Permit City of Tigard
Deferral Until Occupancy Request
T I G A R D Washington County Transportation Development Tax VDT),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: 11/14/2022 Site Address: 15221 SW Coolwater Ln
Project River Terrace Crossing Land Use Case or
Name: ; (Ichijo) Building Permit#: MST2022-00451
Tax Lot 2S108DC04500 Total Parks $11,830.00
#: Lot 49 Amount*:
TDT N/A Total TSDC
Amount: Amount*: $12,004.00
*The total TSDC amount shown above is the sum of$7.760.00 for TSDC-Improvement,$448.00 fox TSDC-
Reimbursement,and$1,796.00 for TSDC-River Terrace,if applicable..
*The total Parks SDC amount shown above is the sum of$6,812.00 for Parks-Improvement,$ 1.887.00 for Parks-
Reimbursement,and either$ N/A for Parks-Neighborhood or$ 3,131.00 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 is greater than the amount for a single-family residence. I further
understand that the amount of 1'DT 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: i���2u u'VQ' Date: 11/16/2022
7 gert-dati 11/16/2022
Developer: Date:
Permit Coordinator: /, ( 1144 b'U Date: 11/14/2022
CITY OF TIGARD MASTER PERMIT
�'! COMMUNITY DEVELOPMENT Permit#: MST2022-00451
T I G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/2912022
Parcel: 2S 108DC04500
Jurisdiction: Tigard
Site address: 15221 SW COOLWATER LN
Subdivision: RIVER TERRACE CROSSING Lot:
Project: River Terrace Crossing, Lot 49
Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN
PAID.
BUILDING
Floor Areas Required Setbacks Required
Stones: 2 Bedrooms: 4 First: 1164 sf Basement: 0
sf Left: 3 Parking Spaces: 0
Height: 22 Bathrooms: 3 Second: 1512 sf Garage: 440
g sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 2676 sf Value: $431,958.28 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 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
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: Y Hoods: 1
Other Units: 0
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders 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: 0 801+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
Other: N Other Description: Ecom P 9 asin Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2676
Owner: Contractor:
ICHIJO USA CO.,LTD. ICHIJO USA CO LTD Required Items and Reports(Conditions)
3800 SW CEDAR HILLS BLVD,STE 3800 SW CEDAR HILLS BLVD STE 130 1 (2)layers of 2x fire blocking
131 BEAVERTON,OR 97005 at area indicated
BEAVERTON,OR 97005 2 Ersn Cntrl 503-639-4175
PHONE: 503-430-7413 PHONE: (503)430-7413
FAX:
Total Fees: $24,882.27
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
ar ..nn11IMn thrni in A oc9_nM_nnon Vn„ v nou&nf tho mloc nr dirurt nr ocanne+n cu inir by ra Minn col 7i9 10R7 nr 1 arm 117 90,44
Issued By: Permittee Signature: 7 a.e c:Zp� I1 (af t Pk?
Call 503.639.4175 by .00 a.m.for the next available inspection date. /
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
P
Building Permit Application Checklist ,
0
One- and Two-Family Dwelling FOR OFFICE USE ONLY
Received
City of Tigard Date/By: Permit No.:
v 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing ❑ Mechanical
TIGARD Internet: www.tigard-or.gov
0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW yes No \/,1
I Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district approval required. Name of district: . ❑ 0 0
5 Septic system permit or authorization for remodel. Existing system capacity 0 0 0
6 Sewer permit. 0 0 0
7 Water district approval. ❑ 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ 0 ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state • 0 0
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 be 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 II 0 0
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 0 ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, MI 0 ❑
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- • 0 ❑
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. • ❑ 0 1
Exterior elevations must reflect the actual grade if the change in Bade 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- • 0 0
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 • 0 ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 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 a 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. IN 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 ❑ ❑
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 t 0 0
architect licensed in Oreton and shall be shown to be ap p licable to the .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
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. • 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. IN 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 III ❑ 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, ❑ ❑ U
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.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
it
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
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.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Permits\MEC_PermitApp_040113.doc 2
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description I Qty. I Each I Total I *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved:
5.01 to 15 kva 133.56 2
n Audio and Stereo Systems* 15.01to25kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >t00 kva(fee in accordance
552.26 2
with OAR 918-309-0040)
El 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 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
pceifically listed('G hr min)
m _ ELECTRICAL PERMIT.FEES
COMMERCIAL WORK ONLY: a
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
❑ Boiler Controls
El Clock Systems
n Data Telecommunication Installation
El Fire Alarm Installation
El HVAC
El Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:113ui1d1ngwermitswELC_PermitApp_ELR_ERE.doc Rev 06/1 72 01 5
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footagc: Permit Fee:
Footing drain-1s'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-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $1.00 to S5,000.00 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
Qty. Fec(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$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
❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
El Any multipurpose fire sprinkler system.
Dishwasher: -Commercial-Domestic
❑ 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
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lay/Bar non-food related
-Bradley
-Com/ServAltil 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:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
City of Tigard
114 COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: MST-2022--COLiSi
Site Address: 15 c
22k 9 V 'l),) 'Qj\' [1'JVeriffie�d in Accela
Project Name: �� C� f3\ Lot/Unit l#: Oct
Proposal (include housing type): Zone: e�-C'S—C-
Required Site Plan Elements:
113 3 copies of site plan on max 11x17"
❑ Drawn to standard scale Retained trees, drip line/ tree protection
A North arrow -- Street and site trees shown / labeled
Site address, project name, lot # Table calculating tree canopy at maturity
Cr Street names r SFR)
OApplicant name and phone # Cou y ngle dimensioned (if applicable)
Lot and setback dimensions ❑ Vision clearance triangle
'Existing structures &square footage ❑ Utility locations &easements
l Footp''rint of new structure and FFE 0 Property corner elevations
ff?Sidewalk/driveway dimensioned .D't1-9A-(- 1,000 sf disturbance)
1pLot area and lot coverage percentage r Erosion control
N
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Garage doors dimensioned
wn to standard scale S mmary table with calculations for:
-height dimensioned - Total facade area
Façade dimensioned Total window and door area
Windows and doors dimensioned Total garage area
'red Floor Plan Elements: ❑ Summary table that includes
❑ Eac ' ned ❑ Total floor area
❑ Each story floor calculated ti❑ Floor area per story
Planning Review
The followin standards have been met: �( �
Setbacks Front: 12/5 Rear: 10 Side: Min/Max Street Side: ��3 / !` Garage: 'vVn
Height 14 Max. Height: ./2- ---
Yes 0N/A Landscape 242j4V
AA ^y(�Q�J
It)Yes ❑ N/A % Window Coverage 12"7, V►ikY\ i `1 �- C1e�1
91 Yes ❑ N/A Garage (SFR Only) &,' f7 , J
IL}Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
es bui ' ign standards (Rowhouse only)
❑ Yes ❑ N/ cessory tandards
❑ No Qualifying pre-existing unit exe dards (Cottage unit only)
Ad 'tional standards for Courtyard U rits, Cottage Clusters, Rowhouses, and Quads:
El Yes A Unit Count:
CI Yes 0 N/A t Width and Size'
❑ Yes ❑ N/A Pat
Additional standards f rtyard Units and Cottage Clusters only:
❑ Yes ❑ N/A Unit a:
❑ Yes 0 N/A or Area (per story)
❑ Yes ❑ N Courtyard
❑ Y N/A Fence
❑ Yes ❑ No'-N/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
.Yes 0 No ❑N/A Public Facilities Improvement (PFI) Permit: �
Required: ❑ Yes El No ` _-S\�
\` - 1 -QC Qp L� b ,",n
L�-- '/
Applied For: ❑ Yes ❑ No, stop intake A 0' ' `- -1 ( 4b1t-
'❑ Sensitive Lands: CI Yes VNo , 7+
❑ Land Use Case #: ?\--) -77Q\ l9 ` pro\\ II?r-zo18 111 Conditions met prior permit issuance
13 / 00005
�Q `S Date: _ 111
Approved By Planning: II On l
1,
Notes
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: ❑ Approved 0 Not Approved Date:
Building Permit Submittal
Original Submittal Date: It!O9(202.2
Site Plans #: 3
Building Plans #: `J
Building Permit #: 2Building permit # entered on page 1
Workflow Routing: nning-ErShgineering .121 Permit Coordinator .12-BLilding
Workflow Sign-off: eSign-off for Planning (include notes from planning review)
Route Documents: _Engineering: (1) copy of permit application, (1) site plan, (1) building plan
and original plan review routing form.
,!3tuilding: original permit application, site plans, building plans, engineer and
f beam calculations and trust details, if applicable, etc.
Permit Technician: s Date: 1 L I01 20z2
Notes:
En�eering Review
Le Slope at building pad: 4/t
/V/'4-M'Conditions met prior to issuance of permit
IP-Easements (encroachments) per engineering conditions of approval and plat
IVWater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: 0 Yes ❑ No
LIDA Facility on lot: 0 Yes ❑ No Add Fee: ❑ Yes ❑12/final Plat Recorded
0 NOT Approved: Date:
Notes: �—,
Approved By Engineering: / '/ .Date: �/� .
Revision 1: CIApprove 0 Not Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date:
Permit Coordinator Review
idsConditions met prior to permit issuance
6. Approved, NOT Released: Date notified applicant: .
❑ ENG Revisions Required: Date notified applicant:
DC Exemption: 0 Applied for ❑ Received ❑ Does not apply
litSDC Fees Entered: Wash Co Trans Dev Tax: Yes 0 N/A
Tigard Trans SDC: Yes ❑ N/A Deferred
Parks SDC: Yes ❑ N/A Deferred
LIDA 0 Yeses N/A
4 OK to Issue/Approved by Permit Coordinator: 1 `\\CV Date: \' 23 �2
Revision 1: 0 Approved CI Not Approved hhh ��� Date:
Revision 2: 0 Approved 0 Not Approved Date: