Permit City of Tigard
Deferral Until Occupancy Request
TIGARD Washington County Transportation Development Tax (TDT),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: 11/30/2022 She Address: 12547 SW Main Street
Project AVA Tigard Land Use Case or BUP2022-00097
Name: Building Permit#:
Tax# Lot 2S102AB02100 Total Parks $158,861.30
TDT nt*:
(Amount based Total TSDC
Amount: $67,846.63 on 7/1/2022 Amount*: $25,791.22
fees)
*The total TSDC amount shown above is the sum of$24,388.95 for TSDC-Improvement,$1.402.77 for TSDC-
Reimbursement,and$ N/A for TSDC-River Terrace,if applicable..
*The total Parks SDC amount shown above is the sum of$97,110.60 for Parks-Improvement,$23,206.70 for Parks-
Reimbursement,and either$35,544.00 for Parks-Neighborhood or$ N/A 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: �• Date: 2VOI/- 34' -2%'0 Z
/ �Developer: Date: O Qj, J .2
Permit Coordinator: p to eAMPL4' .• Date: 11/30/2022
I` CIT9
Y OF TIGARD BUILDING PERMIT
1 COMMUNITY DEVELOPMENT Permit#: BUP2022-00097
•
T t GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 1/5/2023
Parcel: 2S102AB02100
Jurisdiction: Tigard
Site address: 12547 SW MAIN ST
Project: Ave Tigard Subdivision: AVA MIXED USE Lot: 15
Project Description: A new three-story mixed use apartment building with 22 dwelling units and retail on the first floor.
Contractor: YORKE Si CURTIS Owner: AVA TIGARD DEVELOPMENT LLC
4480 SW 101 ST AVE 4770 SW HALL BLVD
BEAVERTON, OR 97005 BEAVERTON, OR 97005
PHONE: 646-2123 PHONE:
FAX: FAX 643-5531
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: NEW Type of Const: VB Permit Fee-COM-New Construction 12/21/2022 $28,198.42
Occupancy Grp: R-2 Occupancy Load: 114 12%State Surcharge-Building 12/21/2022 $3,383.81
Plan Review 12/21/2022 $18,328.97
Dwelling Units: 22 DC Provision Review,COM New-Bldg 12/21/2022 $218.50
Stories: 3 Height: 40 ft DC Provision Review,COM New-Ping 12/21/2022 $218.50
Bedrooms: 30 Bathrooms: 22 Plan Review-Fire Life Safety 12/21/2022 $11,279.37
Value: $6,200,000 Info Process/Archiving-Lg$2.00(over 12/21/2022 $148.00
11x17)
Floor Areas: Info Process/Archiving-Sm$0.50(up to 12/21/2022 $127.00
11x17)
Total Area: 24651 Metro CET 12/21/2022 $7,440.00
Accessory Struct: 0 Tig-Tual School CET-Residential 12/21/2022 $34,757.91
Basement: 0 Tigard CET-Residential-Admin 12/21/2022 $2,480.00
Carport: 0 Tigard CET-Residential-ODHCS 12/21/2022 $8,928.00
Covered Porch: 0 Tigard CET-Residential-AH 12/21/2022 $50,592.00
Deck: 0
Garage: 0
Mezzanine: 0
Total $166,100.48
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes Parapet: Yes 1 Special Inspection(see plans)
Fire Alarm: Yes Protected Corridors: Yes
Smoke Detectors: Yes Manual Pull Stations: Yes
Accessible Parking: 1
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
952-001-0010 through OAR 952-001-0090.52 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
4.g,
Issued By: S j%4T ' Permittee Signature: ��O 6 ,-4 .-1
Call 503.639.4175 by 7:00 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.
V
Building Permit Application ilb
Commercial RECEIVED ^ FOR OFFICE USE ONLY
Received,J Y �,„'n,
IICity of Tigard Date/BY ,/1 F d a Permit No.f ,.i p a,y q 00c 9 7
" 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Rev eyy �1 j1 VV'
Phone: 503-718-2439 Fax 503-598-1960 APR 04 2022 DateBV: J - Q� ./) Related Permit.
Fr(i A R[) Inspection Line: 503-639-4175 Date Ready/By: Jena: 61 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: I1 3Ip — Supplemental Information
BUILDING DIVISION ,,'L,., 1/,Za
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
ew constmction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑ ddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
ID 1-and 2-family dwelling 0 Commercial/industrial
Valuation: $ '�
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder Other: V)i X W trj f_, Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
r _ j �
Job site address: I a 1 1tl 1 C CV M P i N ST, New dwelling are • square feet
City/State/ZIP: („pc-(it( 8 it- 1 -1.4_3 Garage/carp area: square feet
Suite/bldg./apt.#: Project name:ANik. Ti.in D Cover rch area: square feet
Cross street/directions to job site: area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: 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.
C3) o n- M 1 c us r t1 11,O/Dr "J f Valuation: $ jp!
ExistingZ ® r o a o . oU
�'�v C atN V_ QNbuildingarea: .--- square feet
ETA F I�s'�
3 V c2 1 �-p/A YZTm C�'r L-C—,\/c 7- t New building area:2�Ff (P S 1 square feet
1 0 PJOPERTY OWNER 1 0 TENANT Number of stories: C 3• �
Name: -f) )( ✓1 r-�xiG(t 4 � �CL/ l rv1,/,S c � 'f✓I/O.-y Type of construction:
Address: / // 9(6 a 5:.C) �«/ oI/l eas Occupancy groups: /_—2 / R - 2,
City/State/ZIP: .eG&J e(� l (11 (7<_ .9 -y O�� Existing: v---
1 l
T
Phone:(9 ) ,332 — 7746 Fax( )
New: L.,
0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: iz-A .,►Pt ^��4 IN'na2( lvl Af.c- i (i '- 1�(VrNi ci c
P Structural plan review fee(or deposit): 17 $ 47
Contact name: R4 I H RA y'�
P FLS plan review fee(if applicable):
Address: .3 3 3 S• r
Total fees due upon application:
CitylState/LIP: L t-1(.l. 05141t t' 012 - 94- O 3 4-
Phone:(c0 li 5-13 C} M-.)0 Fax::( ) Amount received:
E-mail A L.p u TA H R j�,(J C'D Y►'!e Aci. /W(� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: - -• Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: i1 0 St.--) id-/ Solar Installation Specialty Code checklist.
City/State/ZIP: [i,�s W �� 17 Permit fee(includes plan review $180.00
V'w and administrative fees):
Phone:( �) ��p j- t�� Fax:( ) State surcharge(12a/o of permit fee): $21.60
CCB Lie.: 15•1yf
1 7 Total fee due upon application: $201.60
Authorized signs re: t �j/l / -i' This permit application expires if a permit is not obtained
jj within 180 days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUPCOM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM{WEB)
City of Ti.gard
IliCOMMUNITY DEVELOPMENT DEPARTMENT
I
rlr;nzD Building Permit Review — Commercial - With Land Use
Building Permit #: (5UP a64,a -000G77
Site Address: /z3-117 Sc)C t Y1.j /JJ sr Suite/Bldg#:
Project Name: t///7 7/6-if2j eU�Col'i97 ,tr-
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 3 -.T /fri„.„-, c)5 ,3/J/ftl,
ia Verify site address/suite# exists and active in permit system.
ZRiver Terrace Neighborhood: ElYes it5 No
MELand Use Case #: DDT t , p b f 7,O ? -coca( , DA lM t>,2.,e3.20-6 2
Ca Plans Match Approved Land Use: n
Site Plan a-Landscape Plan Ff. Other: EA 1/P72'/vi d?CG t2Gfi' 3 S�(&
Urban Forestry Plan Elevation Plan A L79w5l5 w/ily pOoe,�5J f ',
E Building Height: Maximum Height Actual Height e ri"
❑ Conditions Met: ❑ Prior to Submittal Prior to Permit Issuance
❑ Business License:
Exists: ❑ Yes ❑ No,applicant was provided a business license application
❑ Public Facilities Improvement(PH)Permit:
Required: ❑ Yes,applicant was notified 0 No Applied For. ❑ Yes ❑ No,stop intake
Notes: Cv-n/))/764v5 ) -9 4 DD l22)9l to-06a63 Yw et jE l P plc- t `Fb
5tr/4oPissa c . /' iw to . ez t Ott S1tiG A1.3
Approved by Planning: ��,,wAi r Date: J.//y"Z Z
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: v/1/3a
Site Plans: # 3
Building Plans: #
Building Permit#: ar Enter building permit#above.
Workflow Routing: Planning Engineering Permit Coordinator TBuilding
Workflow Sign-off: ,[. Sign-off for Planning(include notes from planning review)
Route Application Documents: CJ building original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: / 9A-41 -P-64 Date: l/ /`l/aa`
I:\Building\Fonus\BldgPemutRvw_COM_W ithLandUse_111819.docx
L
Engineering Review
'Slope at building pad: I%
lJ PFI Permit#: 1_0/W__6165/
9 Conditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat (not typical on SDR/CUP)
❑ Water Quality/Quantity Facility: /
Assess Water Quality Fee in-lieu: ❑ Yes E No
Assess Water Quantity Fee in-lieu: ❑I Yes 2/No
LIDA Facility on lot: R Yes ❑ No Add Fee: ❑ Yes X No
❑ NOT Approved by Engineering: Date
Notes: to ,,„4- r,e-Cv..i' . vnfil c,„ A.,}4"s .tvx_ - J cwC.,l 1°f7' (S t S$"-tCj.
Approved by Engineering: 7 7L,ter% Date: 11/26(20ZZ
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: 0 Approved El Not Approved
Permit Coordinator Review
0 Conditions "Met"prior to issuance of building permit
,Approved,NOT Released: VJq,l-`-B( KI 4 CO As- At.- S11 l i v Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
71. SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A r^�OV
Tigard Trans SDC: V(Yes 0 N/A , See din n`�
Parks SDC: / Yes ❑ N/A o' " '
LIDA Fee: ❑ Yes SZr N/A
)OK to Issue Permit /�\-- �
Approved by Permit Coordinator: T" \ /C^`— Date: 2-(21(2622._
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse_i 11819.docx