Permit (46) Plumbing Permit Application
Building Fixtures ,, FOR OFFICE USE ONLY
� 1 `tReceived
City of Tigard " ,,ef L. 2 '"'" Date/By: /2/��//9 41 ?Limit No.: fAST2019-00221
- 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
DEC7 2019 Date/By: 1 1$--, 'd 4Gt'n Other Permit No.
Inspection Line: 503.639.4175 U' Date Read/B orris: 0 See Page 2 for
rIGARD ti a "4 Ready/By: //.'/ fj d1T�
Internet: www.tigard-or.gov 9, t a Date Read/By: / Supplemental Information
TYPE OF WORK ti In 1 / EE* SCHEDULE
®New construction ❑ Demolition For special information use checklist
Description Qty. I Ea. Total
0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
01 CATT.G6iii OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling El Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
El Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
ElMaster builder 0 Other: Fire sprinkler(1384 sq.ft.) ✓r Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 14249 SW 169°'Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Roshak at River Terrace Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision:Townhomes at Roshak Lot no.:66 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
.OF-
DESCRIPTION WORK
Clothes washer 25.02
MULTIPURPOSE FIRE SPRINKLER SYSTEM
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
►i4 PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:Polygon Northwest Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
El APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:Polygon Northwest Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Jennifer Lopez
Roof drain(commercial) 12.51
Address:703 Broadway St.Suite 510 Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax: :(360)816-7817 Tub/shower/shower pan 12.51
E-mail:jennifer.lopez@polygonhomes.com Urinal 25.02
• Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Alliance Plumbing,LLC Water piping/DWV 56.29
Address:146 W Historic Columbia River Hwy Other: 25.02
City/State/ZIP:Troutdale,OR 97060 Subtotal
Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50
CCB Lic.:184601 Plumbing Lic.no.:PB732 Plan review (25%of permit fee)
^'� State surcharge(12%of permit fee)
t
Authorized signature: � / 1 1 TOTAL PERMIT FEE
{Print name:Gavin Thomes Date:12.16.2019 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.
1\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain- I" 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum lee$72.50
Storm&Rain Drain-each additional 100- 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Other Fixtures:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quantity by Fixture Type
Fixture Type for Replace/ Plan Review for Plumbing Installations
Work Performed: apped Added Relocate
Baptistry/Font Plan review is required for any of'the following.
Bath -Tub/Shower Please check all that apply.
-Jacuzzi/Whirlpool ❑ Any new commercial building with water service 2"and
Car Wash -Each Stall greater,except systems designed and stamped by licensed
-Drive Thru engineer.
Cuspidor/Water Aspirator 0 New exterior plumbing site utilities for any complex structure
Dishwasher -Commercial as defined in OAR918-780-0040.
-Domestic 0 Medical gas and vacuum systems for health care facilities.
Drinking Fountain ® Any multipurpose fire sprinkler system.
Eye Wash 0 Any complex structure as defined in OAR918-780-0040.
Floor Drain/sink -2"
3" Submit 2 sets of plans with any of the above.
-4',
Car Wash Drain Isometric or Riser Diagram
Garbage -Domestic-non-food
•
Disposal -Domestic-food related 0 Isometric or riser diagram is required for new buildings
-Commercial-food related that meet the qualifications above.
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station)
Rec.Vehicle Dump Station Comments regarding fixture work:
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes
Water Extractor *Note: If the fixture work under this permit results in an
Water Closet-Toilet increase of sewer EDUs,a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
https://allianceplumbing-my.sharepoint.com/personal/gavin_allianceplum1521ng_net/Documents/Documents/Fire Sprinklers/RT/PLMF_PermitApp
(3).doc
CITY OF TIGARD MASTER PERMIT
N
---, ST2
Permit#: M019-00227
COMMUNITY DEVELOPMENT Date Issued: ST22019
TtGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S107AA06600
Jurisdiction: Tigard
Site address: 14249 SW 169TH AVE
Subdivision: ROSHAK RIDGE Lot: 66
Project: Polygon at Roshak Ridge, Lot 66
Project Description: New SFA.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 670 sf Basement: 80 sf Left: 0 Parking Spaces: 0
Height: 37 Bathrooms: 3 Second: 634 sf Garage: 532 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 0
Detectors: Yes
Total: 1384 sf Value: $189,364.40 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: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 1
Other Fixtures: 0
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: 2 201-400 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: V
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA VB R-3 1384
Owner: Contractor:
POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
103- ACWAY fi ESTE tit -rnk tY Stem, 91.0 --4
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: $24,979.70
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 �1 „,-1/4......._ Permittee Signature: — -- '_ (NNl -�CA,-AMC:4—N\
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.
•
Building Permit Application U.
U
Residential FOR OFFICE USE ONLY
City of Tigard 4--- -- Received
ii., Date/By: C Permit No.
N .. 13125 SW Hall Blvd.,Tigard,OR 97223 J` r �� ��� U�� 1
Plan Review
Phone: 503.718.2439 Fax: 503.598.1964 Other Perini.
a ,•' i Date Re k 1 I� •1 1ti Pt_(,,' \--19
TIGARD Inspection Line: 503.639.4175 ° Date Ready/By: Tuns. ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method:
Supplemental Information
ti.i l Y Of ;(:,.,,r0
Rix - ,
TYPE OF'M)R '-', REQUIRED DATA:1-AND 2-FAMILYDWELLING
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $
1(b°1 1.24
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms: /
JOB S111. INFORMATION AND LOCATION Total number of floors: lI K g
Job site address: l 1�� q l ` J �q I+ln 1 1/Z 1 AQ ) New dwelling area: square feet V5.4City/State/ZIP:Tigard,OR 97224 ` Garage/carport area: , square feet (170
Suite/bldg./apt.no.: \\ Project name:Polygon at Roshak Ridge Covered porch area: square feet CA.J
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKT,i.+;'t
Subdivision:Polygon at Roshak Ridge I Lot no.: (eV 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 SEA Valuation: S
IExisting building area: square feet
,3 New building area: square feet
0 El PROPERTY OWNER
0 TENANT Number of stories:
- Name:Polygon WLH LLC
Type of construction:
/� Address:703 Broadway Street Ste 510 Occupancy groups:
c ' City/State/ZIP:Vancouver,WA 98660sc . Existing:
Phone:(360)695-7700 Fax:(360)693-4442
New:
( . ® APPLICANT' 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Polygon WLH LLC " (Please refer tofee sehednte)
Structural plan review fee(or deposit):
Contact name:Amanda Gavin
Address:703 Broadway St.Ste 510 FLS plan review fee(if applicable):
City/Qtnm/7ID•Vose...._._..[v♦ norm Total fees date uDca iagiiatiAu•_s _.a_.�. .,
r= _ - ---- s -
Phone:(360)695-7700 Fax::(360)693-4442 Amount received:
E-mail:permitsubmittals@polygonhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTORCommercial 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:(360)693-4442
State surcharge(12%of permit fee): $21.60
CCB lir.:207247
Total fee due upon application: $201.60
Authorized si - This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Ama i . .yin I Date: �/�/b / / 1 I *Fee methodology set by Tri-County Building Industry
�/ f l_//!/ C Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Applicati tz 'i �'
� `�" � c:-.7t, r= ' °. . ... ��,._. ..FOR OF)!;ICE IJSE ONLY _ x,
City of Tigard Received
q Date/By:
Permit No.(\h •�-�1, ,(14-4).."-A-
.
13125 SW Hall Blvd.,Tigard,OR 97223 11)N 1 9 7019 t \ 7V
'r . Phone: 503.718.2439 Fax: 503.598 1960 Plan Review
Date/By: Other Permit
71 4,1,4 Ito Inspection Line: 503.639.4175 d 11'"�y �t=
a k ;'°....-.7-.. ,;--,1 Date Ready/By: Juris: 21 See Pa e
Internet: www.tigard-or.gov o s l e! F ; 4, ,fie,, Notified/Meth2 for
'�4 Et ,;^ .' od: n Supplemental Information
TYPE OF WORK COMMERCIAL:FEE*.SCHEDULE,;— USE CHECKLIST.
®New construction Mechanical permit fees*are based on the value of the work
❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
E Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF,CONSTRUCTION Value:$
S
® 1-and 2-familyRESIDENTIAL EQUIPMENT/SYSTEMS FEES*
,. ,
dwelling ❑Commercial/industrial E Accessory building For special information use checklist.
I j Multi-family 0 Master builder
0 Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION ANI) LOCATION Heating/cooling:
Job site address: t'-tZlk R • l� 1.1,9-‘-c-IA Air conditioning 46.75
Furnace 100,000 BTU(ducts/vents) 46.75 _
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: ,` Project name:Roshak Ridge Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: Hydropic 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.: 1 6Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater —
23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
�
'�'�- i/��� Z�.-� Flue vent for water heater or gas
r f/ 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 OWNEROther:
0,TENANT 23.32
Environmental exhaust and ventilation:
Name:Polygon WLH,LLC Range hood/other kitchen
Address:703 Broadway St.,Ste.510 equipment 33.39
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 ❑ 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
W81�/gLgnnnrlKihmit hest t __
Water heater
Phone:(360)695-7700
Fax: :(360)693-4442 Fireplace
E-mail:permitsubmittals@polygonhomes.com
Range
Barbecue
4 CONTRACTOR Clothes dryer(gas)
Business name:Pro Heating&Cooling Other:
Address: NW Alociek Dr,Ste.1104
MECHANICAL PERMIT FEES*
Subtotal
City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00)
Phone:(360)270-1590 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lie.:209001 TOTAL PERMIT FEE
QA1)(A-4.44/,
^ N, This permit application expires if a permit is not obtained within 180
U�-,t� t„ tit c.i� days after it has been accepted as complete.
Authorized signature:
* Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:04/08/2019
Electrical Permit Application .,:.,- , ' 4 `.' FOR OFFICE USE ONLY
Received
City of Tigard ,o, .•.'r ;a 1412MMEIENECI
. '[ 13125 SW Hall Blvd.,Tigard,OR 97223 i" -'' '-' `= Date/B
Plan Review Related Permit#:
Phone: 503.718.2439 Fax: 503.59$.19{Q Date/B
TIGARD Inspection Line: 503.639.4175 Ready Date/By: kris: Ei See Page 2 for
c Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
El New construction 0 Addition/alteration/replacement Please check all that apply(submit i'acts of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑Other: where the available fault current 0 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 agricultural
amps for all other installations. buildings.
❑Multi family ❑Master builder
❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
1 0 Addition of new motor load of system.
Job#: Job site address: \'4(1401 6\10 {,t/y1ct I(��.l lool-iP or more. ❑"A","E","1-2","1-3^,
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: _ Project name:Polygon At Roshak Ridge 0 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:Polygon at Roshak Ridge Lot#: (DLO 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
s ( (V\Si.nN Ck...
b0 221 (with above sq.ft.) 75.00 2
Ctr
(�(A Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
tEl 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 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 ❑ 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
Address:703 Broadway St Suite 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 Emanufactured modular 67.84 2
dwellaching,service and/or or feeodder
Email: permitsubmittals@polygonhomes.com Reconnect only 67.84rs42
_ -
rfirpmtretreie
Business name:Alameda Electric Sign or outline lighting 67.84 2
Address:3415 NE 44th Signal circuit(s)or limited-energy 0 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
CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: 4871/S specifically listed('A hr min) 90.00/hr
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: r� 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.
Plumbing Permit Application
Building Fixtures ",fr g 3*-h* ti 1 FOR OFFICE USE ONLY
City of Tigard Received
'► 13125 SW Hall Blvd.,Tigard,OR 97221II-. 1 7 2011 Date/By: AC �'A vc Permit \c‘C.;T")...ci,\C1_
Phone: 503.718.2439 Fax 5039 p60
IN
Plan Reviewk Date/By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 - { o ; " Date Read /B Suns: H See Page 2 for
Internet: www.tr and-or. ov 3` ` i r N.B d q , r-- Ready/By:
g g �(_l� �� 1"„b� l l i1't� y�,> Notified/Method Supplemental Information
TYPE OF WORK1:;:.,-..,7...-
. . ._.. .�� . . . . . . �t��a.�F�,��CSEDUX.�.,.. �.� rum .�P�,-,
®New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
`; CATEGORY OF CONSTRUCTION > ; SFR(1)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑ Accessory building ®Multi-family SFR(3)bath 500.32
❑ Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler
sq.ft.) Page 2
JOB;SITE INFORMATION ANI) LOCATION , Site utilities:
Job site address: 1(.ii7 1 SW `tp s-ra pt.,k-,- 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.: t \ l 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
I _ Water service(no.linear ft.:_) Page 2
(P
Subdivision:Roshak Ridge I Lot no.: to Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK.' Backwater valve 12.51
C V_ _ _t Osr1 i �,CA."OD 272:1Clothes washer 25.02
J� Q�7� Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
►a PROPERTY OWNER , ., ( ❑ 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 Ty , Snlar_vniti.(IilQtii Ht ,: .--
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
E-mail: ermitsubmittals Urinal 25.02
p @polygonhomes.com
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Alliance Plumbing Water piping/DWV 56.29
Address:146 W Historic Columbia River Hwy Other: 25.02
City/State/ZIP:Troutdale,OR 97060 Subtotal
Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: $72.50
CCB Lic.:184601 Plumbing Lic.no.:PB732
Plan review (25%of permit fee)
/ 141116/iv. State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Robert Dishman Date: This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set byTri-County Building Industry Service Board.
l\Building\Permits\PLMU-PermitApp,doc 10/01/09 440-4616T(10/02/COM/WEB)
K
City of Tigard
..71a COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c n Building Permit Review — Residential
Building Permit #: \ (\C-c \G- C3 .7 -
Site Address: /`72 z/ 7 .Qu fiv1, fiy_L. `
Project Name: PO C� n e0g ,� Lot #: (e
(New���Y""g=subdivision name;Addition or Alteratio - ast name of owner) C
Planning Review
Protsal: .A) C7P°9
V Verify address/suite#active in Accela. iiZi In River Terra e: ❑ No11ZYes,River Terrace Review Addendum
SPlan Elements: YT rosion Control
itX copies of site plan on 8-1/2"x 11"or 11 x 17"paper el‘'i.tained trees with drip line and tree protection measures
VJ rawn to scale(standard architect or engineer scale) MF:otprint of new structure(including decks)and FFE
4rth arrow T. . 'ty locations&easements(required for new and additions)
.43te address,project or subdivision name and lot number i4 Sidewalk/driveway approach
V •plicant information(name and phone number) 111 a cation of wells/septic systems
7 Lot dimensions and building setback dimensions Ti S eet tree size,type and location
0``: are footage of buildings to be demolishedeet names
;• ,ads•ting structures on site VCorner elevations(2'contours if more than 4'differ tial)
V .t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? lY1Yes LIN
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shownWYes Mo
AW1ean Water Services-Service Provider Lette of platted prior to 9/10/1995):
r� quired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
IV/Public Facill-ties'fmprovement(PFI)Permit:
Lequired: t Yes,applicant was notified ❑ No Applied For: YJ Yes ❑ o,stop intake
and Use Case#: �v1 �l� ( )OO()`� ❑ Zoning: - 6b- ----)
g -
e uired Setbacks: Front: Rear: _
q � Side: 0 Street Side: ���- Garage:
i :uilding Height: Max. Height: ! Actual He' ht:
5 LandscapeArea: "�C) % 1p Lot Coverage Max: _—
Entrance - .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 . eet-facing wall 0 ❑ Yes ❑ No,one o •- .i owing is met:
❑ Door extends no more than 5 r. .ll and there is a covered so • - ending beyond garage.
❑ Door extends no more than 5'from wall an. i • - sq ft.window above garage on 2nd floor.
❑ Garage door width is ❑ 12'or less • F o or less of faca.• ■ 60%or less and includes 7 of following:
❑ Covered porch ❑ sed entrance D Wall offset_ _id 1' •.___!...2 0-Roof-offset- -_
Fire s.•. ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roo ■ Dormer
Accent siding ■ Window trim ❑ Window recess ❑ Window projection ❑ :. .-
I1l� isual Clearance 7 Urban Forestry MnP
rk. -nsitive Lands: ❑ Yesi No Type:
7 Conditions met prior to issuance of building permit
Not
1
Approved By Planning: Date: h j
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw RES 022819.docx
Building Permit Submittal
Original Submittal Date: a ii-I l S
Site Plans: # ;3
Building Plans: # , 43
Building Permit#: �L�pJ/� Enter building permit#above. D/
/
Workflow Routing ["Planningi.Engineering I Permit Coordinator Ei Building
Workflow Sign-off: Er Sign-off for Planning(include notes from planning review)
Route Application Documents: Di 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: 1f\A,.........3>4A.„,,...Engineering Review
-Slope at building pad: d
Zr Conditions "Met"prior to issuance of building permit
fa' Easements (encroachments)per engineering conditions of approval and plat
(a Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes Er No
Assess Water Quantity Fee in-lieu: 0 Yes No
LIDA Facility on lot: 0 Yes No
21 Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
4.'Approved by Engineering: _/, Date: ' I'
Revisions (after Building Submittal only) Reviewer II ate
Revision 1: ❑ Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
0 Conditions "Met"prior to issuance of building permit
0 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:
EDC Fees Entered: Wash Co Trans Dev Tax: 2r-Yes 0 N/A
Tigard Trans SDC: Yes 0 N/A
Parks SDC: Yes ❑ /A
LIDA 0 Yes Fig /A
OK to Issue Permit ,� / `�
Approvedby Permit Coordinator: / Date: / 3
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
4
City of Tigard
1,1 .Ili COMMUNITY DEVELOPMENT DEPARTMENT
C
r 1 c A R D River Terrace Building Permit Review Addendum
Building Permit #: k\M--V -( -X -
Site Address: /422/ 9 J'i( ) /Li &-e—
Project
y- i
Project Name: /11P) "��
: + J 4 •, F �.
' .jI� Lot #: ( (ta
ew.( � /�
g=subdivision name;Addition or Alteration= iiname of owner)
Planning Review of River Terrace Plan Disct Design Standards (18.640.070.1):
Is the project subject to the plan district design standards? VT 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 ft. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dorm
ft. deep min. 2ft., 5 ft.wide min. 2 ft., 6ft.wide
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum gf 12%of ch street facing facade must include windows or entrance doors.
sPercentage Shown: ' 6 c
3. trances:At least one entrance must meet both of the folio g standards:
Max. 8 ft. setback from longest street acing wall Parallel 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. ❑ 25 sq.ft.min.
❑ One street facing entry ❑ 12 ft. max. roof above floor of porch
❑ 5 ft. depth min. ❑ 30%min. porch roof coverage
4. Detailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
❑ Covered porch min. 5 ft.wide x 5 ft. deep ❑ Ijeeessed entry area min. 5 ft.wide x 2 ft. deep
❑ ll offset min. 16 inches ® Dormer min. 4 ft.wide
Roof eave min. 12 inch projection ❑ oof offset min. of 2 ft.
❑ Roof shingles either tile or wood Tr Gable,hip or gambrel roof design
❑ycoof pitch oriented south min. 500 sq. ft. ❑ Ijeirizontal lap siding min. 3-7 inches wide
011 Accent siding min. 40%of street facade VWindow 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% or less of street facade
5:-Garages andCarporis:May fice the front or side to on a corner lot.
s:
I No closer to ro- . '.e lot line,than longest street-facing wall. ❑ Yes ❑ ► e. No (Check one):
❑ May extend up to 5 ft.if there ' : a ered front porch and • - a oes not extend beyond the front porch.
❑ May extend up to 5 ft. where the garage is par . .."o-story building and there is a window at the second story
above the garage that faces the street wi . . . area of 12 sq. .
Width: (Check one)
❑ 12-foot- :- •arage door ❑ 40%max. of street facade
• i`o max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: W Date: c"-Mal,
1:\Building\Forms\B1dgPermitRvw_RES_RT_12 14 17.docx