Permit (44) CITY OF TIGARD MASTER PERMIT
IN al..'' COMMUNITY DEVELOPMENT Permit#: MST2019-00194
T[ ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/19/2019
Parcel: 2S 107AA02700
Jurisdiction: Tigard
Site address: 14294 SW 169TH AVE
Subdivision: ROSHAK RIDGE Lot: 27
Project: Polygon at Roshak Ridge, Lot 27
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 809 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 1858 sf Value: $240,968.70 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: 2 Backwater Value: 1
Other Fixtures: 0
Drywall-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!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 1858
Owner: Contractor:
POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 r 1 Ersn Cntrl 503-639-4175 I
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $33,609.42
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 OA 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: -- S Permittee Signature: k-. C.A-1A
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.
LO \uilding Permit Application a_____:
Residential RECEIVE . FOR OFFICE USE ONLY
City of Tigard Received
FEB
Date/By: C Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 C 0 y �� —` ��� S-NtC,1_C �q
I 6 2019 Plan Review
Phone: 503.718.2439 Far: 503.598.1960 Other Pe '. r
Date/By- J Z 11 � r"i �G\�i''l�ll/\2i.
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By- Juris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:I-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
❑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., dwellingValuation: $ �(�I O�(1(02)Y 0 CommerciaUindustrial v (0
ElAccessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms: 3
SOB SITE INFORMATION AND LOCATION Total number of floors: 2 ZZ 1 S"'
Job site address: t(-1< 1A)1k n) I V (1, lk I V/R) New dwelling area: Cd s5 square feet`049
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 4 9) square feet $o Ct
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: l 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.: 91 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New SF Valuation: $
Existing building area: square feet
New building area: square feet
El 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:
0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH LLC {Pleaserejertejeeschedule
Structural plan review fee(or deposit):
Contact name:Amanda Gavin
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)695-7700Amount received:
Fax: :(360)693-4442
E-mail:permitsubmittals@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL 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
and administrative fees): $180.00
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lie.:207247 I
Total fee due upon application: $201.60
Authorized signature: ,• This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:A• • i.0'avinVIIP Date: /C�I f tr{ *Fee methodology set by Tri-County Building Industry
/ / t I Service Board.
I:ABuilding.\Permits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
Cita'Of Tigard Received
q Date/By: , I
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
' 11 Phone: 503.718.2439 Fax: 503.598.1960Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Saris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORKCOMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
I-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:
Job site address: 11,-12Q t4 (5(10 I. n Air conditioning 46.75
A1/�J 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,' Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
VN20 tck C`ct Fluevent for water heater or gas
Y ti� 4 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 t 33.39
City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 3 23.32
Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32
El APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Polygon WLH,LLC $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
61. 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
t:'Buildingt_Permits'MEC PennhtApp 040113.doc 440-46171(11/02/COM/WEB)
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received ` �_,•_, [ a��
Date/B : Permit#. C
„ • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
• • Phone: 503.718.2439 Fax: 503.598.1960 Date/8 : Related Permit 4:
I I�iaS HLL7 Inspection Line: 503.639.4175 Ready Date/By: Juris. H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
' ,. . TYPE OF WORK PLAN REVIEW
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION -- exceeds 10,000 amps at 150 volts or ❑Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
0 Multi-family ❑Master builder amps for all other installations. buildings.
❑Other: ID pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
�y e I W_ (� ❑Addition of new motor load of system.
Job#: Job site address:
4 . 14 CI—r1-1 17 100HP or more. ❑"A, E, 1_� , I.3 ,
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Roshak Ridge 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qtvv, I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision:Roshak Ridge Lot#: 41 Includes attached garage.
1,000 sq.ft.or less 1 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion ' . 33.92 1
DESCRIPTION OF WORK
Limited energy,residential
ry 5•r Zbl - 0O,a� (with above sq.ft.) 75.00 2
J l Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
�� OWNER0TENANT Renewable Energy ❑ See Page 2
PROPERTY 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
0 APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Polygon WLH,LLC above service or feeder fee,
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 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 Fax::(360)693-4442 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:permitsubmittals®polygonhomes.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Portland Electric Sign or outline lighting 67.84 2
Address: 1915E 5th St.,Ste D Signal circuit(s)or limited-energy 0 See Page 2 2
panel,alteration,or extension. b
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 rain) 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.;,A 'L 1VS specifically listed('h hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: x Subtotal:
Print name: Alex Shalya Date: 04/08/2019 0 Plan Review Requireduired(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: ...s in -•k, TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: MISHCHUIC,SERE Y Date: 04/08/2019 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:1Building\Permits\ELC_PermitApp ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received Permit No..
III q 13125 SW Hall Blvd.,Tigard,OR 97223Pla
Date/By: � �- 1\��
• Date/By:
>a Phone: 503.718.2439 Fax: 503.598.1960 n Review Other Permit No.:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: cors: 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
❑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
Ist 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building 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: VA 2-a14 ti Uet-nt RUE 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.: J 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
J Water service(no.linear ft.:_) Page 2
Subdivision:Roshak Ridge Lot no.: �', Fixture or item:
Tax map/parcel no.: Backflow preventer t 31.27
DESCRIPTION OF WORK Backwater valve 1 12.51
yyt
. -T ZDl Q-00t9.4 Clothes washer 1 25.02
Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:Polygon WLR,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:703 Broadway St.,Ste 510 Garbage disposal k 25.02
City/State/ZIP:Vancouver,WA 98660
Hose bib 7.---• 25.02
Phone:(360)695-7700 Fax:( ) Ice maker 12.51
C4 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 3 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)
Q_1�_ , State surcharge(12%of permit fee)
Authorized signature: ,g.{Q,l}(� - •
_ .__.�. 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.
L•ABuWing+Perm itstPLMU-PennitApp.doc 10/01439 440-4616T(10,02/C064/WEB)
. F
City of Tigard
II COMMUNITY DEVELOPMENT DEPARTMENT
ill Ili
T 1 c A x o Building Permit Review — Residential
Building Permit #: \\(\ 7- A.C\- C)U.Ci
Site Address: /2A294 ,PA) / 4 e
Project Name: P6/ '1).71 a4 P. £� e Lot #: 3--
(Ne- 6 Ming=subdivision name;Addition or Alteratioast name of owner)
Planning Review
Proposal: !V-A} . F
1a Verify address/suite# active in Accela. gAli In River Terr.ce: LI No 4J Yes,River Terrace Review Addendum
Site/Plan Elements: IL Ere sion Control
,,__/,copies of site plan on 8-1/2"x 11"or 11 x 17"paper t ' Gained trees with drip line and tree protection measures
awn to scale(standard architect or engineer scale) VA F.otprint of new structure(including decks) and FFE
�rth arrow pr
1 tility locations&easements(required for new and additions)
t�J address,project or subdivision name and lot number 7 Si.ewalk/driveway approach
plicant information(name and phone number) 0.1''‘'cation of wells/septic systems
RC1 . dimensions and building setback dimensions Z5,treet tree size,type and location
41.. are footage of buildings to be demolished V,reet names
'6 sting structures on site VComer elevations(2'contours if more than 4'diffe ntial)
V Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? Mes0
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Yes No
Clean Water Services—Service Provider Lette of platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified m No Received: ❑ Yes ❑ No
6a Public Facili�ti Improvement (PFI) Permit:
Required: L✓J Yes,applicant was notified ❑ No Applied For: LVJ Yes ❑ No,stop intake
,Rand Use Case#: )u6.0/c- D�Uz/ ❑ o�g:
IJP .'equired Setbacks: Front: g Rear: CfSide: Street Side: /�'r Garage:
uilding Height: Max. Height: Actual Hei ht:
Landscape Area: v0 C.) % Lot Coverage Max: J _
Entrance PI Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 d• •- or less
.
Windows ❑ .... 12%of area of all street-facing facades
Garage ❑ Garage door is . .d widest street-facing wall ' ❑ Yes L' o,one of the following is met:
❑ Door extends no mo I an 5'from wall an there• " .vered porch extending beyond garage.
❑ Door extends no more than : w, ere is a 12 sq ft.window above garage on 2nd floor.
❑ Garage door width is ❑ 12' . s ❑ 1' . • less of facade ❑ 60%or less and includes 7 of following:
❑ Covered por • a Recessed entrance ❑ 1 , i : et ❑ 1'Roof eave ❑ Roof offset
❑ F" - gles ❑ Lap Siding ❑ Roof pitch ❑ a. : or gambrel roof ❑ Dormer
■ Accent sidingWindow trim ❑ Window recess ❑ f :" .rojection ❑ Balcony
csual Clearance Urban Forestry t an
III Po ensitive Lands: ❑ Yes J No Type:
F Conditions met prior to issuance of building permit
No s: _
Approved By Planning: --- ""-"`- > /' — Date: Q
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPemiitRvw_RES_022819.docx
Y
Building Permit Submittal
Original Submittal Date: Q'lst,kCC
Site Plans: # '?
Building Plans: #j__,....___
Building Permit#: Plif Enter E3Engineering
#above.
Workflow Routing: Ll Planning Engineering C"Permit Coordinator Building
Workflow Sign-off: [r 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.
R Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: 5 lapAel
Engineering Review / `-j
.0"-Slope at building pad: (O �j
Conditions "Met"prior to issuance of building permit
2—Easements (encroachments) per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes .'No
Assess Water Quantity Fee in-lieu: El Yes No
LIDA Facility on lot: ❑ Yes No
...12 Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
„Lil Approved by Engineering: al,/kg- kJ , Date: S /2--t)//1'
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
LI Conditions"Met"prior to issuance of building permit
El Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
vision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: a,Yes ❑ N/A
Tigard Trans SDC: g/Yes ❑ N/A
Parks SDC: Yes ❑ /A
LIDA ❑ Yes A N/A
OK to Issue Permit /2{(/t
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
IL
City of Tigard
q
COMMUNITY DEVELOPMENT DEPARTMENT
s' ■
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: \\-\ST,\Ck-CyCIACk
Site Address: J19z/ \ctio /(` ,tP
Project Name: PO/r ,y/ , -1 sL Lot #:
(New # g=subdivision name;Addition or Alteration=1 name of owner)
Planning Review of River Terrace Plan District Design Standards (18.640.070.1.):
Is the project subject to the plan district design standards? Of Yes ❑ 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.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 deep ft. deep
❑ min. 2ft., 5 ft.wide
❑ min. 2 ft.,6f de Gabled dormer
1=1-err n4- eid-L
2. Eyes on the street: a minimum of 12%of each street f cing facade must include windows or entrance doors.
Percentage Shown: F.',( 1 aJa g ' P ° o
3. E><ynances:At least one entrance must meet both of the follo g standards:
/Max. 8 ft. setback from longe street- facing wall arallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: Yes ❑ No
If yes,all the following apply: sq.ft.min.
lVieil street facing entry ft.max.roof above floor of porch
1/J 5 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:
overed porch min. 5 ft.wide x 5 ft. deep-e ❑ Recessed entry area min. 5 ft.wide x 2 ft. deep
Vy/all offset min. 16 inches ❑ Dormer min. 4 ft.wide
q,Q Roof eave min. 12 inch projectionf/ ❑ oof offset min. of 2 ft.
❑ Roof shingles either tile or woodable,hip or gambrel roof design�/ n
❑ ; •of pitch oriented south min. 500 sq. ft. horizontal lap siding min. 3-7 inches wide>
V Accent siding min. 40%of street facade/ "�Window trim min. 2 1/2"wide by 5/8"deep?erC
❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35%or less of street facade
. .• .es and Carports:May face the front or side lot line ower lot.
Setbacks:
No closer to front or sue • :_.- than longest street-facing� worrier
. ❑ Yes ■ •... If No (Check one):
❑ May extend up to 5 ft.if there is a co - _• front porch and v. .ge does not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is part •°!' tory building and there is a window at the second story
above the garage that faces the street i.• . min. area of 12 sq. t.
Width: (Check one)
❑ 12-foot- ••• garage door ❑ 40%max. of street facade
11/0 max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: Date:
I:\Building\Forms\BIdgPermiiRvwRESRT_121417.docx
Electrical Permit Application:. '$ i FOR OFFICE USE ONLY
Received t`\ ,t rI S � \ W\"l
City of Tigard l-• Date/B : "t Permit#: t
114 - v 13125 SW Hall Blvd.,Tigard,OR 97223 I U L 1 8 ?_01 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
TIGARD Inspection Line: 503.639.4175 ( i k ' = Ready Date/By: loris: El See Paget for
G, Internet: www.tigard-or.gov -,1t ls¢ a: ' . Notified/Method: Supplemental Information
TYPE OF WORK ill PLAN,.REVIEW, -
®New construction 0 Addition/alteration/replacement11.x;• m
v, Please check all that apply(submit 1 sets of plans w/ites checked):
0 Demolition El Other:
x • 0 Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION %" \"' exceeds 10,000 amps at 150 volts or ❑Floating buildings,
►1 1-and 2-familydwellingCommercial/industrialless to ground,or exceeds 14,000 0 Commercial-use agricultural
0 0 Acce s." .uilding
amps for all other installations, buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND mLOCATION ❑Emergency system. larger separately derived
Job#: I Job site address: a� ',tiOC 12. ❑100H Addition of new motor load of system.
W `� �1i�' (hoe, 100HP or more. ❑"A","E ,"1-2","1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units.
ccupancy.
0 Health-care facilities. 0 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. 1 Each I Total I +
New residential single-or multi-family dwelling unit.
Subdivision: Polygon at Roshak Ridge I Lot#: 21 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
0)fp p1. o aY1 \(\1\5-1- 2O t-00kQ 9 above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ 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
El
APPLICANT I ❑- CONTACT PERSON Branch circuits—new,alteration,or extension;per panel
A.Fee forbranch 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
serAddress:703 BroadwaySt Suite 510 branchce i feederstfee,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 I Fax: : (360)693-4442 Each manufactured or modular
67.84 2
dweEmail:permitsubmittals@polygonhomes.com Reconnect service and/or feeder
Reconnect only 67.84 2
CONTRACTORPum or irri.ation 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 Electrical Lic.: c923 Suprv.Lic.: 4871/S, specifically listed(14 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: ,, •(/,rTOTAL PERMIT FEE:
re* 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_PennitApp_ELR_ERE.doc Rev 06/17/2015 440-46t5T(lI/05/COM/WEB