Permit Plumbing Permit Applicp rn' IN! '"'-. n
Building Fixtures FOR OFFICE USE ONLY
312 W H 223 i3 I ( Reeel ea j! 7 {-2/�/ /�/r [J
`J Tigard Date/ByY • c o 4 Permit NoM SI GV l�'-(/V�G-/
r 13125 SW Hall Blvd.,Tigard,OR 97223 F Plan Review
Phone: 503.718.2439 Fax: ��S f 9b0-)!' '- Date'By: B $1/2 0 40(q ether Permit No.:
TIGARD Inspection Line: 503.639.41}�4;) I:1 rot„,;(_, i;1 i Date Ready/By. ? i-1 . V is. See Page 2 for
Internet: www.ngard-or.go� •--- - Notiticd/Method: ' Su®pplemental Information
TYPE OF WORK ?747L 7[J,/t7 4--"FEE* S#Bn ULE i l i 1,
.New construction ❑ Demolition For special information use checklist.
-- - - - -- Description I Qty. I Ea. I, Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OFC CONSTRUCTION 1 SFR(1)bath 312.70
XI-and 2-family dwelling ❑Commercial/industrial SFR(2)bath _ 437.78
---- SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen�t � 25.02
0 Master builder ❑Other: Fire sprinkler(\L.kr,`�q.ft.) ',M Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
,lob site address: 1421 I 30 l L--)q ..�7 Ave_ Catch basin or area drain 18.76
�l" (t�� (7 i/I� -- - Drywell,leach line,or trench drain 1836
City/State/ZIP: Q , -x'1 0Q_ cl-- IT0 -
�� - VSI l K--� - Footing a tune home neil fie ) - P50. 3
Suite/bldg./apt.no.: .� Project name: Manufactured utilities _ 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76 3
,,..�� (( Sanitary sewer(no.linear ft.: ) Page 2
(n�
lRl A k1)Cis‘ 1'2_ L (lA t_z)% Storm sewer(no.linear f:_) Page 2
Water service(no.linear R.:_) Page 2
Subdivision: I Lot no.: _ Fixture or item: _ _
Tax map/parcel no.: Backflow preventer 31.27
---- -- - - _ Backwater valve 12.51
DESCRIPTION OF.WORK
----- Clothes washer 25.02
_ _______ _ Dishwasher 25.02
.1,0 t :'f,L 1 • •__ n�,r s- _. Drinking fountain 25.02 -----
Ejectors/sump I 25.02
❑ PROPERTY OWNER L3 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
----- - - Floor drain/floor sink/hub 25.02
Address:
Garbage disposal I 25.02
City/State/ZIP: ___ Hose bib 25 02
Phone:( ) I Fax:( ) Ice maker 12.51
❑.APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
-- ---
Medical gas(value:$_) Page 2
Business name:
___ _. .--- -- -- -- --- _. i Primer 12.51
Contact name. -II
__-_ _ _ -. _. -- ---- Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) I Fax::( ) Tub/shower/shower pan 12.51
-- : Urinal 25.02
E-mail:
Water closet 25.02
CONTRACTOR ---
' Water heater 37.52
Business name: ve. O I t KI k ow 644 ' Water ptpmg/DWV 56.29
P1�pp /1 , Y�( r� Ind (� It
-
Address: 1 0`4 S- (� Cilsf,. W�,(_,((l 4.ia_24 '�14,-_,`� Other 25.02
- TnN . p Subtotal
City/State/ZIP: 1 �-LA A C1�� t ,Q__q O ._ __ ---
Phone:(,� 69Y2� - f (�\ Fax:(SO („ .5 , q�,g Minimum permit fee: 5"12.50
Plan review (25%of permit fee)
CCB Lie.: Plumbing Lic.no.: - gig n
__ : - 1 State surcharge(12%of permit fee)
/■n�,! \
Authorized signatur. ��3 I - TOTAL PERMITFEE
^^ a9AC, L. -- SI' �- This permit application ezpires if a permit l8 not obtained waken 180 days
Print name: Y , \1 Datta: after it has 6cen accepted as complete.
°Fee methodology set by Tn-County Building Industry Service Board.
I".13911ding'Permn0.\PLMU-PermitApp,doe 10/01,09 440-4616T(1002/COMIWLB)
a •
CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT
Permit#: MST2019-00324
T I 'oARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/27/2020
Parcel: 2S107AA06800
Jurisdiction: Tigard
Site address: 14271 SW 169TH AVE
Subdivision: ROSHAK RIDGE Lot: 68
Project: Polygon at Roshak Ridge, Lot 68
Project Description: New SFA.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 2 First: 562 sf Basement: 85 sf Left: 0 Parking Spaces: 0
Height: 28 Bathrooms: 3 Second: 562 sf Garage: 430 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes
Total: 1209 sf Value: $169,008.04 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 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
Bckfiw 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<10OK: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 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: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFA VB R-3 1209
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 NFPA 13D Sprinklers
Required
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX
Total Fees: $24,569.89
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.
c. _.. .xf � . i- ' ' G .
Issued By: -. ' Permittee Signature:
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
Residential t}'�` a"\f;C FOR OFFICE USE ONLY
City of Tigard Received c 1 1 c PermitN�'t�S-c'�A�bU
Date/By. �. ,4
'l Phone S50 Hall Blvd.,Tigard,0R 98.193 0 U 7 2019 Plan Renew y�/lei�,g �1� �'- C
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: (_�(/ `Z//� Other Pe
TIGARD Inspection Line: 503.639.4175 L 4l�' t f- s_9&AE1D Date Ready/B / rr lulls H See Page 2for
Internet: www.tigard-or.gov Bt tl t-D,telG f•i )'is10Notified/Method: (Agile? S / Supplemental Information
TYPE OF WORK t a i� J 3 Nii 4 REQUIRED DATA:I-AND 2-FAMILY DWELLING
,;\ ®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
v 0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
00 CATEGORY OF CONSTRUCTION work indicated on this application.
® I-and 2-family dwelling 0 Commerciallindustrial Valuation: $ i oOa
ElAccessory building ❑Multi-family Number of bedrooms: '2,..
El Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: t 14
Job site address: \
w21 (JI&) I b(t- 16j/9 New dwelling area: 1 z.c square feet ?j
'. yl City/State/ZIP:Tigard,OR 97224 Garage/carportv area: � square feet 2
.
Suite/bldg./apt.no.: ` , Project name:Polygon at Roshak Ridge Covered porch area: , square feet ?"5.-
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.:ivic Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no. equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New SFA 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:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT 1. 5*
Business name:Polygon WLH LLC (PfmurefermjeeschedNle)
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
Amount received:
Phone:(360)695-7700 Far::(360)693-4442
E-mail:perm itsubmittals@polygonhomes.corn PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photovoltaic Solar Panel System.
Business name:William Lyon Homes,Inc. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:703 Broadway St.Ste 510 Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)6934442 State surcharge(12%of permit fee): $21.60
CCB lic.:207247
Total fee due upon application: $201.60
Authorized signature This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Amanda avin Date: ((J/�] *Fee methodology set by Tri-County Building Industry
` ` Service Board.
I:1Buildine\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB)
Mechanical Permit ApplicatiDECEIVED FOR OFFICE USE ONLY
Received � r�
CI of Tigard DaleBy: '�'� q.1 y :13
`.I g Pcrtnil No. Wes'
" 13125 SW Hall Blvd.,Tigard,OR 97223 AUG 2 9 2019
t''1 Phone: 503.718.2439 Fax: 503.598.1960 Plan Review 14
Other Permit:
DaleBy:
1114i..411.1) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: lads: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
Z 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist
Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75
Job site address: 14:2.11 SW 11sck-h1 pc- 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/bldgiapt.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.: 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
(IY\S"1 2,01.'1-tx)3 24 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 ❑ 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
® 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
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
'vt CONTRACTOR Clothes dryer(gas)
Business name: Pro Heating&Cooling Other:
MECHANICAL PERMIT FEES*
Address: NW Alociek Dr,Ste. 1104 Subtotal
City/State/ZIP:Hillsboro,OR Minimum pemtit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee)
CCB tic.: 209001 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: '0,� - lU �' t Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:04/08/20I9
t'\Ail ildinu\Pern,ilc\41Fr Pnmdi 4n., nen111 d,... .... .......................
Electrical Permit ApplicatiotRECEIVED FOR OFFICE USE ONLY
City of Tigard Received Permit t1/ 1.�1t_�` ( -
\\\� 1
't 13125 SW Hall Blvd.,Tigard,OR 97223 AUG 2 9 2019 Date/By:
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Related Permit#:
TIGARD:,
Line: 503.639.4175 CITY OF TIGARD Ready Date/By: Sara ® Sea Page 2 for
: Internet: www.tigard-or.gov BUILDING DIVISION 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):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑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.
El1-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building less to ground or exceeds 14,000 0 Commercial-use agricultural
amps for all oiler 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
[IJob#: Job site address: `�12,1% tS W U,pg"h( TALC, 100Addition of new motor load of system.
00HP or more. ❑"A" ••&„"1-2","i-3"
City/State/MP:Tigard,OR 97224 ❑Six or mom residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suitelbldg.lapt.#: _ Project name:Polygon At Roshak Ridge 0 Hazardous locations. ❑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 Qty. I Each I Total I •
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: (0,2) Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less I 168.54 4
Ea.add')500 sq.ft.or portion ( 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.R.) 75.00 2
{�,� CtNnkYUA}�R mST2o\9-oo32y Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
®'PROPERTY.OWNER.. ❑ 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 I 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
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
serAddress:703 BroadwaySt Suite 510 branch
or feederitfee,first
branch circuit 56.18 2
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
P.m ail: permitsubmittals@polygonbomes.com dwell nnl service and/or feeder
Reconnee ctt o only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Alameda Electric Sign or outline lighting 67.84 2
Address:3415 NE 44th Signal )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) 6625/hr
Phone:(503)319-2192 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: solarpdx@me.com Industrial plant(1 hr ram) 78.16/hr
Inspections for which no fee is 90A0/hr
CCB Lie.: 199188 Electrical Lie.: c923 Suprv.Lie.: 4871,E S specifically listed('A 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):
f� 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 I days after it has been accepted as complete.
•
Plumbing Permit Application RECEIVE I
Building Fixtures FOR OFFICE USE ONLY
City of Tigard AUG 2 9 2019 Received n 9
r 13125 SW Hall Blvd.,Tigard,OR 97223
Date/By: Permit No.�S^'`��"1�
' i. Phone: 503.718.2439 Fax: 503.598.1 ITY OF TIGARD Plan Review Other PermitNo.:
�ILDING DIVISIO DateBy:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Suns: RI See Page 2 for
Internet. www.tigard-or.gov y o'
Notified/Method; Supplemental Information
TYPE OF WORK FEE* SCHEDULE
® New construction ❑ Demolition For special information use checklist.
Description I Qty, 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 ❑Commercial/industrial SFR(2)bath 437.78
ElAccessory building ®Multi-family SFR(3)bath ( 500.32
El Master builder Each additional bath/kitchen 25.02
❑ Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: i t..t-L-1` 6\A..1 1 P ve, Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:Roshak Ridge Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) _ Page 2
Subdivision:Roshak Ridge I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer { 31.27
DESCRIPTION OF,WORK Backwater valve I 12.51
I 1 rw „ 61 t\ Vy\5 2o1 Clothes washer { 25.02
�._ V CN1 lJc0 " 4 J bb J� Dishwasher ( 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER', I ❑ TENANT Expansion tank 12.51
Name:Polygon WLH,LLC Fixture/sewer cap 25.02
Address:703 Broadway St.,Ste 510 Floor drain/floor sink/hid, 25.02
Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02
Phone:(360)695-7700 Fax:( ) Ice maker ' 12.51
® APPLICANT ❑ 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 2 12.51
E-mail:permitsubmittals@polygonhomes.com Urinal 25.02
CONTRACTOR Water closet 3 25.02
Water heater ‘ 37.52
Business name:Alliance Plumbing Water PP t m 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)
Authorized signature: _ TOTAL PERMIT FEE
Print name:Robert Dishman Date: Sl `q 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.
I:1Building\PertaitsNLMU-PermiIApp.doc 10/01/09 440-4616T(IN02/COM/WEB)
r •
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D Building Permit Review — Residential
Building Permit #: hc-\5 i-, q_ Q,01 a s
Site Address: 1 -1 o / 9-A ,9y�
Project Name: /4/.`- ,it f J L fl ' Lot #: 6
(Ncw4 I' g=subdivision Addition or Alteration st name of owner) P.
Planning Review
Pr posal: AJk) -P4-
1 Il Verify address/suite#active in Accela. /In River Terr.ce: 0 No 0/Yes,River Terrace Review Addendum
Site Plan Elements: iG Erosion Control
aopies of site plan on 8-1/2"x 11"or 11 x 17"paper 111�; twined trees with drip line and tree protection measures
rawn to scale(standard architect or engineer scale) 1 F otprint of new structure(including decks)and FFE
�orth arrow . ty locations&easements(required for new and additions)
14Site address,project or subdivision name and lot number /Sidewalk/driveway approach
o
101 +.licant information(name and phone number) ‘41 #.cation of wells/septic systems
IG . dimensions and building setback dimensions et tree size,type and location
1141 uare footage of buildings to be demolished IVSjottet names
I :: sting structures on site Comer elevations(2'contours if more than 4'diffe ntial)
'4 Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced> es 0 I�i6
impervious area(applicable if R-7,R-12,R-25&R-40) If es,is a storm water .uali • facili shown? ' es o
104 lean Water Services-Service Provider Lett of platted prior to 9/10/1995):
equired: El Yes,applicant was notified No Received: ❑ Yes ❑ No
ru( Public Facili46 Improvement(PFI) Permit:
quired: Yes,applicant was notifiedti 0 No / Applie For: Yes 0 o,stop intake
and Use Case#: 16,2nO1 6600'/ tQZoning.
' equired Setbacks: Front: lac Rear: I / Side: 0 Street Side: Garage: (.5
uilding Height. rn Max. Height: I Actual H i ht:
Landscape Area: �26 % P.-1 Lot Coverage Max: e %
Entrance back no more than 8' from street-facing wall ❑ Parallel to street or o degrees or less
Windows El Minim %of area of all street-facing facades
Garage ❑ Garage door is be - widest street-facing wall ❑ No,one of the following is met:
❑ Door extends no mor 5'from wall an then covered porch extending beyond garage.
❑ Door extends no more than 5' r ere is a 12 sq ft.window above garage on 2nd floor.
❑ Garage door width is 0 12'or le 5 ess of facade 0 60%or less and includes 7 of following:
❑ Covered porch essed entrance ❑ W et 0 1'Roof eave ❑ Roof offset
❑ Fire s - Lap Siding 0 Roof pitch ❑ ,or gambrel roof ❑ Dormer
❑ nt siding Window trim 0 Window recess 0 rojection ❑ Balcony
it
sual Clearance Urban Forestry an
�� ensitive Lands: 0YesivNo Type:
Co ditions met prior to issuance of building permit
N
Approved By Planning: l.� Date: M a
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: 0 Approved ❑ Not Approved
1:\Building\Fonns\BldgPennitRvw_RES_022819.docx
Building Permit Submittal
Original Submittal Date:
Site Plans: # 3
Building Plans: # 3
Building Permit#: El Enter building permit#above.
Workflow Routing: IS/Planning a Engineering III--Pennit Coordinator [ Building
Workflow Sign-off: R Sign-off for Planning(include notes from planning review)
Route Application Documents: [S' Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
QVBuilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: _ Date: $(15 lq
Er3gineering Review
Slope at building pad:
0//Conditions "Met"prior to issuance of building permit �/�
L� Easements (encroachments)per engineering conditions of approval and plat
L�1 Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes No
Assess Water Quantity Fee in-lieu: 0 Yes No
LIDA Facility on lot: ❑ Yes U,�,/No
It/Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
[Approved by Engineering: Date: 3
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
iP'SDC Fees Entered: Wash Co Trans Dev Tax: es 0 N/A
Tigard Trans SDC: Yes 0 N/A
Parks SDC: E'Yes 0 N/A
LIDA 0 Yes �N/A
K to Issue Permit Approved by Permit Coordinator: ,,4 ' Date: °/ G t l
I:1Building\Fonns\BldgPermitRvw_RES_022819.docx
City of Tigard
® COMMUNITY DEVELOPMENT DEPARTMENT
T l c ARD River Terrace Building Permit Review Addendum
Building Permit #: '(\c\ -c- 2,0ACk- p( 3a.t.li
Site Address: / 29-1 /1 i 1xe
Project Name: Pp/ .e77 - ei)-42. Pi,i, ' Lot #: 60
(New e 'ng=subdivision name;Addition or Alte 41�.', =last name of owner)
Planning Review of River Terrace Plan Dist ct Design Standards (18.640.070.I.):
Is the project subject to the plan district design standards?2I 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.,6fy.wide
.arDe
2. Eyes on the street: a minimum of 12')/0o each street facing facade must include windows or entrance odors.
Percentage Shown: >/2 °/d ya
ances:At least one entrance must meet both of the folio g standards:
x. 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: 0 Yes No
If yes,all the following apply: ❑ 25 sq.ft. min.
❑ One street facing entry 0 12 ft. max.roof above floor of porch
❑ 5 ft. depth min. 0 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:
❑ overed porch min. 5 ft.wide x 5 ft. deep 0 I3.Ecessed entry area min. 5 ft.wide x 2 ft. deep
1W all offset min. 16 inches [ Dormer min. 4 ft.wide
t Roof eave min. 12 inch projection?i > ❑ of offset min. of 2 ft.
❑ Roof shingles either tile or wood Id Gable,hip or gambrel roof designf j
❑ Roof pitch oriented south min. 500 sq. ft. ❑ I1orizontal lap siding min. 3-7 inches wide
kyr Accent siding min. 40%of street facade'/ Window trim min.2 1"wide by 5/8"deep f.
❑ Window recess min. 3 inches for all street facing 0 Bay window min. 5 ft.wide by 2 ft. deep
❑Balcony min. 5 ft.wide x 3 ft. deep with inside access 0 Attached garage is 35%or less of street facade
5.tb and Carports:May face the front or side lot linet`"1 Q a co er lot.
Setbacks:
No closer to front or side lot , longest street-facing wall. 0 Yes 0 No. heck one):
❑ May extend up to 5 ft. if there is a covere t orch and gara not extend beyond the front porch.
❑ May extend up to 5 ft.where the garage is part of a building and there is a window at the second story
above the garage that faces the street with ' . area of 12 sq.ft.
Width: (Check one)
❑ 12-foot- ' ge door 0 40%max. of street facade
o max. of street facade with 7 detailed design elements
Notes:Approved By Planning: —1— Date: / i/ c
I:\Building\Forms VBldgPamrtRvw_RES_RT 121417.docx /