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Permit
7/ y CITY OF TIGARD BUILDING PERMIT I • COMMUNITY DEVELOPMENT Permit#: BUP2021-00307 Date Issued: 2/10/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110AD12200 Jurisdiction: Tigard Site address: 10895 SW ANNAND HILL CT Project: Annand Hill Partition,Lot 1,(1 of 2)ADUs Subdivision: ANNAND HILL CT PARTITION Lot: 1 Project Description: New multi-family dwelling(Upper level)ADU.Trade permits to be obtained separately. NO FINAL INSP UNTIL WATER METER UPSIZED. Contractor: BLUE PALOUSE PROPERTIES Owner: BLUE PALOUSE PROPERTIES LLC 333 S STATE ST, SUITE V452 333 S STATE ST STE V452 LAKE OSWEGO, OR 97034 LAKE OSWEGO, OR 97034 PHONE: 503-936-3212 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: MF Class of Work: NEW Type of Const: VB Building Permit-New Construction 02/08/2022 $915.06 Occupancy Grp: R-2 Occupancy Load: 4 12%State Surcharge-Building 02/08/2022 $109.81 Dwelling Units: 1 Wash Co Trans Dev Tax- 02/08/2022 $5,756.00 Condominium/Townhouse Stories: 3 Height: 35 ft Plan Review-Fire Life Safety 02/08/2022 $366.02 Bedrooms: 2 Bathrooms: 2 Metro CET 02/08/2022 $134.06 Value: $111,671 DC Provision Review,SF-Ping 02/08/2022 $110.00 Tig-Tual School CET-Residential 02/08/2022 $1,300.02 Plan Review 02/08/2022 $594.79 Floor Areas: Total Area: 922 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 25 Deck: 0 Garage: 0 Mezzanine: 0 Total $9,285.76 Required: Required Items and Reports(Conditions) Fire Sprinkler: Yes Parapet: No Fire Alarm: Yes Protected Corridors: No Smoke Detectors: Yes Manual Pull Stations: No Accessible Parking: 0 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: Eolga-rolo-1Na.(.do-vtazto- Permittee Signature: yQ,Q, 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. J3uikclixl,s Perrnut Application azesiclt:ntial RECEIVER lcaRt) l< Et AM" Il1111fflIII1 11111 it City of Tigard and Received d4 �� (�ir►� _ g Dam/B : � Perini No.: n(�3(� 1312'SW Hall Blvd.,Tigard,OR 97223 DEC 0 Y 2021 Man Review -- --- - ---- -- --- �-` • Phone: 503.718.2439 Fax: 503.598,1960 pate/n : I (1 / Other Permit: l'I , ,,,,,I.,, Inspection Line: 503.639 4175 CITY OF TIGARD Date heady/e : ,r /t ' Ju is. 61 See Pore 2 for --Internet: www.tigard-ar.gov BUILDING DIVISIO ot;hd;Met ,, i� . �`t upatemeutn!Information 7 A PP OF '1801f1t ltt:Qt�l)tr D n'Arr t' k1)aor t ...1.�c °`(1 i1:; Ott=,,.. > ,,aii . i'i IKlUcw construction ❑Den-ioll:ion P in:fees" are based on the value of the work performed. -- - -- - -- Indicate the value(mounded to the mares(dollar)of all ' ❑Addition/alteration/replacement ❑Othe iand for the �- - - - -- - .- u,ui anent,trot erials,labor, v ^liesthe profit u t a d, 1 a CiOtia " t` r#RECTIO1 i= w irk;nd/icated on this apphc ttonV---- a .a.oii:: / $ - 0I-and 2-family dwelling ❑Commercial/icJustruii ---__-. Rili-- _ 1--- ' ❑Accessory building 0 Multi-family Number o1'bedrooms: Z ❑Master builder El Other: — Number of bathrooms: Q- a(lli dl'1"N €l'i_E±t1:1 e1TI( ,h'1). :4}C,_'F,'U€Jn --- ' ` Total number of.floor, / fi , Job site addtesaM -- - -New dwelling area: - ?i ' •square eet City;'StateiZ_[P: n io /}fJ Lj 72 tel.- Ciatageicatport area: square feet Suite/bldg./apt.no.: Project name: C'o""ered porch area: squarefeet Cross street/directions to job site: � - - ��J(/��� Aj{/�7Fj�// Dot k area: n r square beet Other structure area: square feet i�� a,�Liir yYed�;ty � A0 laiil d t, Subdivision: 1 Lot no.: / Pernii fees*are based on the value 31 the work performed. Indicate the value(rounded to the m raresl dollar)of all Tax rn iplpatcel no.: Z s 7 f 2,2r0© equipment,materials,labor overhei d,and the profit for the DES(Ill i't1CN (H WE 1111ti Ib i i 010111 work ndicated on this applirct rt_ Z UrPa�� Valca.ion: $ _77 t _ /J_._G__ r.'S Cl✓G_*� -Existing building area: ----square feet New building area: square feet 0 RoPEi0 1 (0001E11 I • ED 'TE.VA'T Number of stories. Name: .13Z Ve- Adt��s- ',a4 TTET Type of construction: Address: 333 5 5,... .i-sr/ Y Occupancy groups: - - --- - -- C.'ity/State/Z iT': -------- --_____ -- --- k X _�!�!i! (� -- -Existing: Phone i S7 pp36 52 f Z T-F3x I 1 ------- - -- - - ,, I.__- hew ..__ API'1 I( 4. L. C] t COI'iii4 I i I1,s(a`d �I �E IP H�Jf[[I�EFt . Business name: f j- 4.S A-�p .,.yILI:itifili ...__t) —. __—..,.._._ . Strucnr:al plan review fee(or deposit): Contact name: ----- -------- -------------. - - - -- EIS plan review fee(if uppl cable): - Address: — --- Total Fees due upon appl cation, City/Stale Z iP: ------------------- ----------- Amourtre Phone:( l Fax: :( ) - _- iced E-mail: - - ;.a a r aaa ti. - 2 ytm'r".. „a.t„•ss,:,c.,u„�'.a,sc=."..rd,...:e:1ua`.. iti:L.,.,w.:... 'f' r l; KT , 'r i .— 77.p-r.-- ; Commercial and residential presctiftive installation of er r r �lt.1.' t 'f ff ,,.s., ti . , -.d:._�,. .i. ��,�,.... . . ,o.. .... ...... ...a. . u ` y:,,,,�,_,•�� �' roof-top mounters Photo Voltaic 5oltr Farrel System. Business name: g 7f( D' o e 77 Submit two(2)sets of roof plan wit'connection details /" and fire department access,along w th the 2010 Oregon Address: 3.33 c. S$- sr S-Z Solar installation S eciaty Cod?chieciclist. City/State/Z:IP:� i( Os'(l Permit Fee(includes plan rev ew $180.00 --------- and administrative fe s): -Phone:( ) 9 6 Fax:( ) -_ - - State surcharge(12°a of permit foe): $21.60 CCB he. - --- --- Total fee due upon appi cation_ '(2t,1.60 Authorized signature: This permit application expire;if r.permit Is not obtained within I8tr days after it has been accepted as complete. print name: -- �+ /JC Date: *Ice methodology Sc'by Tri-County ty Building':ndusrry " � �� Service Boars. I:\Building\Peamits\BVP-RESPermitApp.doc 02/24/2011 440.•46t3T(l 1r02/COM/WEB I 1 Mechanical Permit Application FOR OFFI('E t SE O\l_1 City of Tigard RECEIVED Received /�IN Date/By: Permit No.: pUP2,02/t (0307 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review • Phone: 503.718.2439 Fax: 503.598.1960 (s ® 1 0 2(� Other Permit: DE(. 21 DatcBy: 1 1 c .i 1.; Inspection Line: 503.639.4175 Date Ready/By: 3uxis: ® Sec Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information I DI G _ Mechani,ral permit fees*are based on the value of the work ❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. 1�-;'C.._ .w,.—'_ ,. Value:$ 4. ❑ 1-and 2-family dwelling 0 Commercial/industrial Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total "— ---- '-_----—=„.„IZ---f,X__:-s Heating/cooling: :._.__�._...._, R.....�. .,.-. , - -..__..., ,.._,,w...,... .,.._,.....,.__.._ Air conditioning 46.75 Job site address: (DI?G7 i JkIv NA tJ D 1..( '(- ( fP�) Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: fl�, I/ `O Qr`l d Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Heat pump J 61.06 Duct work ( 23.32 Cross street/directions to job site: GE.�R e(Zcp(jy Hydronic hot water system 23.32 /'�` LS '+«- Residential boiler(radiator or �j" hydronic) i 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above TS 23.32 Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: 2 cj (k 0 (Z2-00 Water heater t 23.32 Gas fireplace/insert 33.39 Flue vent for water heater or gas . - al h/ ' -- fireplace I 23.32 pp2 C�r— Log lighter(gas) 23.32 j ! Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 -n-- Other: 23.32 s„, --ram --.- `a `'> ` , . -::r Environmental exhaust and ventilation: Name: R-V E Pt C-OO SE P Rp PEA-11 f� Range hood/othcr kitchen /',{ equipment I 33.39 Address: �3 • 5 Sr .V`' 6 Clothes dryer exhaust 1 33.39 City/State/ZIP: 1.,A lL • ((r,0 D77._. 'Y RO �i Single-duct exhaust(bathrooms, t toilet compartments,utility rooms) 3 _23.32 Phone:(933) C3k, 3 Z(Z Fax:( ) Attic/crawlspace fans 23.32 Y: , .. . 3 ' .l= Other: 23.32 • Business name: 51.504F Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: IUD #iti7(..(rtJS Furnace,etc. Address: Gas heat pump WalUsuspended/unit heater City/State/ZIP: Water heater Phone:( (�[)�((��� ( ' ^Fax: :( ) /� Fireplace ✓M Q �vy PAL DU • C O V t Range E-mail: Barbecue ', _. -= - ...........wn_.. ,.._, . �r(gas)) _ Clothes Business name: 1 � A SUlti/2 Cou er Other: WV Address: 20 t tV . ., I�t'�T (Z-� _ Subtotal City/State/ZIP: ©fz q.01 S C(Ty op_ ('70� Minimum permit fee($90.00) Phone:(y'b3) A� K v,�l Qr Fax:( ) Plan review(25%of permit fee) "f t�� 2-44-DState surcharge(12%of permit fee) CCB lic.: TOTAL PERMIT FEE • / n This permit application expires if a permit is not obtained within 180 'p� ' days after it has been accepted as complete. Authorized signature: , ` * Fee methodology set by Tri-County Building Industry Service Board Print name: (/�("� i N am_ ( Date: (1. ,7 7 I:Bnildiag\Permits\MEC_`PendtApp_040113.doc ""'`-► .140-4617T(11/02/COM/WED) Electrical Permit Application RECEIVE I t)k flI<l Ich I ,�1 f1�i.v RECEIVE k i f I ; Received ;�,t p2 -dO3a7 City of Tigard .Ratese permit_ w t/ 13125 SW Hall Blvd.,Tigard,OR 97223 DEC 01 2021 Plan Review ¢ Phone: 503.718.2439 Fax: 503.598.1960 catdBs•: -_ - Related Perrot 4: Inspection Line: 503.639.4175 Ready llazerB : Juni: #a :tee Page :for #:: p CITY OF TIGARD l hotiticd/McBhcd: Internet: www.tigard-or.giv t)plume ctal(dorm'film . n y Kit r !f1�g l IEiii It.0 • �1 i; � ,. r': :: : �:•h'F It a tt`i:..r1 1 5c#�I�,;'�: 13t3i;. i:�, t ' New construction ❑Addition/alteration/replacement Plat:c chu cti all that apply(submit 2 sets r pl arts w,it:nt,c hocks l: 0 S:rv:cc or feeder 400 amps or more 0 1 htildirg cnt:r:hree snnits. 0 Demolition 0 Other: utere:he available fault current 0 Mar nes ant n:.:tya:ds ��r 11 ` a cx xr p s 0I I:Sl of build na; 4 -� ': '� `;sg:)"Tt' ,' a'�� �' ':.; '..- -::ar;�l: � .t:;�:�� >. 'r�..€: t';;¢:dstU.0D0ansatl_0�o,u;or 1 and 2-family dwelling 0 Commercial/industrial ❑Accessory building less no ground,of execeds 14.000 (J(•ontnter:u,-use agricultural asps for all other installations. t uibimg.. ❑Multi-family 0 Master builder 0 Other: ❑Fire pcntp. D 1 nudiation of 15.0 xt,:'t of if:?3s «f :l ) @ A ': ,e te.t' r Yt1i1 k n;h ❑Energencysystem. 1tr.,'rienar.telvderlved as+-� . . . .. .. ❑.Addition of new motor load of s ystcn: Job#: Job site address: /O e' 475' a/xx/�(/�fj(/e g ( r101:F or more ❑ 't - I City/State/ZIP: �` ❑Ss or care mstdaotial units. ccecpaecy. f(?7 0� 97 ❑ileah:h•cumnesakoti. ❑i.e.vtauntta!sriuclepa:ks. Suite/bldg.,apt.#: I Project name: ❑Hazarc sus locations. ❑y upply vohttc:for mere aan 0 Serene:orfeeder 60(1 amps or more vc(00 wit:sworn cal ', Cross street/ rections to job site: it �� f Lj ,v/ ( 3ift NZ. 4al l ki�Ia it,a 'T'r 'TT11 Ft t.i NO t>� . X Yll,tt vI+`l,,,}, i-,Y,„„ t 7 _21 9 Uascrf Zi n'_ J_ c. Lta -_ T ul" New residential single-or multi-fa milt dwelling snit. Subdivision: Lot#: / Include:attached garage. -__ 1,000 sq.ft.or less Tax mapfpxrcel#: 2SZ Z C7h 168 54 1 4 f( _ Y Ed.add'1500 sq.ft.or portion 33.92 . ga 4 # , 'm 37 . i1a, ,-,...., �l lhlga ,..',., '- --- 1 I imitcd tacrgy,residential 75.00 2 f ADO 1 U/n Z e 1 (with:above sc.ft.) ' J Limited energy,multi-family 75.0) resiee.usal(with above so.ft.) .. L,/, Renewaale Enemy 0 Se Page_ � at a, f ad'arar-' '.a;+ +s,,. <'^ AtO-rtIMIR Services or feeders installation,afterat ion,and/or relocation Name: 13t4)e- el+4OL5e— `77/Ze �5 201 am?: or less — 100.70 f 2 C 201.amp:to 400 amps 133.56 2. Address: 33 3 S. $ sr: l �¢ 401 amp:to 600 amps 2Cd1,i4 City/State/ZIP: G4tr- �5 / tj 9703¢ — 601 amp:to 1,000 amps -- 30,`04 -- Pbone:(03) r G 36 3L/Z. Fax:( ) Ove,1,0n0 amps or volts 552.226 • Email: f 1" Ctrs BL- /e-?'Y 'e'IC� Temporary services or feeders installation,alteration,and/or relocation . Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.3,5 _ intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amp:to 400 amps 125.08 ' Owner signature: Date: 401 amp to 599 amps -_ 168.54 r °, -:€r ii a sit Branch`circuits-new,alitratiun,,tractensioapx and .�- ., ., .. - ...-t 4141 gtigPVI A.Fe:,o:branch circuits trait Business name: 3 4- above service ar freder fcc, 7.41 ., each branch circuit .. Contact Contact name: B.Fez"11r branch circuits without -- seavic::or tcecor fee.first jo13 A . ddnsss- brand circuit i City/State/ZIP: Each add'I esnc1i circuit 7,42 21 Miscellaneous(service or feeder not included)___ . Phone:( ) Fax: :( ) Each manufactured or modular —_-- dwcll g service and'or feeder 67.8,3 Email: Reconnect only 67.84 a y�.� slkt e_ a�;;u it 4 0 1$ :'I .t .I , ; 1, .'.1 ';Ii" I -. : Y;.:` ..; .ta aTitn@ Punfor irrigation circle 67.84 Business name: Ne)(T' L,EvEz_ Ir l" GtiL Sign or outline lighting -- 67.84 ' Signal circuit(s)or limited-energy s `, Address: S�' 77 S to it - /owe-AD panel.alt nation,or extension. ❑ See Page Each additional inspection over at owttble in any of the above City/State/ZIP: t/ Ql(ioIV(t1- Q Addition d inspection(1 hr min) _ •56.25r hr Phone:( ) Fax:( ) investiga:icn(1 hr min) l ')0,00/hr Email: plant(I hr min) 1 78.18/hr faspcctio as for which no fcc is >O.UT hr CCB Lic.: 274( [ . Electrical Lic.: G,f4-6( Suprv.L.ic.: 6,3'7 <¢ ti?ca!1 listed ri lrr mine � �art. ., arl a 4- -13s' t4'6— t:._.. .'fi a if iiii:4t . Suprv.Electrician signature,required: Stbostal: Print name: Date: 0 Plan Review Required(25%of porn it fee): -8:4 4_,.._ — State surcharge(12%of pcm_it lee): __ ____Authorized signature: _ TOTAL PEF:MTf FEE:This permit application expires If a permit'is not ob:ahled within la0 Print name: Date: days after it has beet,accepted as complet::, ' ° !Numb r of inspections allowed pe r pe;nut. f:'Building'Remtit,'ELC_PctmiLApp ELR_ERE.doc Rev 06/17/2015 44114615Tt i 1(05-COWWE13 01.,4 E srb-'v / l'lumbine Permit Application Building Fixtures RECEIVE o ! ' , ' 'IS(ili (�>'i 1( 1 1's tll i ; {,(' I it 1: City of Tigard RxetvedDate/By: Permit No. 2O2(-00367 ' 't 13125 SW Ha11 Blvd.,Tigard.OR 97223 E(' A 1 2021 Plan Review ' i D 011Fcr Ntrmil No. Phone: 503.718.2439 Fax: 503.598.1960 Date/By: '' Insp.xtion Line: 503.639.4175 Due Read/B Juris: El Sea Page 2 for :' , „,,) CITY OF TIGARD y y. $ Internet: www.tigard-or.gov otifiedlMethod: supor.talInformation 4 F t:Tl ib..:;-. 1t= -^oF .,.....i :a.< ..k ..�{.&r.F.>, trt s x ni a i a i ��.., ^ fi,". .i:i i 4!i I il New construction 0 Demolition Far special information use checklist. Description j ?tv.-iE.i I Total' ❑Addition/alteration/replacement 0 Other: Nevi 1-2-family dwellings(inclt,des l0O ft.t)1-,each utility connection) .j tF' :()i f j 'ra; s i ii ,Ky� ;yap „�{",.a.. yn t rty 'i x i u,l;"e� u r 6 1€, :"t,�}'::.t SFR(1)bath I 312 70 .na i4 i i , t1 f1 ,—..r i-40.1. ..n - wi i'%I� M it." A. < t .' h -{ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath — I 437.7X ❑Accessory building 0 Multi-family SFR(3)bath SOU 3^. - -_ Each additional bath/litchen 25.0. ❑Master builder 0 Other: Fire sprinkler( sq.ft.) 4 Paige:. i u}� i�-�_' �)iF m r e�Fr.t a �u,rJ> � x� .1 '"1—��_— t i r �s: .e` � i ',. ,,.1 °10 1 is r im a Site utilities: Job site address: LOSIr t5W NW/VW R7GG Catch basin of area drain l s 76 Drywell,leach line.or trench drain 18 76 Ci yiState'ZIP: --- — - --a----- - - ..._ / �N ry�'� (//� 7 7D -- Footing drain(no.linear(E:—) i iP ag e 2 Suite/bldg./apt.no.: Project name: Manufactured home utilitiesi 50,0, Cross street/directions to job site: CA.Wie-1 / ijrf/(40Oa Manholes 1t, 1S.7 -- ' Rain drain connector I 18 76 Sanitary sewer(no.linear ft.:—_) Page 2 -- Stonn sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: I Lot no.: ) Fixture or item: --_.._ Tax map/parcel no.: Of Z S ((0 A-i0 (2 ZG1U Backflow pre-:enter - _— -7 31.27 --- a t I a k € a = Backwater valve 12.51 ' Ada f: 'i... 41 n i.. ir`t. 4.4 l ` -- >i is l' — -- - ---_.. Dv - Clothes was ter �I 25.02 2 PPM _3La Dishwasher I 25.02 Drinking fountain 25.0:: Ejectors/stoup 25.0_ HA ii t.�,T aF I ems' jt r .: ^L i., .. ,4 1Bc. .5 E i ''F a 11 Expansionteink 1:..5I --- Name: gjL,�i/f t-0 - 19/1Q TYES il Fixture/sewer cap —__ 25.02 _------- ,/- Garbage. � Floor draitvtlooF•sink1tub 25.02 Address: ;3 7 5. s -sr- a(J/7� v't' ---- , 2. 0:: City/State/ZIP: 1,z4/ 654/ of . 7 7d% _ Hose bib H I 25.02 Phone:(03) q36 J?Z(Z Fax:( ) Ice makc - 12.51 ________ a , 1j ,4a� .14 at14iI r . n Interceptor/grease trap 25.0: ,..4,..,, &:;e,. . , .,x- .i. � . . i n , tx - Business name: �G Medical gas(value:S_) — Paga_� -- Primer 1.2 51 Contact name: - Roof drain(commercial) I o 5 I Address: Sink/basin/lavatory f/ 25.02 — City/State/ZIP: Solar units(potable water) 62.5'- Phone:( ) Fax: :( ) Tub/showerisliower pan - 12.51 Urinal 25.02 E-mail — - -—._ "I t"S t r t r ,; €1 w t r 9 Water closet 22 ------ . tad F I ! - apes s cs t a I . . ,4,. .#a Water heater -L_ - 37.52 Business name: FAX split pui.fiismicr. Water i in 7WV 56.29 Address: 6/3 g , i Other: ---_25.02 -- - City/State/ZTP: pO]jje 9 -_ -_-Subtotal Phone:(63) 17 7 - coco Fax:( ) Minimum permit fee: S725i, -- -- CCB Lic.: ' /7, S Plumbing Lic.no.: PR 37o Plan review (25%of permit`eel ---- - State surcharge(12%ofpennit reel Authorized signature: ..7--....... � TU"1'AL PeR\1l'1'F E:E---_ - Print name: C'i GVW�r Date: This permit application expires if a pm mit 1s net obtained within ISO days J after It bus been accepted as complete. *Fee methodology set by Tri-County Bulling Iedus iy Sw,ice Board. i:tOuikfingiPcrmiiePLA4U-PcrmiiApp.dne 10101119 440.4r,16r(10tl17.'COAt/WEB) i Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su yression S I;eins ,. t c r t 1 raw! rq Rig ar yg . ii iniRN1 t ;it. '-�, j� -r� 8 y }�jAR ,y T�� 1 1, �,_ 1. {r, i "�a ,. ."' - '. ...,.,t "^ SI.I-�j..Rii fi t„ ';11ma animus 'g. .Ilt tut.` Rioting drain-1"100' 50.03 0 to 2,000 —_- $121 90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169 F9 !,_ 3,601 to 7.200_ I $233.20 Sewer-1st 100' 62.54 7,201 and greater___ _T-$32754 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas S'stems' Water Service-each additional 100' 37.52 `'. ilE s n i 1t r it s ohs i 77 Storm&Rain Drain-I st 100` 62.54 St.co to$5,000.00_Minimum fee$72 50 _ _ _� Storm&Rain Drain each additional 100' 37.52 $5,001.00 to$10,t00 $i1.00 72.50 for the fin $5.1000.00 and$1.`2 for ,TE_„ . a , each additional$1000 o fraction thereof,to r l � t ..,x<� n <. ,n.. aid including.$1000C 00.- - --- -- Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,01)0.00 rind$l 54 for which no fee is specifically indicated 90.00/hr each additional,$100.0 t of fraction thereof,to (minimum charge-1/2 hour) ar.d including$25.000_00._____ Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the fits:$-'I:5,0)0.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 01 traction thereof,to Reins-pcetien Fees 90,00/hr -__ and including$50.000.00. Additional plan review for revisions 90.00/hr 5.50,001.00 and'an V 42.00 ter the his'$_30,0)0.00 and$1.20 for _kpinimum charge- 1/2 hour) -� ._------ each additional$100.C,0 or fraction thereof Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to r;� accurately report fixtures could result in increased sewer fees'. ';° r !,Ii� y p 1 14 ,..,.a"t, `F t,c b,,$ Ht ,r. a I. Plan review is required for any of the following. t1Pf` a l:;,' i yk f . m %r Please check ail:hat apply. fia t o . t1 :3i.., [ Any new commercial building with water s.ntce 2' and Baptism/Fbm greater,a:.eept systems designed and strunfed by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. _ -Drive Thru Cuffidor/W'ater Asairator - C Medical gas and vacuum systems for health cue facilities. Dishwasher -Commercial 0 Any multipurpose fire sprinkler system. Domestic _ C Any complex structure as defined in ORR918.780-(t04U. Drinking Fountain Submit 2 sets of plans with any of the above. Eve Wash Floor Drain'sink: -2" — r. ¢� j! 1 ff � y{(�rL x 1 PI x # ;:th _3•' i".,..illI :(Emits l r' 5V 3 ...ti-.',- f Isometric or riser diagram is required for new buildings -Car Wash Drain - that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related - -Industrial food related { ice MachiRefrig.Drains -- Comments regarding fixture work: Oil Separator(Gas Station) ___ _ -- --- ------Rec.Vehicle Dump Station _— ^____ — Shower: -Gang -_- -Stall _ Sink: -Lav/Bar non-food related _— ---- ------- �- -Bradley - ` -Com/Ser+/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer El)Us,a sewer permit will be issued and W ashen-Clothes — -- fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet - plumbing permit tun be issued. Urinal - Other Fixtures: l:\Building1Permits\PLMF_PermitApp.doc 08/04/2011 2 City of Tigard .71e COMMUNITY DEVELOPMENT DEPARTMENT ' ■ TIGARD Building Permit Review — Residential Building Permit #: UPZQ2J-n0347 Site Address: 10 0 4 S SW 4nvutua. gill CI-. Project Name: A tan MA,MA,A, H► 6l Cd v r* Lot #: ? Planning Review Proposal: Pt' pt.) 4„, 44--- L I ,� 4l tuetlivy C vpper (pllt) rgo Verify address/suite#active in Accela. ❑ In River Terrace: Iftil No 0 Yes,River Terrace Review Addendum Site Plan Elements: Erosion Control /23 copies of site plan on 8-1/2"x 11"or 11 x 17"paper 110Retained trees with drip line and tree protection measures Drawn to scale(standard architect or engineer scale) 11 Footprint of new structure(including decks)and FFE Worth arrow PUtility locations&easements(required for new and additions) fjite address,project or subdivision name and lot number [Sidewalk/driveway approach Applicant information(name and phone number) of welisl,,.t ti,.apleare PLot dimensions and building setback dimensions pStreet tree size,type and location C treet names [Corner elevations(2'contours if more than 4'differential) tiR;iLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? MYes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes liallo Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No lo Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No N SDC Exemption for ADU applied for: 'p Yes ❑ No Received: ❑ Yes clifNo a . Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake cr Land Use Case#: v 2V 2(—0.00 a Zoning: �,--1Z Required Setbacks: Front: ( 5 % Rear: (, 5 t Side: Street Side: ( O Garage: t p Building Height: Max. Height: 3 6 Actual Height: 25 5 Landscape Area: 2 0 % , Lot Coverage Max: S 0 °A) ntrance CPSet back no more than 8'from street-facing wall ? Parallel to street or offset 45 degrees or less i Windows Igo Minimum 12%of area of all street-facing facades Garage ❑ e door is behind widest street-facing wall ❑ Yes [ ,one of the following is met: ❑ Door e triesa no more than 5'from wall and there is a co porch extending beyond garage. ❑ Door extends no mo 5'from wall an is a 12 sq ft.window above garage on 2nd floor. ❑ Garage door width is 0 12'or less ° or less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ ssed entrance ❑ set ❑ 1'Roof eave ❑ Roof offset ❑ Fire shingle Lap Siding ❑ Roof pitch ❑ a , . or gambrel roof ❑ Dormer ❑ Acc siding ❑ Window trim ❑ Window recess ❑ Win o 'ction ❑ Balcony pVisual Clearance ❑ Urban Forestry Plan Sensitive Lands: jg Yes ❑ No Type: ❑ Conditions met prior to issuance of building permit Notes: N Approved ByPlanni PP ng: Date: 1217120 24 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Buildin \Forms\Bl P g dg emutRvw_RES_122419.docx Building Permit Submittal_ / Original Submittal Date: 40(72U2-1 Site Plans: # III 3 Building Plans: # ? Building Permit#: CYBnter building permit# above. Workflow Routing: IW-Planning I /Engineering Permit Coordinator B'Building Workflow Sign-off: 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. [Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Date: /. %?/emu • Engineering Review Slope at building pad: Apt,' 3 Conditions"Met"prior to issuance of building permit Easements (encroachments) per engineering conditions of approval and plat L'/Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Lk1 No Assess Water Quantity Fee in-lieu: ❑ Yes ["No • LIDA Facility on lot: ❑ Yes 'No (Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: V Date: 10 l Revisions (after Building Submittal only Reviewer Date Revision 1: ❑ Approved ❑ Not approved . Revision 2: ❑.Approved ❑ Not Approved Permit Coordinator Review ,ICJ 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: SDC Exemptions 0 Received ,A Does not apply_ prtga SDC Fees Entered: Wash Co Trans Dev Tax: ,Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: , Yes ❑ N/A LIDA ❑ Yes N/A 0 OK to Issue'Permit Approvedby Permit Coordinator: // 1 Date: t Z((S/za zr 1:\Building\Forms\B1dgPermitRvw_RES_122419.docx RECEIVED City ofTigard JAN 1 0 2022 11 FINANCE DEPARTMENT CITY OF TIGARL 3u DIVISION. TIGARD Systems Development Charge (SDC) Exemption Application REQUEST FOR ACCESSORY DWELLING UNIT (ADU) SDC EXEMPTION (Allowed under TMC 3.24.100.F) Note:Refer to TMC 3.24.180 and the Systems Development Charge(SDC)Exemptions forAccessoryDwelling Units Guideline for eligibility requirements before completing application.City Transportation and Park SDCs exemption only. REQUIRED DOCUMENTS PROPERTY INFORMATION ❑ Recorded Deed with the legal Name of property owner(s): Blue Palouse Properties description of the Property ❑ Proof of Ownership/ Authorized Representative Address of ADU : 10895 SW Annand Hill Ct Tax map and tax lot numbers: 2s 110 ad 12200 Land Use Approval Case Number: Ml_P2020-00002 ADU 2020-0021,0022,0023 Type of Unit Total Units Square footage of each unit Attached ADU 1 992 Detached ADU APPLICANT INFORMATION Name(s),as appears on title of property: Blue Palouse Properties Mailing address: 333 S State St Suite V452 City/State: or Zip: 97034 Phone: 503-936-3212 Email: robm@bluepalouse.com Applicant's representative (if not property owner): Phone: Email: robm aabluepalouse.com THE PROPERTY OWNER ACKNOWLEDGES AND AGREES TO THE FOLLOWING: 1. I understand that acceptance of this application and required documents by the City does not constitute an approval of an exemption. Exemptions are not granted until after all required documentation is received, the property owner(s) sign, notarize and record with Washington County the restrictive covenants agreement. 2. I understand that if at any time during a period of 10 years from the time my final inspection is approved the Page I 1 Rev. 10/21 accessory dwelling unit for which an exemption is granted is rented or listed as a short-term rental(AirBnb, VRBO,etc.),the owner of the property at that time will be required to pay to the City the amount of the exempted system development charges,plus interest. I also understand that an advertisement of the accessory dwelling unit as a short-term rental is sufficient evidence for the city to assess the amount of the exempted SDCs. I understand that this restriction will bind the property even through transfers of ownership. 3. I understand that the City may verify any of the information contained in this application at any time. 4. I understand that the City, its agents,successors and assigns will rely on the information contained in this application and the information represented herein;if any information should change prior to obtaining a certificate of occupancy,I will notify the City. I certify that to the best of my knowledge,all the information provided in this application is true and accurate as of the date rovided opposite my signatures below. Rob Matthews 11/23/21 r erty owner signature Print Name Date Property owner signature Print Name Date APPLICANTS It is the responsibility of the applicant to ensure that the application for the SDC exemption is submitted and approved before the payment of all SDCs are due to the City.SDCs are calculated and due and payable pursuant to Tigard Municipal Code 3.24.080. In accordance with TMC 3.24.080.B,the City may not issue a building permit or allow connection to the City's systems until either all SDCs have been paid in full or an exemption has been granted.It is the applicant's sole responsibility to ensure an exemption application is submitted to the City in a timely manner in order to meet the timelines in TMC 3.24.080. Electronic submittal of this application and required documentation is preferred and can he sent to SDC(c tigard- Hardcopy applications and required documentation can be mailed to: City of Tigard—SDC Administrator, 13125 SW Hall Blvd.,Tigard,OR 97223. Questions can be directed to Christine Moody,at christine(%ti ard-or.gov or 503-718-2415. \ {)\1.� Date Received: 11/23/21 Approved by: l)a'i:11/23/21 Christine Baker 1/6/22 Amount of SDCs Exempr$11,719.00 Park $7,591.00 Transportation $4,128.00 Page 12 Rcc. 1{0;21 DocuSign Envelope ID:BC90FBCB-4DD5-4DF5-AF50-2F06296F94F1 Washington County,Oregon 12/10/2021 01:56:00 PM 2021-127148 D-IRUL Cnt=1 Stn=10 A DUYCK $35.00$5.00$11.00$60.00-Total=$111.00 RETURN T O: 1 1I1 1 I I! 1Ii 1 1 l 1 f I ++ IN City of Tigard 628323%202 i 0127 i 98G0 J0077 t,Joe Nelson,Director of Assessment end Taxation Finance and Information Services and Ex•Ofncio County clerk for Washington County, Contracts&Purchasing Oregon,do hereby certify that the within Instrument of -'*v writing was received and recorded In the book of r' '~P 13125 SW Hall Blvd. records of said county. l tryt � Tigard,OR 97223 Joe Nelson,Director of Assessment and Taxation,Ex- Officio County Clerk - SPACE ABOVE FOR RECORDER'S USE CITY OF TIGARD COMPLIANCE AGREEMENT,DECLARATION OF RESTRICTIVE COVENANTS AND EQUITABLE SERVITUDE SDC EXEMPTION FOR ACCESSORY DWELLING UNIT THIS COMPLIANCE AGREEMENT, DECLARATION OF RESTRICTIVE COVENANTS AND EQUITABLE SERVITUDE (the "Agreement") is made and entered into this 1st day of December 2021, by and between Blue Palouse Properties(the"Grantor")and the City of Tigard(the"City"). PURPOSE The City desires to exempt the construction of an accessory dwelling unit ("ADU") located at 10895 SW Annand Hill Ct., Tigard, Oregon, and approved through case File No. ADU2020-00021. (the "Project"), from payment of City of Tigard parks and transportation system development charges ("SDCs") pursuant to Tigard Municipal Code. The legal property description of said Project is set forth in Exhibit A,which also is attached hereto and incorporated herein by reference. The SDCs exempted for eligible Project units are shown on Exhibit B. Grantor desires to receive the exemption, to satisfy the conditions thereof, and to execute and record this Agreement for the purpose,in part,of creating restrictive covenants and an equitable servitude that shall run with the Project land and bind any and all subsequent owners of the Project for the term of this Agreement. AGREEMENT SECTION 1. REPRESENTATIONS,COVENANTS AND WARRANTIES OF THE GRANTOR CONCERNING USE OF THE ACCESSORY DWELLING UNIT. Grantor hereby represents, covenants, warrants,and agrees that Grantor will not use the ADU on the Property as a short-term rental,as defined in Tigard Municipal Code 3.24 (as amended July 9,2019),for a period of 10 years (the"Exemption Period") from the date of final approval of final inspection of the building permit ("Exemption Date"). For the purposes of this Agreement, posting a listing of the ADU on the Property on a short-term rental website is prima facie evidence that the property owner has violated this requirement. SECTION 2. COVENANTS TO RUN WITH THE LAND; EQUITABLE SERVITUDE. The Grantor represents,covenants,warrants and agrees that: a. The City is granting the exemption to the Grantor as an inducement to the Grantor to construct and operate the Project in accordance with the terms of this Agreement. In consideration of the receipt of the exemption, the Grantor has entered into this Agreement with the City and has agreed to restrict the use of the Project during the Exemption Period as set forth in this Agreement. SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 1 of 7 DocuSign Envelope ID:8C90FBCB-4DD5-4DF5-AF50-2F06296F94F1 b. The representations,covenants,and restrictions granted by Grantor therein with respect to the Project shall be deemed restrictive covenants running with the Project land and also shall be deemed an equitable servitude running with the Project land in favor of and enforceable by City.These restrictive covenants and equitable servitude shall pass to and be binding upon the Grantor's successors in title including any purchaser,grantee, or lessee of any portion of the Project, shall pass to and be binding upon the respective heirs, executors, administrators, devisees, successors, and assigns of the Grantor or any purchaser, grantee, or lessee of any portion of the Project and shall pass to and be binding upon any other person or entity having any right,title, or interest in the Project. Each and every contract,deed,or other instrument hereafter executed covering or conveying the Project or any portion thereof or interest therein shall contain an express provision making such conveyance subject to the covenants,restrictions,and charges contained herein;provided,however,that any such contract, deed, or instrument shall conclusively be held to have been executed, delivered, and accepted subject to such covenants, restrictions and charges regardless of whether or not such covenants, restrictions and charges are set forth or incorporated by reference in such contract,deed,or instrument. SECTION 3. BURDEN AND BENEFIT. The parties hereby declare their understanding and intent that the burdens of the covenants,restrictions,and charges set forth herein touch and concern the Project land and that the Grantor's legal interest in the Project may be rendered less valuable thereby. The parties further declare their understanding and intent that the benefits of such covenants,restrictions,and charges touch and concern the Project land by enhancing and increasing the enjoyment and use of the owners and tenants of the development,the intended beneficiaries of such covenants, restrictions, and charges and by furthering the public purposes for which the exemption is granted. SECTION 4. COMPLIANCE. The Parties hereby agree that Grantor, if requested by the City, will provide certification,in a format approved by the City in its sole discretion,that the Grantor is fulfilling its obligations under this Agreement. SECTION 5. TERM OF AGREEMENT. The parties agree that this Agreement and the restrictive covenants and equitable servitude created hereunder become effective upon execution of this Agreement and will remain in full force and effect for a 10-year Exemption Period. Notwithstanding any other provision of this Agreement,this Agreement will terminate and be of no further force and effect in the event of a completed foredosure by the primary financing lender or by a lender to whom the City has subordinated this Agreement,or their successors or assigns,or in the event of a delivery by the Grantor of a deed for the Project to the primary financing lender in lieu of foreclosure,or to a lender to whom the City has subordinated this Agreement,or their successors or assigns. SECTION 6. TERMINATION. The City may terminate this Agreement,without further liability,upon 30 days'notice and opportunity to cure. Notwithstanding termination, City may pursue any remedy provided for in Section 7. If the Grantor fails to perform or breaches any of the terms of this Agreement;or immediately and without notice and opportunity to cure if the City loses the authority to grant the exemption,as determined by its counsel or otherwise as lacking the authority to administer the exemption, or fails to receive or loses necessary funding, appropriations, limitations, or other expenditure or position authority sufficient to carry out the terms of this Agreement. SECTION 7. REMEDIES. If the Grantor defaults in the performance or observance of any covenant, agreement,or obligation set forth in this Agreement and if such default remains uncured for a period of 30 days after the notice thereof shall have been given by the City to the Grantor,then the City,at its option,may take any one or more of the following steps: a. Terminate the exemption of the Project or a portion thereof,in which case the SDC's exempted herein shall be immediately due and payable to City in the amounts shown on Exhibit B,along with interest accruing from the Exemption Date at the rate shown on the City's Master Fees and Charges Schedule for"SDC Financing" SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 2 of 7 DocuSl n Envelope ID:8C9OFBCB-4DD5-4DF5-AF50-2F06298F94F1 calculated semi-annually.City may,in addition to an action to collect SDC's due,withhold issuance of building or development permits until paid in full; b. Take such other action under this Agreement,at law,or in equity as may appear necessary or desirable to the City to enforce the covenants,agreements,warranties,and obligations of the Grantor hereunder. No waiver or delay in enforcing the provisions hereof as to any breach or violation shall impair,damage,or waive the right of any person entitled to enforce the same to obtain relief against or recover for the continuation or repetition of such breach or violation or any similar breach or violation thereof at any later time or times. SECTION 8. RECORDING AND FILING. The Grantor shall cause this Agreement and all amendments and supplements hereto to be recorded and filed in the real property records of Washington County and in such other places as the City may reasonably request The Grantor shall pay all fees and charges incurred in connection with any recording.The Grantor shall provide either the original recorded document or a certified copy of the recorded document within ten days of the date of this Agreement. SECTION 9. GOVERNING LAW;VENUE. This Agreement shall be governed by the laws of the State of Oregon. The courts of the State of Oregon,or to the degree necessary,the U.S.District Court for the District of Oregon,shall have exclusive jurisdiction over any action brought by or against the City under this Agreement. The Grantor hereby consents to such exclusive jurisdiction and waives any and all objections it might have thereto. SECTION 10. AUTHORITY. Grantor hereby represents,warrants,and certifies that: a. It possesses legal authority to apply for and accept the terms and conditions of the exemption and to carry out the proposed Project; b. Its governing body,if any,has duly authorized the filing of the application,including all understandings and assurances contained therein; c. The person identified as the official representative of the Grantor in the application is duly authorized to act in connection therewith and to provide such additional information as may be required. The Grantor's official representative has sufficient authority to make all certifications on its behalf; d. This Agreement does not and will not violate any provision of any applicable law,rule,regulation,or order of any court, regulatory commission, board, or administrative agency applicable to the Grantor or any provision of the Grantor's organic laws or documents; e. This Agreement has been duly executed by an official representative of Grantor,delivered by Grantor,and will constitute the legal,valid,and binding obligations of the Grantor,enforceable in accordance with their terms. SECTION 11. AMENDMENTS. This Agi..ement may be amended only by a written instrument executed by the parties hereto or by their successors and duly recorded in the real property records of Washington County. SECTION 12. SEVERABILITY. If any provision of this Agreement shall be invalid, illegal, or unenforceable,the validity,legality,and enforceability of the remaining portions hereof shall not in any way be affected or impaired thereby. SECTION 13. CONSTRUCTION. The parties to this Agreement acknowledge that each party and its counsel have participated in the drafting and revision of this Agreement Accordingly,the parties agree that any rule of construction to the effect that ambiguities are to be resolved against the drafting party shall not apply in the SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 3 of 7 DocuSign Envelope ID:8C9OFBCB-4DD5-4DF5-AF50-2F06296F94F1 interpretation of this Agreement or any amendment,modification,supplement,or restatement of the foregoing or of any exhibit to this Agreement. SECTION 14. NO LIMITATIONS ON ACTIONS OF CITY IN EXERCISE OF ITS GOVERNMENTAL POWERS. Nothing in this Agreement is intended,nor shall it be construed, to in any way limit the actions of the City in the exercise of its governmental powers.It is the express intention of the parties hereto that the City shall retain the full right and ability to exercise its governmental powers with respect to the Grantor,the Project,the land,and the transactions contemplated by this Agreement to the same extent as if it were not a party to this Agreement or the transactions contemplated thereby,and in no event shall the City have any liability in contract arising under this Agreement by virtue of any exercise of its governmental powers. IN WITNESS WHEREOF,the parties have caused this Agreement to be executed by their duly authorized representatives as of the day and year first above written. GRANTOR(s): FULL NAME: By; _ Signature Name:1*)1'e-) 1 ' ak-6 STA FE OF Ott- County of i i r1 ) ss: The foregoing instrument was acknowledged before me this(day of etCJ'"D 1, O 1 ,by Notary Public for the State of My commission expires: Jam)3 i I c /="r, OFFICIAL STAMP TOM A RICCARDI NOTARY PUBUC-OREGON f!;f/ COMMISSION NO.1012794 MY COMMISSION EXPIRES MAY 31,2025 SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 4 of 7 DocuSign Envelope ID:8C90FBCB-4D05-4DF5-AF50-2F06296F94F1 CITY: CITY OF TIGARD,an Oregon municipal corporation "—Mediated br: By: 56)14. Nt l^ Steve Rymer, City Manager SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 5 of 7 :�anlr► DocuSign Envelope ID:8C9OFBCB-4DD5.4DF5-AF50-2F06296F94F1 EXHIBIT A LEGAL DESCRIPTION OF THE PROJECT A tract of land situated in the Northeast quarter of Section 10,Township 2 South,Range 1 West of the Willamette Meridian,in the City of Tigard,County of Washington and State of Oregon,described as follows: Beginning at a point on the North line of the Southeast quarter of the Northeast quarter of said Section,North 89°34'10"West 990.18 feet,more or less,from the East line of said section and running thence South 0°51"50'West parallel with said East line of section,124.71 feet,more or less,to the North line of a 50.0 foot deeded roadway; thence South 68°30'East on said roadway Northerly line 106.95 feet,more or less,to the West line of that tract of land described in Book 1092,Page 594,Deed records of said county;thence North 0°51'50"East on said West line 163.17 feet,more or less,to the North line of the Southeast quarter of the Northeast quarter of said section;thence North 89°34'10"West on said line 100.09 feet,more or less to the point of beginning. SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 6 of 7 DocuSign Envelope ID:8C9OFBCB-4005-4DF5-AF50-2F06298F94F1 EXHIBIT B SCHEDULE OF SDCs EXEMPTED System Exemption Amount City Transportation $4,128.00 Parks $7,591.00 Water NOT ELIGIBLE Sanitary Sewer NOT ELIGIBLE Stormwater NOT ELIGIBLE County Transportation Development Tax NOT ELIGIBLE Total Exemption $11,719.00 This SDC exemption is granted to the units located at the property address(es)listed below: 10895 Annand Hill Ct.,Tigard,OR 97223 SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 7 of 7 Washington County,Oregon 2019-087839 RECORDING REQUESTED BY: D-DW Stn=8 J CHOATE 12/04/2019 01:34:35 PM 11181 Lawyers Title $15.00$11.00$5.00 S60.00$336.00 $427.00 of0..x.4,LLC I,Richard Hobernicht,Director of Assessment and Taxation and Ex- Officio County Clerk for Washington County,Oregon,do hereby certify that the within instrument of writing was received and 12550 SE 93rd Ave,Ste 420 recorded in the book of records of said county. Clackamas,OR 97015 Richard Hobernicht,Director of Assessment and Taxation,Ex-Officio GRANTOR'S NAME: Joseph M Van Lom Trust dated 12/21/2006 GRANTEE'S NAME: Blue Palouse Properties LLC,an Oregon limited liability company AFTER RECORDING RETURN TO: Order No.: 161901394-SB Robert Matthews Blue Palouse Properties LLC,an Oregon limited liability company 333 South State Street Ste V452 Lake Oswego,OR 97034 SEND TAX STATEMENTS TO: Blue Palouse Properties LLC,an Oregon limited liability company 333 South State Street Ste V452 Lake Oswego,OR 97034 =J APN: R1014397 Map: 2S110A008805 No Situs Address,Tigard,OR 97224 SPACE ABOVE THIS LINE FOR RECORDER'S USE ' STATUTORY WARRANTY DEED r•~`' Joseph M Van Lom and Cynthia S Van Lom, Trustees of the Joseph M Van Lom Trust dated 12121/2006, < Grantor, conveys and warrants to Blue Palouse Properties LLC, an Oregon limited liability company, t4 Grantee, the following described real property, free and clear of encumbrances except as specifically set forth below,situated in the County of Washington,State of Oregon: A tract of land situated in the Northeast quarter of Section 10,Township 2 South, Range 1 West of the Willamette Meridian, in the City of Tigard, County of Washington and State of Oregon,described as follows: Beginning at a point on the North line of the Southeast quarter of the Northeast quarter of said Section, North 89°34'10"West 990.18 feet, more or less,from the East line of said section and running thence South 0°51"50'West parallel with said East line of section, 124.71 feet, more or less, to the North line of a 50.0 foot deeded roadway;thence South 68°30'East on said roadway Northerly line 106.95 feet,more or less,to the West line of that tract of land described in Book 1092, Page 594, Deed Records of said county;thence North 0°51'50"East on said West line 163.17 feet, more or less,to the North line of the Southeast quarter of the Northeast quarter of said section;thence North 89°34'10"West on said line 100.09 feet,more or less,to the point of beginning. THE TRUE AND ACTUAL CONSIDERATION FOR THIS CONVEYANCE IS THREE HUNDRED THIRTY-SIX THOUSAND AND NO/100 DOLLARS($336,000.00). (See ORS 93.030). Subject to: SEE EXHIBIT"A"ATTACHED HERETO AND MADE A PART HEREOF BEFORE SIGNING OR ACCEPTING THIS INSTRUMENT, THE PERSON TRANSFERRING FEE TITLE SHOULD INQUIRE ABOUT THE PERSON'S RIGHTS, IF ANY, UNDER ORS 195.300, 195.301 AND 195.305 TO 195.336 AND SECTIONS 5 TO 11, CHAPTER 424, OREGON LAWS 2007, SECTIONS 2 TO 9 AND 17, CHAPTER 855, OREGON LAWS 2009, AND SECTIONS 2 TO 7, CHAPTER 8, OREGON LAWS 2010. THIS Deed(Statutory Warranty) ORD1293.doc 1 Updated: 04.26.19 Page 1 OR-LT-FXEB-01060.474579-161901394 STATUTORY WARRANTY DEED (continued) INSTRUMENT DOES NOT ALLOW USE OF THE PROPERTY DESCRIBED IN THIS INSTRUMENT IN VIOLATION OF APPLICABLE LAND USE LAWS AND REGULATIONS. BEFORE SIGNING OR ACCEPTING THIS INSTRUMENT, THE PERSON ACQUIRING FEE TITLE TO THE PROPERTY SHOULD CHECK WITH THE APPROPRIATE CITY OR COUNTY PLANNING DEPARTMENT TO VERIFY THAT THE UNIT OF LAND BEING TRANSFERRED IS A LAWFULLY ESTABLISHED LOT OR PARCEL,AS DEFINED IN ORS 92.010 OR 215.010, TO VERIFY THE APPROVED USES OF THE LOT OR PARCEL, TO DETERMINE ANY LIMITS ON LAWSUITS AGAINST FARMING OR FOREST PRACTICES, AS DEFINED IN ORS 30.930, AND TO INQUIRE ABOUT THE RIGHTS OF NEIGHBORING PROPERTY OWNERS, IF ANY, UNDER ORS 195.300, 195.301 AND 195.305 TO 195.336 AND SECTIONS 5 TO 11, CHAPTER 424, OREGON LAWS 2007, SECTIONS 2 TO 9 AND 17,CHAPTER 855, OREGON LAWS 2009,AND SECTIONS 2 TO 7,CHAPTER 8,OREGON LAWS 2010. IN WITNESS WHEREOF, the undersigned have executed this document on the date(s)set forth below. Dated: G 1 f 0 i Joseph aniom Trust d ed 12/21/2006 BY: t IT' VAL Jos Van Lom Trut lI BY.t1;tl A''1CA, /04/1/ vW Cynthia S Van Lom Trustee State of " /'f �^ County of t`,�/_1.,, '"n This instrument was acknowledged before me on ./ ' ,f by Cynthia S Van Lout, as Trustee for Jos h aniorn Trust dated 12/21/2006 and Josep M Van Lom,as Trustee for Joseph M Vanlom Trust dated p t 12/21 0 . Notary Publi -State of Oregon My Commission Expires: C\<___,,'="—.�.-/ ._ � OFFICIAL STAMP ,; '. DEBORA J OLSON r NOTARY PUBLIC-OREGON ��^ COMMISSION NO. 947119 _._ MY COMMISSION EXPIRES FEBRUARY 03,2020 Deed(Statutory Warranty) ORD1293.doc I Updated: 04.26.19 Page 2 OR-LT•FXES•01060,474579-161901394 EXHIBIT "A" Exceptions Subject to: Covenants, conditions, restrictions and sewer easements but omitting any covenants or restrictions,if any, including but not limited to those based upon race,color, religion, sex,sexual orientation,familial status,marital status, disability, handicap,national origin,ancestry, source of income,gender,gender identity, gender expression, medical condition or genetic information,as set forth in applicable state or federal laws,except to the extent that said covenant or restriction is permitted by applicable law, as set forth in the document Recording Date: August 29, 1978 Recording No: 78 38656 Deed(Statutory Warranty) 0RD1293.doe I Updated: 04.26_19 Page 3 OR-LT-FXEB-01060.474579-161901394