Permit (17) CITY OF TIGARD MASTER PERMIT
(� s , Permit#: MST2023-00275
COMMUNITY DEVELOPMENT
T t G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08l10/2023
Parcel: 2S108DC29400
Jurisdiction: Tigard
Site address: 15471 SW MISSOURI AVE
Subdivision: CROSSING AT BULL MOUNTAIN Lot: 149
Project: River Terrace Crossing, Lot 149
Project Description: New detached dwelling with 56 sq.ft. patio cover. NO FINAL INSPECTION UNTIL DEFERRED SDC
FEES HAVE BEEN PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1258 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1614 sf Garage: 440 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 2872 sf Value: $461,579.60 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: Storm Sewer: 100
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 0
g Water Lines: 100 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
BckFlw Prevntr: 0
Other Fixtures: 0
Drywell-Trench Drain: 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
Furn<100K: 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'I 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
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 SF VB R-3 2872
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 (2)layers of 2x blocking at
BEAVERTON,OR 97005 area indicated
PHONE: PHONE: (503)430-7413
FAX:
Total Fees: $25,709.93
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
oc9_nn1_ n1n rhrm, h t og9_nn1_nnon Vna v m d nhtain a rn ,of the n cc nr rlirart n„nctinnc In n r h„h ir raelnn/n R9919 10R A09 7 nr'I ann 'IAA
Issued By: C� /i!'%� !//7.G�� //I
Permittee Signature: / i
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 lob site at the time of each inspection.
Building Permit Application
Residential F
ko. .. FOR OFFICEl'sr.ONLY
City of Tigard Date/ReceiB laII5 13- 3/f- Ah iv\STea"�3"0,�,-
Permit Na
• 13125 SW Hall Blvd.,Tigard,OR 97223 I''''I 1 5 ` d
`' Plan Review s,�1 p/� -�a/I
INZ 3 ''i C+::-� I Z'3 Other Pen-nit: •v IC 14 011
• Phone: 503.718 2439 Fax: 503.598.1960 DateBy:
Inspection Line: 503.639.4175 ,� t„.r, Date Ready/B . /J y�I� kris- VI See Page 2 for
TIGARD Internet: www.tigard-or.gov t /' . "I Notirtifiedd/Metth�od:: Ir \n'Y11� 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.
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. tit
Valuation: $ y ( ( Sig t
II 1-and 2-family dwelling ❑Commercial/industrial vv
IDAccessory building El Multi-familyNumber of bedrooms: 4
❑Master builder ❑Other:
Number of bathrooms: 3
. JOB SITE INFORMATION AND LOCATION Total number of floors: 2 35)
Job site address: 15471 SW MISSOURI AVE New dwelling area: 2872 square feet I (,t/
ty Tigard / OR / 97224 Garage/carportarea: 440 square feet 1 ZS�City/State/ZIP:
Suite/bldg./apt.no.: Project name:River Terrace Crossing Lot 149 Covered porch area: square feet
Cross street/directions to job site: Deck aarrje��a__:I.Ia .�Jr square feet
OtherFtructure area: Ra4ie-1$'13"syuare feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Crossing At Bull Mountain Lot no.: 149 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.:2S108DC TL#149 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
Jo
Request the Transportation and Parks SDCs to be deferred to occupancy New building area: square feet
I♦ PROPERTY OWNER ❑ TENANT _ Number of stories:
Name: ICHIJO USA CO., LTD. Type of construction:
Address: 3800 SW Cedar Hills Blvd. Ste. 131 Occupancy groups:
City/State/ZIP: Beaverton/OR/97005 Existing:
Phone:(503)430-7413 Fax:(503)430-7621 New:
• APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
ICHIJO USA CO., LTD. (Please refer to fee schedule)
I3usincss na;nz: -
Structural plan review fee(or deposit):
Contact name: Naoki Yamaoka
Address: 3800 SW Cedar Hills Blvd. Ste. 131 FLS plan review fee(if applicable):
City/State/ZIP: Beaverton/OR/97005 Total fees due upon application:
Phone:(503)430-7413 Fax: :(503)430-7621 Amount received:
E-mail: nao@ichijousa.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
-- — Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic 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. Ste. 131 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 hc.: 215360 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: Naoki Yamaoka Date: 06/15/2023 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
•
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY'
City Tigard TI d Received
111111 Associated
Permit No.:
Date/By13125 SW Hall Blvd.,Tigard,OR 97223
I Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
24-Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing ❑ Mechanical
TIGAILD
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAIN REVIEW ' es No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 ❑ 0
3 Verification of approved plat/lot. 0 0 0
4 Fire district approval required. Name of district: . 0 0 0
5 Septic system permit or authorization for remodel. Existing system capacity 0 0 0
6 Sewer permit. 0 0 ❑
7 Water district approval. 0 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 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
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, • 0 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 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 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- • 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 ® ❑ ❑
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 • ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ® 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 NE 0 ❑
architect licensed in Oregon and shall be shown to be ap.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 l 1"or 11"x 17". • ❑ ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. • ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. • 0 ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. • 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. • 0 ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard • 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, d 0 0
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 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.
mke I*Building\Permits1BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
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
t ;
4
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 Qly. I Each I Total ^
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* 15.01 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
❑ 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
n 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
specifically listed(4 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEESTMarefral
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 + Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ 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
Plnuilding\Permits\ELC_PemtitApp ELR_ERE,doe Rev 06/l7/2015
•
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-l'100' 50.03 0 to 2,000 $121 90
2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 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$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
Qty. Fee(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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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 ❑ Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
Dishwasher -Commercial El Any multipurpose fire sprinkler system.
❑ Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2" -
3„ Isometric or Riser Diagram
4" 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: -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 plumbing permit can be issued.
Water Closet-Toilet
Urinal
Other Fixtures:
I:\Building\Petmits\PLMF_PermitApp.doc 08/04/2011 2
City of Tigard
III m
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: MS'Iioilt•00 j15
Site Address: 15471 SW Missouri Ave a4 Verified in Accela
Project Name: River Terrace Crossing Lot/Unit #: 149
Proposal: New Single Detached SFR Zone: RES 6
Housing Type: D4 SFR(X Single Detached El Duplex El Triplex❑ADU)❑ Rowhouse❑Cottage Cluster El CYU ❑Quad ❑Other
Required Site Plan Elements:
0§ 3 copies of site plan on max 11x17"
X Drawn to standard scale
X North arrow
1 Street and site trees shown / labeled
DQ Site address, project name, lot # ^ T_1 1.. .. I.,aIi it t....i , t .....F. ri y
X Street names (N/A for SFR)
X Applicant name and phone # El C.,,,,L,u,J ,Cd4.11 yll. Jnln.,,a1uncJ (;f.,E,Gk.eble)
X Lot and setback dimensions
❑ G.i.U. A ,..L...,...r&-sgLe,C R..el,.y,, X Utility locations &easements
X Footprint of new structure and FFE X Property corner elevations
X Sidewalk/driveway dimensioned El-LUGA4{a.i,GCA of diF,t.w.r.W se)
X Lot area and lot coverage percentage X Erosion control
Re ' levation Plan Elements:
(For SFR: calc only on street-facing) Summary table with calculations for:
❑ Drawn to standard sc ❑ Total facade area
❑ Building height dimensioned ❑ Total window and door area
❑ Façade dimensioned
❑ Windows and doors dimensioned
❑Garage doors dimensioned
Requir n Elements:
(Not required for SFR) ❑ Summary table that includes
❑ Each story dimensioned oor area
❑ Each story floor area calculated 0 Floor area pe
Planning Review
The following standards have been met:
Setbacks Front: 8 Rear: 101 Side: 31 Min/Max Street Side: 81 / Garage: 201
Height Max. Height: 351 Proposed Height: 27
El Yes ❑ N/A Landscape
❑ Yes ❑ N/A Screening (Quad only)
❑ Yes ❑ N/A % Window Coverage
❑ Yes ❑ N/A Garage (SFR Only) Parking (Other Res)
❑ Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes ❑ N/A Other building design standards (Rowhouse only)
❑ Yes ❑ N/A Accessory Structure Standards
❑ Yes ❑ No Qualifying pre-existing unit exempt from standards (Cottage unit only)
Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
0 Yes N/A Unit Count:
❑ Yes N/A Lot Width and Size
❑ Yes N/A Pathway
Additional standards for Courtyard Units and Cottage Clusters only:
❑ Yes N/A Unit Area:
❑ Yes N/A Floor Area (per story)
❑ Yes N/A Courtyard
❑ Yes N/A Fence
❑ Yes ❑ No SIN/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
❑ Yes ❑ No 1IN/A Public Facilities Improvement (PFI) Permit: ,
Required: ❑ Yes ❑ No
Applied For: ❑Yes ❑ No, stop intake
X Sensitive Lands: ❑ Yes X No
❑ Main Land Use Case #s: PDR2016-00016/PDR2018-00005 ❑ Conditions met
MApplicant notified of land use expiration ,: 3/2 / 6 �5/
Approved By Planning: Date: 6/7/73 X?
Notes
Revision 1: ❑ Approved 0 Not Approved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Building Permit Submittal -^?
Original Submittal Date: ( t I�lW UJ
Site Plans #:
Building Plans #:
Building Permit #: E"Building permit # entered on page 1
Workflow Routing: VPlanning teEngineering C"ermit Coordinator 'Building
Workflow Sign-off: VSign-off for Planning (include notes from planning review)
Route Documents: VEngineering: (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.
n
A. t io 6I2Ui201/3 .
Permit Technician: 'Y�'� Date:
1 Notes:
Engineering Review
❑ PFI Permit:
s
Slope at building pad: 2./7
iVConditions met prior to issuance of permit
p}Easements (encroachments) per engineering conditions of approval and plat
pt Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: El Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No Add Fee: ❑ Yes ❑ No
Final Plat Recorded
0 NOT Approved: Date:
Notes:
Approved By Engineering: Date: 3e9
Revision 1: ❑ Approved ❑ Not pproved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Permit Coordinator Review
Conditions met prior to permit issuance
❑ Approved, NOT Released: Date notified applicant:
ENG Revisions Required: Date notified applicant:
///���DC Exemption: ❑ Applied for ElReceived Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: i Yes DI N/A
I/ Tigard Trans SDC: Yes ❑ N/A
❑ N/A Deferred
Parks SDC: Yes Deferred
LIDA ❑ Yes f (�/A
OK to Issue/Approved by Permit Coordinator: I �lSt/l✓0 Date: `� C3
Revision 1: ❑ Approved CI Not Approved \ Date:
Revision 2: 0 Approved 0 Not Approved Date:
RECEIVL
JUN 15 2023
City ofTigard CITY OF TIGARD
" Deferral Until Occupancy Request BUILDING DIVISION
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: 6/2/2023 Site Address: 15471 SW MISSOURI AVE
ProjectRiver Terrace Crossing LandUse Case or
SName: IChijo Building Permit#: I`-`1
Tax Lot 2S108DC itl Total Parks
$11,830.00
#. Lot 149 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$ 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 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: �R�i' Date: 6/2/2023
Developer: Date: C, '
Permit Coordinator: Date: —7` S' Z