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Permit . . /111 Building Permit Applicatio>r}'"t--ECEIVED 31 2, 1411r°44 Residential � FOR OFFICE USE ONLY 312021 City of Tigard AUG Date ReceiBvey:d C / Z/ /,Q Penult NotiSf �f ' -t 2 D 35? 1,1 a 13125 SW Hall Blvd.,Tigard,OR 97223& OF TIGAR D Plan Review C Phone: 503.718.2439 Fax: 503.598. DateB : 0 J OtherPerpg� 2. ,©0 3 / TIGARD Inspection Line: 503.639.4175 � �WING Q��� ���1 Date Ready/>y: J &I See Page 2 for Internet: www.tigard-or.gov No ed Method: bit/it �� ftf�� e Supplemental Information fit!- - G TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. dwellingValuation: ® 1-and 2-family $ �t�17 0-\‘ ❑Commercial/industrial ❑Accessory building 0 Multi-family Number of bedrooms: 4 ❑Master builder 0 Other: Number of bathrooms: 2 Q JOB SITE INFORMATION AND LOCATION Total number of floors: 3 332 O Job site address: 16635 SW DARWIN LOOP New dwelling area: 2,966 square feet lCS% City/State/ZIP:Sherwood, OR 97140 Garage/carport area: 422 square feet 1 4 Suite/bldg./apt.no.: Project name:Polygon at Roshak Ridge Covered porch area: `7( square feet gab Cross street/directions to job site: Deck area: 1li;j square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Polygon at Roshak Ridge Lot no.: 224 Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. New Construction/Type: SFU /Elevation plan: 222403 D Valuation: $ 17 Deferrals:YES-deferral of TSDC fees and park SDCs until occupancy. Existing building area: square feet Projected start: 2022 New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:Polygon Homes WLH LLC Type of construction: Address:703 Broadway St., Ste 510 Occupancy groups: City/State/ZIP:Vancouver, WA 98660 Existing: Phone:(360) 946-8674 Fax:( ) New: ® APPLICANT 0 CONTACT PERSON 0i9 BUILDING PERMIT FEES* Business name:Polygon Homes WLH LLC (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name:Omar Alami Abouhafs FLS plan review fee(if applicable): Address:703 Broadway St., Ste 510 Total fees due upon application: City/State/ZIP:Vancouver,WA 98660 Phone:(360)946-8674 Fax::( )360 693-4442 Amount received: E-mail: permitsubmittals@taylormorrison.com-OAlamiAbouhafs@taylormorrison.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name:Polygon Homes WLH LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:703 Broadway St., Ste 510 Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review ty Vancouver WA 98660 and administrative fees): $180.00 Phone:( )360 695-7700 Fax:( )360 693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 Total fee due upon application: $201.60 Authorized signature: Oilf.4 t.4 Z-46.91.1� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name:Omar Alami Abouhafs Date: 08/24/2021 Service Board. 1:\Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) .,-- . , Mechanical Permit Application IIIIIIIIIIEEIIIZIETIIIIIIIIIII City of Tigard Received 11, .. It 13125 SW Hall Blvd.,Tigard,OR 97223 ' 1 : Phone: 503.718.2439 Fax: 503.598.1960 Date/By. Petmit No.: Plan Review Datc/Ety: Other Permit: Inspection Line: 503.639.4175 IMAM) Date Ready/By: Juris- El See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees°are based on the value of the work Z New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. _ Value:S CATEGORY.OF CONSTRUCTION RESIDENTIAL EQUIPMEiNT/SYSTEMS FEES" Da I-and 2-family dwelling El Commercial/industrial 0 Accessory building For special information use checklist Multi-family n Master builder 0 Other: _Description Qty. Ea, Total Heating/cooling: JOB SEER INFORMATION AND LOCATION Air conditioning I 46.75 Job site address: 16635 SW DARWIN LOOP Furnace 100.000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97224 Furnace 100,000t BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Polygon at Roshak Ridge Duct work 23.32 ............... _ Cross street/directions to job site: Hydronic hot waterlystem 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 ........._.....„.„.... — - Flue/vent for any of above 23.32 Other: 23.32 Subdivision: Polygon at Roshak Ridge . Lot no.: 224 , _ Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 - Flue vent for water heater or gas New construction-Type SFU fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert _ 23.32 Chimney/liner/flue/vent 23.32 Other 23.32 e, PROPERTY OWNER . 0 TENANT t — Environmental exhaust and ventilation: Name:Polygon WLH,LLC Range hood/other kitchen equipment 33.39 Address:703 Broadway St.,Ste.510 Clothes dryer exhaust 33.39 -- City/State/ZIP:Vancouver,WA 98660 Single-duct exhaust(bathrooms, - toilet compartments,utilitylooms) 23.32 Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32 0 APPLICANT 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name:Polygon WLH,LLC ....._ — $14.15 for first four;$4.03 for each additional Contact name: Omar Alami Abouhafs Furnace,etc. - — Gas heat pump Address:703 Broadway St.,Ste 510 — Wall/suspended/unit heater City/State/ZIP:Vancouver,WA 98660 Water heater --- Phone:(360)695-7700 Fax::(360)693-4442 Fireplace Ranee E-mail:permitsubmittals@taylOrMOrfiSOILCOM Barbecue "At CONTRACTOR Clothes dryer(gas) Other: Business name:Pro Heating&Cooling MECHANICAL PERMIT FEES' Address: NW klociek Dr,Ste. 1104 Subtotal ..... City/State/ZIP:Hillsboro,OR Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(360)270-1590 Fax:( ) State surcharge(12%of permit fee) CCB lic.:209001 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180— ‘1.i,a, le,c_Jul..4, days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name:Ella Duran Date: 1 0/30/20 t,iTiniklmo1P,rntraMlqi"P.rrnit..n„mom an, Electrical Permit Application FOR OFFICE i'SF ONLY City of Tigard Recei` ' Dement t 1�ate D_v • 13125 SW hall Blvd.,Tigard,OR 97223 Plan Review F_..._ ill' Phone: 503.718.2439 Fax: 503.598 1960 1)atc,By. Related Permit i1 Inspection Line' 503.639 4175 '('1 tiA.R U heady t)amBy. turn: B(See Page Z for Internet: www.tigard-or.gov _NohfrcdIMcdiod_ Supplemental Information TYPE OF WORK PLAN REVIEW El New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wiitems checked) El Demolition Otter: ❑Some or feeder 400 amps or morn ❑Budding over three stones. where the available fault current 0 Marinas and boatyard, CATEGORY OF CONSTRL:C ioN exceeds 10,000 maps at)50 volts of 0 Floating bwidrnps M 1-and 2-ftemity dwelling ❑Commercial/indtutrial ❑Accessory building less to wound,or Cxeeeck 14A00 El d onantercial-sex agficuhurxl amps fen all other installations buildings ❑Multi-family ❑Master builder ❑Other: ❑Fire pump 0Installation of 150 KVA or JOB SITE INFORMATION AND I AH`,ATION ❑Emergency system larger separately danced Job it: 1 Job site address:16635 SW I)ARWIN LOOP ❑Jtddtioo 10011P or m more.ornee. otorktsd of systw,. ❑"A"."k;" "1-2"."1-3", City/State/ZIP: Tigard,OR 97140 ❑SIX of more residential units occupancy -_.. ..,_ ['Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Polygon at Roshak Ridge 0 Hazardous locations 0 Supply voltage to wore than ❑Service or let-de,600 amps or more 600 cola aomar al Cross street/directions to job site: FEE SCHEDULE .... 1 atactiptioe 1 r?t7• I Each l 'total I • New residential single-or multi-family dwelling unit- Subdivision:Polygon at Roshak Ridge Lot#: 224 Includes attached garage. Tax map/parcel ': 1,000 sq th or less 168 54 4 Ea.add'l 500 sq.tt,or portion 33.92 1 _ry DESCRIPTIONaI ►ORK Limited energy,residential New construction.Type SkU (with above sq.ft.) 75_00 2 Limited energy,multi-family 75 00 2 residential(with above sq.ft.) Renewable Energy 0 Sec Page 2 © PROPERTY OWNER I ❑ TENANT Servicts or feeders installation,alteration,and/or relocation Name: Polygon Homes WLH LLC 200 amps or less 100.70 2 Address: 703 Broadway St.,Ste 710 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200 34 s 2 City/State/ZIP: Vancouver,WA 98660 Got amps to 1,000 amps 301 04 2 Phone:(360 )946 8674 Fax:( ) Over 1,0130 amps or volts 552.26 v 2 Email: OAltbmiAboullafs to lormorrison.com-PermitSubmittal data•lorrnorrison.com Temporary services or feeders installation,alteration,ane/nr y �.� Y relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amiss to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168 54 2 Branch circuits—new tcratidm,or extension per paged 0 APPLICANT 1 ❑ CONTACT PERSON A Fee for branch circuits with Business name: Polygon Homes WIN LLC above service or f-e din fee, 7.42 each branch circuit Contact name: Omar Alami Abouhafs B Fee for branch circuits without Address: service or feeder fee,first 2 703 Broadway St.,Ste 710 _ branch circuit 56.18 City/State/ZIP:Vancouver,WA 98660 Each add't branch circuit 7.42 1 2 Phone: 360 946$674Miscellaneous(service or feeder not included) ( ) Fax::( ) Each manufactured or modular 67 84 2 dwelling,sen1ce and/or feeder Email:OAlamiAbouhafs ittaylormorrison.com-PclmilSubmittals@taylnrmomson.com Reconnect only 67 2 CONTRACTOR Pump or rnrgxtiun circle 67.84 2 Business name: Wallace Electric Sign or outline lighting 67.84 2 signal circuits)or limited-energy Address: 105 Dresden St panel,alteration,or extension. ❑ See Page 2 2 Ci /StatelZlP: Each additional inspection over allowable in any of the above tY Astoria OR 97103 Additional mspecuon(1 hr min) 66 25/hr { Phone:(503 308 0563 Pax:( ) Int cmugation(1 hr min) 90,0X)/hr Entail: Dar id*waI lslCcwires.Com Industrial plant(1 hr min) 78 IVhr Inspections for which no fee is CCII Lie.:224868 Electrical Li" C 1441 Su v.I: :: 6363S specifically listdxi(%hr min) 90 011f hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: — ark......**- ! subtotal Print name: J tp o , rz. Date: ` /, /z a, ❑Plan Review Required(25%of pemtit foe): / (y State surcharge(12%of permit fee) Authorized signature _ ,/ TOTAL PERMIT FLU: Tftis permit application expires if a permit is not obtained within 180 Print name: ;�. _�� Date: /�I days after It has been accepted as complete_ dl'ai ( ' Number of mspectrons allowed pet permit. 1.18teldingPemtilitaC_ensaApp_EIR ISRE.doe RevOt/l'J120li 4-6-7615T(lIi05,C0WWEB Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of Ti and Received g Date/B Permit Na.: .t 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 11111 s Phone: 503.718.2439 Fax: 503.598.1960 Datc!dv: Other Permit No.: It G A R D Inspection Line: 503.639.4175 Date Ready/By: tuns: Ea See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist. . �.. - Description I Qty. I Ea. 1 Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 Xl-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building -Multi-family SFR(3)bath 500.3? Each additional bath/kitchen 25.02 tl ❑Master builder 0 Other: Fire sprinkler(__sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 16635 SW DARWIN LOOP Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name:44aapiwirikieraPolygon at Roshak Ridge Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 1 drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft,:®) Page 2 Subdivision: Polygon at Roshak Ridge Lot no.: 224 _ Fixture or item: Tax map/parcel no.: Back-flow preventer 31.27 fDESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 New construction-Type SFU l Dishwasher 25.02 Drinking fountain 25.02 i Ejectors/sump 25.02 0 PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name:Polygon VVLH,LLC Fixture/sewer cap 25.02 Address:703 Broadway St.,Ste 510 Floor drain/floor sink1hub 25.02 Garbage disposal 25.02 City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02 Phone:(360)695-7700 Fax:( ) lee maker 12.51 ® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Polygon WLH,LLC Medical gas(value:S ) Page 2 Contact name: Omar Alami Abouhafs Primer 12.51 Roof drain(commercial) 12.51 Address:703 Broadway St.,Ste 510 Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 -Tub/shower/shower pan 12.51 E-mail:permitsubmittatstrr polygonhomes.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 1 37.52 Business name:G&B Plumbing&Sons Inc Water piping/DWV 56.29 Address:P.O.Box 92 Other. 25.02 City/State/ZIP.St.Paul,OR 97137 _Subtotal Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit fee: S72.50 Plan review (25%of permit fee) CCB Lie.:184372 Plumbing Lie.no.:pb634 State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name:Steve Fowler Date: 10/30/20 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. "Fcc methodology set by Tri-County Building Industry Service Board. 11Buildine'Pcrn its\PLMU.PermitAppdnc IWOIM) 440-4616T((0,02±COM•1vEa) City of Tigard IIr COMMUNITY DEVELOPMENT DEPARTMENT 1 f T i G A R D Building Permit Review — Residential Building Permit #: iti 5 12...c 2.1 --0 0 3 _5 7 Site Address: 16635 SW Darwin Loop f` Project Name: Polygon at Roshak Ridge Lot #: 224 Planning Review Proposal: New house t1 ® Verify address/suite# active in Accela. ® In River Terrace: 0 No n Yes, River Terrace Review Addendum Site Plan Elements: IEErosion Control E3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper 0Retained trees with drip line and tree protection measures ®Drawn to scale (standard architect or engineer scale) ®Footprint of new structure(including decks)and FFE ❑X North arrow ®Utility locations&easements(required for new and additions) ®Site address,project or subdivision name and lot number ®Sidewalk/driveway approach t ]Applicant information(name and phone number) ifiLocation of wells/septic systems ii ®Lot dimensions and building setback dimensions EStreet tree size,type and location fU3quare footage of buildings to be demolished ©Street names FFxisting structures on site 1L]Corner elevations(2'contours if more than 4'differential) i �C]Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? [ J s ❑No impervious area(applicable if R-7 R-12 R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes ❑No , E Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified 1] No Received: ❑ Yes ❑ No ® Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs 3 Required: ❑ Yes,applicant was notified al No Received: ❑ Yes ❑ No 0 SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No ® Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ® No Applied For: ❑ Yes ❑ No,stop intake PE Land Use Case#: SUB2015-00004 © Zoning: R-7 ® Required Setbacks: Front: 8 Rear: 10 Side: 3 Street Side: na Garage: 20 k7 Building Height: Max.Height: N/A Actual Height: El Landscape Area: 20 % X❑ Lot Coverage Max: 80 Entrance ® Set back no more than 8'from street-facing wall ICI Parallel to street or offset 45 degrees or less Windows K] Minimum 12%of area of all street-facing facadesF: 14%I R: 19% Garage IE Garage door is behind widest street-facing wall ® Yes ❑ No,one of the following is met: ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage. ❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor. $7 Garage door width is ❑ 12'or less ] 50%or less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony K] Visual Clearance ® Urban Forestry Plan ip Sensitive Lands: ❑ Yes x❑ No Type: ® Conditions met prior to issuance of building permit Notes: MMD2020-00044 only required to eet standar s in 8.290. 0 Approved By Planning: Date: 9/2/2021 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: gl 3 t/2-/ ', Site Plans: # `3 Building Plans: # 3 Building Permit#: Enter building permit# above. Workflow Routing: E"Planning ,engineering ❑ Permit Coordinator uilding Workflow Sign-off: g'Sign-off for Planning(include notes from planning review) Route Application Documents: I 'Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. C building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: ,0407- er-2---- Date: 9/s/Z-/ Engineering Review Pi/ at building pad: 2,� B I(�Q,/Conditions "Met"prior to issuance of building permit I!d Easements (encroachments) per engineering conditions of approval and plat [C/cvater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ['No Assess Water Quantity Fee in-lieu: ❑ Yes QrNo LIDA Facility on lot: ❑ Yes 'No inal Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: VApproved 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 /I Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: 4 Yes ❑ N/A / Tigard Trans SDC: 4 Yes ❑ N/A Parks SDC: AlAi Yes ❑ N/A LIDA ❑ Yes X N/A /yJ OK to Issue Permit Approved by Permit Coordinator: fn Date: ��C (2o2_ 1:\Building\Fonn s\BI dgPerm itRvw_RES_122419.docx City of Tigard Deferral Until Occupancy Request T I GARD Washington County Transportation Development Tax (TDT),Transportation and Parks System Development Charges (SDCs) qi#0,004#47MAIIMPAWCIAMWOM~AVItaf far This form is to be signed and submitted prior building permit issuance or, if no building permit is required,then upon land use approval(TMC 3.24,as amended by Ordinance No. 21-09). Date: 11/3/2021 Site Address: 16635 SW Darwin Loop Project Polygon at Roshak Ridge Land Use Case or MST2021-00357 Name: Building Permit#: Tax Lot 2S107AA22400 Total Parks $8,017.00 #: Lot 224 Amount*: TDT Total TSDC Amount: N/A Amount*: $3.658.0 *The total TSDC amount shown above is the sum of$ 0 for TSDC-Improvement,$ 386.00 for TSDC- Reimbursement,and$3.272.00 for TSDC-River Terrace,if applicable.. *The total Parks SDC amount shown above is the sum of$6,278.00 for Parks-Improvement,$ 1,739.00 for Parks- Reimbursement,and either$ N/A for Parks-Neighborhood or$ 0 for Parks-Neighborhood River Terrace. This constitutes my request to defer payment of the TDT,TSDC, and Parks SDCs, as provided above, until occupancy. Payment of the TDT,TSDC, and Parks SDCs may be deferred until issuance of the occupancy permit. In requesting this option, I understand that any deferred TDT,TSDC, and Parks SDCs must be paid prior to final inspection or issuance of an occupancy permit. TDT may only be deferred if the TDT is greater than the amount for a single-family residence. I further understand that the amount of TDT due on deferred obligations shall be the amount in effect at the time of issuance of the building permit. For a deferral request to be accepted both the Property Owner and the Developer must sign this request. Property Owner: O n44 •Akmtu.A6au Date: 11/4/21 Developer: OtrcaA,Warn";,c46er.e Date: 11/4/21 Permit Coordinator: Alr,6 iNtitetrb Date: 11/3/2021