Permit (169) CITY OF TIGARD MASTER PERMIT
i 11COMMUNITY DEVELOPMENT Permit#: MST2019-00117
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/02/2019
T E "� 'O 9 Parcel: 2S 107AA02800
Jurisdiction: Tigard
Site address: 14270 SW 169TH AVE
Subdivision: ROSHAK RIDGE Lot: 28
Project: Polygon at Roshak Ridge, Lot 28
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 805 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 939 sf Garage: 423 sf Front: 12 Smoke
Detectors: Yes
Dwelling Units: 1 Third: 0 sf Right: 3
Total: 1744 sf Value: $226,796.20 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 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 SrvclFeeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 1744
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
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $33,324.20
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 throue •'- 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 B41/ Permittee Signature:
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
• Building Permit Application L-0-1— as
Residential RECEIVED FOR OFFICE USE ONLY
Received
City of Tigard FEB 6 2 19 y �� �`� Permit No.K1- JPt_Ci C
71 " 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: 'Li/i A� Other PermrkC‘_
Inspection Line: 503.639.4175 I,ITY OF TIGARD Date Ready/By. runs: ® See Page 2 for
TIGARD p g g BUILDING DIVISIONtf y
Internet: www.tt aid-or. ov Notified/Method: /� 9 4ir"4I Supplemental Information
e1.q/1_. C y60 -
TYPE OF WORK REQUIRED DATA.1-AND:2-FAMILYDWELLING
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El.and 2-family dwelling ❑Commercial/industrial Valuation: $ G ) 1(0
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 Z.t(j 7
Job site address: 11,1 11 n 6t ) I LO O A�1 . ) New dwelling area: ) 1 LJ LI square feet Ce,
City/State/ZIP: 11tj- O� oil�72V�'� Garage/carport area: 4 square feet t, b
Suite/bldg./apt.no.: 03 Project name:Polygon at oshak Ridge Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Polygon at Roshak Ridge Lot no.: Z(g 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
DESCRIPTION OF WORK work indicated on this application.
r\�\�pp,� I�
Valuation: $
Existing building area: square feet
New building area: square feet
ID PROPERTY OWNER ❑ TENANT Number of stories:
Name:Polygon WLH LLC Type of construction:
Address:703 Broadway Street Ste 510 O• ccupancy groups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360)695-7700 Fax:(360)693-4442 New:
TA APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH LLC
(Please refer to fee
Structural plan review fee(or deposit):
Contact name:Amanda Gavin
FLS plan review fee(if applicable):
Address:703 Broadway St.Ste 510
Total fees due upon application:
City/State/ZIP:Vancouver WA 98660
Amount received:
Phone:(360)695-7700 Fax::(360)693-4442
E-mail:permitsubmittals@poiygonhomes.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 98 I i 0 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 lic.:207247 _ Total fee due upon application: $201.60
Autho• I i t.10,I -• 4111111111111'. This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:A f a'.a Gavin Date: 1/
/J1 *Fee methodology set by Tri-County Building Industry
r ` Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit ApplicatiRECEIVED
FOR OFFICE USE ONLY
City of Tigard Received
Date/By: Permit N'"/S 7:249 f—a,//7
13125 SW Hall Blvd.,Tigard,OR 97223R R 2 b L Q i 9 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 CITYO �r DateReady/By: jug I H See Page 2 for
Internet: www.tigard-or.gov ` I' ° leas Note Read ethod: JI Supplemental Information
BUILDING DMsl
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
g[1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
1 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 1y'L1O 6W wc\--1/4-NA 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.: 2.Ca 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 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)
Electrical Permit Application RECEIVE .� FOR OFFICE USE ONLY
City of Tigard ? ReceivedrilliffirgliEni
N ... Plan 13125 SW Hall Blvd.,Tigard,OR 97223 AF R 2 b 2019 Dane :
Review
Phone: 503.718.2439 Fax: 503.598.1960.., • w* Date/B : Related Permit#:
Inspection Line: 503.639.4175 CITY OF/16AR ad Date B tuns: Fd
age 2 for
L1li,;.N_U Internet: www.tigard-or.gov BUILDING D1viS!'., tified/Method: See Supplemental
g o Supplemental Information
TYPE OF WORK. PLAN REVIEW ,
® 0 Addition/alteration/replacement apply(submit planschecked):
New constructionPlease check all that a 1 2 sets of w/items
❑Service or feeder 400 amps or more ❑Building over three stories.
0 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.
E 1-and 2-family dwelling 0 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 0 Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION' ❑Emergency system. larger separately derived
Job#: Job site address: � Q� ❑Addition of new motor load of system.
14210 � ) 1ti 1T �) 100HP or more. ❑ A> E„ 1.2„ 1.3>
City/State/ZIP:Tigard,OR 97224 El Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Roshak Ridge ❑Hazardous locations. ❑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 Qtv. I Each I Total <..I Y_:..
New residential single-or multi-family dwelling unit.
Subdivision:Roshak Ridge Lot#: 7S 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 75.00 2
(with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
® PROPERTY OWNER Q 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-c ne ,alteration,or extension,per panel
A.Fee for branch circuitswwith
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'1 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
-,:z7, .mom rF :;.''`tom .,. d.vim, 'v ? 1 ` .u,,-, , z,• = Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
Business name:Portland Electric Sign or outline lighting 67.84 2
Address: 1915E 5th St.,Ste D Signal circuit(s)or limited-energy ❑ 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(I hr min) 90.00/hr
Email:pawl@portlandelectric.biz Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lic.; 3 VJ specifically listed(1/2hr min) 90.00/hr
4
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Ci ., A� Subtotal:
Print name: Alex Shalya Date: 04/08/2019 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: }� �i„aa1...,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.
L\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Plumbing Permit Applicati E E V
ED
Building Fixtures 2 FOR OFFICE USE ONLY
City of Tigard A P R 6 2019 Received
-
Date/By: Permit No.: /�Lt/1 ��z7
v 13125 SW Hall Blvd.,Tigard,OR 97223 �w
Phone: 503.718.2439 Fax: OF ti
Plan Review
Date/By: Other Permit No.:
T I GA R D Inspection Line: 503.639.4175 BUILDING D IV/S I O Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
For special information use checklist
®New construction El Demolition
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
tg 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building Multi-family SFR(3)bath 500.32
ID Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: L 4 Zi O S 1.1L) t is:Pk/�-1 1,E 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 I Lot no.: 2,5 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 1 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
Water closet 25.02
CONTRACTOR
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: 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 10/01/09 440-46I6T(10/02/COM/WEB)
. .
i City of Tigard
111 11
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Residential
Building Permit #: MsT?yo\C\- 00\ '
Site Address: Z 6 ll 2.
Project Name: 19,;1y-soN ,- ry k kf Z Lot #: Z,8
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Pro osal: klattml sr / �_/
L� Verify address/suite#active in Accela. 1t�1' In River Terrace: CI No L1 Yes,River Terrace Review Addendum
Sit Plan Elements: eft ion Control
l copies of site plan on 8-1/2"x 11"or 11 x 17"paper N. . •tained trees with drip line and tree protection measures
LyDwn to scale(standard architect or engineer scale) rt of new structure(including decks)and FFE
rth arrow A • 'ty locations&easements(required for new and additions)
iS' address,project or subdivision name and lot number LL.idewalk/driveway approach
plicant information(name and phone number) !t", .cation of wells/septic systems
21,ot dimensions and building setback dimensions �IE S et tree size,type and location
j�5quare footage of buildings to be demolished LKS eet names
IL1dLo'' ting structures on site Lf Corner elevations(2'contours if more than 4'diffffere�tial)
t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? [ es ❑No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑"st]No
[13 Clean Water Services-Service Provider Letter of platted prior to 9/10/1995): rz
�
Required: ❑ Yes,applicant was notified [lYNo Received: CI Yes CI No
IL:1 P-ublic Faciliti mprovement(PFI) Permit: u�� (Jit[V es,applicant was notified
CI Applied For: [ Y/�es ll❑ No,stop intake
nd Use Case#: POP 2 S''LL cO L R.— PVI
Zoning:
q �) Side: S Street Side: L Garage: P./,k. g
e aired Setbacks: Front: °�. Rear:
L,1Y�Building Height: Max. Height:___VActual Height: Z,`.i.:7-
Ly'Landscape Area: V % Lot Coverage Max: rJ
ntrance CI Set back no more than 8'from street-facing wall CI Parallel to street or offset 45 degrees or less
WIJ Windows El Minimum 12%of area of all street-facing facades
Garage El Garage door is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
F\1 ❑ 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.
7 ii.r(( ❑ Garage door width is ❑ 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following:
El Covered porch ❑ Recessed entrance El Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch El Gable,hip,or gambrel roof El Dormer
❑ Accent sidingk7 Window trim CI Window recess CI Window projection CI Balcony
a�Visual Clearance C `Urban Forestry Plan
Sensitive Lands: El Yes INo Type:
Q)Conditions met prior to issuance of buildin permit t n.i4t\ti E1�.t<j e.t{ ,�; �;.,"',K PJ-r6, P,�r "k dA pu" Gf� ,'4 piwN)
S IrzA a- 3.At�:i�ry ()Isms yN l,ii)1 R p,,It A9 A,;.ri fib, 1.6tO 4►ay.4 by tit , .i r ilr- ISW0,0-
Approved By Planning: ✓t4 ( 1I Date: `11 i
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved El Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES_022819.docx
Building Permit Submittal
Original Submittal Date: Q I u i t C.i
Site Plans: # 3
Building Plans: # 9
Building Permit#: R"Enter building permit#above.
Workflow Routing: [Planning Engineering R'Permit Coordinator ErBuilding
Workflow Sign-off: [ Sign-off for Planning(include notes from planning review)
Route Application Documents: [Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
E"Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: i..\ k‘.4 I VI
Engineering Review `J
-Slope at building pad: '` D
Afr Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
,Er Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: El Yes No
Assess Water Quantity Fee in-lieu: El Yes ,0' No
' LIDA Facility on lot: El Yes -Er No
/CJ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
C Approved by Engineering: %1. C Date: 'f /4)//7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Re .sion Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: -/Yes ❑ N/A
Tigard Trans SDC: Lees CIN/A
Parks SDC: s ❑ /A
LIDA ❑ Yes 14 N/A
V'OKto Issue Permit
•
Approved by Permit Coordinator: Date: °11/)0 11(1
I:\Building\Forms\BldgPermitRvw RES_022819.docx
City of Tigard
p COMMUNITY DEVELOPMENT DEPARTMENT
III
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #: ' S-j - \C\_ O\c-+
Site Address: t 9 2- O S\d i f{f-h
Project Name: Pei 9,:^ u4 rdAtA[ Ri p` Lot #: 2g
(New welling=subdivision name;Addition or Alteration=last name of owner)
Planning Review of River Terrace Plan Diist ct Design Standards (18.640.070.1.):
Is the project subject to the plan district design standards? ['Yes ❑ No
1.Articulation: a minimum of 1 element per each street-facing façade 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. deepBalcony w/access 2 Window Projection Vertical Wall Offset a
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide Gabled dormer
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: 2_'1.07,
3. E trances:At least one entrance must meet both of the followingllstandards:
L� Max. 8 ft. setback from longe t street- facing wall DParallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: Yes ❑ No
IIffyes,all the following apply: 21,5 sq.ft.min.
:V 9Ine street facing entry [ '112 ft.max.roof above floor of porch
L(5 ft. depth min. 2/30%min.porch roof coverage
4. D�tailed Design:All buildings shall include a min. of five of the following elements on all street-facing façades:
[Novered 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
LI Roof eave min. 12 inch projection ❑ of offset min. of 2 ft.
O Roof shingles either tile or wood Ltd Gable,hip or gambrel roof design
❑ f pitch oriented south min. 500 sq. ft. 0 Horizontal lap siding min. 3-7 inches wide
Accent siding min.40%of street facade ❑ Window trim min. 2 1/2"wide by 5/8"deep
O Window recess min. 3 inches for all street facing 0 B�y 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:
M. No closer to front or side lot line,than longest street-facing wall. 0 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.
{�ftur ❑ 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.
Aiit Width: (Check one)
1G14 ❑ 12-foot-wide garage door ❑ 40%max. of street façade
,o ..Q 50%max. of street facade with 7 detailed design elements
7 Notes:
Approved By Planning: Date:
I:\Building\Forms\BldgPermitRvw_RES_RT_121417.docx
Electrical Permit Applicatiolp I µi. FOR OFFICE USE ONLY
ili City Of Tigard Received ,,1�, _
Date/I3 ; ESEEkirja.ISINEM
'4 13125 SW Hall Blvd.,Tigard,OR 97223 �1': gill
I Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 , t Ready Date/By: Jam: G3 See Page 2 for
TIGA1tD Internet: www.tigard-or.gov "'A' r 't Notified/Method: Supplemental Information
TYPE OF WORk' ,. 41, PLAN REVIEW,.:�r:
®New construction 0 Addition/alteration/replacement .- Y,. " Please check all that apply(submit 2 sets of plans w/items checked):
S...41 0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other: ..1:' where the available fault current 0 Marinas and boatyards.
CATEGORY OF- CONSTRUCTIONL \ exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accesso wilding less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder D Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INF`ORIVIATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: I Job site address: ('&2,1D 'SW (,' 'S n-I L, 1001W or more. ❑"A",``E","1-2","1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
0 Health-care facilities. ❑'Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Polygon At Roshak Ridge 0 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 1 Qty. I Each I Total I +
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge I Lot#: 245 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1
-r -' DESCRIPTION OF WORK Limited energy,residential
l'NN (V , J I- '" ,0L q--0 0 1 it (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
® 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
(Si 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,
each branch circuit 7.42 2
Contact name:Nichole Thorpe B.Fee for branch circuits without
sAddress:703 BroadwaySt Suite 510 branch
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 67.84 2
dweEmail:permitsubmittals@polygonhomes.com Reconnect
t onlyserve and/or feeder
Reconnect 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 Lie.: 199188 Electrical Lic.: c923 Suprv.Lie.: 4871 S specifically listed('/:hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Kile Rood LDate: 03/08/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: Jac 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.
!:\Building\Permits\ELC PerrnitApp_ELR_ERE.doc Rev 06/17/2015 440-46151(11/05/COM/WEB