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Permit
CITY OF TIGARD MASTER PERMIT 4 '• COMMUNITY DEVELOPMENT Permit#: MST2022-00164 Date Issued: 08/25/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S108DC10100 Jurisdiction: Tigard Site address: 15797 SW VANDERWOOD AVE Subdivision: RIVER TERRACE CROSSING Lot: 109 Project: River Terrace Crossing, Lot 109 Project Description: New detached dwelling(Model Home.) NO FINAL INSPECTION UNTIL DEFERRED SDC FEES ARE PAID. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1414 st Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1597 sf Garage: 432 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 3011 sf Value: $423,534.14 Rear: 10 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add"500 sf: 5 201-400 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 Y Audio&Stereo: N HVAC: N Securit 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 SF VB R-3 3011 Owner: Contractor: CND-RIVER TERRACE LLC STONE BRIDGE HOMES NW LLC Required Items and Reports(Conditions) 1111 N POST OAK RD 4230 GALEWOOD STREET#100 1 Ersn Cntrl 503-639-4175 HOUSTON,TX 77055 LAKE OSWEGO,OR 97035 PHONE: PHONE: 503-387-7577 FAX: 503-387-7615 Total Fees: $24,758.64 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 g69-nM-nnln rhrnllnh nAP oc9 1-nnon vn, P\,nhrAT o nu ni th ,iA<,,r rlerorr ni locenne to ni mu-.h„ramnn gn1 0A7 nr 1 Ann 119 owe ,O�y Issued By: Rermittee Signature: ` [� p f'`* Call 503.639.4175 by 7:00 a.m.for the next available Inspection date. Y/' 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 lob site at the time of each inspection. Buildkng Permit Application Residential FOR OFFICE USE ONLY J3267 Received City of Tigard RTC109 Date/By:ivePermtNo.. NI 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review/// // -QC II(`/` 2 - Phone: 503.718.2439 Fax: 503.598.1960 Date/By: �P -] y2- ffJJ��((dd" OtherPermit:4 acaa--00(%�� TI G A R D Inspection Line: 503.639.4175 Date Ready/By: aria: See Page 2 tar Internet: www.tigard-or.gov N • ed/Method: / Supplemental Information TYPE OF WORK REQUIRED DATA:I-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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Ilt Valuation: $ X❑ I-and 2-family dwelling ❑Commercial/industrial 'f1�'LiZ31 Jul ❑Accessory building 0 Multi-family Number of bedrooms: ❑ Master builder ❑Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 34(-f 5 Job site address: 15797 SW Vanderwood Ave. New dwelling area: 3,011 square feet 1597 City/State/ZIP: Tigard, OR 97224 Crarage/catport area: 482 square feet l(l f 4 Suite/bldg./apt.no.: Project name: River Terrace Crossing 1ttb square feet Cross street/directions to job site: Deck area: ) W0 square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: River Terrace Crossing Lot no.: 109 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, single family residence Valuation: $ 1 {l flea Existing building area: square feet �"` I� New building area: square feet IXI PROPERTY OWNER ❑ TENANT Number of stories: Name: Stone Bridge Homes NW, LLC Type of construction: Address: 423-Galewood St. Suite#100 Occupancy groups: City/State/ZIP: Lake Oswego, OR 97035 Existing: Phone:( 503)387-7577 Fax:( ) New: l]] APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Stone Bridge Homes NW, LLC Structural plan review fee(or deposit): Contact name: Permit Tech FLS plan review fee(if applicable): Address: 4230 Galewood St. Suite#100 Total fees due upon application: City/State/ZIP: Lake Oswego, OR 97035 Phone:( 503) 387-7577 Fax::( ) Amount received: E-mail: portlandpermits©stonebridgehomesnw.corn PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: Stone Bridge Homes NW, LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 4230 Galewood St. Suite#100 Solar Installation Specialty Code checklist. City/State/ZIP: Lake Oswego, OR 97035 Permit Fee(includes plan review $180 00 and administrative fees): Phone:(503)387-7577 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: 173318 Total fee due upon application: $201.60 Authorized signature: : , A f!1 This permit application expires if a permit is not obtained ACLI? ��r�/ within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry 5 19-2022 Print name: Tiana Rudolf Date: Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB) Mechanical Permit Application FOR OFFICE I SF oM.Y City of Tigard Received III • 13125 SW Hall Blvd.,Tigard,OR 97223 Pla Re �� • t _ Phone: 503.718.2439 Fax: 503.598.1960 PlanDatr view e/BOther Permit: T IGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑X New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑X 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑ Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB S1fL INFORMATION AND LOCATION Heating/cooling: Air conditioning Joh Site address:15797 SW Vanderwood Ave. (requires site plan showing placement) 46.75 Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP: Tigard, OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: River Terrace Crossing Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Subdivision: River Terrace Crossing Lot no.:109 Flue/vent for any of above �4— 23.32 Other: 23.32 Tax map/parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater 1 23.32 New, single family residence Gas fireplace 1 33.39 Flue vent for water heater or gas 2 fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 IX-1 PROPERTY OWNER 0 TENANT Chimney/liner/flue/vent 23.32 Other: 23.32 Name: Stone Bridge Homes NW, LLC Environmental exhaust and ventilation: Address: 4230 Galewood St. Suite#100 Range hood/other kitchen equipment 1 33.39 City/State/ZIP: Lake Oswego, OR 97035 Clothes dryer exhaust 1 33.39 Single-duct exhaust(bathrooms, Phone:( 503)387-7577 Fax:( ) toilet compartments,utility rooms) 6 23.32 l] APPLICANT 0 CONTACT PERSON Attic/crawlspace fans 23.32 Business name: Stone Bridge Homes NW, LLC Other: 23.32 Fuel piping: Contact name: Permit Tech S14.15 for first four;S4.03 for each additional Address: 4230 Galewood St. Suite#100 Furnace,etc. 1 Gas heat pump City/State/ZIP: Lake Oswego, OR 97035 Wall/suspended/unit heater Phone:(503) 387-7577 Fax:: ( ) Water heater 1 Fireplace 1 E-mail: portlandpermits@stonebridgehomesnw.com Range 1 CONTRACTOR Barbecue Business name: Comfort Zone Clothes dryer(gas) Other: Address: 1032 NW Corportate Dr. MEC,HANICALPERMIT'_FEES* City/State/ZIP: Troutdale, OR 97060 Subtotal Minimum permit fee($90.00) Phone:( 503)667-5595 Fax:( ) Plan review(25%of permit fee) CCB tic.: 110091 "f /3(2-7 State surcharge(12%of permit fee) TOTAL PERMIT FEE Authorized signature: ` This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: David Heldstab Date:5-19-2022 • Fee methodology set by Tri-County Building Industry Service Board 1\Building\PermitsMEC-PermitApp doe 09/09/10 440-461TT(I 1/02/COM/WEB) Electrical Permit Application I ORoFFicy. i-sf:oNLv City g ofTigard Received `' Date/B : Pi r 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Permit#. Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit II: VI L C7 O IV Inspection Line: 503.639.4175 Ready Date/By: kris: ® See Page 2 for TIGARD Internet www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑X New construction ❑ Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): O Service or feeder 400 amps or more 0 Building over three stones. ❑ Demolition ❑ Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. X❑ 1-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 El Commercial-use agricultural amps for all other installations. buildings. 0 Multi-family ❑ Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: 3267 Job site address: 15797 SW Vanderwood Ave. l00HP or more. ❑"A","E 't-z^,"1-3", Ci /State/ZIP: Ti ard, OR 97224 0 Six or more residential units. occupancy. ty 9 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: River Terrace Crossing 0 Hazardous locations. 0 Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision:River Terrace Crossing Lot#: 109 Includes attached garage. 1,000 sq.ft.or less 3 168.54 4 Tax map/parcel 4: Ea.add'I 500 sq.ft.or portion 1 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 New, single family residence Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 IX1 PROPERTY OWNER. ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: Stone Bridge Homes NW, LLC 200 amps or less 100.70 2 Address: 4230 Galewood St. Suite#100 201 amps to 400 amps - 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Lake Oswego, OR 97035 601 amps to 1,000 amps 301.04 2 Phone:( 503) 387-7577 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: portlandpermits@stonebridgehomesnw.com relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I intended for sale, lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 LEAPPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension, ter panel A.Fee for branch circuits with Business name: Stone Bridge Homes NW, LLC above service or feeder fee, 7.42 2 each branch circuit Contact name: Permit Tech B.Fee for branch circuits without Address: 4230 Galewood St Suite#100 branch circuit City/State/ZIP:Lake Oswego, OR 97035 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( 503)387-7577 Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: portlandpermits©stonebridgehomesnw.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Garner Electric Sign or outline lighting 67.84 2 22�j�qq U Signal circuit(s)or limited-energy 0 Ste Page 2 2 Address )SE Brookwood Ave. Suite A panel,alteration,or extension. City/State/ZIP: Hillsboro, OR 97123 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( 503)648-4552 Fax:( ) Investigation(I hr min) 90.00/hr Email: chelsea@garnereleFtric.com CB �'t'�N' Industrialplant(lhrmn) 78.18/hr TElectrical Lic.:34-305C Suprv.Lic.:303 S Inspections for which no fee is specifically listed(1/2hr min) 90 00/hr C Licl A /�� pp l��7{ ELECTRICAL PERMIT FEES Suprv.Electrician si nature,required: aa,./LQ. gaIZ,l.4/4 Subtotal: Print name: Charles Garner Date: 0 Plan Review Required(25%of permit fee): �-/ / / State surcharge(12%of permit fee): Authorized signature: ,/ y2 . C_ ..i1 �y TOTAI.PERMIT FEE: df fl; This permit application expires if a permit is not obtained within 180 Print name: Tiana Rudolf Date: 5-19-2022 days after it has been accepted as complete. ' Number of inspections allowed per permit. I,Building\Permits\ELC_PermitApp_ELR ERE.doe Rev 06/17/2015 440-4615T(1 l/05/CONUWEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined: $75.00 Description Qty. Each Tom, y Renewable electrical energy systems: Check Type of Work Involved: 5 kva or 1e55 100.70 2 5.01 to 15kva 13356 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200 34 2 Wind generation systems in excess of 25 kva: n Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 n Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 • ❑x Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: • System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: • ❑ Other: Each additional inspection is 66.25/hr t charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(%:hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page I): Fee for each commercial system: $75.00 • Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls ❑ Clock Systems U Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC ❑ Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical n Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:IBuildingWermitslELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Plumbing Permit Application `Building Fixtures FOR OFFICE USE ONLY Cityof Tigard Received gan Date/By. Permit No_ i Y4A (j --O° • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 111 _ . Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: T I G A R D Inspection Line: 503.639.4I75 Date Ready/By: 7uds: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE 2 New construction ❑Demolition For special information use checklist Description I Qty. I Ea. Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ❑X 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 0 Accessory building ❑Multi-family SFR(3)bath 1 500.32 Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 15797 SW Vanderwood Ave. Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard, OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name:River Terrace Crossing Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: River Terrace Crossing J Lot no.: 109 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 1 25.02 New, single family residence Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER 1 0 TENANT Expansion tank 12.51 Name: Stone Bridge Homes NW, LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 4230 Galewood St. Suite#100 Garbage disposal 1 25.02 City/State/ZIP: Lake Oswego, OR 97035 Hose bib 2 25.02 Phone:(503)387-7577 Fax:( ) Ice maker 12.51 E. APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Stone Bridge Homes NW, LLC Medical gas(value:$_) Page 2 Primer 12.51 Contact name: Permit Tech Roof drain(commercial) 12.51 Address: 4230 Galewood St Suite#100 Sink/basin/lavatory 7 25.02 City/State/ZIP: Lake Oswego, OR 97035 Solar units(potable water) 62.54 Phone:(503 )387-7577 Fax:: ( ) Tub/shower/shower pan 4 12.51 E-mail: portlandpermits@stonebridgehomesnw.com Urinal 25.02 Water closet 3 25.02 CONTRACTOR Water heater 1 37.52 Business name: Edward Mullen Plumbing Water piping/DWV 56.29 Address: S. E. River Road Other: 25.02 City/State/ZIP: Hillsboro, OR 97113 Subtotal Phone:( 503) 640-01 13 Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: 92689 Plumbing Lic.no.: 34-260PB State surcharge(12%of permit fee) Authorized signature:4e. TOTAL PERMIT FEE Print name: Jeremy Crace Date:5-19-2022 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1.1Building\Permits\PLMU-PermiiApp.doc 10/01/09 440-46161-(10ID2/COM/WEB) IN11 City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT T[GARD Building Permit Review — Residential Building Permit #: }-'V_) —an I IA Site Address: 1 S76t1 5y VQ Project Name: r.t tf Cd2 ( bV-ef.c c,,l d.o Lot #: Ic76:\ Planning Review Proposal: OW le Pl', ( kiC) erify address/suite#active in Accela. Ll'In River Terra -. El No I� Yes,River Terrace Review Addendum Site Plan Elements: r rosion Control 03 copies of site plan on 8-1/2"x 11"or 11 x 17"paper ;"etained trees with drip line and tree protection measures Drawn to scale(standard architect or engineer scale) �A F nn of new structure(including decks)and FFE North arrow locations&easements (required for new and additions) OS ite address,project or subdivision name and lot number E ' k/driveway approach fa1 3 cant information(name and phone number) ❑L a ' n of wells/septic systems t dimensions and building setback dimensions L7S ee e s ze,type and locat on e ootage of buildings to be demolished Set names • ting structures on site Corner elevations (2'contours if more than 4'differ-.:a) of area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? `YY.. No impervious area(applicable if R-7,R-12,R-25&R-40) If es,is a storm water .uality facili shown? G -s No I9 Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): R uired: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs aired: El Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No ❑ Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified El NoApplied For: ElYes ElNo,stop intake and Use Case#: ¶ 1 -0ZZ- CiZe..6 la Z/oning: l-- ❑ Required Setbacks: Front: II, Rear: Side: Street Side: $ Garage: 20 41 n ding H ' t: �/ Max. Height: lv A" Actual Height: I�- 17 Landscape rea: 2' % ❑ Lot Coverage M : g0 Entrance V Set back no more than 8'from street-facing wall 'Parallel to street or offset 45 degrees or less Windows ❑ ' um 12%of area of all street-facing facades Garage ❑ G a door is behind widest street-facing wall ❑ Yes . No,one of the following is met: 'Door extends no more than,5'front 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.wirido above garage on 2nd floor. - Garage door width is ❑ 12'or less tin *I%or less of facade ❑-60 ss and includes 7 of following: El Covered porch Recessed en ce , ❑ Wall offset Cl l'teioleave ❑ Roof offset ❑ Fire shingles ❑ Lap Siding El Roof pitch ❑ Gable,hi ,or gambrel roof El Dormer ❑ Accent siding ❑ Window trim ❑ Window r illw projection ❑,dalcony Visual Clearance Urban Forestry Plan ��` Sensitive Lands: Yes No Type: ❑ Conditions met prior to issuance of building permit' tes Approved By Planning: )4ci:A0,41(� 67 Vi Date:�_7_.3 •Z� Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:1 Building\Forms\BldgPennitRvw RES I 22419.docx Building Permit Submittal Original Submittal Date: Site Plans: # Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: IR Planning [ " Engineering 'Permit Coordinator 4E-Building Workflow Sign-off: i'k^Sign-off for Planning(include notes from planning review) Route Application Documents: 1 1" Engineering: (1) copy of permit application, (1) site plan, (1)building plan and original plan review routing form. „IR-Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: V6s tun Ok 1 1, Date: 5 31 Engineering Review 1(d' Slope at building pad: l�p ' Conditions "Met"prior to issuance of building permit /19 t'Easements (encroachments)per engineering conditions of approval and plat VWater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes CZNo Assess Water Quantity Fee in-lieu: ❑ Yes VV'lo LIDA Facility on lot: 0 Yes [ No O Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: IV Approved by Engineering: Date: 45 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 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: slZif SDC Exemption: ❑ Received / Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: X yes ❑ N/A Tigard Trans SDC: 12r Yes ❑ N/A Parks SDC: //1Zi Yes ❑ N/A LIDA ❑ Yes / N/A Kf OK to Issue Permit At\rApproved by Permit Coordinator: Date: -7((z[1aZ I:\Building\Forms\BldgPennitRvw_RES_122419.docx City of Tigard • Deferral Until Occupancy Request T I G A rt D Washington County Transportation Development Tax (1'DT),Transportation and Parks System Development Charges (SDCs) 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: 6/22/2022 Site Address: 15797 SW Vanderwood Ave Project River Terrace Crossing Land Use Case or MST2022-00164 Name: (Stonebridge Homes) Building Permit#: T#ax Lot Lot 109 Aotal mo narks $10,903.00 TDT N/A Total TSDC $10,348.00 Amount: Amount*: *The total TSDC amount shown above is the sum of$6,690.00 for TSDC-Improvement,$ 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 .278.00 for Parks-Improvement, $ 1.739.00 for Parks- Reimbursement,and either$ N/A for Parks-Neighborhood or$2,886.00 for Parks-Neighborhood River Terrace. This constitutes my request to defer payment of the TDT,TSDC, and Parks SDCs, as provided above, to prior to final inspection. 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. TDT may only be deferred if the TDT isgreater 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 acc 71 ted both the Property Owner and the Developer must sign this request. 67Y; Property Owner: III ' Date: ' V iI 7,1 I" Developer: / Date: 1 Permit Coordinator: \ ®n nn Jlt Date: 6/22/2022