan T e g iI ,'/ �i A.„ :gg ❑ Condition `Met"prior to issuance of bylding permit / Notes: _a 4/ I a _! I/ Il , .II a / Approved By Planning: . ---- z>l Date: 02 A Revisions (after Building Submittal only) Revision 1: 0 A dReviewer Date PProve0 Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved I:\Building\Forms\B1dgPermitRvw RES_061417.docx Building Permit Submittal Original Submittal Date: Site Plans: # Building Plans: # Building Permit#: 0 Enter building permit#above. Workflow Routing: 0 Planning 0 Engineering 0 Permit ee pnti Coordinator 0 Building Sign-off: 0 Sign-off for Planning(includenotes Route Application Documents: 0 Engineering (1) copy of permit application, (1)site plan, (1)building plan and original plan review routing form. 0 Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: Date: By Permit Technician: Engineering Review 0J Slope at building pad: ik 7° ❑ Conditions"Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat la Water Quality/Quantity Facility. Assess Water Quality Fee in-lieu: 0 Yes k] No Assess Water Quantity Fee in-lieu: 0 Yes 0 No LIDA Facility on lot: 0 Yes a No 12 Final Plat Recorded: Date: ❑ NOT Approved by Engineering: Notes: wry IT - L P P1 Pt. -)Ev i N I-V-44 t p 4 c Date: -. 2,, 1`" El Approved by Engineering: ' Date Revisions(after Building Submittal only) Reviewer Revision 1: 0 Approved 0 Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved Permit Coordinator Review C "Met"prior to issuance of building permit Date: 2 } �9 Approved,NOT Released: 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: SC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: idY 0 N/A Parks SDC: Yes ❑ O N LIDA 0 Yes /A gkOK to Issue Permit 1(p �� Approved by Permit Coordinator. __________At) Date: 1:113uildinglForms\BldgPermitRvw RES 010118.docx City of Tigard a COMMUNITY DEVELOPMENT DEPARTMENT I T 1 c A R o River Terrace Building Permit Review Addendum „-:,..um's,a,t�. .bb.,;c» ..,yr.y�-sL•..YS:%'�iY3Ri� r� Building Permit #: Site Address: / /411/ a) ( Ld 6L- Project Name: Ai , /249,/249,,A.4 (� J .� Lot #: A.Z2-f (Ne f-lling=subdivision name;Addition or Alteration= name of owner) g Planning Review of River Terrace Plan Dista esign Standards (18.640.070.1.): Is the project subject to the plan district design standards? UtYes El No 1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional element required for lots with over 60 ft. of street frontage shall be provided every 30 ft. Porch min. 5 ft. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a ft. deep min.2ft., 5 ft.wide min. 2 ft.,6ft.wide Gabled do ❑ ❑ ❑ ❑ 2. Eyes on the street: a minimum cif 12%of each street facing facade must include windows or entrance doors. Percentage Shown: ) 1Q 7D 3. trances:At least one entrance must meet both of the follo g 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: ❑ Yes ❑ No If yes,all the following apply: ❑ 25 sq.ft. min. ❑ One street facing entry ❑ 12 ft.max.roof above floor of porch ❑ 5 ft. depth min. ❑ 30%min.porch roof coverage 4.Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades: ❑ Covered porch min. 5 ft.wide x 5 ft. deep ❑ Ij,ecessed entry area min. 5 ft.wide x 2 ft. deep ❑ �Yall offset min. 16 inches 2/ ormer min. 4 ft.wide Roof eave min. 12 inch projection f offset min. of 2 ft. ❑ Roof shingles either tile or wood Gable,hip or gambrel roof design ❑ Roof pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide ❑ Accent siding min. 40%of street facade VWindow trim min.2'/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 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 No. If No (Check one): ❑ y 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. W : (Check one) 12-foot-wide garage door ❑ 40%max. of street facade ❑ 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: Date: —2gh4,-- -3 I:\Building\Forms\BldgPebmitRvw REs RT 121417.docx Plumbing Permit Application R trF� r ., Building Fixtures .. .,, ' #` ` FOR OFFICE USE ONLY City of Tigard Received. _ rZ (�' Date/By: I1kk'kc1 S\ Permit No. c _st. . 's 13125 SW Hall Blvd.,Tigard,OR 97223�� T �� "�"�v 1111 Plan Review • Phone: 503.718.2439 Fax: 503.598.1 ,o : Other Permit No.: Ins ection Line: 503.639.4175 i t f i t,.3 r•, Date/By: TIGARD p p e , ; Date Ready/By: Juris: FA See Page 2 for Internet: www.tigard-or.gov i--3‘.I I 1 ,_P E h.;e, )1 1 i S't .- '" Notified/Method: Supplemental Information TYPE OF WORK los% . : ',' -r FEE.t.„.CHED , , '. _ . ®New construction I� t ❑Demolition tfi For special information use checklist 3 -- } Description Qty. Ea. Total ❑Additic n/alteration/replacement ❑Other �\ New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION :f; SFR(1)bath 312.70 0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 0 Accessory building ®Multi-family SFR(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: it Gott, C:o -r -�F.e�2. Job site address: , Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: ' I Project name:Roshak Ridge Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision:Roshak Ridge I Lot no.: iii{ Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WOfic Backwater valve 12.51 Clothes washer 25.026NCUMtse- UJ,YUalinaW\ tl {"K201ot--OD0-3ZDishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name:PolygonWLH,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 ® APPLICANT.: 0 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) 42-14 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 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 Lic.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Robert Dishman 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. L:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Electrical Permit Application,- ,;.� FOR OFFICE USE ONLY City of Tigard Received (( r Date/B * 1 k�J T Permit#: \c'-` �\a- ( J3 II 3 '' 13125 SW Hall Blvd.,Tigard,OR 97223 t , ? Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Date/B : Related Permit#: TlGARD Inspection Line: 503.639.4175 Ready Date/By: Juris: See Page 2 for e Internet: www.tigard-or.govNotified/Method: Supplemental Information .,t TYPE OF WORK :. . _ PI.AN;REVIEW. El New construction ❑Addition/alteration/replacement w„ - } Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition �` ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Other: `Qa where the available fault current ❑Marinas and boatyards. CATEGORY,OF-CONSTRUCTION •: t;.-ac. exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1 and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground or exceeds 14,000 0 Commercial-use agricultural ❑Multi-family ❑Master builder ❑Other: amps for all other installations. buildings. ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND'LOCATION. ' 0 Emergency system. larger separately derived Job#: Job site address: kti\t.\Ik C' 00s GA sY -� 0 Addition of new motor load of system. �� I OOHP or more. ❑"A","E","1-2","1-3", City/State/ZIP:Tigard,OR 97224 0 Six or more residential units, occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: _ Project name:Polygon At Roshak Ridge 13Hazardous 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 Each I Total I New residential single-or multi-family dwelling unit. Subdivision:Polygon at Roshak Ridge Lot#: \2..1 Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK' Limited energy,residential m HJT 7 Q(-`1-600 Z (with above sq.ft.) 75.00 2 �� Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy 0 See Page ® PROPERTY OWNER`.: 0 TENANT_ Services or feeders installation,alteration,and/or relocation Name:William Lyon Homes,Inc. 200 amps or less 100.70 2 Address: 703 Broadway St Suite 510 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2 Phone:(360)695-7700 Fax:(360)693-4442 Over 1,000 amps or volts 552.26 2 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 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: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 Address: 703 Broadway St Suite 510 service or feeder fee,first 56.18 2 branch circuit City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 Fax: :(360)693-4442 Each manufactured or modular ' dwelling,service and/or feeder 67.84 2 Email:permitsubmittals@polygonhomes.com Recaanectoaly 67.84 21 -a CONTRACTO1 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. 0 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) 66.25/hr Phone:(503)319-2192 Fax:( ) Investigation(1 hr min) 90.00/hr • Email:solarpdx®me.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: 4871, S specifically listed('/s hr min)- ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Kile Rood Date: 03/08/2019 0 Plan Review Required(25%of permit fee): — State surcharge(12%of permit fee): Authorized signature: -7e!"-e' 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.