Permit (170) CITY OF TIGARD MASTER PERMIT
11 11 ' COMMUNITY DEVELOPMENT Permit#: MST2019-00105
T t G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/02/2019
Parcel: 2S107AA00600
Jurisdiction: Tigard
Site address: 14257 SW 168TH AVE
Subdivision: ROSHAK RIDGE Lot: 6
Project: Polygon at Roshak Ridge, Lot 6
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 1174 sf Basement: 140 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 555 sf Garage: 437 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 1869 sf Value: $242,271.65 Rear: 0
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: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1 Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 0 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
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF
1869
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 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 Geo Tech Required Prior To
Pour
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $33,738.58
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•'- 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.
Issued By: 4 * ' e Permittee Signature: ' i/ e/"/' L /e"9-j-7/i"/
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.
a_,_,.
' Building Permit Application
Residential E E I V E D FOR OFFICE USE ONLY
City of Tigard FEB 0 6 2019 ReceivedDateBy: � y C1 `-")' — Permit No' �c t- _,(_i`U
- '� 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review -} ` ,
Phone: 503.718.2439 Fax: 503.597223 Y OF TIGARD DateB : ,� I /\4" OtherPemn :' `,\Cy- (,`6.'S
TIGARD
Inspection Line: 503.639.4175 BUILDING DIVISION DateReadyBy: u /G /;1� 7uris: ® See Page 2for
Internet: www.tigard-or.gov Notified/Method: ! .../„.",,,,
� Supplemental Information
I.1/1— ,O G/617 -
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: 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: $ �Li a) 71 t.
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms: 3 , ',
LAA 1
JOB SITE INFORMATION AND LOCATION Total number of floors: c 3 O
Job site address: ;if" f2,(7/ Sou ' 69 k ) New dwelling area: I gI square feet ss1-1
' /�
City/State/ZIP: T 1./'A irA 0����Z Garage/carport area: (�u�l�' square feet r I U
Suite/bldg./apt.no.: C/V Projectojname:Polygon at Roshak Ridge Covered porch area'} square feet 1`y 0
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.: l.!/ 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
n,
^ l DESCRIPTION"OF WORK" work indicated on this application.
New SF Valuation: $
Existing building area: square feet
New building area: square feet
0 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 iofee 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:
r City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax::(360)693-4442
E-mail:permitsubmittals@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic 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)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247
Total fee due upon application: $201.60
Authorized si:.i atttre This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
'riot name:Aman, : Gavin Date: Mel"' *Fee methodology set by Tri-County Building Industry
Service Board
:�Building�Permits�BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
A
Mechanical Permit Applicatifit
uEIVED FOR OFFICE USE ONLY
City of Tigard Received Permit No. .
13125 SW Hall Blvd.,Tigard,OR 97223 APR 2 b 2019 PlanR Date/By: ,M�T� / QUr��
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD
Date Ready/By: Juris: Q See Page 2 for
Internet: www.tigard-or.gov BUILDING 0 VtSlQ Notified/Method: Supplemental Information
TYPE OF WORK V F !^✓ COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
�1 Air conditioning 46.75
Job site address: H `fjam( 5A) Lo$-TN PvE 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.: 6, Other. 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32 _
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER 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
® APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:Polygon WLH,LLC Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Address:703 Broadway St.,Ste 510 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Range
E-mail:permitsubmittals@polygonhomes.com polygonhomes.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Apex Air LLC Other:
MECHANICAL PERMIT FEES*
Address:18004 NE 72nd Ave Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee)
CCB lic.: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\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
, 0 •
' Electrical Permit Application RECEIVE FOR OFFICE USE ONLY
CityofTigard
Received
- ' g Date/By: Permit#: ?„0O
III .• 13125 SW Hall Blvd.,Tigard,OR 97223 ����R ty 2019
plan Review/ /��
Phone: 503.718.2439 Fax: 503.598.1960 R' '
Date/13y: Related Permit#:
y Inspection Line: 503.639.4175 CITY
Ready Date/By: Juris: RI See Page 2 for
ii-i H.0 Internet: www.tigard-or.gov C9 OF i I ARD Notified/Method: Supplemental Information
TYPE OF � _� � � �. PLAN REVIEW
®New construction D Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
D Demolition 0 Other: where the available fault current
❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION 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
amps for all other installations. buildings.
0 Multi-family ❑Master builder ❑Other:
❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
l 4' `1 S W I loc3 (�_ ,� ❑Addition of new motor load of system.
Job#: Job site address: �t 1 r 1R�j lO0HP or more. ❑`A","E","I-2","I-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑,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 Each I Total I '::'
New residential single-or multi-family dwelling unit.
Subdivision:Roshak Ridge Lot#: (O' 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
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ 2
PROPERTY OWNER TENANT Services or feeders installation,alteration,SeePage 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
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 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
121 APPLICANT ❑ CONTACT PERSON Branch circuits-c 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:Jolene Smith B.Fee for branch circuits without
Address:703 Broadway St,Ste.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 Reconnect only 67.84 2
*a m., . ,i.=t's' .K,z` 4-ri,v1.,,, I*CTT s . .v, t5.74,1.::,t- ;.`sem+Mr..,. -ri, .Y_'
Pump or irrigation circle 67.84 2
Business name:Portland Electric Sign or outline lighting 67.84 2
ih Signal circuit(s)or limited-energy
Address: 1915 E 5 St.,Ste D panel,alteration,or extension. ❑ See Page 2 2
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 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lic.:„ /�,DJ specifically listed('/hr min) 90.00/hr
n �- _ I. CTItICAI PERMIT FEES
Suprv.Electrician signature,required: l�t,��, Subtotal:
Print name: Alex Shalya Date: 04/08/2019 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: ,L4 C ,k 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.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
i
Plumbing Permit ApplicationREC
Building Fixtures hh p t, FOR OFFICE USE ONLY
City of Tigard ri P R 2 4 Z019 Received
. DateB
Permit No.:�t�J
II 13125 SW Hall Blvd.,Tigard,OR 97223 Y` /�` r /�a-
Phone: 503.718.2439 Fax: 503.598.196Y1 O V TIGARD Plan Review
{� �+ r�p`g to/By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 BUILDING OI ISIONteReady/By: kris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist.
Description Qty. Ea. Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
21-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑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:
Job site address: 1 4 is i W t -n4 Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Roshak Ridge Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision:Roshak Ridge Lot no.: Co 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 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
® 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) 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 piping/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
CCB Lic.:184372 Plumbing Lic.no.:pb634 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: 'iatVoeS"\,_ TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days
Print name:Steve Fowler Date:04/08/2019
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)
I City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c A R D Building Permit Review — Residential
Building Permit #: C`c1 -T77)- \Ck- AC<
Site Address: .192:S3' S`Ni 16r±. AO,
Project Name: P.I ,,, al" J L g,Jnr Lot #:
(New fl&elling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Pro osal: 1\itl,/ .S11:
M Verify address/suite#active in Accela. IV/In River Terrace: ❑ No IJ Yes,River Terrace Review Addendum
Sit lan Elements: CSE Sion Control
3 opies of site plan on 8-1/2"x 11"or 11 x 17"paper wined trees with drip line and tree protection measures
awn to scale(standard architect or engineer scale) tprint of new structure(including decks)and FFE
rth arrow L�f[J 'ty locations &easements (required for new and additions)
S' address,project or subdivision name and lot number L�Sidewalk/driveway approach
25,pplicant information(name and phone number) n •cation of wells/septic systems
ZLot dimensions and building setback dimensions Peet tree size,type and location
are footage of buildings to be demolished IgSixeet names
,__,sting structures on site [ tomer elevations(2'contours if more than 4'differential)
Lt�tot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? es ❑No
_/im'
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑'* No
L✓J Clean Water Services—Service Provider Letter t platted prior to 9/10/1995):
fi.equired: ❑ Yes,applicant was notified [ No Received: ❑ Yes ❑ No �ti
le Public Facilities provement(PFI) Permit:
144v4{
quired: applicant was notified ❑ No Applie. For: lid" Yes ❑ No,stop intake
[ and Use Case#: roK:Lojc"u± u L Zoning: giiLE �."1�—equired Setbacks: Front: I z.. Rear: 0Side: .J Street Side: Garage: 3
''ding Height: Max. Height: Actual Height: Z6
PI/Landscape Area: "L,v % Lot Coverage Max: g t
` F A Entrance ❑ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
lu" Windows ❑ Minimum 12%of area of all street-facing facades
Garage ❑ Garage door is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
R, ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
ti..rrk'L- i ❑ Garage door width is ❑ 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave I=1 Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
-- ❑ Accent sidingWindow trim ❑ Window recess CIWindow projection ❑ Balcony
6/Visual Clearance Urban Forestay,P n
[? Sensitive Lands: ❑ Yes M" No Type:
Q)teConditions met prior to iss ance of biding permit
o : (,. 11, titi4 �t r�.t f4rcr ,,,1 i� t r,rt- •Nudkct
Approved By Planning: � t� Date: 3 Z 7-i 'I
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
i:\BuildingWorms\BldgPermitRvw_RES_022819.docx
Building Permit Submittal G_
Original Submittal Date: at G I 1 C ..r'4
Site Plans: # " j
Building Plans: #2/Enter
s '
Building Permit#: L/ Enter building permit#above.
Workflow Routing: g PlanningEngineering gPermit Coordinator E Building
Workflow Sign-off: [Sign-off for Planning(include notes from planning review)
Route Application Documents: Er Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
EV-Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: �,
By Permit Technician: L._,,'L.`L,''— Date: ::_71::'—i- ) 101
Engineering Review 761 Slope at building pad: 51)
,2 Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
B'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes No
Assess Water Quantity Fee in-lieu: ❑ Yes ifr No
LIDA Facility on lot: ❑ Yes ,.1:1.-No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
'Approved by Engineering: %,,,,
Date: �' �� �,
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved El Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
Q_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:
RR vision Notice 3: Date Sent to Applicant:
Lit" SDC Fees Entered: Wash Co Trans Dev Tax: 'Yes ❑ N/A
Tigard Trans SDC: V Yes ' ❑ N/A
Parks SDC: 2(Yes �❑ /A
LIDA CI Yes L5' N/A
1
OK to Issue Permit �'
Approved by Permit Coordinator: �71/Date: 411°(11
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
•
q City of Tigard
i
il
■
COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #: \ --v \C ,10t3
Site Address: N2.g S' j 6X Ave,
Project Name: p� yv ��- .tr-� it Lot #: (
(New ening
=subdivision name,Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Distiict Design Standards (18.640.070.I.):
Is the project subject to the plan district design standards? UYes ❑ 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 dee Balcony w/access 2 Window Projection Vertical Wall Offset a
P ft. deep min. 2ft., 5 ft.wide min. 2 ft., Eft.wide Gabled dormer
CICI ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: 2.1,0Z
3. Entrances:At least one entrance must meet both of the folio'Y' g standards:
iUr VIax. 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: li/J Yes ❑ No
If yes,all the following apply: 4 sq.ft. min.
Cf9 e street facing entry [I 1 ft.max. roof above floor of porch
l '5 ft. depth min. [ '30%min. porch roof coverage
4.petalled Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
[
overed porch min. 5 ft.wide x 5 ft. deep CI Recessed entry area min. 5 ft.wide x 2 ft. deep
Wall offset min. 16 inches ❑ Dormer min. 4 ft.wide
❑ Roof eave min. 12 inch projection 0/Roof offset min. of 2 ft.
❑ Roof shingles either tile or wood Ltd'Gable,hip or gambrel roof design
❑ of pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3-7 inches wide
Accent siding min. 40%of street facade ❑ Window 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 L.id< ttached garage is 35%or less of street facade
5. Garages and Carports:May face the front or side lot line on a corner lot.
VASetbacks:
No closer to front or side lot line,than longest street-facing wall. ❑ Yes ❑ No. If No (Check one):
kir ❑ May extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch.
L441CI 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
L above the garage that faces the street with a min. area of 12 sq.ft.
��jj Width: (Check one)
i79Z
❑ 12-foot-wide garage door ❑ 40%max. of street façade
❑ 50%max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: A. l Date: 3 1-4-(9
I:\Building\Forms\BldgPermitRvw_RES_RT_121417.docx
q City of Tigard
TIGARD
RECEIVED
MAR 282019
March 27,2019 CITY OF TIGARD
BUILDING DIVISION
RE: Roshak Ridge—Lot 6
Project Information
Building Permit: MST2019-00105 Construction Type:VB
Address: 14257 SW 168th Ave. Occupancy Types:R3 , f
Area: Roshak Stories: 2 "I0>
The plan review was performed under the Oregon Structural Specialty Code (ORSC) 2017 edition.
The submitted plans have been reviewed and the following information is required prior to issuance
of the permit.
1. Per ORSC Chapter 11 Energy Efficiency the plans submitted do not meet the minimum
prescriptive envelope requirements. The code requires that a minimum of R21 be
maintained at the top plate of the wall. Please advise how you will meet the minimum
requirement. ORSC Table N1101.1(1). Please see Table notes f and a.
Thank you,
Allyson Armstrong
vim; R X48 •
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
` Transmittal Letter
TIGARD 13125 S W Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Sa�tJ AY1' 5 T120 A)0 DATE RECEIVED:
DEPT: BUILD G DIVISION
RECEIVED
•
FROM: pIVJf} 012215 MAR 2 8 2019
COMPANY: l )16pAl CITY OF TIGARD
`J(J BUILDING DIVICION
PHONE: 360 - (/15- 1-1 00 By:
RE: /11257 5&() /607.1 14W ins 2o/q- Do/0 5
(Site Address) (Permit Number)
?OJ1k i b&aC — 1I7 ('o
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s)of plans. K Revisions: F--,,_ SeTS
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: Sofjet
FC60ert
FO FICE USE ONLY
Routed to Permit Technician: Date: 4 Z ("1 Initials: 444,
Fees Due: pes L 1 No Fee Descript n: Amount Due:
$ _VO /
1/1, IF Loticm r1,4",'N .J $ Lf S ,/
$
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes No ❑ Done
Applicant Notified: Date: Initials:
l:\Building\Forms\TransmittalLetter-Revisions_061316.doc
Electrical Permit Application I . ' FOR OFFICE USE ONLY
City of Tigard 1 j r'� Received --4.\ `i� \+ Permit#:(\C -�- C(-M.\
11111 q. _U Plan
Re
13125 SW Hall Blvd.,Tigard,OR 97223 i%i- Plan Review
Phone: 503,718.2439 Fax: 503.598.1960 Date/By: Related Permit#:
Inspection Line: 503,639.4175 (,,s Ready Date/By: Jurist I H See Page 2 for
TIGARD
Internet: www.tigard-or.gov 'j , '; Notified/Method: Supplemental Information
TYPE OF WORK .; itI coAPLAN REVIEW
®New construction 0 Addition/alteration/replacement
S4=` Please check all that apply(submit a sets of plans w/items checked):
i cc, 0 service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 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-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 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#: I Job site address: tt{j51 `JW 1(p 4,_ (-)--u , LOOHP or more. ❑"A",'E","1-2"; 1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I Project name:Polygon At 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 Each 1 Total I *—
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 _ 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF:WORK Limited energy,residential
6(\ S C 1. _0U l U (with above sq.ft.) 75.00 2
C Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0
See Page 2
® PROPERTY OWNER - ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: William Lyon Homes,Inc. 200 amps or less 100.70 2
Address:703 Broadway St Suite 510 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2
Phone:(360)695-7700 Fax:(360)693-4442 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 59.36 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
e APPLICANT. +' ❑ CONTACT PERSON Branch circuits--new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:William Lyon Homes,Inc. above service or feeder fee,
7.42 2
each branch circuit
Contact name:Nichole Thorpe B.Fee for branch circuits without
sAddress:703 BroadwaySt Suite 510 branchee or feeder fee,first 56.18 2
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 I Fax: :(360)693-4442 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: permitsubmittals@polygonhomes.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Alameda Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 See Page 2 2
Address:3415 NE 44th panel,alteration,or extension.
City/State/ZIP: Portland,OR 97213 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 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 I Electrical Lic.: c923 I Suprv,Lic.: 4871/s , specifically listed(A hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: Subtotal:
Print name: Kite Rood Date: 03/08/2019 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: Kile Rood Date: 03/08/2019 days after it has been accepted as complete.
* Number of inspections allowed per permit,
I:\BuildinglPermits\ELC_PermitApp_ELR ERE.doc Rev 06/17/2015 440-46151(11/05/COM/WEB