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Permit
r FOR OFFICE USE ONLY-SITE ADDRESS: This form is recognized by most building departments in the Trj-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ■ 4 II Transmittal Letter T 1 G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.7182439 • www.tigard-or.gov TO: 4D/ 1i444 di DATT:ntED.: WED DEPT: BUILDING DIVISI APR 2 6 2022 FROM: c 17,/ Z. /' ,. CITY OF TIGAHL COMPANY: 3UILDING DIVISION PHONE: jy/ %/ -5337 By EMAIL: ' le 9 RE: /Zf 32i/. in y 5/ /ram IJ,P /42 7 O,iZ / J (Site Address) ‘, 77Z.L (Permit Number) 15("1 ' GWi,Iti 4rOu /,o-f ZI i5"34/COO MOO(Project name or subdivision name and t number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 1 Additional set(s) of plans. Revisions: Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. I Beam calculations. 1 Engineer's calculations. Other(explain): REMARKS: i FO FFICE USE ONLY Routed to Permit Technic'.n: te: �i2 Initials: A-A-- Fees Due: n Yes V Now Fee Descripion: Amount Due: $ ./� � 1v p $ Special Instructions: Reprint Permit (per PE): Yes E No" E Done R , Applicant Notified: Date: ' // fu-- Initials: CITY OF TIGARD MASTER PERMIT '. 1.•. COMMUNITY DEVELOPMENT Permit#: MST2022-00105 Date Issued: 05/23/2022 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S134CB01800 Jurisdiction: Tigard • Site address: 12132 SW SUMMER ST Subdivision: SUMMER HILLS PARK Lot: 21 Project: Boren-Lamb ADU Project Description: New 616 sq.ft.detached ADU. NO FINAL INSPECTION UNTIL WATER METER IS UPSIZED. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 1 First: 616 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 13.75 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 20 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 616 sf Value: $95,205.92 Rear: 5 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 1 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: D Storm Sewer: 0 Tubs/Showers: 1 Garbage Disp: 1 Water Heaters: 1 Water Lines: 200 Catch Basins: 0 Bckfiw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 1 Backwater Value: 0 Other Fixtures: Drywell-Trench Drain: 1 Other Fixture Units: MECHANICAL • Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 1 Electricity Heat Pump: Y Hoods: 1 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets. 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: D 0-200 amp: 0 W/Svc or Fdr'. 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y Other: N Other Description: Ecompasing, BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW ADU VB R-3 616 Owner: Contractor: LAMB,RICHARD PIERCE& JANNA MAENW TACTICAL DESIGNS LLC Required Items and Reports(Conditions) 12130 SW SUMMER ST 1931 SE 143RD AVE 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 PORTLAND,OR 97233 PHONE: PHONE: 971-888-1168 FAX: Total Fees: $13,380.18 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 C Those rules'' dd are set forth in OAR gc9_nnt_nnln rhrn„nh r sR 0c,Jin1-nnan Vn,mn nv of That n data nr Ara.",ni iacflnnc to nl Inic by ncllinn cm;9 1Qa7 1 a G%3 �� Issued By: Fermittee Signature: • all 503.639.4175 by 7:00 a.m.for the next available tnspec ri dat . This permit card shall be kept in a conspicuous place on the job site u il,co etion of the project. Approved plans are required on the iob site at the time of each Inspection. Building Permit Application • ' Residential R `CEIV FOR OFFICE USE ONLY Received ,i ( "^i .[ City of Tigard 1 gtv/ry Date/By: 1 ( t( fs!/ J� Permit No.: MST 1 n'Zio �, GUtG W • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review . '� a Phone: 503.718.2439 Fax: 503.598.1960 CI TY OF TIGARD DateBy: /�/ 2' _ Other Permita4_,26Z—i qg TIC A R D Inspection Line: 503.639.4175 RV' t 1,.�ryP1RLJS Date Ready/By: !!v /}y t�s: ® See Page 2 for Internet: www.tigard-or.gov BUILDING DIVI8I \Noti�tieed/1Method:5/ / Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING New construction ❑Demolition Permit fees*are based on the value of the work performed. Q /i Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement Other: `l,9U equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. /5/ X G)� ❑ 1- d 2-familydwellingValuation: 8�rf�G94�—"I2fiir4,- p�(�� r ❑Commercial/industrial Accessory building 0 Multi-family Number of bedrooms: I ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: I Job site address: /2/1 Z J/ ,,,,.,tom `64 New dwelling area: 67/6) square feet City/State/ZIP: Tp� O/ 9''7.023 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: gi e9m5/20 k1i, Covered porch area: square feet Cross street/directions to job si �,'Lf/J9dtt9Gl� t l�5/-J.7 Deck area: a _ 2� quaze feet F‹51/r�# ,/ G(�'ve ue—frGie//�'/' Other structure are5:' 1quare feet YG 1n W 6'`j{ Q h . REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:S4r�, er- �5 f'die" �'C�t no.: ' Permit fees*are based on the value of the work performed. Tax map/parcel no.: / J /3 9 ce 0/ 200 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the ,A�/ DESCRIPTION OF WORK work indicated on this application. lV u' .dCTiwe ilo" 63,,,,..e7, '� 5 G�/�P��/�l /'1� Valuation: $ QT ..-Ali.-- a 0,� if P �l/G. f5> frilk/ Existing building area: square feet ii'V�r / New building area: square feet nit/PROPERTY OWNER 0 TENANT Number of stories: Name:``/,7/14,i �r.ey- r .416 Type of construction: Address: /2 f 3 g5 ,i 0 ,5-urfr7 Y LC/ Occupancy groups: City/State/ZIP: T ,.� 4 97ZZ.� Existing: Phone:(�f/ ) 2 S 3--5 - Fax:( ) New: APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Iffleuse refer to fee schedule) Business name: Structural plan review fee(or deposit): Contact name: , l an Iv l Nrb FLS plan review fee(if applicable): Address: 17,i 60 5-1,43 6, ,1 yytQr,S4 Total fees due upon application: City/State/ZIP: -f; ar6 92 9- ?Z 3 Phone:(C I ) -� 2 f-' Fax::( ) Amount received: E-mail: ' PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Jzt N�1/7�1 Commercial and residential prescriptive installation of NTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: I/j J!/ / �RC I �ls/ .f' ' L�G Submit two(2)sets of roof plan with connection details /� v l J and fire department access,along with the 2010 Oregon Address: /c7-./ r 5! / /y3 /9�' Solar Installation Specialty Code checklist. City/State/ZIP: /�a/f/�srd Z 2 9713 3 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(77/) /� /l(O Q Fax:( ) State surcharge(12%of permit fee): $21.60 CC lic.: 212 t!/ Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: /_ / Date: /l *Fee methodology set by Tri-County Building Industry Gf�1719 ��7`�y Service Board. I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440.4613T(I 1/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY ., City of Tigard Received Permit No.: II • 13125 SW Hall Blvd.,Tigard,OR 97223 AssoBy. 6 Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: TIGARD 24-Hour Inspection Line: 503.639.4175 El Electrical ❑ Plumbing El Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Ves No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. L4 ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. El ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ID 6 Sewer permit. ❑ ❑ 0 7 Water district approval. El ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ 0 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- El ❑ ❑ basin protection,etc. ,�,/ 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state (E ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed if copyright violations exist. —/' 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if �y ❑ ❑ there is more than a 4-ft. elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size V ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, Or ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. �/ 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- [ ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ei ❑ 0 Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- Er ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. ,/ 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing Er ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ 0 0 systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ architect licensed in Ore:on and shall be shown to be a r r licable to the r ro&ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 0 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. C\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application (/�� (�/CC FOR OFFICE USE ONLY City of Tigard V I V L Dateivyd l 4 J 7, Permit No ' • 13125 SW Hall Blvd.,Tigard,OR 9722 V Date B : (/ r` lrl � (N ZZ aQ'ay = an Review ,'ry Phone: 503.718.2439 A .' 1 4 Z011 Date/By: Other Permit: 9,1 pf�'®//,nVZ , /t}ryK.�('( T I G A R IJ Inspection Line: 503.639.4175 Date Ready/By: Juris: El See Page 2 for V w 1 v Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information h 'D}lI TYPE OF W' hft th��tltula 13114SIOI` COMMERCIAL FEE*SCHEDULE USE CHECKLIST New construction 0 Addition/alteration/replacement Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition El Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling ❑ Commercial/industrial Aou sort'building ❑ Multi-family El Master builder E Other: For special information use checklist. Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: l I Z' .?,j iV s 1 „no� Air conditioning 46.75 � y Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: TrI 07„ Qe C/ 77Z 3 Furnace 100,000+BTU(duets/vents) 54.91 Suite/bldg./apt.no.: Project name: Geri//24 '46 fi( Heat pump I 61.06 Cross street/directions to job site: c5� S�nrrr¢r�..S1 Duct work 23.32 L 'j�T Hydronic hot water system 23.32 /z 5T 5/ Residential boiler(radiator or l / hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Lot no.: Other: 7� 23.32 Tax map/parcel no.: Other fuel appliances: Water heater ( 23.32 2'3 52 DESCRIPTION OF WORK Gas fireplace/insert 33.39 �(6 �/J I/ e4 lle-Ge�©/� Gl/ Flue vent for water heater or gas � /� fireplace 23.32 5f-if/71 q/ /Pq/'. �� f/ , Log lighter(gas) 23.32 ���G� Wood/pellet stove 33.39 " `"`�/ (df�/J/J �� iQ/,` Wood fireplace/insert 23.32 // Chimney/liner/flue/vent 23.32 J4'1 13PERTY OWNER 0 TENANT Other: 23.32 Name: %` �� {� Environmental exhaust and ventilation: �/ �h ( lP / Range hood/other kitchen Address: /� Q / ,. ts�s � t�}� equipment I 33.39 Clothes dryer exhaust I 33.39 City/State/ZIP: 7i` �.7 Fi( ,e, 97 ZZ 3 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) I 23.32 Phone:(S V/) j,, eye) 5 5"-. "7_ Fax:( ) Attic/crawlspace fans 23.32 L' APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: ari41ff /Gib Furnace,etc. Address: 1242 5 J �� e, Gas heat pump City/State/ZIP: J!/r ��/ae Q' Z 7 Wall/suspended/unitterhea heater , // !� Water heater Phone:(x7/I) f o SS 37- Fax: :( ) Fireplace E-mail)Ci NNd FJMT 0 ,,,f, ,/ar,-, Range COl4x .ACTOR Barbecue Cloth a Other ) 9/ (Ski/ dryer(MECHANICAL PERMIT FEES* Business name: �Qiea1 � �5 �� - Address: / ✓Y3 A City/State/ZIP: �or�/Gfid ge ( Subtotal 7Z 3 Minimum permit fee($90.00) Phone:( 71 ) 08 /l(o ( > Plan review(25%of permit fee) � Fax: State surcharge(12%of permit fee) CCB lie.: a �G Q cO TOTAL PERMIT FEE t This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board Print name: �� �' �y�� Date: l/��//�/f I:\Building\Pemmits\MEC_PermitApp_082520.doc 440.48%17T(11102/COMNJE`B) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information , Commercial Submittal Requirements: • (2) sets of plans, drawn to scale. • (2) sets of equipment cut sheets. • (2) copies of site plan for ground and roof top equipment location and screening per Tigard development code. Commercial& Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. I:1Building\Permits\MEC_PerniltApp_082520.doc 2 • ti„ `Electrical Permit Application FOR OFFICE ESE ONLY City of Tigard RECEIVE L Re°iiDateJnved Permit tit r a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.7182439 y ,no, Dale/B : Related Permits: Email: TlgardBuildingPennits atTigarc.or.gd,1l .L AY LU Ready Date/By: hots: El Sec Page 2 for 1 ic,A It l> Inspection Line: 503.639A175 Internet: www.ligard-or.gov Notified/Method: Suppl:mental Information ;.3 sy's.3' lii-34, .t4v�",A .z".ir...ft" ?•`.erVPIJ'f It tle.a.0.'biUJ .C'ivi°it,r,',FZ; `t..l..vr.«:r..: ri. e.. . ..'PLAN:,REVIEWr3 :,r ., 0 ra. r:.:i';; INigew construction 0 Addi ion/alterf.st•, 7.y,1is x•r b" ON Please check all that apply(submit j sets of plans watems checked) ❑Demolition ❑Other, s 0 Serviee or feeder 400 amps or more 0 Building over three stories. 44 where the available fault current 0 marina;and boatyards. �lia31^try4;4's'artIC`.: ties, .ry' CA EGOr YI.CF(C e I • 11 s Vr ,��€wx:.r.�% exceeds 10,000 amps st ISO volts or y g, �/ p ❑FloaOn bulidm s ❑ 1-and 2-family dwelling 0 Commercial/i . .�,, • tttiIding less to around,or exceeds 14.000 ❑Commercial-use agricultural amps for all other hutellations. buildings. ❑Multi-family ❑Master builder 0 Other. ❑Fire pump. 0 Instaaadon of 150 KVA or sa wvL'tS i '�d " ' 3 s .q`.,+ ❑Emergency system. larger nparatoly derived :ofet *z,� a "vies.�t)BIT,EtRVF9RMA''P( zi'",A�Ii�N, ':tbfrt 'YSIr`<'^r�. ..A'.. / ,] ❑Addition of now motor load of system. Job#: I Job site address: t JcI'zn/w�' loom'or more. ❑"A '0"."I.2",`1.3 City/State/LW: l/ ❑Six or mare aid unit. occupancy /GI �e) en� / ❑Heallh•cert facilities, ❑Rama gone'vehicle parks. Suite/bld /a t.#: Project name: A l� /s ��? ['Hazardous locations. ❑Supply voltage for more than g P I Q� GJ ❑Service or feeder 600 amps or more. 600 vats nominal Cross street/directions to job site: /Z1 S+, a d di /kJ J2 n,,,de m,, ;;ti ?, ; „'` r. r FEE'SCHElitil ` .:)-1 ',: s Inspegli, J't omerlpuo° 107. I Esc), I Total I • �• New residential single-or multi-family dwelling unit. _ SUbdIVI8lOn .5/! A?Ay,"1///4 v 'p/ I Lot#:2/ includes attached garage. Tax map/parcel# 1,000 sq.R,or less f 163.54 4 T 5 y R z 6:,7 f,((�, //JSJ✓3,(C6�/ 4, - Ea.add'I 500 sq ft or portion 33.92 1 .'W,lku7•,14Y"a E ?:•!`as,', •::°�FirVill)E5 a tON,.O?ev �(ittxt, iLT'u tr.'..f ttl +:.yf' Limited energy,residential 75.00 2 y�/I/,�� may ,y7 (with above so.0.) / f/C/ �l//i�71L� �/�N�!/�/ G(/T/T L(mited energy,mold-family /� 75.00ge2 2 / residential above above so.ft.) C S l �� - Renewable Energy ❑ See Page 2 f.U„m ,.k iE[£ ' ,LVi'NLR tIva-'.;" . ,'.:'it:e " ' v- ,Pt' --.+ ).'';: Bervlees or feeds Installation,Alteration,and/or relocation Name: 200 amps or less Q S 100.70 2 �� �' / 201 amps to 400 am S.56 2 Address: /2,9 ) ter./ . 11/nag- JET. � 401 amps to 600 amps 20C.34 2 City/State/ZIP: // /1 0� �/Z 601 amps to 1,000 amps 301.04 2 Phone:(C J ) $c•S5-- Over 1,000 amps or volts 552.26 2 Temporary services or feeders Installation,'Iteration,and/or } v'" * . ,4'(a.e a . ,itlA d r j(�A'yr relocation Cwne s ation:This installation is ' g made on property that 1 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 amps to 400 amps 12108 2 Owner signature: / Date: 401 amps to 599 amps 168.54 2 1••,1."' r - •.w. •..,• Branch circuits—new,alteratio or extension,per panel r:r S'3s,•,yt-iw .Ay;�'Y71�Ai+17'„�✓i�i,.(�}7�';t�kt:a1❑��0�'pA�P�iSbN:t.;,C'.r AF�fotbmachcircuitswltA Business name: above service or feed r f , 7.42 2 / each branch circuit Contact name: LlGe�� `y9/jl/� a B.Fee for branch circuits wit au ser/ /�SSIi/�P / ( branch or feeder foe,first 56 18 2 Address: /� 3 J branch circuit City/StatdZlP: / /. Ne y /�Z- Each add.]branch circuit 7 42 I 12- � f Miscellaneous(service or feeder not included) Phone: Cr ( , /) Q ��3-7 Each manufactured or modular 6784 2 dwelling,service and/or feeder Email: Y`H� �,� qr A , �O H1 Reconnect only 6784 2 j)..r• ' ,: ! toy -P;:+ .y'r'c1'CQ Ot . .. ,. .I - .•-.t .. . pump or irrigation circle 6784 2 ! Y^� � pay gfec/rG tar; Sign or outline lighting 67-44 2 'S ' t.s�- .v. f ( !a Signal circuit(a)or limited-energy Address 15 81 b ('al I/ ✓M9om' Pei panel,alteration,or extension ❑ Sec Page 2 2 City/State/ZIP: v j`'" Each additional Inspection over allowable In any of the above D�7 Hi rPle fed S Additional inspection(I hr min) 66.25/hr Phone:(SJ ) b31f`9700 Investigation(1 hr min) 90.0(1 hr Email: .� n / _ �/' .vJ Industrial plant(I hr min) 78.I81 hr I6 1x/4! ePO Inspections Ibr which no fee is 90.00/hr CCB Lie.:/'724- ` f Electrical Lie.: tat Suprv, Lio.: Zs eprcincoly0ated(6 hr min) __ _ `� 4'/� G .- , ELECTRICAL PERMIT.FEES - Suprv.Electrician signature,required: / , !/ Subtotal: Print name: �/�"9. 1 Dale: , 0 Plan Review Required.(25%of permit fee): State surcharge(12%ofpermil foe). Authorized signature' TOTAL PERMIT FEE: This permit application expire,Its permit Is not obtained within ISO ,,,Rrip.fl@me:_-. 'IA.q /ryes/ Date: y//y/1 days after It he,been accepted as comp etc. 3{ s ! - �`l f • Number of inspections allowod per permit. tit -PenullApp_ELR BRL'.doe Rev 10/36/2017 a40d615T(11/os/COM Was Or p x sled G Ve&?u ire S ( uCcF ) Fit c._ ) Plumbing Permit Application`Bluilding Fixtures R CELV S r FOR OFFICE USE ONLY City Of Tigard Received g �' ' s Y 1 `I Permit tfo • 13L25SW Hall Blvd.,Tigard,OR 97223 �' ' "��� DatelB . � ��1�2 �Py �5 ' _"2�i �C1��5 i Plan Review111 S Phone: 503.718.2439 Fax: 503.598.196q,, DatelBy: Other Permit No.:5I(�ZoZ2-ai. g T I G A R D Inspection Lme: 503.639.4175 I.ITY OF 71GARD Date Ready/By: kris: 0 See Page 2 for Internet: www.tigard-or.gov B IULVIf t1ING DwiSIO Notified/Method: Supplemental Information TYPE OF WORK �VV FEE* SCHEDULE ❑New construction D Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑Addition/alteration/replacement Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 El1 d 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 Accessory building ❑Multi-family Each additional bath/kitchen 25.02 El Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: I� 2 a, //0 `y�( Catch basin h area t 18.76 Drywall,leach line, orr trench drain 18.76 City/State/ZIP: I� �`d ©' c t7 Z ZJ ! {� Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Li I Project name:�)(J r 9/��h �l}",( Manufactured home utilities 50.03 Cross street/directions to job site: /Z/S f I.- �' �eJ s�� v5"1 Manholes 18.76 Rain drain connector ' 18.76 Sanitary sewer(no.linear ft.:_) f Page 2 Storm sewer(no.linear ft.:_) Page 2 � Water service(no.linear it: ) 2, Page 2 � Subdivision: . � r ,/ �//c ��� I Lot no.: Zi Fixture or item: Tax map/parcel no.: ( ) 1 qy��'/// /it sl 3 1-C' 0,iA0 p Backflow preventer 31.27 DESCRIPTION IOFWORK Backwater valve 12.5t � fJ Clothes washer t ( 25.02 G.0/ '[Jt � A71 e 7E ram //� Dishwasher + 25.02 � � u`//7L_O1�Q� // s, j �f Drinking fountain 25.02 ���/ y4�,7 ��/J Ejectors/sump 25.02 len PROPERTY OWNE /, ❑ TENANT Expansion tank 12.51 Name: `J�� ,� 4-re �tnf,J Fioorrd/sewer cap 25.02 Address: � s-/C LLLJJJ / Floor drain/floor sink/hub 25.02 �?'�3 d ��Uz�/�7fYlld �T Garbage disposal i 25.02 .45,o7._ City/State/ZIP: 7; 3t:�/ 49,e 97Z23 Hose bib 1 rJ._f- w I 25.02 �5,0% Phone:(ce/I )�����lt�O -^�S 3 I-- Fax:( ) Ice maker /�"' > 12.51 t�APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: ort/tv DU7iti�1 Medical gas(value:S_) Page 2 / Primer 12.51 Contact name: N..) Ar/K el 1 0l�I h Roof drain(commercial)commercial 12.51 Address: )2.1, 3 OLilo LU$I fro/ ji, Sink/basin/lavatory 2_ 25.02 5D.Q'f City/State/ZIP: // I/d' ie 47 ZZ 3 Solar units(potable water) 62.54 Phone:($f/J ) s-$'3i- Fax::( ) Tub/shower/shower pan I 12.51 12..$1 E-mail: Urinal i5 25.02 NKa n�ce.bare'!�J f cl '1 CO / OR Water closet 1 25.02 2.5,OZ Water heater ;Na 1 37.52 37.6j1 Business name: d- *n (��� /�u .(7 Waterpiping/UWV 56.29 Address: /9 3 7/ G aaLq IQOU a Other: 25.02 City/State/ZIP: (9 (i 7121-/ 5-5 fin�J a?poi(, Subtotal ) G,�.<! -'' .'b�. y 503 .-704---'lei Minimum permit fee: $72.50 Phone:(503 CCB Lic.: (7 3 7L 7 . //UIL 3 Plumbing Lic.no.:066).42?Itt�� Plan review (25%of permit fee) / State surcharge(12%of permit fee) Authorized signature: ! TOTAL PERMIT FEE .df Print name: �41 /� h Date: 6/// This permit application expires if a permit is not obtained within 180 days v i / / after It has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Budding\Pemnts'PLMU-PemitApp.doc 10/01/09 440-4616T(10/02/COtv/WPB) Plumbing Permit Application - City of Tigard • Page 2 - Supplemental Information ' Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain- I"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st100' ' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $I.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to P and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the fast$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry Font El Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure Drive Tall - as defined in OAR918-780-0040. Cuspidor/Water Aspirator ElMedical gas and vacuum systems for health care facilities. Dishwasher: Commercial 0 Any multipurpose fire sprinkler system. Domestic 0 Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram -4" ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -LavBar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter _ increase of sewer EDUs,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: 1:1Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 City of Tigard 114 v COMMUNITY DEVELOPMENT DEPARTMENT C T I c A a D Building Permit Review — Residential Building Permit #: tAs-rw> ' DDIOS Site Address: 12130 501 V bt/f twAr S4 . Project Name: '5'0 11 La ' PI Lot #: Z( Planning Review Proposal: °Ak ( I) ete i GLditaA ov f" Verify address/suite #active in Accela. ❑ In River Terrace: No ❑ Yes,River Ten-ace Review Addendum Site Plan Elements: Ptrosion Control 1j3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper ARetained trees with drip line and tree protection measures Drawn to scale(standard architect or engineer scale) tFootprint of new structure(including decks) and FFE North arrow A JUtility locations&easements(required for new and additions) cite address,project or subdivision name and lot number Sidewalk/driveway approach pApplicant information(name and phone number) ef�ve11 / c s terns tot dimensions and building setback dimensions n ❑Sgrrrrefootage o£4it **olisi ed PStreet names ,Existing structures on site Comer elevations (2'contours if more than 4'differential) y T eeuexa e a ea a eegt ei c >1,000 sf of impervious area created or replaced? EYes NNo If yes,is a storm water quality facility shown? ❑Yes,'iNo 7J? Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified P. No Received: ❑ Yes ❑ No , ] Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs Required: Yes,applicant was notified ❑ No Received: Yes ❑ No a SDC Exemption for ADU applied for. 1ii Yes El No Received: ® Yes ❑ No �,1 Public Facilities Improvement (PFI)Permit: Required: ❑ Yes,applicant was notified l5 No Applied For: ❑ Yes ❑ No,stop intake 12 Land Use Case #: A-DU 713 2 2- -AXOC t p Zoning. (2._-11-.s ® Required Setbacks: Front: 0` Rear:_$ti Side: 5 t Street Side: I 91 Garage: 20 t p Building Height: Max. Height: -' t Actual Height: l 3- �."I D LaadOlap�Aaa.a. % $ -oereragc Max: - Fntran a rl e ti ckno more than R'from ctreer facinu wall B Parallel to street er o ❑ Garage door is behind widest street-facing wall ❑ Yes ❑ No a ne following is met: extends no more than 5'from wall and there is a cove rc extending beyond garage. ❑ Door exten s n an 5'from wall and ' a 12 sq ft.window above garage on 2d floor. ❑ Garage door width is ❑ 12'or less /o or less of facade ❑ 60%or less and includes 7 of following. ❑ Covered porch ❑ sed entrance ❑ 1'Roof eave ❑ Roof offset ❑ Fire shin Lap Siding ❑ Roof pitch ❑ Gab e, , ambrel roof ❑ Dormer ❑ nt siding ❑ Window trim ❑ Window recess ❑ Window pro ❑ Balcony ❑ Visual Cle,arance ❑ Urban Forestry Plan Q+ Sensitive Lands: ❑ Yes No Type: ❑ Condition -mtt prior tv Ysoua nc,..of Iltii,1i..g-pl.u..it Notes: II) Approved By Planning: A-e0144 121 Stie Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Fonns\BldgPemutRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: q/1I/W ---2"' Site Plans: # Building Plans: # 9 Building Permit#: Enter building permit#above. Workflow Routing: )Planning ? Engineering Permit Coordinator ("' Building Workflow Sign-off: eR4. 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: � r /a2zW� Date: /`� ZO-Z Gd En 'neering Review Slope at building pad: .2'4 ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat II` ❑ Water Quality/Quantity Facility: NAssess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No LIDA Facility on lot: ❑ Yes ❑ No Add Fee: ❑ Yes ❑ No ❑ Final Plat Recorded: ❑ NOT Approved by Engineering: _ Date: Notes: C9'Approved by Engineering: Date: 14/P—o2Z2 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review 1.1 k 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: 2i SDC Exemption: /Received ❑ Does not apply 7SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: %Yes ❑ N/A L j Qrowo Ej� { I ._ Parks SDC: Yes 0 N/A i' LIDA 0 Yes N/A OK to Issue Permit rr� Approved by Permit Coordinator: tN" Date: 4 l2 (2 21 I:1Building\Fomis\13ldgPemutRvw RES_1208021.docx RECEIVED FEB 17 2022 IN ° FINANCE City of Tigard wI lY OF TlGARG DEPARTMENT TIGARDr Systems Development Charge (SDC Exerri 3 tii-PApl ication REQUEST FOR ACCESSORY DWELLING UNIT SDC EXEMPTION (Allowed under TMC 3.24.100.F) Note:Refer to TMC 3.24.180 and the Systems Development Charge(SDC)Exemptions for Accessory Dwelling Units Guideline for eligibility requirements before completing application. City Transportation and Park SDCs exemption only. REQUIRED SUBMITTAL PROPERTY INFORMATION ELEMENTS Name of property owner. 74,20Lr MAP 1Q„n 4. 1 0 Recorded Deed Restriction: �J.jta aerei LC 6 0-Legal Description of Property �/ 8 Estimate of F.xe_mit SDCs Location (address if available): I Zj30 Si/Se_erresir Si ^^�� / 0 Proof of Ownership/ t/rS. . R 72 Z 3 Authorized Representative Tax map and tax lot numbers: .1 S 1351(&fif($p Type of Unit Total Units Square footage of each unit Attached ADU Detached ADU I (€15_e 2 YZej) APPLICANT INFORMATION Name,as appears on title of property: jN Imp /AV 6afesi 1.444.6 altal64,d/ goy 4746 Mailing address: /7430 5G(/5uMmir- 4, City/State: 0 rr op_ Zip: G7zL3 Phone: C>ql 1340- ss al- Email: ,M., Aq/6e 60,te i (C f pt0i/ 69I11 Applicant's representative: jimeim /7A.0 A'i7 ( Phone: .S/) —8yo—s53 1- Email: jaol iQ #001I21�Dfev109 amfaii 49411 (/ THE PROPERTY OWNER ACKNOWLEDGES AND AGREES TO THE FOLLOWING: 1. I understand that acceptance of this application and documents by the City does not constitute an approval of an exemption. Exemptions are not granted until after all documentation is received and city staff have reviewed and approved my request. 2. I understand that if at any time during a period of 10 years from the time my final inspection is approved the City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 1 of2 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 he required to pay to the city the amount of the exempted system development charges, plus interest. 1 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 provided opposite my signatures below. c72.%77.7a ,21- 4 /n/// I ope owner si na Print Name Date awl/,,'tore //7/O/z/ 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. SUBMIT COMPLETED APPLICATION TO: SDC Administrator,Finance and Information Services, City of Tigard, 13125 SW Hall Blvd.,Tigard, OR 97223. If dropping the application off in person, drop off at the Utility Billing (UB) front counter located within Tigard City Hall. Questions can be directed to the SDC Administrator at SDC@tgard-or.gov or393-1 '* O 503- 7i5- . STAFF USE ONLY Received by V Date: Approved by: Date: / $4, 128 00 • Amount of SDCs Ezempt. Park: r t •oo Transportation: City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 1 of2 • • DocuSign‘Envelope ID:7FA80260-4782-47F5-AC68-C96CD31F89AC Washlnptor County,Oregon 2022-008673 02/03/2022 11:23:34 AM DIRUL Cnt=1 Stn=10 A DUVCK $35.0D$5.00$11.00;60.00•Total=$111.00 RETURN TO: I IIIIIEIIIIII 111111 I IIIIIIIIIII IIIII1I City of Tigard 02848045202200086730070078 Finance and Information Services I,Joe Nelson,Director meat end Taxation e•` ,\ end Ex-Officio County Clerk for Washington County, r` 1..1 Contracts&Purchasing Oregon,do hereby certify that the within Instrument of ./,` -,.•r k; 13125 SW'Hall Blvd. *ruing wee received end recorded In the book of r; ..; Tigard,OR 97223 records of sold county. ^ i.'•. ••g,�a,,..d� ,a�n �t,�.•.; 't3NY 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 26th Day of January 2022, by and between Jana Mae Lamb and Richard Pierce Lamb (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 12130 SW Summer St.,Tigard,Oregon,and approved through case File No.ADU2022-00001. (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, SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 1 of 7 DoctSign Envelope ID:7FA80260-4782-47F5-AC6B-C96CD31FB9AC 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. 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 coveting 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 foredosute,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 SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 2 of 7 DocuSign,Envelope ID.7FA80260-4782-47F5-AC6B-C96C031FB9AC the Exemption Date at the rate shown on the City's Master Fees and Charges Schedule for"SDC Financing" calculated semi-annually.City may,in addition to an action to collect SD C'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 anyway 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 SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 3of7 DocuSign Envelope ID:7FA80 260-47 82-47F5-AC6B-C96CD31 FB9AC of construction to the effect that ambiguities are to be resolved against the drafting party shall not apply in the 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): JANNA MAR.LAMB: RICHARD PIERCE LAMB: By: ` i_s,. ./ By: /7 /Signature I n � ASignature Name: \�(i�1f W-V4 ���{V✓ \�lu`a " STATE OF `�Qn §V ) County of Q.``I \) i ) ss. � The foregoing instrument was acknowledged before me this ay of .0.11 X\-} ,0�117f�,by Notary Public for the State of _• _ My commission expires:5 13 I j af,) 5 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 DocuSign Envelope ID:7FA86267-4782-47F5-ACBB-C96CD31 FB9AC 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: 12130 SW Summer St.,Tigard,OR 97223 SDC EXEMPTION FOR ACCESSORY DWELLING UNIT Page 7 of 7 • Washington County,Oregon 2019-084986 RECORDING REQUESTED BY: D-OBS Fidelity National Title Stn--16 M LOPEZ 11/2512019 08:43:11 AM �'°�r°r`-`*•°° $10.00$11.00$5.00$60.00 $86.00 �`--8564 SW Apple Way I,Richard Hdbemieht,Director of Assessment and Taxation and Ex- Omcio County Clark for Washington County,Oregon,do hereby ky Portland,OR 97225 artily that the within instrument of wiring ng was received and V recorded inthe book of records of said county. t GRANTOR'S NAME: Richard Hobemicht,Director of 3— Richard Pierce Lamb and Janna Mae Marlin Boren Assessment and Taxation,Ex-Officio oGRANTEE'S NAME: ay Richard Pierce Lamb and Janna Mae Boren Lamb. (-‘, AFTER RECORDING RETURN TO: 6 Richard Pierce Lamb and Janna Mae Boren Lamb — 12130 SW Summer Street — Tigard,OR 97223 U' SEND TAX STATEMENTS TO: Richard Pierce Lamb and Janna Mae Boren Lamb 12130 SW Summer Street Tigard,OR 97223 p1 R0267794 CO 12130 SW Summer Street,Tigard,OR 97223 Q SPACE ABOVE THIS LINE FOR RECORDER'S USE >~ O d BARGAIN AND SALE DEED-STATUTORY FORM (INDIVIDUAL pr CORPORATION) is �Orine4 /viac. f3 jren (lc2FY)b CO Richard Pierce Lamb and Janna Mae Martin Boren, as tenants in common with right of survivorship, Grantor, conveys to Richard Pierce Lamb and Janna Mae Boren Lamb,as tenants by the entirety, Grantee. zthe following described real property,situated in the County of Washington,State of Oregon, SEE EXHIBIT"A"ATTACHED HERETO AND MADE A PART HEREOF The true consideration for this conveyance No Dollars And No/100 Dollars($0.00). (See ORS 93.030). Lt. 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 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 20D7,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: / / ! 2c/ter;. Lvnc> tvn f7/f us- phRi Pierce Lam 2Hha Mae 6 nLa State of County of l!I LLf4,1)'/" This,instrumer}tt was cK"no�Jiledged before rye on / �� 7/ by C het/LU 1� 1 , ,-��''��-"" e !(7)/ A/�, % Ja./7 )e j`G7 a P,i�J2i` -/'/ ,,E�/.d Notary Public-State of Oregon ( OFFL S 3GEYE? !!NS ORGINPS j /7 /2J h 'r ✓ MY COMMISSIONES 2021 Deed(Bargain and Sale-Statutory Form)Legal Printed: 10.25.19 rg 12:19 PM by AP ORD1352_doc I Updated:04.26.1 g Page 1 OR-FT-FPYM-01520A70004-45141922924 EXHIBIT"A" Legal Description Lot 21,SUMMER HILLS PARK,in the City of Tigard,County of Washington and State of Oregon. Deed(Bargain and Sala-Statutory Fenny Legal Printed' 1025.19 12:19 PM by AP OFD1352.doc/Updated; 04.26.19 Page 2 OR.FT-PnYM-01520.470004-45141922824 Julie Drinkwater From: Machelle Stephens Sent: Thursday, February 17, 2022 9:19 AM To: Jannamaeboren@gmail.com; #Building Permit Technicians Cc: Agnes Lindor; Toni Riccardi Subject: SDC ADU Exemption Attachments: SCD ADU Exempt 12130 SW Summer St.pdf Categories: Julie Hello Janna, please see the attached approval for exemption SDC ADU 12130 SW Summer Street. Mac In eLl Ste, zwy, GPP6 Sr. Procurement Specialist City of Tigard 503-726-9790 MachelleS@Tigard-OR.Gov DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule." 1 Water Meter Fixture Unit Worksheet for Additions/Remodels/ADUs Please complete the following information: Customer Name: Idirb Service Address: Street/Suite#: /2.-/,311 JUIJ Ls1907/40,r, IA City: /,ll� State: Qde Zip: 97Zz3 Phone Number: _SYf —R4/O 53 31 Email: lCrsi/pp�,rp -j-7&4in ./:awl' J / Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add. Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at total. the proposed total. Fixture Unit Current Point Current Proposed Point Proposed Quantity Value Total Addition Value Total Bar sink x 1 = x 1 = Bidet - x 1 = x I — Clothes washer 1 x 4 = 4 I x 4 = 1t Dishwasher 1 x 1.5 = 1, 5 1 x 1.5 = I , 5- ie Outside Water Spigot 1 x 2.5 = 2, x 2.5 = Water Spigot,each add'l I x 1 = 1 x 1 = Kitchen sink ( x 1.5 = 1, S 1 x 1.5 = l 5 Laundry sink x 1.5 = x 1.5 = Lavatory(bathroom sink) .3 x I = 1 ( x 1 = 1 Water closet,1 6 GPF(tailet) x 2.5 = 7, 5 1 x 2.5 = Z,S Bathtub/whirlpool x 4 = x 4 = Shower stall - x 2 = ar, 4, 1 X 2 = ' Bath/shower combo ,. x 4 = x 4 = Current Points: ,.2' ' Proposed Increase: /2 5 Current Points+Proposed Increase= '`..,J; . =New Total Points =Required Meter Size 1 // Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points='/<" 37.5 and over points= 1" // 2S/,o tB,& New Meter Size Needed for New Total Points: Cost: $ 5 (see page 1) Current Meter Size per Utility Billing: 5/7 Q�_// Cost: $ q//q 5— (see page 1) New Meter Size Cost minus Current Meter Size Cost= $ ,,��_ p/(✓/ JIB-' Ti'(I (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) S/IVA /9 T *******r**a*****************r**ss**************************Ks*******a**s*******s***** FOR OFFICE USE ONLY Address will need meter upgrade to 1 inch Current Meter Size Confirmed with(JB J Bentley 05/16/22 Signature of UB Representative Date 1:/Building/Forms/WaterMeters_070121 Add.dOCX Page 2 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Water Meter Fixture Unit Worksheet TIGARD For Additions /Remodels /ADUs 13125 SW Hall Blvd. • Tigard,Oregon 97223 • 503.718.2439• vn v,'.ti yard-or._ov LOCATION: City of Tigard—City Hall WATER METER SALES: Utility Billing By Email Only.Please contact 13125 SW Hall Blvd. ubonlinepayAtigard-or.gov Tigard,OR 97223 to discuss sending documents and payment METER: SIZE: FEE: Pricing effective 07/01/2021 5/8" $9,495.00 Fee includes: 3/4" $13,554.00 water system development charge, 1" $24,886.00 water meter, and 1-1/2" $73,689.00 meter installation fee. 2" $119,333.00 DETERMINING METER SIZE FOR RESIDENTIAL CUSTOMERS City of Tigard Water Service Area uses the American Water Works Association Manual and the Oregon Plumbing Specialty Code to determine the size of meter needed to adequately serve buildings. Due to the variety of home sizes built in the Tigard area, we count the fixture units of all homes to determine the appropriate meter size. Use the worksheet on Page 2 to calculate the current number of fixture units compared to the proposed increased number of fixture units,which will determine whether an increased meter size will be required. Submit this signed worksheet with your building or plumbing permit application submittal. DOCUMENTATION Once you are ready to purchase the new meter,please provide the following items to the Utility Billing counter: • Completed water meter fixture unit worksheet for additions, remodels, ADUs, etc. (on back page). • Copy of building or plumbing permit application date-stamped by building division. • Copy of issued building or plumbing permit. Your fixture count will be verified and your request will be processed upon receipt of these documents. No exceptions INSTALLATION TIME Once the upgraded meter size has been purchased, most meters are installed within 10-14 business days. 1:/Building/Fortes/WaterMeters_07012111dd.dOCX Page 1 • Branden Taggart From: Jill Bentley Sent: Thursday, May 19, 2022 7:42 AM To: Branden Taggart Subject: RE:Water Meter Approval for 12130 SW Summer St. Attachments: 12130 SW Summer St 051622.pdf Unfortunately,they had a form that had the incorrect meter costs. I signed off on it without looking so we can give them the old rate. Otherwise,the correct cost is$16,392.00. If they will pay the correct cost that would be fantastic, if not, that's ok. Kind Regards, Jill (she/her/hers) ,ill A WORLD; Jill NER „"I0011CANBEkiner � • City of Tigard-Utility Billing G111 Senior Accounting Asst (888)826-7211 Payments (503)718-2460 UB Main . jji1b@tigard-ar.gav (503)718-2494 JE KILL- 13125 SW Hall Blvd. Tigard, OR 97223 From: Branden Taggart<brandent@tigard-or.gov> Sent:Thursday, May 19, 2022 7:28 AM To:Jill Bentley<JILLB@tigard-or.gov> Subject: RE:Water Meter Approval for 12130 SW Summer St. Thanks,Jill. My understanding is that the new amount is$16,400.00 if that sounds correct. Thank you, Branden Taggart 11111 q City of Tigard t Senior Permit Technician Community Development TRCA.Rl 13125 SW Hall Blvd Tigard, OR 97223 (503)718-2449 bra ndent@tigard-or.gov From:Jill Bentley<JILLB@tigard-or.aov> Sent: Wednesday, May 18, 2022 6:28 PM 1 ' To: Branden Taggart<brandent(a tigard-or.gov> Subject: Re: Water Meter Approval for 12130 SW Summer St. I think that is the newest one but I can check in the morning. Jill Bentley (from my phone) On May 18, 2022, at 6:07 PM, Branden Taggart<brandent@tigard-or.gov>wrote: Hey Jill, I'm about ready to issue the ADU Building permit forJanna Lamb at 12130 SW Summer Street. We have the approved Water Meter form with the cost of$15,391.00, but she mentioned that you have a more recent one? If so, could you send it to me? Thank you, Branden Taggart ■ City of Tigard II . . Senior Permit Technician Community Development TitsARD 13125 SW Halt Blvd Tigard,OR 97223 {503J 718-2449' brandent@tigard-or.gov DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule." 2