Permit City of Tigard
" Deferral Until Occupancy Request
T I G A R 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: 10/26/2022 Site Address: 15210 SW Coolwater Ln
Project River Terrace Crossing Land Use Case or
Name: (Ichijo) Building Permit#: MST2022-00418
Tax Lot 2S108DC04400 Total Parks $11,830.00
#: Lot 47 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 for TSDC-
Reimbursement,and$3,796.00 for TSDC-River Terrace,if applicable..
*The total Parks SDC amount shown above is the sum of 56,812.00 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 TDT due on deferred obligations shall be the amount in effect at the time of
issuance of the building permit.
For a deferral request to be accepted both the Property Owner and the Developer must sign this request.
Property Owner: //i'!�`�'V Date: 10/28/2022
7 4- 3B 11/02/2022
Developer: Date:
Permit Coordinator: Pikro-N.6 itivtebt) Date: 10/26/2022
CITY OF TIGARD MASTER PERMIT
''1 r COMMUNITY DEVELOPMENT Permit MST2022-00418
Date Issued: 12/29/2022
T'GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S108DC04400
Jurisdiction: Tigard
Site address: 15210 SW COOLWATER LN
Subdivision: RIVER TERRACE CROSSING Lot:
Project: River Terrace Crossing, Lot 47
Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN
PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 1088 sf Basement: 518 sf Left: 3 Parking Spaces: 0
Height: 0 Bathrooms: 4 Second: 1470 sf Garage: 440 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 3076 sf Value: $503,859.20 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 3 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
Other Fixtures: 1
Drywell-Trench Drain: 0
Other Fixture Units: Ejector/Sump
MECHANICAL
Fuel Woes Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1
Natural Gas Heat Pump: Y Hoods: 1 Other Units: 0
Fuma100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn>=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. 6 201-400 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 8 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 SF VB R-3 3076
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 Ersn Cntrl 503-639-4175
131 BEAVERTON,OR 97005 2 Geo Tech Required
BEAVERTON,OR 97005 3 (2)layers of 2x fire blocking
at sides-no eave vents
PHONE: 503-430-7413 PHONE: (503)430-7413
FAX:
Total Fees: $25,958.26
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
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Issued By: Permittee Signature:
all 03.639.4175 y 7:00 .m.for the next available inspection date.
This permit card shall be kept In a co picuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application Lc'T' 4w'?
Residential
City of Tigard cei°ea 1`U y _ OLI I
al 13125 SW Hall Blvd.,Tigard OR 97223 ������ ateBy: PermitNo.: 2L U
8 Plan Review t/7 22 3(Z 2022 Do t g l
Ill ® Phone: 503.718.2439 Fax: 503.598.1960 UCT r4 ® rtga� Dant R Other Pemt:
U ! ULL y
TIGARD Inspection Line. 503.639.4175 Date ReadyBy. rods ® See Page 2 for
Internet: www.tigard-orgov , of-� . 3'Notified/Method: q �1- Supplemental Information
SAT., t r.) ; � r
TYPE. OF WO1 REQUIRED DATA:A -�AND 2-FAMILY DWELLING
I Ncw construction ❑Demolition Permit fees*are based on the value of the work performed.
---- Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
1-and 2-family dwelling ElCommercial/industrial Valuation: $ b ' 5C1
I
❑Accessory building 0 Multi-family Number of bedrooms: 4
❑Master builder El Other:
Number of bathrooms: 4
` JOB SITE INFORMATION AND LOCATION Total number of floors: 3 3 5 l
Job site address: 15210 SW COOLWATER LN New dwelling area: 3076 square feet 1,47
City/State/ZIP: Tigard / OR / 97224 Garage/carport area: 440 square feet 1D
Suite/bldg./apt.no.: Project name:River Terrace Crossing Lot 47 Covered porch area: 67 square feet 5(B
Cross street/directions to job site: Deck-area: n 190 square feet v
1913 square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: River Terrace Crossing Lot no.: 47 Permitfees*are based on the value of the work performed.
Tax map/parcel no.: 2S 108 D C04400 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Single Family Detached Dwelling Valuation: $
Existing building area: square feet
P►C9y;,0+0"Ci C9� .. e e A f eir l r4A4 r•I c,``.,1,14144e New building area: square feet
ll II PROPERTY OWNER 0 TENANT 7 Number of stories:
Name: CND-RIVER TERRACE,LLC Type of construction:
Address: 111 North Post Oak Road Occupancy groups:
City/State/ZIP: Houston/Texas/77055 Existing:
Phone:(713)316-3128 Fax:( ) New:
• APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: ICHIJO USA CO., LTD. Structural plan review fee(or deposit).
Contact name: Naoki Yamaoka
FLS plan review fee(if applicable):
Address: 3800 SW Cedar Hills Blvd. Ste. 130
Total fees due upon application:
City/State/ZIP: Beaverton/OR/97005
Phone:(503)430-7413 Fax: :(503)430-7621 Amountrecetved:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: nao@ichijousa.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: ICHIJO USA CO., LTD. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 3800 SW Cedar Hills Blvd Solar Installation Specialty Code checklist.
City/State/ZIP: Beaverton/OR/97005 Permit Fee(includes plan review ' $180.00
and administrative fees):
Phone:(503)430-7413 Fax: (503)430-7621 State surcharge(12%of permit fee): $21.60
CCB lie.: 215360 Total fee due upon application: $201.60
Authorized signature: �� �1. This permit application expires if a permit is not obtained
`S within 180 days after it has been accepted as complete.
Naoki Yamaoka 10/17/2022 *Fee methodology set byTri-County Building Industry
Print name: Date: Service Board.
I:1Building\Permits\BUP-RESPeimitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application Poi OFFICE USE ONLY
Received
City of TigardIIIIIII Date/By: Permit No.:
"I 13125 SW Hall Blvd.,1'igard,OR 97223 e
vmw
2 Phone: 503.718.2439 Fax: 503.598.1960 anny.DateB : Other Permit:
T I G AR D Inspection Line: 503.639.4175 Date Ready/By lens: id See Page 2 for
Internet: www.tigard-or.gov Notificd/Mcthod: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
▪New construction ❑Addition/alteration/replacement performed Indicate the value(rounded to the nearest dollar)of all
❑ Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
• 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist.
El Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Hearing cooling:
Air conditioning 46.75
Job site address: 15210 SW COO L WAT E R L N Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tigard / OR / 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 1 61.06
Suite/bldg./apt.no.: Project name: River Terrace Crossing Lot 47 Ductwork 1 23.32
Cross street/directions to job site: 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
Flue/vent for any of above 23.32
Subdivision: River Terrace CrossingLotno.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: 47 Water heater 1 23.32
2S1o$17e1Y4'I000F WORK Gas fireplace/insert 3339
u"�'" Flue vent for water heater or gas
Single Family Detached Dwelling fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
• PROPERTY OWNER ❑ TENANT Other: 23.32
.-------- - Environmental exhaust and ventilation:
Name: CND-RIVER TERRACE,LLC Range hood/other kitchen
equipment 1 33.39
Address: 111 North Post Oak Road Clothes dryer exhaust 1 33.39
City/State/ZIP: Houston / Texas / 77055 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 6 23.32
Phone:(713) 316-3128 Fax:( ) Attic/crawlspacefans 23.32
APPLICANT 0 CONTACT PERSON Other: 23.32
_.___ ----- - Fuel m I
Businessrlame. ICHIJO USA CO. LTD. Pp $14.15 for first four;$4.03 for each additional
Contact name: Naoki Yamaoka Furnace,etc.
Address: 3800 SW Cedar Hills Blvd Ste. 130 Gas heat pump
Wall/suspended/unit
d/unit heater
City/State/ZIP: Beaverton / OR / 97005 Water heater 1
Phone:(503)430-7413 Fax: :(503)430-7621 Fireplace
Range 1
E-mail: nao@ichijousa.com Barbecue 1
CONTRACTOR Clothes dryer(gas)
Business name: Supreme Heating and Cooling LLC Other.
MECHANICAL PERMIT FEES*
Address: 13009 NE 91ST Circle Subtotal
City/State/ZIP: Vancouver, WA 98682 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)333-3213 Fax:( ) State surcharge(12%ofpennit fee)
CCB Be.: 221 270 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
41days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: Naoki Yamaoka Date: 10/17/2022
hlBuilding3Permits1MEC_PermitApp_040113.doc 440-4617r(I 1l02/COM/WEB)
•-•• Efectrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
DesFee for all residential systems combined: $75.00f" °" I Q�• I EachTotal I •
y Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 00.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to25 kva 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
n Garage Door Opener* >100 kva(fee in accordance
552.26 2
with OAR 918-309-0040)
❑ 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
charged at an hourly(1 hr min)
_._ Inspections for which no fee is 90.00/hr
specifically listed(`A hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: S75.00 subtotalerpermt. Page l).
y * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n B• oiler Controls
❑ Clock Systems
n D• ata Telecommunication Installation
❑ Fire Alarm Installation
El HVAC
n Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I9Brulding\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015
. Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received Permit No. Q'l
III • 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By. ����, (�� 1"
: Phone: 503.718.2439 Fax: 503.598.1960 an Review
Dan
Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Suns H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
El New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
IIIII 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 1 500.32
❑Accessory 0Multi-family
Each additional bath/kitchen 1 25.02
0 Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 15210 SW COOLWATER LN Catch basn or area drain 18.76
City/State/ZIP: Tigard / OR / 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: River Terrace Crossing Lot 47 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 R: ) Page 2
Subdivision: River Terrace Crossing I Lot no.: 47 Fixture or item:
Tax map/parcel no.: 2 S 108 D C04400 Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 1 25.02
Single Family Detached Dwelling Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump ' 25.02
PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:
CND-RIVER TERRACE,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 111 North Post Oak Road Garbage disposal 1 25.02
City/State/ZIP: Houston / Texas / 77055 Hose bib 2 25.02
Phone:(713) 316-3128 Fax:( ) Ice maker 1 12.51
El APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: I C H I J O USA CO., LTD. Medical gas(value:$_) Page 2
Primer 12.51
Contact name: Naoki Yamaoka -
Roof drain(commercial) 12.51
Address: 3800 SW Cedar Hills Blvd. Ste. 130 Sink/basin/lavatory 7 25.02
City/State/ZIP: Beaverton / OR / 97005 Solar units(potable water) 62.54
Phone:(503)430-7413 Fax: :(503)430-7621 Tub/shower/shower pan 3 12.51
Urinal 25.02
E-mail: nao@ichijousa.com
Water closet 4 25.02
CONTRACTOR
Water heater 1 37.52
Business name: Pipe It Plumbing LLC. Water P !'/
IP m DWV 56.29
Address: PO BOX 1389 Other: 25.02
City/State/ZIP: Boring / OR / 97009 Subtotal
Phone:(503) 544-0477 Fax:(503) 912-0045 Minimum permit fee: $72.50
CCB Lie.: 174351 Plumbing Lie.no.: P B297 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: Naoki a m a o ka Date: 10/17/2022 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:\BaildingWermits\PLMU-PermiiApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
•lig
° COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: '2 --c0y 18-
Site Address: ISZ1 CooitLotlacverified in Accela
Project Name: ` CYli:S'n0\ L�o /Unit #: zo
Proposal (include housing type): ` `(2. - Zone: n n C,
Required Site Plan Elements:
" 63 copies of site plan on min 11x17"
0Drawn to standard scale ip line/ tree protection
6 North arrow Street and site trees shown / labeled
to Site address, project name, lot # ❑ Tabl c atin tree canopy at maturity
til Street names N A for SFR)
rig Applicant name and phone # --❑ Cc: a dimensioned (if applicable)
Lot and setback dimensions ❑ Vision clearance triangle
Existing structures &square footage ❑ Utility locations & easements
9 Footprint of new structure and FFE iielaroperty corner elevations
EpSidewalk/driveway dimensioned ❑ LIDA (>1,000 sf disturbance)
9JLot area and lot coverage percentage lrosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Garage doors dimensioned
❑ Drawn to standard scale Summary table with calculations for:
❑ Building height dimensioned ❑ Total facade area
❑ Façade dimensioned ❑ Total window and door area
❑ Windows and doors dimensioned ❑ Total garage area
Required Floor Plan Elements: 0 Summary table that includes
❑ Each story dimensioned 0 Total floor area
❑ Each story floor area calculated ❑ Floor area per story
Planning Review
The following standards have been met: /� ��p
Setbacks �i Front: >, & Rear:_ de: Min/Max5trcet-3tde: / ( Garage: _v0.
Height 1❑ Max. Height: ''t 1k Proposed Height:
43 Yes ❑ N/A Landscape
❑ Yeses N/A Screening (Quad only)
'3 Yes ❑ N/A % Window Coverage
`[ Yes ❑ N/A Garage (SFR Only) G.S1)c o U)f ON-Clel
�,(� Parking (Other Res)
�`rYes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes io N/A Other building design standards (Rowhouse only)
❑ Yes 'N/A Accessory Structure Standards
❑ Yes DAP) Qualifying pre-existing unit exempt from standards (Cottage unit only)
Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
Yes 0 N/A Unit Count:
❑ 0 N/A Lot Width and Size
❑ Yes A Pathway
Additional s dards for Courtyar s and Cottage Clusters only:
❑ Yes ❑ N/A Un rea:
❑ Yes ❑ N/A Floo er story)
❑ Yes ❑ N/ ourtyard
0 Ye /A Fence