Permit (116) CITY OF TIGARD MASTER PERMIT
r F
'', COMMUNITY DEVELOPMENT Permit#: MST2019 00233
T i G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/27/2019
Parcel: 23107AA04600
Jurisdiction: Tigard
Site address: 16820 SW SUNSHINE COAST ST
Subdivision: ROSHAK RIDGE Lot: 46
Project: Polygon at Roshak Ridge, Lot 46
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: 25 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
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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!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: $33,336.20
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 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: \_,,1 ,k...__ Permittee Signature: C� 1� -2\
\`CAN-7\. .C-Th
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.
.\___\\.c_
Building Permit Application L ---\-----
Residential FOR OFFICE USE ONLY
Cityof Tigard Date/By:Received
J r0'4(N�
g 1 Permit No. r
III . V 13125 SW Hall Blvd.,Tigard,OR 97223 t;, c, P1anReview 4 I� �� � la�
Phone: 503.718.2439 Fax: 503.598.1960 " u- DateBy: (VI Fl`tat piOther Perm t `e' _3r (
T I GA RD Inspection Line: 503.639.4175 ; E ; Date Ready/By: .turas: H See Page 2 for 1
Internet: www.tigard-or.gov Notified/Method:
g _,t s '7 ""-.4t,,,,,," „ Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FA11ILY DWELLING
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ 4 . .k.1 ` �
❑Accessory building 0 Multi-family Number of bedrooms:
El Master builder 1:1 Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:a^ Z,,l(4'7
Job site address: .rn 9-') c C/k) S tkV1,G,�/) I U► 11X (V CS S New dwelling area: Ii LfL_ square feet 3C1
City/State/ZIP:Tigard,OR 97224 !/V t lGarage/carport area: a square feet
Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: ►r : 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.: ~IV 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
® 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:
Ea APPLICANT 0 CONTACT PERSON , BUILDING PERMIT FEES*
Business name:Polygon WLH LLC Plleasere-/erto-eeschedudeej
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
Phone:(360)695-7700 Fax::(360)693-4442
Amount received:
E-mail:permitsubmittals@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CON RACTOR 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 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247 A Total fee due upon application: $201.60
Authorized signature: A
, This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print'mine:Am: k,.•.;, • Date: % ., f _, ,_ •, by Tr
Service Board.
I:\Building\Permits :'/'-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard ,...4 i—i ' ,...g't,2 •,...4 Received
Date/By: Permit
" 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
' • Phone: 503.718.2439 Fax: 503.598.1960 ),,,u Date/By: Other Permit:
T I GARD Inspection Line: 503.639.4175 11)N i 9 , H ,
Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov ', Notified/Method: Supplemental Information
4, , • .
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TYPE OF ORK ,- COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
Mechanical permit fees*are based on the value of the work
[E]New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition El Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
El.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
Heating/cooling:
JOB SITE INFORMATION AND LOCATION
Air conditioning 1 46.75
Job site address: k(Azo 641161.4 I to E mc\srSr- 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.: Litt) 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
N\45-1' '2,0kC\"* 0472:6 fireplace _ 23.32
Log lighter(gas) 23.32
Wood/pellet stove , 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
El PROPERTY OWNER 0 TENANT
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
1:0 APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Polygon%VLH,LLC
$14.15 for first four;$4.03 for each additional
Contact name:Tonja Morris Furnace,etc.
Gas heat pump
Address:703 Broadway St.,Ste 510
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
GI' CONTRACTOR Clothes dryer(gas)
Other:
Business name:Apex Air LLC
MECHANICAL PERMIT FEES*
Address: 18004 NE 72'd 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
j---
Athodays after it has been accepted as complete.
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Print name:Tim Hay Date:04/08/2019
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Electrical Permit Application,-,- --- �_ .FOR OFFICE USE ONLY
CityO Tigard JUN014 ReteReceiv d
Permit
f g • kt� `` Qk-L w
I` 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
INPhone: 503.718.2439 Fax: 503.59 .)aif6U;' Date/B : Related Permit#:
Inspection Line: 503.639.4175 ")t r 1 i ' v4 e ,' l Ready Date/By: Lurie. H See Page 2 for
'L luAti-U- Internet: www.tigard-or.gov '" l' 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):
El Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
El 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.
0 Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORNLATION AND LOCATION 0 Emergency system. larger separately derived
7 �'•
0 Addition of new motor load of system.
Job#: Job site address:
`(pct ZO UAS K Me GAST 10OHP or more, ❑ A", E„ 1.2 1.3",
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
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description 1 Qtr. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision:Roshak Ridge Lot#: L-(0 Includes attached garage.
1,000 sq.ft.or less Q 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion /L 33.92 1
DESCRIPTION OF WORK Limited energy,residential
1tl\n57 `e\_ utras (withaboves ft. 75.00 2
1� Jq )
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 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
201 amps to 400 amps 133.56 2
Address:703 Broadway St,Ste510
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
® 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
sAddress: 703 BroadwaySt,Ste.510 branche it feederitfee,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
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 It circuit(s)or extension. 0 See Page 2 2
panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: Vancouver,WA 98661
Additional inspection(1 hr min) 66.25/hr
Phone:(360)314-4945 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: paul@portlandelectric.biz Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
90.00/hr
CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lic.si 3'L �O5 specifically listed(Y hr min)
/� �� ELECTRICAL PERMIT_FEES
l�l
Suprv.Electrician signature,required: �, A Gadea, 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: ...vs,,, , Y / Li.,,,, ,_„, 64.4_. TOTAL PERMIT FEE:
This_permit application expires if a permit is not obtained within 180
Print name: MISHCHUK,SEP.O Date: 04/08/2019 days after it has been accepted as complete.
s. Number of inspections allowed per permit.
L\Building\Permits\ELC_PermitApp_ELR ERE.doc Rev 06/17/2015 410-4615T(11/05/COM/WEB
Y u `
Plumbing Permit Application _
Building Fixtures , Vin'. ,,-.-- ..' FOR OFFICE USE ONLY
City of Tigard A '�)t Received Permit No.:\\(^\( 1-• I� �
.ill q 13125 SW Hall Blvd.,Tigard,OR 97223 /i,N Date/By: 1�Ct W.���
Plan Review Other Permit No.:
Phone: 503.718.2439 Fax: 503.5984964-1� Date/By:
TIGARD Inspection Line: 503.639.4175 a ':,,/,=',;(-‘1.
Date Ready/By: .turfs: 1 l� See Paget for
Internet: www.tigard-or.gov 3( 11 ;D .at t i ,+,' t,,:I '' 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 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
jg 1-and 2-familydwellingi SFR(2)bath 437.78
❑Commerctal/industrial
❑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: Vb20 SuhS{f 1 nE. &A-ST {.0 Catch basin or area drain 18.76
V 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
Water service(no,linear ft.:_) Page 2
Subdivision:Roshak Ridge I Lot no.: Lib Fixture or item:
Tax map/parcel no.: Backflow preventer l 31.27
DESCRIPTION OF WORK. Backwater valve I 12.51
�J"1"2.05i- 062.33 Clothes washer ) 25.02
Dishwasher t 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
CA 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 125.02
City/State/ZIP:Vancouver,WA 98660 Hose bib Z 25.02
Phone:(360)695-7700 Fax:( ) Ice maker
1 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 it- 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 Z 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
D Q -- State surcharge(12%of permit fee)
Authorized signature: ; ___ ,-_ ,I 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 ecce rested as complete,
*Fee methodology set by Tri-County Building Industry Service Board.
I\Building`Permits'PLMU-PermitApp.doe 10/01;09 4,10-46161110/02/COM/WEB)
Electrical Permit Application , , , FOR OFFICE USE ONLY
4"'+ 4" 1 ''
City of TigardReceived�'
"l J
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
rari
Phone: 503.718.2439 Fax: 503.598.1960 1 �- Date/13 . ��Date/B : Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: kris: 10 See Page 2 for
TIGARD, Internet: www.tigard-or.gov ' ° Notified/Method: Supplemental Information
TYPE OF Vw'ORK' - PLAN REVIEW
0 New construction ❑Addition/alteration/replacement `:' ,,e �' ' 4..._ Please check all that apply(submit;sets of plans w/items checked):
0 Demolition ❑ Other: Cil Service or feeder 400 amps or more ❑Building over three stories.
\, where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION ;'-kAv 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: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE;.INFORMATION AND LOCATION ' 0 Emergency system. larger separately derived
l 4 LC) SW tS�t Oa WA St-' 0 001Addition of new motor load of system.
Job#: Job site address: loollor more. ❑system.
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑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 [ Total I *
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge I Lot#: 4A., 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
6g:tlJgt, n^G (with above sq.ft.)
��� 6�1 ,Y��Zb��{- OO Z-6 3 Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2.
® PROPERTY OWNER 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 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
01 APPLICANT I 0 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
service or feeder fee,first 56.18 2
Address: 703 Broadway St Suite 510 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
• .�_a•_::. .1...._.....;-.. :,:,..--.-CC,NTRA TQL^ _... . '..._ 484 .-2-
Business name:Alameda Electric Sign or outline lighting 67.84 2
Address:3415 NE 44th Signal circuit(s)or limited-energy ❑ See Page 2 2
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.: 487V S ,. specifically listed(%z hr min)
ELECTRICALPERMIT,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):
TOTAL PERMIT FEE:
Authorized signature: Cl
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. 1
* Number of inspections allowed per permit.
City of Tigard
III COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD River Terrace Building Permit Review Addendum
e
Building Permit #: A,,,k a.t. • _ oh c)a?,--),
2
Site Address: A ,L7 0 --gV ; - e , •
Project Name: POI ,,e n ,24- f K , , ,,e Lot #: 271
(New d 7 g=subdivision name;Addition or Alteratilast name of owner)
Planning Review of River Terrace Plan Dispict Design Standards (18.640.070.1):
Is the project subject to the plan district design standards? gl 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.
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., .6 wide Gabled dormer
0 0 ❑
f§ � 161(s-e--
windows or entrance doors.
2. Eye on the street: a minimum of 12%of each treet facing g facade must inclu e
Percentage Shown: ' ,..,, T % ' /z--/-0/
trances:At least one entrance must meet both of the foil. ' g standards:7r1 Parallel to street,angle no more than 45° from street,
Max. 8 ft. setback from longe street- facing wall or open onto porch
Entrance opens to a porch: VJ Yes 0 No
If r,all the following apply: sq.ft. min.
one street facing entry ft. max. roof above floor of porch
VA 5 ft. depth min. 30%min.porch roof coverage
4. etailed Design:All buildings shall include a min. of five of the following elements on all street-facing façades:
i
overed porch min. 5 ft.wide 5 ft. deep. 0 Recessed entry area min. 5 ft.wide x 2 ft. deep
gi Wall offset min. 16 inches 0 ..rmer min.4 ft.wide
O Roof eave min. 12 inch projection IE ' a of offset min. of 2 ft.S
O Roof shingles either tile or wood E Gable,hip or gambrel roof design,,p--e>
ay..00f pitch oriented south min. 500 sq. ft. 0 orizontal lap siding min. 3-7 inches wide
Accent siding min.40%of street façade 04 4 Window trim min. 2'/z"wide by 5/8"deep° '
O 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 façade
...rages and Carports:May face the front or side 1 line on a corner lot.
Setbacks:
No closer to front or 51.- c. e,than longest street-fac' g wall. ❑ Yes • ''o. If No (Check one):
O May extend up to 5 ft.if there is a c.•_ -d front porch a . -, age does not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is par e-. - .-story building and there is a window at the second story
above the garage that faces the street .• . min. area of 12 sq.
Width: (Check one)
O 12-foot- .- garage door ❑ 40%max. of street façade
112 " 11/4 max. of street facade with 7 detailed design elements
Notes:
ill
_—Approved By Planning: .. _ _-- Date: 61 i
I:\Building\Forms\B1dgPermitRvw_RES_RT_121417.docx
City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
ll
TIGARD Building Permit Review — Residential
Building Permit #: kg ♦ _ r
Site Address: (pO - /4 /tk6
04 -9-717.-
Project Name: , ! Lot #: ____4(e_
r ,��r .sem /�/ / Dom,
(Ne .f' ' g=subdivision name;Addition or Alteration 41,t name of owner)
Planning Review
Pro. Isal: /U..fa) ,r,', -
TA' Verify address/suite#active in Accela. In River Terrace: ❑ No 14 Yes,River Terrace Review Addendum
Sit Plan Elements: Erosion Control
V yopies of site plan on 8-1/2"x 11"or 11 x 17"paper tr ained trees with drip line and tree protection measures
6firth
rawn to scale(standard architect or engineer scale) •otprint of new structure(including decks)and FFE
arrow a ' 'ty locations&easements(required for new and additions)
1e address,project or subdivision name and lot number 11lJSidewalk/driveway approach
irr
.plicant information(name and phone number) I11 .cation of wells/septic systems
74 it dimensions and building setback dimensions �Y S eet tree size,type and location
11 tt .re footage of buildings to be demolished V�S eet names
.• '•-sting structures on site 1QCorner elevations(2'contours if more than 4'diffe nntial)
f et area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replace ? V� es ❑i
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Yes VNo
VD\flean Water Services—Service Provider Lette of platted prior to 9/10/1995):
equired: ❑ yes,applicant was notified No Received: ❑ Yes ❑ No
g 1 Public Facili�ti Improvement(PFI) Permit:
Required: AQ Yes,applicant was notified ❑ No Applie or: VZJ(es No stop intake
4andUseCase#: `SUAQ j�evc YJZoning: d�-712 )}q.uired Setbacks: Front: Rear: O Side: Street Side: 5 Garage:
weilding Height: Max. Height: Actual He' ht-,,,I vQ
Landscape Area: % Lot Coverage Max: %
Entrance mi .- .ack no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows ❑ Minimum . • area of all street-facing facades
Garage ❑ Garage door is behind wt.- eet-facing wall kinYes ❑ No,one of the fo • 2. • -s met:
❑ Door extends no more than 5' ro and re s a covered porch e - : .eyond garage.
❑ Door extends no more than 5'from wall and e - •- . .window above garage on 2nd floor.
❑ Garage door width is ❑ 12'or less ■ _e' . or ess of facade = (%or less and includes 7 of following:
❑ Covered porch • -ssed entrance ❑ Wall offset ❑ 1'Roo e.' ❑ Roof offset
❑ F. - - _es ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof : 1.rmer
• Accent siding Ci Window trim ❑ Window recess ❑ Window projection ❑ Balcony
VI((isual Clearance V, rban Forestry Plan
Cnsitive Lands: IV' Yes ❑ No Type: LOU? V.Ai f 4 1 I2+
onditions met prior to issuance of building permit
No s: _
01 Approved By Planning: '— `, W Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
Building Permit Submittal
Original Submittal Date: a b.1p (kC\
Site Plans: #
Building Plans: #
Building Permit#: LTJ Enter building permit#above.
Workflow Routing: [/Planning ['Engineering 2/Permit Coordinator Y'Building
Workflow Sign-off: 12( Sign-off for Planning(include notes from planning review)
Route Application Documents: Et/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: .......-4-/V".."--- Date: 1-01Q,\\O
E ingineering Review
EK Slope at building pad: 4
O Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility: �/
Assess Water Quality Fee in-lieu: CI Yes 12 No
Assess Water Quantity Fee in-lieu: ❑ Yes [K9No
LIDA Facility on lot: ❑ Yes LSI'No ________
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
far-Approved by Engineering: Date: _ �/
Revisions (after Building Submittal only) Reviewer 7� 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:
Re ' ion Notice 2: Date Sent to Applicant:
' vision Notice 3: Date Sent to Applicant:
::: SDC Fees Entered: Wash Co Trans Dev Tax: sy Yes ❑ N/A
Tigard Trans SDC: f es CI N/A
Parks SDC: Yes ❑ N/A
LIDA CI Yes kir N/A
OK to Issue Permit r
Approved by Permit Coordinator: AVDate: I 13
I:\Building\Fonns\BldgPennitRvw_RES_022819.docx