Permit ;II OF TIGARD MASTER PERMIT
`' , v COMMUNITY DEVELOPMENT Permit#: MST2019-00027
Date Issued: 06/17/2019
T I ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107AA04200
Jurisdiction: Tigard
Site address: 14157 SW RIVER TERRACE BLVD
Subdivision: ROSHAK RIDGE Lot: 42
Project: Polygon at Roshak Ridge, Lot 42
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 1119 sf Basement: 140 sf Left: 3 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1062 sf Garage: 422 sf Front: 8 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2321 sf Value: $295,094.05 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 RainStorm 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 Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'l 500 sf: 4 201-400 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
Ecompasing: Y
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2321
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 Report Required
Prior To Pour
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $34,776.30
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: f\_,\./8,---. Permittee Signature: r
--\ L1L1 plc
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.
- ,
BuildingPermit Application ___c
Residential RECEIVED FOR OFFICE USE ONLY
City of Tigard c Received _ �,{
= C�•p V 20 9
Plan
��I� i�� 3 Permit No. t< , `' '�`
13125 SW Hall Blvd.,Tigard,OR 97223r GD 0 m�\ t
Plan Review � , �.
Phone: 503.718.2439 Fax: 503.598. Other Permit: \
Inspection Line: 503.639.4175 CITY OF TIGARD Date/B : —
TIGARD Date Ready/BNotified/Method:
���� S SeePage2for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: t�lV Supplemental Information
b-7476-'91Z ®acyGo
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-famil dwellin Valuation: $ , � -,�/ Q
❑CommerciaUindustrial 1
Y g
0 Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION"AND LOCATION Total number of floors:2-, .27 Li
Job site address: l� ''l W 9)\i9X�.p YY/I /n. Fl
v k - New dwelling area: 2')7,� square feet ‘tQ)(0�
City/State/ZIP: ' m ��q „ Vjn T t'] �1 t �.l X Garage/carport area: /19,2, square feet `k ‘c
Suite/bldg./apt.no.: �U Project name:Polygon at Roshak Ridge Covered porch area: � square feet
I"0 q (•-(C ,
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.: Li Z 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
DCESSCCR^IPTION OF.WORK work indicated on this application.
IU.P,w c7T 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:
El APPLICANT 0 CONTACT PERSON
BUILDING PERMIT FEES*
Business name:Polygon WLH LLC (Flv+sorefertofeeschedule)
Contact name:Amanda Gavin
Structural plan review fee(or deposit):
Address:703 Broadway St Ste 510 FLS plan review fee(if applicable):
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Phone:(360)695-7700 Fax::(360)693-4442 Amount received:
E-mail:permitsubmittals@polygonhomes.com PHOTOVOLTAIC"SOLARPANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
-
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 $180.00
- and administrative fees):
Phone:(360)695-7700 Fax:All (360)693-4442
State surcharge(12%of permit fee): $21.60
CCB lie.:207247 - _
Total fee due upon application: $201.60
Authorized signa This permit application expires if a permit is not obtained
within 180 da s after it ha "d ac rnmplete
Print name:Amanda Gavin Date: /1 *Fee methodology set by Tri-County Building Industry
O Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
•
Bg.
Mechanical Permit App CEIVED
FOR OFFICE USE ONLY
City of Tigard APR 9 2019 Received
Date/By: Permit N..
111
= " 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598. �J:1�OF TIGARD Other Permit:
Date/By:
TIGARD Inspection Line: 503.639.4175 L
BUIL DING DIVISION DateReady/By: Jam: 0 SeePage2for
Internet: www.tigard-or.gov BUILDING J Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
1-and 2-family dwelling ❑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: ''1I 7 .SW Te rraCQ VD 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.: 44_
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 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 methodology set by Tri-County Building Industry Service Board
Print name:Tim Hay Date:04/08/2019
I:\Building\Permits\MEC_PermitApp_040113.doc 440-46171(11/02/COM/WEB)
Electrical Permit Application RECEIVE[ FOR OFFICE USE ONLY
City of Tigard ft PR 'A 201(9 Received Pernvt# S�' ���
hl1l PR L DateBy: 00(1,) -7
'iii 13125 SW Hall Blvd.,Tigard,OR 97223 _ Plan Review
r,.. Phone: 503.718.2439 Fax: 503.598.196(y�� O��yy w/� Related Permit#:
VITY OF TIGARD DateBy:
Inspection Line: 503.639.4175 , 1 {�pn,�+ �-y`! �yf adyDateBy: loris: 0 See Page 2 for
tllis:NU Internet: www.tigard-or.gov BUILDING I" I..otifed/Method: I 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.
❑Demolition ❑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 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use amicultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
ElAddition of new motor load of system.
'�
Job#: Job site address: sW 1 HCE w D 100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: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. J Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision:Roshak Ridge Lot#: 4'L 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 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
City/State/ZIP:Vancouver,WA 98660 401 amps to 1,000 600 amps 200.34 2
601 amps to 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- 0 CONTACT PERSON- Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Polygon WLH,LLC above service or feeder fee, 7 42 2
each branch circuit
Contact name:Jolene Smith B.Fee for branch circuits without
service or feeder fee,first
Address:703 Broadway St,Ste.510 branch circuit 56.18 2
City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 Fax: :(360)693-4442 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:permitsubmittals®polygonhomes.com
Reconnect only 67.84 1
CONTRACTOR
Pump or irrigation circle 67.84 2
Business name:Portland Electric Sign or outline lighting 67.84 2
Address: 1915 E 5th St.,Ste D 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(1 hr min) 90.00/hr
Email:paul®portlandelectric.biz `1 C k 3. Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lie.: , s --
o- - specifically listed(%hr min) 90.00/hr
i
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: ., � 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: -inx„J eJ u,k, TOTAL PERMIT FRP-
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.
Plumbing Permit Application
Building Fixtures RECEIVED FOR OFFICE USE ONLY
City of Tigard Received
«�
IN a 13125 SW Hall Blvd.,Tigard,OR 97223 APR 9 2019 Date/By: Permit No �G+/9--C,�/,l�j�
Plan Review
- g
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:
Inspection Line:
503.639.4175 CITY OF TIGAAD Daattee/RByea:
dy/By:TIGARD Juris: H See Page 2 for
Internet: www.tigard-or.gov BUILDING D/V S O
otified/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 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
Xi 1-and 2-family dwellingSFR(2)bath 437.78
0 Commercial/industrial
❑Accessory buildingII-Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: %915'1 5w %J. � .�.�v` - k v 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.: 1 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
Subdivision:Roshak Ridge Water service(no.linear ft.:_) Page 2
Lot no.:
Z 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
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:G&B Plumbing&Sons Inc WaterPg�
ip m WV 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: iiiErpt 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 trims peen acceprea as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
14 COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD
Building Permit Review — Residential
Building Permit #: e\-r r \(A - coo ..---i-
Site Address:Address: /21l sC Z -C)iit ,e -er- 77-{-37a2 Ce ,Svj
Project Name: At, 1�� /° Lot #:
(N-`e" , g=subdivision name;Addition or Alteration la name of owner)
Planning Review
Proposal: Ala) ' '
ermit t
[Xerify site address/suite#exists and active in
p em.
f2jRiver Terrace Neighborhood: 0 No tad Yes,See River Terrace Review Addendum Attached
S 'Plan Elements:
ee(3)copies of site plan 11
sting structures on site
bai' rtt .Ian must be on 8-1/2"x 11"or 11 x 17"paper V. ootprint of new structure(including decks)with finished
wn to scale(standard architect or engineer scale) I.o elevations
.rth arrow I ,tility locations&easements(required for new and additions)
I•S. address,project or subdivision name and lot numberS d alk/driveway approach
plicant information(name and phone number) \10
•tion of wells/septic systems
IPI'Lot dimensions and building setback dimensions M �;sting trees to be retained with drip line,and tree
11 uare footage of buildings to be demolished o •tection measures
iT Lot area,building coverage area,percentage of coverage and 1 r
t tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40)
Z Property corner elevations(2 foot contour lines if more than >1,000
000 sf treet names
impervious area created or replac L�JYes ❑
4 foot differential) If es,is a storm water •uali , facili , shown? v �'U Yes 1LINo
11l� ean Water Services—Service Provider Lett- (lot platted prior to 9/10/1995):
'equired: 0 y: ,applicant was notified to No Received: 0 Yes 0 No
•4 Public Facili s s Improvement(PFI)Permit:
: -quired: VA Yes,applicant was notified 0 No Applied For: Yes 0 No,stop intake
/L--find Use Case#: Z'( 0/S= oct)
' ontng. 'WV/
rp7quired Setbacks: Front r' Rear CI Side Street Side ✓ �� , age
dscape Requirement
of Coverage Maximum: ii-T- %
PS Building Height Maximum Height 13) ! c J e 7/
Actual Height
ill,°`,isual Clearance
FTA/ensitive Lands: II(es 0 No
V
Urban Forestry Plan
Type '/ / � "i"-- A0.4J )2_
0 Condition ` et"
prior to issuance of building permit
Notes: ViiiIAQ +'t{s)-- 27A C.- _ br- p-urzl-?-- 73 'hc (
t� A roved ByPlanning:rr Date: _L-_-.2_13,22.9_
Revisions (after Building Submittal only) Reviewer
Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
I:SuildineForms\BldgPermitRvw RES o61417.docx
Building Permit Submittal
Original Submittal Date: �-t (.;t L t C-1
Site Plans: #
Building Plans: # 3
Building Permit#: O`Enter building permit#above.
Workflow Routing: [2/Planning Engineering R'Permit Coordinator I/ Building
Workflow Sign-off: 12/Sign-off for Planning(include notes from planning review)
Route Application Documents: I]/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: \,...A. _ Date: rA 6
Engineering Review 9
a
,Slope at building pad:
❑ Conditions"Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
/('I Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 4E1 No
Assess Water Quantity Fee in-lieu: 0 Yes 3 No
LIDA Facility on lot: 0 Yes No
'a Final Plat Recorded:
❑ NOT Approved byEngineering: Date:
PP '° ' �
Notes: Ps 11 1072- (N1 - - ec eLPs"JNtN 1t is`'-Uc.-
Xi Approved by Engineering: C----- . Date: 21 2/ 1 `t
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
Conditions"Met"prior to issuance of building permit
p/ipte: a-_e/iC
proved,NOT Released: Da // l
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant
Revision Notice 2: Date Sent to Applicant
Re n Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: IL}"Yes 0 N/A
Tigard Trans SDC: CYYes 0 N/A
Parks SDC: g'Yes 0 N/A
LIDA 0 Yes Cr\1/A
OK to Issue Permit Lt( (�I 1.1Approved by Permit Coordinator: 4-(1-‘-
Date:
I:\Building\Forms\BldgPermitRvw_RES 010118.docx
City of Tigard
IIII " COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: m )T'..c,\C CCI:J g--.1-
Site Address: /1---"0-3- ` 4 ever. :�wr_1 Jvi
Project Name: f -r671 j� Lot #: ii
(Ne ding=subdivision name;Addition or Alterati_ Mast name of owner)
Planning Review of River Terrace Plan DistfeiDesign Standards (18.640.070.1.):
Is the project subject to the plan district design standards?Of ❑ 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
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12%of each street facing facade must include windows or entrance doors.
Percentage Shown: /J
3. E rances:At least one entrance must meet both of the follo ' g standards:
Max. 8 ft. setback from longe street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: Yes ❑ No
If yps,all the following apply: sq.ft.min.
ITO e street facing entry1�ift.max. roof above floor of porch
ft. depth min. 30%min.porch roof coverage
4
. tailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
iCovered porch min. 5 ft.wide x 5 ft. deep ❑ Recessed entry area min. 5 ft.wide x 2 ft. deep
❑ all offset min. 16 inches ❑ Dormer min. 4 ft.wide
'Roof eave min. 12 inch projection ❑,,� R of offset min. of 2 ft.
❑ Roof shingles either tile or wood ,,l1X le,hip or gambrel roof design
❑ Roof pitch oriented south min. 500 sq. ft. lid .orizontal lap siding min. 3-7 inches wide
❑ Accent siding min. 40%of street facade 1/ 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 ❑ Attached garage is 35% less of street facade
5. Gar._ .. .. d Carports:May face the fro r\i ,r lot line on a corn- .t.
Setbacks:
No closer to front or side lot -, •. longest s eet-f. g wall. ❑ Yes ❑ No. If No (Check one):
❑ May extend up to 5 ft.if there is a covere. . -s.t .orch and garage does not extend beyond the front porch.
❑ May extend up to 5 ft.where the r. .ge is part of a two- -r building and there is a window at the second story
above the garage that faces eet with a min. area of 12 sq.ft.
Width: (Check on
❑ 12-f.: -wide garage door ❑ 40%max. of street facade
0%max. of street facade with 7 detailed design elements
Notes:
T; �wih
. . . . . .. ��►irii : . • _ AVANATI
I:\Building\Forms\BldgPermitRvw_RBS_RT_121417.docx
Electrical Permit Applicatiofn ,!',,n ii\;' " FOR OFFICE USE ONLY
City of Tigard R ceived (� ry7
1 i�I i'"� Date/B : Permit#. �� ii„ G ��l
111 'r 13125 SW Hall Blvd.,Tigard,OR 97223 ' " `'' = Plan Review
li Phone: 503.718.2439 Fax: 503 59 -.19 11 Date/B : Related Permit#:
Inspection Line: 503.639.4175 ,r '' + : Ready Date/By: Jurist E! See Page 2 for
T1GARD •
Internet: www.tigard-or.gov r _ Notified/Method: Supplemental Information
TYPE OF WORK ,. PLAN REVIEW. t ,
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
,W. , trt ""(( 0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑Other: lQ� `� where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION .}')\\. _,T..-- "�,n exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling ❑ 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
g ...LOCATION
0 Addition of new motor load of system.
Job#: Job site address: `1-(Gj, Z1.1 1, ,� l00HP or more. ❑"A","E "l-2","I-3"
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
0 Health-care facilities. b 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 I *
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge I Lot#: A-2.- 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 WORKLimited energy,residential
�ivi (5Y• ' ST 2 COO 271 (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 I 0 TENANT Services or feeders installation,alteration,and/or relocation
Name:William Lyon Homes,Inc. • 200 amps or less 100.70 2
Address: 703 Broadway St Suite 510 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2
Phone:(360)695-7700 Fax:(360)693-4442 Over 1,000 amps or volts 552.26 2
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
1) 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
servAddress;703 BroadwaySt Suite 510 branche orfeederfee,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, e and/or feeder
Email:permitsubmittals@polygonhomes.com Reconnect only
67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Alameda Electric --Sigh ointitTiiiellefilig __ --b71 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 Lie.: c923 Suprv.Lic.: 4871,,55 specifically listed('/3 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Kile Rood Date: 03/08/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: �- - 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:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB