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Permit
CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit#: BUP2021-00308 Date Issued: 2/10/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110AD12200 Jurisdiction: Tigard Site address: 10891 SW ANNAND HILL CT Project: Annand Hill Partition, Lot 1,(2 of 2)ADUs Subdivision: ANNAND HILL CT PARTITION Lot: 1 Project Description: New multi-family dwelling(Lower level)ADU.Trade permits to be obtained separately.NO FINAL INSP UNTIL WATER METER UUPSIZED. 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 $755.29 Occupancy Grp: R-2 Occupancy Load: 3 Plan Review 02/08/2022 $490.94 12%State Surcharge-Building 02/08/2022 $90.63 Dwelling Units: 1 Stories: 0 Height: 0 ft Wash Co Trans Dev Tax- 02/08/2022 $5,756.00 Condominium/Townhouse Bedrooms: 1 Bathrooms: 1 Plan Review-Fire Life Safety 02/08/2022 $302.12 Value: $82,976 Tig-Tual School CET-Residential 02/08/2022 $953.16 DC Provision Review,SF-Ping 02/08/2022 $110.00 Floor Areas: Total Area: 676 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 60 Deck: 0 Garage: 0 Mezzanine: 0 Total $8,458.14 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: Edga-rolo-Mad.olo a4o- Permittee Signature: yet, 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. 13uili1inu PPermit Application 1 �� '��,iumil esid:^ntia.l RECEIVE`) ;FuR�t)Fr'I( t:t I;' DEC 0 T p�� Received ROP 21.t28Qe8 l City of Tigard Daec/u :12 ZI �o/ ve�m1 No. s++��G.� tI C J 1312_ SW Hall Blvd.,Tigard,OR 97223 Plan Res ea ------------------- ------- Phone: 503.718.2439 Fax: 503.598.1960 Date/It Jj Z/ ! Other Permit: . Inspection Line: 503.639.4175 CITY OF TIGA__ Date ReadyB ? E1 cam,Pal, 1.for t, BUILDING DIVISIO ( 1. P— Internet: waw.tigard-or.gnv Qotifi- met' -a �r____ttator ____ a-•- 1-•- mrz-^ x r x7 r 1 Z t € .'s aria a at t i r i t C 7t= $r •, t a r �'y� ti T.. t l' � z s �� � ar S is it �r� •;,. v. ,.y,• '1t K<$. .'... . '•t=`a .,g2 , , s,.xl h ..3x.,;;;P,' k ...rx,. , ,3,. ... fin, f'.; . raj n'1,r ,yt �L"�,,',,, , , 7 N.t�9'4r , l IkNew construction 0 Demolition P mti:fees*are hasec on the value of the work performed. -- Ercbcate the value(rounded lc ttc m•ar sl e,olla 1 of all El Addrttore'alteranorvreplacement ❑Other e ui alnent,materials,labor,overlie..d_r i"i lint;Tor the t' t x xwarl ',' x i, 1;'r, ii,A k= t gt i��n not 5 applic rtir,: - . st,4t r s 2 >°.1 .s(, eda,: ...,...,, , ,;t .,& .ti,. . s s1a 1 t<- g •, . < egf� � �• ir ~� ❑ I and 2-family dwelling ❑Commercial/industrial ---- Yalu ion: --$ ❑Aecessor buildin Nunber ol'bedrooms: �y,� y g ❑Multi-family !1!__ __.----------•_-_-. Li ❑Master builder ❑Other: Number of hathnwnts: ?j L t i r?i r)�tt f � . �1e •*tsr{r�:t.�5,�8r �(i;pu ' `il x r F r�lar":, tfa } --------------------.___. d10l : * •t t°st• F.Isl fi Fi 4u kOt1; ii t i "t o t 4IF: t 3 rural number of floors: Job site address: 6 � Stu ---^ New dwelling area: sytutre eet oS q I �A/�tI AJD �irGLu� - stput---'- City/State/L[P: 77U7rf�lJ /}/� 577,.L4 - Cia;age rcarport area: / spur ei_el _.___.___.-. Suite/bldg/apt.no.: Project name: Ca•'ered porch area: square reel Cross stn.etcdirections to job site: � 1 � AN, ., perk area: / square reet - _ Otter struct.rre area: square feet Subdivision: Lot no.: / Fermi.fees*are based on the value of the work performed Tax map/parcel no.: 25 (�d js� �ZZQd Indicate the value(rounded ro tic nearest dollar)of all equipment,materials,labor overlie:d,and the profit.nor the . e i ltl ' i f�a c b tla "p l i' )a a. a work ndicate:d on this anphr at on. , Me�a11u : . zr'�...,. • s.Y s,r�.u. x ;v ,,,,,,,, , ,,,,, .tr,. l,t ...,d,: °,x: -•—- -- ----_---._.__.___.---•---•---- T Q-.' I._- L_IG5 e� LEVE2- Vahra:ion: $ I .h - st Existing building area: square A_et a / i . p um_i ,• " C , $$ #MP t jaue New building area: square feet . ,.„.. +I 4 ;S .4 fl.ieg4: ItA. as. ( (( Uii t, t :te - -- 'ilru5 Number of Stories. Name: ff ,/ ' ,}I-caass- I�.�O 77 Tyl e of construction: --------.-.------.____-_. Address: 333 5 ems+ ' sr.- s'U/7 .(/ z Occupancy groups: City/State/ZIP: F/'4-itr / al/W a Existing: Phone ( 7 '36 5h/Z Fax ( ) - - - - - New: eW " , alI1ti, f 'Sra ' . 11 i a l at o N. GE s , e ill pr d s Ni*-1l1(l° + 77, . / ,' - . x t i r t1I ace + 'el ti gLi Business name: •7'/11s ifitkisc,tr — ----� Struc:u-ai plan review fee On depot it): --- _._-_... Contact name: I--- Ft plan review tee(if tpplcable): Address: �_ ---------•-----._-__.__ _... - - — - - - Total Fees due upon tppl canon- --_—_.._-._.___... City/State/ZIP: Phone:( ) Fax: :{ ) Arwut t re cei N ed E-rnail: a::r, e .a .11:;L tiail:4A.1.! rip nstallation l 3 jt j r 1 11:1o•# ,',,.. ,J t o ,t`,,, ` ' 1,.; )l,J.;tr,T r t ;t c of-t<ip mounted Photoe/oltatc`calt r facia:s. tem.of Business name: sL Ptp1fe- Pwa fi pee Subrn t two(2)sets of roof Ilan wit m earenxtion details and fi.•e depa-t:•nent access,along w th the 2010 Oregon Address: s. 57-A-TE. sr /Tt' ofSZ Solar lnstalla:tconpecialty Cod:cbeciclist, •-_ _.._ ..._ ___ . City/State/ZIP: t/c os Permit Fee(includes plan rev ew i i iic o0 and ztfintinistrative fe:a): Phone:((Z3) 9.6 Fax:( ) y�-- State surcharge(l2°,0 of permit f se): $21.60 CCB lie.: fq 70¢'7 , Total tee due upon app.iat.on 32C1.60 Authorized signature: 1'hts permit application e:xplre;if:.permit is not otn:aitied within 186 days after it ha;been accepted)as enroplete. - — — *Fee methodology set by Tri-C'oumy Building Awry rI not name: Date. ta '7.49' Service Hoare. I:\Building\Pcrmits'BUP-RESPermitApp.doc 02/24/2011 440-46 1.3T(1 1%02/COM/WEB t Mechanical Permit Applicatlo>1RECEIy'E I FOR OFFICE LSE ()NIA City of Tigard Received Date/By: Permit No.:3ufzoz(-&)3e) 13125 SW Hall Blvd.,Tigard,OR 97223 DEC 0 ) Q 21 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 DatcBy: Other Permit: `i,; Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris: ® Sec Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information .._ '.,,a,.,_.;.;. ._,:r ,.,,t.-.:.. .:...L., a...-lsL- fif,..�5-sas II-t,t Tzsacc..:. .:.a, .. ,. Mechanical permit fees*are based on the value of the work a KNew construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value: ❑ 1-and 2-faintly dwelling ❑Commercial/industrial Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total ez.." Heating/cooling: I ct4 AND N I Dwet) Airconditioning0 ,0 46.75 Job site address: jvNlQ7 Gtj I/ J/�xtA�►1 ttv� D I� Furnace 100,000 BTU(ducts vents) 46.75 City/State/ZIP: 1 1(( D Q- C 7 Add Furnace 100.000+BTU(ducts/vents) 54.91 Heat pump I 61.06 Suite/bldg./apt.no.: Project name: Duct work I 23.32 Cross street directions to job site: Grm'`ES " 1 �j 7 , 5 - Hydronic hot water system 23.32 Ste'_ I Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), Q in-wall,in-duct,suspended,etc. yl 46.75 Flue/vent for any of above 'l 23.32 Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Z ft ZZ00 Water heater I 23.32 € 3 .- _ -;! Gas fireplace/insert 33.39 .'-- -..-= "" Flue vent for water heater or gas %---,c 5 Le/7C7) f}-CU.S fireplace I 23.32 Log lighter(gas) 23.32 7 6 et. Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 :I .r> 3 r 3 n Other: 23.32 Environmental exhaust and ventilation Name: F.3I-OE P C-OU SE P R-o PE IK Range hood/other kitchen equipment 33.39 Address: 333 5. 6 ' sT #t/4-67- Clothes dryer exhaust 1 33.39 City/State/ZIP: 1.,,A�E- osujaro Og__ cr--io 4i Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 3 23.32 Phone:( 3) C'3 c 3 Z(Z Fax:( ) Attic/crawlspace fans 23.32 ------------ so _ . ' Other 23.32Y a e a tar ct ! ,by i_ : Business name: 5T 'r`� F. Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: (2.0)j im¢r�L.f r(.AJ,S Furnace,etc. Address: Gas heat pump WalUsuspended/unit heater City/State/ZIP: Water heater Phone:( ((���)�VA �/ ( r ^Fax: :( ) ,�n Fireplace 1-OB VA @ 9L`)EPA OUSE e C OM Range E-mail: Barbecue 1, ,i : o . 1'-w* .-- 774 Clothes dryer(gas) Business name: / SU�� A (/2 co U ez �� Ocher: Address: go( �. �4y R.� _ n Subtotal �.�. City/State/ZIP: OfzeY r" j C try ©i 70 Minimum permit fee($90.00) "� Plan review(25%of permit fee) Phone:(5753) 401 Z4+Q' Fax:( ) State surcharge(12%of permit fee) CCB lie.: 1 ob 4 03 v TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 I days after it has been accepted as complete. Authorized signature + Fee methodology set by Thn-County Building tndusny Service Board Print name: Uk_jr;:. s Date: rJ.2 .,7,7 I.Building\Permits\MEC_PennitApp_040113.doe 440.4617r(11/07JCUM/WEB) OA 11111 Electrical Permit APPhcatiRE E ' ' • . r: : t,)k()PUCE I, . NUll 1I� I ' 1"1 City of Tigard t Faeiyta Permit a: bUPZO2f-c)03O$ 01 �/t �ate/B�': _ 13125 SW Hall Blvd.,Tigard,OR 9727�r E C - ,, Plan Bedew '' a Phone: 503.718.2439 Fax: 503.598.1960 1 di i Batc/B,: Related Perm'/4, - -_- '', PI %' I ReadyDate!B duns: la Sec Page fur Inspection Line: 503.6:39.1175 CITY OF , •R Y ',Il ' I t Internet: wtigard or t iv BUILDING SI i�1 '+ Lhonf,cd/Method tap plena rtal[nfrrmuion sl a(' t)t rg. z a z , Wt.",, < "�„17r �it' ° :11 t. l r V3 .: 77 77.777 Oil: ,rrri-:' t Yii , _.f-fa )it,A � c " i . .(,< ire .. , :':. .:t t st : t I1 •,l l x 1 �,tili t i,._; -:1 i 'New construction 0 Addition/alteration/replacement Pirm a chz cIr all th.rt apply(submit,Z sets "pl ins wit nit ch ekni.: 0 S rv.co or feeder 400 amps or mo r ❑l:uddr..g o•rrr:brae:dories. 0 Demoll ton 0 Other: wt km to available fault current 01 tar rats ant b; tya:d i. . 711 ,, ':t- t ( ?r toi e,,e,,cs:0.000 n rips at 15')0Is or 1:31 6 aUar bt.rlri Ii tll:a fF¢ 't, . 4 x,o.serrl.,rr ,r .`x .,t �,i r. less to ground,or exceeds 14,000 0('onmterur.-use agrrouliursi ❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building arrp:t,rall otter instal hymns. t urld;rrgs. ❑Multi family ❑Master builder ❑Other: 0 Fire ixair 01 rsttlratian)f I Sa x'.A or `: .._ .li :o OM i41 "to l f* r t...y: 1,- 0Enie,viicysysrm Iugr,eita.ueh.derv,ed p 0 Addition of nave motor load of s yst re Job#: Job site address: /O8' / / 5G '���Q ///' laaiiP or more �S7:OC note msxloatial units. ccel Percy. City/State/ZIP:IP: 0� �,��,� ❑ D i:o a oiml cohere Puna y 1 ileab:h-c:rre facilities. 0 Hxzarc one locations. U c.apply voh tgi.for mere:ran Suite/bldg.apt.#: Project name: (co vcut•nr.rn oil. 1 0 Service or feeder 6(10 amps or more. Cross street/directions to job site: G - 4/0 A//CL l t t. .r.LI,,,..!lair,, i..,.: 31 i ° 1 — c rxcnrehm___-- —J.S _I tt la _1 r t1i.[:.L..1 Nr•P;res,dentia}single-or mall i-fa mil.t dPvcllinl;unit. Subdivision: Lad#: / Includet attached garage --- 1 I•a;t map/parcel#: 76 /IQ 0 tZ wD _ Ea tdd'1500 sq.ft.or portion 13.9'2 s '` +-:s a to i'a; Limited Energy,residential i .t w. t xs s s. rU ..,,W s. -' 75.00 2 �j� with above se.ft.) f (�pa/ _ _(/� Limited energy,multi-family residential(with above so.ft.) 75 a) Ron ma ale Energy C2 S_ePapal__- s 1 ,,.,li a, •i r>t < t� r l s t f t _s �,a r �x:.,,. . r;;�i�tsN`t��l,° t -,��i��a;..;.;s,.. .e : . .,...« _ 1g Services or feeders installation,alters rout„ad/or Moodie' _, Name: B14) PAe-auye— P/ZO/gt`gr/e3 20;)am?:or less - 100.74- / 201 amp:to 400 amps 133.5,5 2 Address: 3 3 3 S. $/i ft- $f Sill iF v4 ------- ----- 401 amp:to 600 amps 200.34 ; City/State/LIP: -4it?' OsaerO 9/L 9'07¢ -.-- 601 amp:to 1,00:)amps ---301.01 1 .r Oyer 1,000 amps or volts 552.26 2 1 Phone:(03) `t36 3L/Z Fax:( ) — P — — -- -- - Temporary services or feeders installation,alteration,and/or j Email: ADB1We.)./51-( j+1Atafcf6;CQfl.( relocation _ ----•-- Owner installation:This installation is being made on property that I own which is not 200 amp: or less — 593,5 i intended for sale,lease,rent,or exchange,according to ORS 447,449.670,and 701. 201 amp.,to 400 amps _-- 125.0?_ 2 Owner signature Date _ 401 amp to 599 amps r- -- I e8.54 -- r" r ^-- , Branch zircuits_new,alteratioa3or a ttensicn...E'r pant I__-_ E``1 .s`xs tr t a I..^; ,.t.s _._�.,..0- ;. ,,it.,_: _,' A.Fe..•,c.trench circuits it itJt Business name: 3141-A 1 abase service(r fccdcr feet - - ' r _ea each branch circuit Contact name: 9.Fee`l•branch circirl5 without - ——— soviet or teeter fee,first do l:; Address: brancl circuit __________---- Eaeli add'I blanch circuit , 7.4:' -_2 1 City/State/ZIP: - - - _1 Miscellaneous(service or feeder not it eluded) Phone:( ) , Fax: :( ) Each manufactured or modular Ci7.8.1 -' —_--- dwelling_service and/or feeder Email: Reconne�l only 67.8,1 .1 rg ,r r'"C 5r, (..t ^'„! tdR �" Y r: Tr r f yi fi. 5 - :�>Yr, z,.a -i.1 t `.. .,: .., ;+ . g, :e.z..i. = Pun f or rogation circle —_— — 67.&3 ---- cit �y �r rsf ` 2 . Business name: Nv r k /EZ- G!.er IL-1 e� /w Sign or canine lighting 67.84 ,, Signal ta:crit(s)or limited-energy 0 S:e Page Address: SS7'' Loot- ',we-/Qi() ---_ panel,all trui on,or extension Each additional inspection over al:owttble in alst the above City/Brute/ZIP: RvDit)IA_ Oil_ 77064 Additicn.al inspection(1 hr min) 56.25t hr, -_ Phone:( ) Fax:( ) — Irn•estiga:icn(1 hr min) ; )0,00/lir -i--0/- -- (ndustria plant(Ihrmin) i 78.18/tn _- Ernatl: tnmpc do is for which no fee is r- )0.00'hr Z Zep(T 5- 44( s ui ,,.,listed it he nrml _ CCB Lic.. l Electrical Lic.. G�T Suprv.l.ic.:�,Z Q S �« e fr.. —,,-,,,,,,,,..,- 0i ` Suprv.Electrician signature,required: _ Si.btt,tal: _ - Print name: Date: 0 Plan Review Required(25 of pent it lee):-'c - - - Authorized signature: State surcharge(12%of plot it tee.):--_ - - TOTAL PERMIT ec): --- — r .� Tb(s pe;mlt application expires Its permf Is not ob:xbted within 180 Print name. I Date: days after it has beer aecepte i ai corngleta- " Numb,r of inspections allowed pc r pee nth. Iit3wldinKPermit•t'ELC_P`crmitilApp ELR_ERE.drx:Rcv 0M172r0015 440.4 I iI(i I iOS'CYiM/WEB V(�� ' 6— / m- • Iv Electrical Permit Application-City of Tigard w r9�{I Page 2-Supplemental Information (O 7i 1 Limited Energy Permit Fees: f`P Renewable Energy Permit Fees: x x ,o +s�, , •+ t 1....;y € e � �'i� pa}s' ' „�,`; k .l€'�i`.�a`'j�°j'';" ._.�4-`�`� ' dal .. i�'.�'�. i&T.•Et.;"e55.4 f. a ka:. :.,r� €,..E .. ... �� ..: N.acAi 'I Mat Dturlptlon — Fee for all residential systems combined: $75.00 Renews ale electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 115.01 CO 25 kva 200.34 2-I Win d eneration systems in excess of 25 kva: ❑ Burglar Alarm �25.01 CO 5o kva 301.04 2 1 50.01 to.00 kva 552.26 2 • Garage Door Opener* g I o0 loin fee in accordance ' with OAR 9Il-309-0040 552 76 2 ❑ Heating,Ventilation and Air Conditioning j Solar gt neration systems in excess of:5 kva: System* Each addition€kva over 25 ii� 7.42 1 ❑ Vacuum Systems* >100 kva-no additional charge 1— 0.0 -- i Each additional inspection over allowable in any or the above: Each additional inspection is fi;i.2S hr C Other: charged st an hourly(1 hr snit) inspections for Which no fee is 1 s listed(/hr Into) 9 I OOi br x .'y#q" RI .+ a #t:1 ppecifics ly l;. I� ylL�f .11s0'4 i ° "'f li Subtotal tamer o l Pau l):1 Fee for each commercial system: $75.00 Number of inspections alloy.ed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems O Boiler Controls O Clock Systems ❑ Data Telecommunication Installation n F• ire Alarm Installation ❑ 1• VAC n Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* j ❑ Protective Signaling ❑ Other: - Total number of commercial systems: _ *No licenses are required: Licenses are required for all other installations I�EhrIldingTormoe.ELCPo.mitApp_ELREREdoe Ai,06/17/2015 tS f Plumbing Permit Application® �+ r I Building Fixtures ITV 4 E:� l I.. II! I fi' 'ik . �' 1; O i. ,Ij 'l[ Ij ;I' City of Tigard Rec/B:,•:ved �— Q� Permit I)0_� I p 13125 SW Hall Blvd.,Tigard.OR 97223 DEC 01 2021 — —Flan kevirw --— Other P ami No. — — — Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Inspection Line: 503.639.4175 IGARD Date ReadyBy: Junin: Si See Page 21tf• CITY OF rsn,, ` bohfied/Method .,per �R III' Internet www tlgard or gov snow emental information �:115;44 ,:�` ..�F .. 4...1 9Y,+ itili i = 7i'�F t £ I k ! t„-.: , � ,Pig IOW .A� it I.111 Tt .' IN/New construction ❑Demolition Far special irtformarlon use checklist. ----- Descr,piou —_J—qN. ;_ E.1.— I Total ❑Addition.alteration/replacement ❑Other: Nev, 1-2-family dwellings(includes 150 it.1)r tact utility cceuuxtioit) `1' r:,t is st " .. -" 71 SFR(r Lath --— -- — 7 :1 t;,711 .1:4Y�"rSisraa.;c .., '1.4 4.. ..w ,as,u,..,.t.� :., .xx�ua. El 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437 78 SFR(3)bath —1 500 32 ❑Accessoy building 0 Multi-family — —'—'—" __ — ----- Each additicn d bath/kitchen , 25.0:: ❑Master tuilder ❑Other: Fire sprinkler( sq.ft.) i Page 1: 1s" : '"ik i F �I` ` ' I r 7 Site utilities: .,t dl tRI -S .,ri .t- ...,<< ;.,...::<. ., ,.1.. >.. ..,., ., . ., 1 r 1 ,_ --- —— ---- .. Job site address: Catch basin o:area drain 18.76 --- /0 5 W 5(�f/1 Nwo Nu_ Dry§veh.leach line:or trench drain T 18 76 CityiState.'Z1.P: }— / 72 7Q --- •, / C L7/U!'� O�" Y! --__.—.—____ Fooling dtaio(no.linear i[.: _) agt:- Suite/bldg./apt.no.: Project name: _ Vlanutactcred home utilities 1 50(I- Cross strecL directions to job site: e, / " Afo//fN/D ea. Manhole.------ — —�— 18.71' _ — ' Rain drain connector --1€.7r6 7— Sanitary sewer(no.linear ft.: ) I Pal;::: Storm sewer(no.linear ft.: ) ( Page 2 -- _.—._ Water service(no.linear ft.: ) Page 2 Subdivision Lot no.: / Fixture or item: ____—• _—.— ____— Tax map/parcel no: 25 Up ft-,Q 12zoo � Backflow pre'enter ---_ — — — r 1.2 t W t "g7 tr- t 1` t1 !cfp tP"ems a Backv.atcrvalve ti-51 1� ��rryy�� Clothes H as tt r 5.0-: _J tL- / (G�rlVe'G7''-- L/—Ilw, Dishw'aster I 25.0.. --- Drinking fountain 25.0=__--- ----_- Ejectors'suntf • ata JY-25.02 Pain oit r s ' t � r;tf L +.Y s 41 Expansion tank 11-51 -z t L' in �A� ' A n. — 1, '1C h Name: g1-(fr Pitt — f3/20f T2t -- Fixture/sewer cap U_ — -- ,/ Floor drain/floor sink'hub 25.0: Address: :?3 7 5. s� —s7— aC/f7� V4$S� — _ Garbage&six sal I 25.02.. City/State'ZIP: e Kt- exClf O� r170A6 -- — Hose bib 1—-- 25 0_.• ---- Phone (03) Q136 3L/2.- Fax ( ) icc maker —I l:51 ni g a 1 t 4_" t :w sr i 1£ .,t t r Interc tol/ r.use trap 25.02 1,n;l'TA1 t a. �7is.._tt"xitit>v'.-. ..'i,a ...1.- Business name: �r ,e�i Medical gas('aloe:$ ) ---Page --- Primer 12 51 Contact name: Roof drain(cotnmerc:al) --- 12..5i Address: Sink/basin'lavatory I __25.02 — City/State'ZIP: Solar units(potable water) 62.5' Phone:( ) Fax: :( ) Tub/showurishower pan 1_ --_12.5 i -- — Urinal 25.02 E-mail — -- -- —.1-:1 t 1 o Is a testi I( a Ifill a 11 Water closet _ �c 0. s ik i t..* ;-fa,r l.ita,.i, .W 1�.<. !t F ,r 5: )•t Water heater 3 i_.. Business name: t-j 1�l� split pLu/dB//V� ----- Water piping/DWV 56.29--- --- ---.. Address: 6 r3$ SE /36114` Other: _ --- 25.02 City/State/ZIP: POlLrZM D Z.- Subtotal---- -- -.-___�.— —_--- /� Minimum pelnit ten: $72.50 Phone:(923) qq7-SDI Fax:( ) — Plan review (251' o:'Ixnr.itnee) CCB Lie.: i 17 6 PlumbingLic.no.: 37(� —— ----- State surcharge(12%o`pearl t Tee) • Authorized iignatute: J TOTAL PERVEIT FEE �,� Date: Tins permit application expires It a permit snot obtained within 180 days Print name:_ e tz ] after It bus been accepted a:campktc. *Fcc methodology set by Tri-County Pudding Industry Son ice Board. I:£Building\Pcrmitc'PCMU-PcrmitApp.dnc 10/01,(19 440-4616Tt 10/02 CO'f WE3) , ,,,e6,11( Plunlbine Permit Application - City of Tigard e„, Page 2 - Supplemental Information Fee Schedule: Residential Fire Su ► ression Srieins E �,. . ,.1"w kt ll5CRit<lit ' * R��� iit� l^ *"1 ;"14T� �re t14Fill? 1 grii iii.t ii:: i,;` Footing drat,-1"100' 50.03 (I to 2,000 _ $121 90 2,001 to 3,600 $169_69 Footing drain--•ch additional 100' 37.52 3,601 to 7,200 $233/0 Sewer- 1st 100' 62.54 7,201 and greater $327.54 Sewer-eachadditiona 00' 37.52 Water Service-1st 100' 62.54 Medical Gas S 'stems: _ Water Service-each additi 100' 37.52 . , ill aj ,�.,lI °s 1. ,: .t cl"l'".u'. li pia i t13 px 1;i Storm&Rain Drain- 1st 100' 62,54 $1.00 to$5.000.00 Minimum fee$'r2 50 __ Storm&Rain Drain-each additio ^1100' 37.52 $5.001.00 to$10,000.0C $72.50 for the first$5 000.00 and 11.52 for ittOlt ., I .> each additional$100.00 o friction.hereof,to ,.. u t t....„ a',,. . and including$10,000.00.---- Inspection of existing plumbing or for $10:001.00 to$25,000.(0 $148.50 for the firs_$10,0)0.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 of 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.(0 $:79.50 for the firs:$25,0)0.00 and$1.45 for hours(minimum charge-2.hours) each additional$100.00 oa fraction thereof,to Rcinspcc:tiun Fee;; \ 90.00/hr and includin�$50,000.00. Additional plan review for revisions .0.00/hr $50,001.00 and up $742.00 for the first$.50,0)0.00 and$1.20 for each additional$100.00 of fraction thereof. 1nninimum charge-1/2 hour) - Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to 3f ,. Air a accurately report fixtures could result in increased sewer fees'. if s ' ,; T 1y rUk„ ! ,f'.. s li.iprTilitkf y�,'35 1 i ' h t , L Plan review is required for any of the following. j � � � �,a;` ,�tw~n u t":3� < �' g`V T � '� Please check all:hay apply. v;,' � ; ram.' t.; >_ _ -1- oif : ❑ Any new cutnwercial building with water service 2"and Baptistty/F t - greater,except systems designed and stringed by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure Car Wash: - ach Stall as defined in OAR918-780-0040. -D ve Thru ❑ Medical gas and vacuum systems for healtt cue facilities. Cuspidor/Water Assn for ❑ Any multipurpose fire sprinkler system. Dishwasher: -Com ercial -Domes,c ❑ Any complex structure as defined in 04.12 9 1 8-780-W40. Drinking Fnuntain Eve Wash Submit 2 sets of plans with any of the above. Floor Drain'sink: -2" t g a 3.. '1'Q ��,i '311t i r r Fri F T, ' ' Isometric or riser diagram is required for new buildings -Car wash D -in that meet the qualif.cations above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related \ -Industrial food related lee Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gras Station) \\ Rec.Vehicle Dump Station - — --__ Shower: -Gang \ -Stall `\ — -' Sink: -Lav/Bar non-food related _ -" — -Bradley -Com/ServlUtil food related -Service _ *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EllUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal • \ Other Fixtures: l:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 City of Tigard INpCOMMUNITY DEVELOPMENT DEPARTMENT ■ TIGARD Building Permit Review — Residential Building Permit #: ZOP2021-00308 Site Address: 1 D?q( SW 4 'iv1,014 Hilt j ,r.- Project Name: / tik c-((it COVr 1 Lot #: I Planning Review J ��( Proposal: A70 rI, OG4117 (!oev' 1ev'eI) yp Verify address/suite# active in Accela. ,!In River Terrace: J No ❑ Yes,River Terrace Review Addendum Site Plan Elements: erosion Control 3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper Retained trees with drip line and tree protection measures Drawn to scale(standard architect or engineer scale) Footprint of new structure(including decks)and FFE North arrow jaUtility locations&easements(required for new and additions) Site address,project or subdivision name and lot number giSidewalk/driveway approach Applicant information(name and phone number) DLetauon of wclfsfsepties*stesas.—. t dimensions and building setback dimensions ptreet tree size,type and location Street names ' Corner elevations(2'contours if more than 4'differential) 1 ALot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? fJYes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? EYes pliNo a — o 0 Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No pWater Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: tA Yes,applicant was notified ❑ No Received: [ )Yes ❑ No ie SDC Exemption for ADU applied for: p Yes ❑ No Received: ❑ Yes No Required: ❑ Yes,a plicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake IP Land Use Case#: 0 702,1. ' 000y I gi Zoning: j' 12. 411, Required Setbacks: Front: ( 5` Rear: 1✓ 4 Side: C,t Street Side: t Garage:'' 1 fI) Building Height: Max. Height: 35 t Actual Hei ht: 25, (R Landscape Area: "2-6 % gi Lot Coverage Max: 00 % Entrance [y Set back no more than 8'from street-facing wall IC> Parallel to street or offset 45 degrees or less Windows ti Minimum 12%of area of all street-facing facades Garage a e door is behind widest street-facing wall ❑ Yes ❑ No,one of the f • g is met: ❑ Door a't>' more than 5'from wall and there is a covered porch • g eyond garage. ❑ Door extends no more a ' om wall and there is a 12 . it.idow above garage on 2"d floor. ❑ Garage door width is ❑ 12'or less ❑ o facade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ Recessed e ❑ Wall o s 1'Roof eave ❑ Roof offset i ❑ Fire shingles ap Siding ❑ Roof pitch ❑ Gable,hip,o rel roof ❑ Dormer t siding ❑ Window trim ❑ Window recess ❑ Window proj • ❑ Balcony le Visual Clearance ❑ Urban Forestry Plan g Sensitive Lands: ® Yes ❑ No Type: 0 Conditions met prior to issuance of building permit Notes: it Approved By Planning: Date: r7/ 21 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: 0 Approved 0 Not Approved ElBuilding1Forms1BldgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: L 2/4U f/242j Site Plans: # 3 Building Plans: # Building Permit#: 121'Enter building permit#above. Workflow Routing: ✓❑.Planning ©'Engineering ©"Permit Coordinator �l�uilding Workflow Sign-off: C'Sign-off for Planning(include notes from planning review) Route Application Documents: [v]'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 caldulations and trust tails,if applicable, etc. Notes: By Permit Technician: Date: 09 202 Engineering Review LVJ Slope at building pad: .cP K' Conditions "Met"prior to issuance of building permit VEasements (encroachments) per engineering conditions of approval and plat 171-Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes VNo Assess Water Quantity Fee in-lieu: ❑ Yes C"No LIDA Facility on lot: ❑ Yes 1Er No Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: Date: /2 / Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review /Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: SDC Exemption: Received D ' ` oes not apply pY'" eet • � SDC Fees Entered: Wash Co Trans Dev Tax: �/Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA ❑ Yes 1 N/A /OK to Issue Permit Approved by Permit Coordinator: Date: 121!51Zo Z I I:\Building\Fonns\B1dgPennitRvw_RES_122419.docx RECEIVED i 71 . City ofTigard JAN 1 0 2022 ~ FINANCE DEPARTMENT Systems Development Charge (SDC) Exem ,t��°���® rl to U,ton TIGARD p t REQUEST FOR ACCESSORY DWELLING UNIT (ADU) SDC EXEMPTION (Allowed under TMC 3.24.100.F) Note:Refer to TMC 3.24.180 and the SystemsDevelopment 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 : 10691 swAnnana Hill Ct Tax map and tax lot numbers: 2s 110 ad 12200 Land Use Approval Case Number: MAP 2020-00002 ADU 2020-0021,0022,0023 Type of Unit Total Units Square footage of each unit Attached ADU 1 676 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@bluepalouse.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 (Air$nb, 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 I'r crty owner signature Print Name Datc 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 be sent to SDC(atigard- or.gov 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@tigard-or.gov or 503-718-2415. sT\I 1= t`SI: ONI.\ Date Received: 11/23/21 Approved by: Christine Baker 1/6/22 Date.11/23/21 Amount of SDCs Exempt$11,719.00 Park $7,591.00 Transportation $ 198 00 Page 12 Rex. 10 21 DocuSigh Envelope ID:SC9OFBCB-4D05-4DF5-AF50-2F06296F94F1 Washington County,Oregon 2021.127147 12/10/2021 01:56:00 PM D-IRUL Cnt=1 Stn=10 A DUYCK $35,00$5,00$11.00$60.00-Total=$111.00 RETURN TO: City of Tigard Finance and Information Services 02832395202101271470070070 Contracts&Purchasing i Joe Nelson,Director of Assessment and Taxation .. 13125 SW Hall Blvd. and Ex-0Riclo County Clerk for Washington County. Tigard,OR 97223 Oregon,do hereby Certify that the within Instrument of writing was received and recorded In the book of f. ) records of said county ' , . 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 10891 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 I of 7 DocuSign Envelope ID:8C9OFBCB-4DD5-4DF5-AF50-2F06298F94F1 , 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 foreclosure 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 DocuSign Envelope ID:8CbOFBCB-4DD5-4DF5-AF50-2F06296F94F1 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 Agreement 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 NAMiy By:_..y � -_ Signature Name: 5 7b 1 f.`3L61+ a lkik-Ale STATE OF 0 U 11 ! ' ) ss: County of LdG'iIi 101 The foregoing instrument was acknowledged before me thisQday of`Jte i , I ,by Nib e, aktithew5 . n tricut6t,mou/' Notary Public for the State of O ✓ My commission expires: !2 ! S I / w ,c I= � OFFICIAL STAMP TONI A RICCARDI NOTARY PUBLIC-OREGON ` COMMISSION NO.1012794 MY COMMISSION EXPIRES MAY 31,2025 SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 4 of 7 DocuStgmEnvelope ID:8d9OFBCB-4DD5-4DF5.AF50-2F06296F94F1 CITY: CITY OF TIGARD,an Oregon municipal corporation Doeusbsid by: SkiAt. rttatit By: Steve Rymer,City Manager SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 5 of 7 DocuSign Envelope ID:8C9OFBCB-4DD5.4DF5-AF50-2F06296F94F1 EXHIBIT A LEGAL DESCRI ON OF THE PROJECT A tract of land situated in the Northeast quartet 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,EnveIope ID:8d9OFBCB-4DD5-4DF5-AF50-2F0B296F94F1 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: 10891 Armand Hill Ct,Tigard,OR 97223 SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 7 of 7 • t'tt fitlit tHY ... .ii.t;»w.u.iiiO4.0.,.44..w.Ee#t shawl kta,u.,4i.•. Washington County,Oregon 2019-087839 RECORDING REQUESTED BY: D-DW � Stn=B J CHOATE 12/04/2019 01:34:35 PM d r vyers Title, $15.00$11.00$5.00 S60.00$336.00 $427.00 • J`•' eto..e.,.,u.c 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 Hobemicht,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 6 333 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 APN: R1014397 j Map: 2S110AD08805 No Situs Address,Tigard,OR 97224 SPACE ABOVE THIS LINE FOR RECORDER'S USE ., STATUTORY WARRANTY DEED Joseph M Van Lom and Cynthia S Van Lom, Trustees of the Joseph M Van Lom Trust dated 1212112006, 4. Grantor, conveys and warrants to Blue Palouse Properties LLC, an Oregon limited liability company, f"f 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/Updated: 04.26.19 Page 1 OR•LT•FXEB-01060.474579-161901394 x..aa.ea x.ru[n'ww xafw.a:.aar uaneaxev nart.{as>a. s r f'ftte.4it usaw..a.ua« .xuiiciGst4WFntMiaaNNlMttWiYtHiiutsiIIekA.ra>a+F»SiWkYtYiRKlreLUurWur artre54.txksetbr:Mli..aakYk3t {axMxrutrect«lWedFfxlt 54etraSitlaliM'-ti w,ytiaxaua.,«e..,. 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 undersignedj' have executed this document on the date(s)set forth below. Dated: '�t I I I Lt,�2 Joseph aniom Trust d ed 12/21/2006 BY: , ' al, V , Jos h Van Lom Tru t E BY �rr6;'t, '�(,�{, 1J, i0 �' i11/W 1 I Cyn:hla S Van Lom Trustee State of County of (`4"i-t fl This instrument was acknowledged before me on -� �''f by Cynthia S Van Lam, as Trustee for Jos h W aniom Trust dated 12/21/2006 and Jose 1 M Van Lom,as Trustee for Joseph M Vanlom Trust dated P p 12/21 0 6. 4 Notary Pub!' -State of Oregon --) My Commission Expires: ( '_`,._. `�" """�� %*: � OFFICIAL STAMP w NOTARY_ DEB�RA PUBL1C-OR®ON N �tr COMMISSION NO. 947119 rt1Y COMMISSION EXPIRES FEBRUARY 03,2020 Deed(Statutory Warranty) QRD1293.doc/Updated: 04.26.19 Page 2 OR-LT-FXES-01 O60.474579.161901394 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) ORb1293.doc I Updated: 04.26.19 Page 3 OR-LT-FXEB-01060.474579-161901394