Permit (172) CITY OF TIGARD MASTER PERMIT
ri 1 COMMUNITY DEVELOPMENT Permit#: MST2019-00132
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/13/2019
1 " 9 Parcel: 2S107AA03200
Jurisdiction: Tigard
Site address: 14224 SW 169TH AVE
Subdivision: ROSHAK RIDGE Lot: 32
Project: Polygon at Roshak Ridge, Lot 32
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: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
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
0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvpes Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
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: $33,369.20
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 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: ° ����1� Permittee Signature: e,-/V'' �G`". 77,67,1
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 in pection.
n `�
f ` Building Permit Application \___ c.,„__\___ `�
Residential RECEIVED FOR OFFICE USE ONLY
City of Tigard ReceivedDate/By. 4 , \1 CC` \T Permit No.> s--k-"'1,.c,G_I
. - . 13125 SW Hall Blvd.,Tigard,OR 9722FE8 0 6 2019 P1anReview ,�
• Phone: 503.718.2439 Fax: 503.598.1960 DateBy: 7 (
Other Permi 'r j CA k
TIGARD Inspection Line: 503.639.4175 L i I Y OF TIGARD Date Ready/By. ,-- , Ions: 0 See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: -5 1� 1'b,4 Supplemental Information
L—�"I�"/L ,l?G yrer" / -
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
0 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: $ 22'Vi j i 7
❑Accessory building EJMulti-familyNumber of bedrooms: / 1
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION:AND LOCATION Total number of floors: 2., "LI( 7
Job site address: l(4 2 VA)`) 1 ("TV 1 i 1`r( , New dwelling area: )-.)).44 square feet C 39
City/State/ZIP: II eOP-0
12�J/(if Garage/carport area: �2, square feet 605'
Suite/bldg./apt.no.: Project'x,.e:Polygon at Roshak Ridge ` Covered porch area: iifsquare 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.: v 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 , A c" DESCRIPTION OF WORK work indicated on this application.
\� I Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 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:
)l APPLICANT 0 CONTACT PERSON BUILDING PERMIT.FEES*
Business name:Polygon WLH LLC (Please refer iajee schedule)
Structural plan review fee(or deposit):
Contact name:Amanda Gavin
FLS plan review fee(if applicable):
Address:703 Broadway St.Ste 510
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(360)695-7700 Fax::(360)693-4442 Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:permitsubmittals@polygonhomes.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:William Lyon Homes,Inc. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:703 Broadway St.Ste 510 Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 I Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
LCCB lic.:207247 / Total fee due upon application: $201.60 I
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
] *1-ee methodology set by Tri-County Building Industry
Print name:Amanda Gavin Date: I /l/ Service Board
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit ApplicatHFCEIVED FOR OFFICE USE ONLY
IIICity of Tigard 2019 Date/By: 961-ss% r9'QL�/3 -
- Permit N
" Received
13125 SW Hall Blvd.,Tigard,OR 97223 APR Plan Review
Phone: 503.718.2439 Fax: 503.598.1960y` p� g Date/By: Other Permit:
TIG ARD Inspection Line: 503.639.4175 ' 1 I P e L—' Date Ready/By: Jam: H See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
IA 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:
Air conditioning 46.75
Job site address: `e{22-4 5 w <(o°1 Pi ve, 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.: -3 Z, 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 72"a Ave Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee)
CCB lie.:203034 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methoaotogy set by I ri-County Bunning Industry Service Board
Print name:Tim Hay Date:04/08/2019
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
•
Electrical Permit Application RECFIVE$ FOR OFFICE USE ONLY
City of Tigard Received
APR �� Date : Permit#:/( 7320/9-0e)/2.0.--
il 13125 SW Hall Blvd.,Tigard,OR 97223 ♦J 2 201
g Plan RB eview
p Related Permit#:
. . Phone: 503.718.2439 Fax: 503.598.19 DateB
Inspection Line: 503.639.4175 LAIN OF I I CARD Ready Date/By: Juris: EI See Page 2 for
1.1LiM..L1 Internet: www.tigard-or.gov BUILD/NG D1V SlO , otified/Method: Supplemental Information
TYPE,OF WORK, PLAN REVIEW
®New construction 0 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.
El Demolition 0 Other:
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONS`rRUc1TON exceeds 10,000 amps at 150 volts or ❑Floating buildings.
E 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family ❑Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION Emergency system. larger separately derived
Job#: Job site address: 14224 .s� \1pq,.. ❑ 01-1 on of new motor load of system.
� R-1,6 100HP 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.#: 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 Qty. I....-Each I Total I'..*
New residential single-or multi-family dwelling unit.
Subdivision:Roshak Ridge Lot#: 37.... 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 I
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 " 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
Ei APPLICANT p 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 67.84 2
Email:permitsubmittals@polygonhomes.com dwelling,service and/or feeder
Reconnect only 67.84 2
i° ..'4: 't.,g : ? �' as` a .tit.: x >,Z ,;; n;z a.=x,.r �-.xri Pump or irrigation circle 67.84 2
Business name:Portland Electric Sign or outline lighting 67.84 2
Address: 1915E 5th St.,Ste D Signalles circuit(s)or limited-energy 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(I hr min) 90.00/hr
Email:paul@portlandelectric.biz Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lie.; 23'43 j 5 specifically listed('/hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Qttx �;n� � 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: }i� ,G„,... i_, TOTAL PERMIT FEE:
----v This permitapplication expires-if aparmit is sot obtained within IU
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
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Plumbing Permit Applicatio I
VED
Building Fixtures (� FOR OFFICE USE ONLY
City of Tigard APR 2 4 2019 Received
Date/By: S /
Permit No. 7
/C
q 13125 SW Hall Blvd.,Tigard,OR 97� � L ����
I 3 Phone: 503.718.2439 Fax: 503.59960 Plan Review
Date/By: Other Permit No.:
T T G A R D Inspection Line: 503.639.4175 BUILDING D I VI I O�� Date Ready/By: Jur s: 0 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 I Qty. I Ea. I Total
0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
15(1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building Multi-family
Each additional bath/latchen 25.02
❑Master builder 0 Other:
Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
^�,', S� �-► y� Catch basin or area drain 18.76
Job site address: t�2:2.11( �Lp� 1 rw
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.: 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.: 32 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
Primer 12.51
Contact name:Tonja 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 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
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
*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)
T w
City of Tigard
" COMMUNITY DEVELOPMENT DEPARTMENT
UPI
T 1 G A R 1J Building Permit Review — Residential
Building Permit #: QST 1CI- (MV)jD
Site Address: /2/2-021 . J(9 /5Le.
Project Name: GAO/ , ,n < ei,_,1 Lot #: .5Q
(New. Z g=subdivision name;Addition or Alteration= ame of owner)
Planning Review
Proposal: . 9 -919C- Z
Ji Verify address/suite#active in Accela. ligi In River Terr.ce: ❑ No 'V Yes,River Terrace Review Addendum
Sit/Plan Elements: r Ero ion Control
10 copies of site plan on 8-1/2"x 11"or 11 x 17"paper �1 • tamed trees with drip line and tree protection measures
ZrVAawn to scale(standard architect or engineer scale)
ootprint of new structure(including decks)and FFE
rth arrow tility locations&easements(required for new and additions)
f1 ' e address,project or subdivision name and lot number i Sid a• - ./driveway approach
plicant information(name and phone number) 10 w. ation of wells/septic systems
,I. et dimensions and building setback dimensions ►A eet tree size,type and location
Il z+ u. e footage of buildings to be demolished deet names
I1 ',�' sting structures on site VCorner elevations(2'contours if more than 4'diffe ntial)
Ii Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced es ❑I�Ti
im.ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown?11"j Yes o
IU' an Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
equired: ❑ Ye ,applicant was notified No Received: ❑ Ye ❑ No
Public Faciliti Improvement (PFI) Permit:
,Lequired: Yes,ap licant was notified ❑ No Ap_pliedd or: y�Yes ❑ o,sto intake
and Use Case#: t/d O_S= i0 a'#' - 1/Zoning: /C- -1)
t
equired Setbacks: Front: % Rear: Side: .. Street Side: k1 i4' Garage:
wilding Height: Max. Height: :i Actual He ht:
Landscape Area: -2O 0/Max.
I Lot Coverage Max:
Entrance sack no more than 8'from street-facing wall ❑ Parallel to street or offset 45 de: e- : -ss
Windows ❑ Minimum ' . • area of all street-facing facades
Garage ❑ Garage door is behind wt.-- eet-facing wall 04,r. ❑ Yes 5 o,one of the following is met
❑ Door extends no more than 5' . and - . covered porch extending beyond garage.
❑ Door extends no more than 5'f .•• ••.11 an. - - - - a 12 sq ft.window above garage on 2"d floor.
❑ Garage door width is !a or less ❑ 50%or less of faca.e • 60%or less and includes 7 of following:
❑ C. - . porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roo - ❑ Roof offset
• Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roo • Dormer
❑ Accent siding Window trim ❑ Window recess ❑ Window projection ❑ ;a
.kisual ClearanceLV Urban Forestry an
nsitive Lands: ❑ Yes 21 No Type:
❑ Conditions .•et pi-4r o issuance of building .ermit
No s: _ .6' "• ii r
' . _' /. / r1
— f%J. ti. ,,, �'
I
Approved By Planning: -- '--- __ 1,7 Date: ii
Revisions (after Bjtding Submittal only)
� ( R/,eviewer Date
Revision 1: Approved ❑ Not Approved lel ` 41.-I 4
Revision 2: ❑ Approved ❑ Not Approved `
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
p
Building Permit Submittal
Original Submittal Date: ,a '\, '\01
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: [Planning [Engineering D Permit Coordinator ["Building
Workflow Sign-off: 2/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.
[Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: � �1
( ( 'q
Engineering Review 4 Xi-
Slope at building pad: 0
'Conditions "Met"prior to issuance of building permit
a Easements (encroachments)per engineering conditions of approval and plat
AfiWater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ,No
Assess Water Quantity Fee in-lieu: El Yes 'I No
LIDA Facility on lot: El Yes An No
,,,E'Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: 4/I 17
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: El Approved El Not Approved
Revision 3: ❑ Approved El 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:
Revision Notice 3: Date Sent to Applicant:
DSZLSDC Fees Entered: Wash Co Trans Dev Tax: at'Yes ❑ N/A
Tigard Trans SDC: cl*Yes El N/A
Parks SDC: Yes El N/A
LIDA El Yes 'N/A
c KOK to Issue Permit
Approved by Permit Coordinator: �7� `' Date: 4
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
II '
1111 IN
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
S
T I G A R D River Terrace Building Permit Review Addendum
Building Permit #: MS-T?Jc3\Ct- C O\?
Site Address: /42.2 L. `2 /L974 /�
Project Name: /L/ n II- `� ,� Lot #: „3,2
(Negfjg=subdivision name;Addition or Alteration=name of owner)
Planning Review of River Terrace Plan Dist/'ct Design Standards (18.640.070...):
Is the project subject to the plan district design standards? I! 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.
Balcony w/access 2 Window Projection Vertical Wall Offset a
Porch min. ft. deep ft. deep min. 2ft.,5 ft.wide min. 2 ft.,6ft.wide Gabled dormer
❑ ❑ El ❑
2. Eyes on the street: a minimum of 12%of each street facing façade must include windows or entrance doors.
Percentage Shown: . '°(/
b
3. trances:At least one entrance must meet both of the follo ' g standards:
Max. 8 ft. setback from long t 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 all the following apply: sq.ft.min.
ne street facing entry ft. max. roof above floor of porch
5 ft. depth min. 30%min. porch roof coverage
I4
. etailed Design:All buildings shall include a min. of five of e following elements on all street-facing façades:
Covered 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
T Roof eave min. 12 inch projection ❑ ; sof offset min. of 2 ft.
❑ Roof shingles either tile or wood T Gable,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. ❑ orizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40%of street façade Window trim min. 2 1/2"wide by 5/8" deep
El Window recess min. 3 inches for all street facing 0 Bay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35% or less of street façade
. _ . • • s and Carports:May face the front or side lot ' e n a corner lot.
Setbacks: JX
No closer to front or side lot -, •. longest street-facing all. ❑ Yes . i o. If No (Check one):
❑ May extend up to 5 ft.if there is a covere. .- s orch a • :. age does not extend beyond the front porch.
El May extend up to 5 ft.where the garage is .. . . two-s . ding and there is a window at the second story
above the garage that faces the street . a min. area of 12 sq.ft.
Width: (Check one)
❑ 12-foot- •- garage door El 40%max. of street façade
111 1'/o max. of street façade with 7 detailed design elements
Notes:
v i _;�— C___ r a e: -ari//1/i/
I:\Building\Forms\B1dgPermitRvw_RES_RT_121417.docx
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
sIN Transmittal Letter
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
1-(5 AI -- C.TO: \i\ SC5Y\ ,(ryl 6DATE RECEIVED:
DEPT: BUIL thNG DIVISION RECEIVED
APR 18 2019
FROM: �6V\, \ Ki3Niv S
CIN OF TIGARD
COMPANY: 3� � S `"�,'1BUILDING DIVISION
PHONE:
c\ „ OO By:
RE: \L 224 S UJ \locker► v E OAS-1. ZD .R- ob(32.
Site Address) (Permit Number)
(Project name or subdivision name d lot number)
l
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions: Rk..13 k-� ,S
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: �,•e� (`�y\�,, �y�,S L
9-"?'-' f- -1L-Q6A11--4*'
. FOR OFCE USE ONLY
Routed to Permit Technician: Date: 9[Z?, („/ Initials: Alk
Fees Due: Yes ❑No Fee Description: Amount Due:
$ 00
14/
11 2. ?\.p."-) r�.�; $ lir- VO
$
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes [g No ❑ Done
Applicant Notified: Date: Initials:
1:\Building\Forms\TransmittalLetter-Revisions_061316.doc
Electrical Permit Application-1 dry€" p a' ' = FOR OFFICE USE ONLY
City of Tigard Received -
1 I Ci S' Pi #
Permit :
qIll 13125 SW Hall Blvd.,Tigard,OR 97223 1 L- 1 8 7 Date/B : �� r ��'
g 0'9 Plan Review
: Phone: 503.718.2439 Fax: 503.598. 1., Date/13 : Related Permit#:
Inspection Line: 503.639.4175 -. s Ready Date/By: Juris: El See Page 2 for
TIGAKD Internet: www.tigard-or.gov 3t!q 1, ',.., + ,r :";;, Notified/Method: Supplemental Information
TYPE OF WORK . ., s ' PLAN REVIEW .
®New construction 0 Addition/alteration/replacemer i ' Please check all that apply(submit 2 sets of plans w/items checked):
:xv . r,�S 0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: ON �-" where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION S "C�,�); -•" 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 0 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
I � � 5w t r q ❑Addition1of new motor load of system.
Job#: Job site address: 2 `"1'1rI "'' 10100HP or more. ❑"A","E","1-z^,"t-3",
Ci /State/ZIP:TI and OR 97224 ❑Six or more residential units. occupancy,
ty g '
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 I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge I Lot#: 32 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 WORKK .,, Limited energy,residential
/\ T G.vt,CI—U0 I3 Z (with above sq.ft.) 75.00 2
'T
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
® PROPERTY OWNER 1 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 I 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 I
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
►5 APPLICANT ID 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
servAddress:703 BroadwaySt Suite 510 branche or feederitfee,first 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Each add'/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,
Email: permitsubmittals@polygonhomes.com Reconnect only
on service and/or feeder
ly 67.$4 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(I 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.Lie.: 4873% specifically listed(V2 hr min)
p 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: ..4.......e.....„....-2-----
rTOTAL 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:\Building\Permits\ELC_PemiltApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB