Permit (12) INCITY OF TIGARD MASTER PERMIT
� COMMUNITY DEVELOPMENT Permk#: MST2023-00254
Date Issued: 06/29/2023
T f C.A P.I') 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108DC14100
Jurisdiction: Tigard
Site address: 15477 SW VANDERWOOD AVE
Subdivision: RIVER TERRACE CROSSING Lot: 6
Project: River Terrace Crossing, Lot 6
Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN
PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 1204 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 22 Bathrooms: 3 Second: 1323 sf Garage: 580 sf Front: 8 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2527 sf Value: $433,597.25 Rear: 10
PLUMBING
Sinks: 2 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: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
BdcBw Prevntr: 1
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Woes 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: 5
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 Svo/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 2527
Owner: Contractor:
PACIFIC LIFESTYLE HOMES INC PACIFIC LIFESTYLE HOMES Required Items and Reports(Conditions)
11815 NE 99TH ST#1200 11815 NE 99TH ST#1200 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98686 VANCOUVER,WA 98682
PHONE: PHONE: 360-213-0813
FAX: 360-574-6401
Total Fees: $24,800.95
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 'h 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. ATTENT c ' • egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rule h in OAR
ac9_nM-/IMn fhmu. •—nn1_nnon Vnro. . - foie a rnnw of the ndee nr direrf m,eetinne in re isir`hw rallinn,Sn4 71110117 nr 1 Ann'119 9 A
Issued By: ( ' H'T,•� Permittee Signature: 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 iob site at the time of each inspection.
Building Permit Application
Residential R FOR OFFICE 1'SE ONLY
City of Tigard , `� V "`d Permit No.:
' 13125 SW Hall lvd.,Tigard,OR 97223 CE' Review L T20 .-C
Phone: 503.718.2439 Fax: 503.598.1960 JUNDate/By: �Q I VI Other Permit vf'��a0N—oo 151
TIGARD Inspection Line: 503.639.4175 8 2023 DateReady/ly S''qq �y"��/� ,(gyp turn- �d7la See Page 2for
Internet: www.tigard-or.gov Notified/Method: �ld I Ijt{�If� n,+ I Supplemental Information
dy a ... .,.i. , •
TYPE OF WO"a 11 DING p!Lr'Qf�N REQUIRED DATA:I-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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION ,�
work indicated on this application.
• Valuation: , 0 (�J
0 I !�
® 1-and 2-family dwelling 0 Commercial/industrial fQ •
ElAccessory building 0 Multi-family Number of bedrooms: 3
❑Master builder ❑Other: Number of bathrooms: J,13'3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 \1)-1
Job site address: 15477 SW VANDERWOOD AVE New dwelling area: 2527 square feet 1. u l
City/State/ZIP: Tigard,OR 97224 Garage/carport area: 580 square feet C a,. I
Suite/bldg./apt.no.: Project name:River Terrace Crossing Covered porch area: 74 square feet
Cross street/directions to job site: • 2..55 square feet
o: 255 square feet •
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:River Terrace Crossing Lot no.:6 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S108DC00700 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.
New SFR Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Pacific Lifestyle Homes Type of construction:
Address: 11815 NE 99th Street,Suite 1200 Occupancy groups:
City/State/ZIP:Vancouver,WA 98682 Existing:
Phone:(360)213-0809 Fax:( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:Pacific Lifestyle Homes (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Permit Coordinator-Kellie Franklin
FLS plan review fee(if applicable):
Address: 11815 NE 99th Street,Suite 1200
City/State/ZIP:Vancouver,WA 98682 Total fees due upon application:
Amount received:
Phone:(360)213-0809 Fax::( )
E-mail:permits@buildplh.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Same Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:Same Solar Installation Specialty Code checklist.
City/State/ZIP:Same Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lie.: 173524 Total fee due upon application: $201.60
Authorized signature: !l This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Kellie Franklin Date:6/6/2023 *Fee methodology set by Tri-County Building Industry
Service Board.
I\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
. Mech inical Permit Application FOR OFFI( II I SF.()NI 1
City of Tigard Received
. • 13125 SW Hall Blvd.,Tigard,OR 97223 ^ I Y
Phone: 503.718 2439 Fax: 503.598.196R E1 _F IV E i't'l Other Pemdl
T lc;a R 0 Inspection Line: 503.639.4175 Date Ready/B y hais: ld See Page 2 for
Internet: www.tigard-or.gov 2023 Notified/Method: Supplemental Information
'
,4'N
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
TV
New construction CITY' OF TIC/TO Mechanical permit fees•are based on the value of the work
® ❑AddiGon/alterationR/�rg7r ` tpllll.9ION performed.Indicate the value(rounded to the nearest dollar)of all
""'' ` * mechanical materials,equipment,labor,overhead,and profit.
❑ Demolition 0 Other:
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist.
❑ Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 15477 SW VANDERWOOD AVE 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 Duct work 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 Crossing Lot no.:6
Other: 23.32
Other fuel appliances:
Tax map/parcel no.:2S108DC00700 Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 2 33.39
Flue vent for water heater or gas
New SFR 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 El TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Pacific Lifestyle Homes Range hood/other kitchen
equipment 1 33.39
Address:11815 NE 99th Street,Suite 1200 Clothes dryer exhaust 1 33.39
City/State/ZIP:Vancouver,WA 98682 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 6 23.32 _
Phone:(360)213-0809 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ® CONTACT PERSON Other: 23.32
Business name:Pacific Lifestyle Homes Fuel piping:
314.15 for first four;54.03 for each additional
Contact name:Permit Coordinator-Kellie Franklin Fumace,etc. 1
Address: 11815 NE 99th Street,Suite 1200 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98682 Water heater
Phone:(360)213-0809 Fax::( ) Fireplace 2
Range 1
E-mail:permits@buildplh.com
Barbecue 1
CONTRACTOR Clothes dryer(gas)
Business name:Wolcott HVAC Other:
MECHANICAL PERMIT FEES*
Address: 1075 West Historic Columbia River HWY" Subtotal
City/State/ZIP:Troutdale,OR 97060 Minimum permit fee($90.00)
Phone: Plan review(25%of permit fee)
(503)667-1781 Fax:( )
State surcharge(12%of permit fee)
CCB lie.: 112220 'TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
1Qd days after it has been yaccepted as complete.
Authorized signature: 0 ��• Fee methodology set by Tri-County Building Industry Service Board
Print name:Kellie Franklin Date:6/6/2023
tlBuilding1PernateMEC_PermirApp_040113.doc 440.4617T(I1/02/COM/WEB)
l OR(If f I( i- l SI.ON1.1
Eteretrleal Permit Application
p''� �,q
C1 O Tl and ECI�� ) Received
. g p @ l.. +v Dates : Dlrt�
larlail
III • 13125 SW Hall Blvd.,Tigard,OR 9 27 Plan Review
Phone: 503.718.2439 Fax: 503.598.19601 Date/B : Related Permit#:
Inspection Line. 503.639.4175 1�1, 8 2023 Ready Date/By: Janis. ElSee Page 2 for
TI GARD Internet: www.tigard-or.gov d',� I� Notified/Method: Supplemental Information
TYPE OF WOITM OF TIGARD PLAN REVIEW
®New construction 0 Addition/alters tlArepl d. `ji jON Please check all that apply(submit 2 sets of plans w/items checked):
�' 0 Service or feeder 400 amps or more ❑Building over three stones.
O Demolition ❑Other: where the available fault current ❑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 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:15477 SW VANDERWOOD AVE i0OHP or more. ❑"A","E","1-2","1-3",
(3 Six or more residential units. occupancy.
City/State/ZIP:Tigard, OR 97224 ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.4: Project name:River Terrace Crossing ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Rack I Total 1 *
New residential single-or multi-family dwelling unit.
Subdivision:River Terrace Crossing Lot#:6 Includes attached garage.
Tax map/parcel#:25108DC00700 I,000 sq.ft.or less 3 168.54 4
Ea.add'l 500 sq.ft.or portion 1 33.92 1
DESCRIPTION OF WORK Limited energy,residential
New SFR (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
® PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name:Pacific Lifestyle Homes 200 amps or less 100.70 2
Address:11815 NE 99th Street, Suite 1200 201 amps to 400 amps I 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Vancouver, WA 98682 601 amps to 1,000 amps 301.04 2
Phone:( 360)213-0809 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:permits@buildplh.com relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
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
® APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Pacific Lifestyle Homes above service or feeder fee, 7.42 2
each branch circuit
Contact name:Kellie Franklin B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: 11815 NE 99th Street, Suite 1200 branch circuit
City/State/ZIP:Vancouver, WA 98682 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360 )213-0809 Fax: :( ) Each manufactured or modular 67.84 2
ermltS build Ih.eom dwelling,service and/or feeder
Email:
{) @ p Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Garner Electric Signor outline lighting 67.84 2
Address:2890 SE Brookwood Ave. Signal alcteration,
n or limited-energy
❑ See Page 2 2
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:(503)642-7925 Investigation(1 hr min) 90.00/hr
Email:permits@garnerelectric.com industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 121159 Electrical Lic.: 34-305C Suprv.Lic.: 3707-S specifically listed('/z hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Charles Garner Date:6/6/2023 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: ,6 TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Brittany Buri Date:6/6J2023 days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:1Building\PermitsiELC_PemtilApp_ELR_ERE.doc Rev 06/I7/2015 440-4615T(I I/05/COM/WEB
'Plumbing Permit Application
Building Fixtures 9e�/
Cityof Tigard �EC 1 Y atei �y 5-/�g y Permit No.:MSif-71-'(SDra17
• 13125 SW Hall Blvd.,Tigard,OR 972 3 ate/8
E
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 2023 Date/By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 EN 8 Date Ready/By: kris: H See Paget for
Internet www.tigard-Orgov Notified/Method: Supplemental Information
TYPE OF WORK CITY OF TIGARD FEE* SCHEDULE
1 f�1'
El New construction CI I�attgtY~.G I)I a°i ! ' For special information use checklist.
Description I QtY_ I La. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 1 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler(3107 sq.ft.) • Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 15477 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.: ) I Page 2
Suite/bldg./apt.no.: I Project name:River Terrace Crossing Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 9 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear it.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision:River Terrace Crossing I Lot no.:6 Fixture or item:
Tax map/parcel no.:2S108DC00700 Backflowpreventer I 31.27
DESCRIPTION OF WORK Backwater valve I 12.51
Clothes washer 1 25.02
New SFR
Dishwasher I 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:Pacific Lifestyle homes Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:11815 NE 99th Street,Suite 1200
Garbage disposal 1 25.02
City/State/ZIP:Vancouver,WA 98682 Hose bib 2 25.02
Phone:(360)213-0809 Fax:( ) Ice maker 12.51
® APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name:Pacific Lifestyle Homes Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Permit Coordinator-Kellie Franklin
Roof drain(commercial) 12.51
Address: 11815 NE 99th Street,Suite 1200 Sink/basin/lavatory 7 25.02
City/State/ZIP:Vancouver,WA 98682 Solar units(potable water) 62.54
Phone:(360)213-0809 Fax: :( ) Tub/shower/shower pan 3 12.51
E-mail: permits@buildplh.com Urinal 25.02
Water closet 3 25.02
CONTRACTOR
Water heater 1 37.52
Business name:Wolcott Plumbing Water piping/DWV 56.29
Address: 1075 West Historic Columbia River HWY Other: 25.02
City/State/ZIP:Troutdale,OR 97060 Subtotal
Phone:(503)667-1781 Fax:( ) Minimum permit fee: $72.50
n ii_ p^A n g Plan review (25%of permit fee)
CCB Lic.:112220 Plumbing Lic.no.: V o V Y
�//p/. I��ti3 State surcharge(12%of permit fee)
Authorized signature: Kg��a, fiad'y1t�-&d... TOTAL PERMIT FEE
Print name:Kellie Franklin Date:6/6/2023 Phis permit application expires if■permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I1Building\Pernuls1PLMU-PermilApp.doc 10/01/09 440-46167110/02ICOM/WEB)
City of Tigard
" COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
a Building Permit #: /14*T 20.73 .-(�Dd- i-
p
Site Address:1S9'11 SW Vanderwood Ave X Verified in Accela
Project Name: River Terrace Crossing Lot/Unit #: Lot 6
Proposal: New Single Detached SFR Zone: RES -G
Housing Type: R4 SFR(k,'I Single Detached 0 Duplex 0 Triplex❑ADU) ❑ Rowhouse❑Cottage Cluster❑CYU ❑Quad 0 Other
Required Site Plan Elements:
IX 3 copies of site plan on max 11x17"
X Drawn to standard scale
X North arrow DA Street and site trees shown / labeled
X Site address, project name, lot # ^ T'b'^ c. 'c u'J''iaq trod ca^opy at -cItur'ty
X Street names (N/A for SFR)
XI Applicant name and phone # Cl Ce„rt,a,d .cam II, dlu-..,,i„,J (J ,.PF,li..uble)
X Lot and setback dimensions ❑ Vision clearance triangle
El CAi.,ti,ly at.u..tvl el Q .,.,u..,ei.,.,t,.y.. X Utility locations &easements
X Footprint of new structure and FFE X Property corner elevations
X Sidewalk/driveway dimensioned ❑ LIDA (-1,060 cf d'ctu-ba-ico)
X Lot area and lot coverage percentage X Erosion control
Re ' levation Plan Elements:
(For SFR: calcs only on street-facing) Summary table with calculations for:
❑ Drawn to standard sc 0 Total facade area
❑ Building height dimensioned ❑ Total window and door area
❑ Facade dimensioned
❑ Windows and doors dimensioned
❑ Garage doors dimensioned
Requir n Elements:
(Not required for SFR) ❑ Summary table that includes
❑ Each story dimensioned loor area
❑ Each story floor area calculated 0 Floor area pe
Planning Review
The following standards have been met:
8' 3' 8' 20'
Setbacks ❑ Front: Rear: �� Side: Min/Max Street Side: / Garage:
Height 0 Max. Height: 35' Proposed Height: 2-t 3 "-I"
❑ Yes ❑ N/A Landscape
❑ Yes C7 N/A Screening (Quad only)
❑ Yes ❑ N/A % Window Coverage
❑ Yes ❑ N/A Garage (SFR Only) Parking (Other Res)
❑ Yes C N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes 0 N/A Other building design standards (Rowhouse only)
❑ Yes 0 N/A Accessory Structure Standards
O Yes ❑ No Qualifying pre-existing unit exempt from standards (Cottage unit only)
Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
❑ 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
O Yes N/A Fence
❑ Yes ❑ No XN/A Clean Water Services - Service Provider Letter(lot platted prior to 9/10/1995)
0 Yes 0 No 151N/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes ❑ No
Applied For: 0 Yes 0 No, stop intake
X Sensitive Lands: ❑ Yes x No
❑ Main Land Use Case #s: PDR2016-00016/PDR2018-00005 ❑ Conditions met
NI Applicant notified of land use expiration 3/2 /26
Approved By Planning: Date: 6/6/23 /�'/?-3
Notes
Revision 1: 0 Approved ❑ Not Approved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Building Permit Submittal /
Original Submittal Date: t(S4)-3
Site Plans #: 7
Building Plans #: Zi
Building Permit #: Building permit # entered on page 1
Workflow Routing: Planning 0 Engineering t Permit Coordinator f Building
Workflow Sign-off: Sign-off for Planning (include notes from planning review)
Route Documents: iA Engineering: (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
1 beam calculations and trust details, if applicable, etc. /r
Permit Technician: `'X Date: ! P / '3
Notes:
Engineering Review
❑pFI Permit:
IS Slope at building pad: /2j ok
conditions met prior to issuance of permit
�XEasements (encroachments) per engineering conditions of approval and plat
Qa Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes itt1 o
Assess Water Quantity Fee in-lieu: 0 Yes CZ-No
LIDA Facility on lot: ❑ Yes l Add Fee: ❑ Yes ❑ No
❑ Final Plat Recorded
❑ NOT Approved: Date:
Notes:
Approved By Engineering: `( � Date: ���� N
CIN Revision 1: 0 Approved pproved Date:
Revision 2: D 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:
%SPC Exemption: 0 Applied for ❑ Received i2Does not apply
DC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A ❑ Deferred
Parks SDC: Yes 0 N/A ❑ Deferred
LIDA 0 Yes 1 i'N/A
❑ OK to Issue/Approved by Permit Coordinator: Date:
Revision 1: 0 Approved ❑ Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
DocuSign Envelope ID:08ABE211-09F2-40A5-9780-855CB8A1A009
City of Tigard JUN 15 2023
INDeferral Until Occupancy Request ���OF�'�?4:;n
■ P Y q BUILD:
1 I G A R 1� Washington County Transportation Development Tax(1'D'1),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).
River Terrace Crossing Lot 6
Date: 6/6/2023 Site Address: 15477 SW VANDERWOOD AVE
Project River Terrace Crossing [sled Use Case or MST2023-00254
Name: (Pacific Lifestyle Homes) Building Permit#:
TaxLot 2S108DC14100 Total Parka $11,630.00
#: Lot 6 Amount*:
TDT Total TSDC
$12,004.00
Amount: NIA Amount*:
*The total TSDC amount shown above is the sum of$7.760.00 for TSDC-Imptoventent,S 448.00 for TSDC-
Reimbursement,and 13.796.00 for TSDC-River Terrace,if applicable..
"The total Parks SAC amount shown above is the sum 01$6,812.00 for Parks-Improvement,5 1,887.00 for parks-
Rc mbursement,and either$ N/A for Parks-Neighborhood or$3.131.00 for Parks•Ncighborhood River Terrace.
This constitutes my request to defer payment of the TDT,TSDC,and Parks SDCs,as provided above,
until occupancy.
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 or issuance of an occupancy permit.
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.
oocualgned by:
Property Owner: C Sent r` F8 Date: 6/6/2023
14
Developer: Date: 'K- Z^9
6/15/2023
Permit Coordinator: Date: 1
DacuSign Envelope ID:08ABE211-D9F2-4DA5-9780-855CB8A1 A009
RECEIVED
City of Tigard JUN 8 2023
Deferral Until Occupancy Request CITY OF TIGARD
"l ll r'lr! r'.'''''"M
I I co A i a Washington County Transportation Development Tax(1 D'1),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).
River Terrace Crossing Lot 6
Date: 6/6/2023 Site Address: 15477 SW VANDERWOOD AVE
Project River Terrace Crosabtg Lend Use Case or
Name: Building Permit#:
(Pacific Lifestyle Homes)
Tax Lot Total Parks
#: 2S108DC00700 Amount*: $11,830.00
TOT' Total TSDC
Amount: N/A 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 Packs-
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 die TDT,TSDC,and Parks SDCs,as provided above,
until occupancy.
Payment of the TDT,TSDC,and Parks SDCs may be deferred until issuance of die occupancy permit. In
requesting this option,I understand that any deferred'PDT,TSDC,and Parks SDCs must he paid prior to final
inspection or issuance of an occupancy permit.
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.
0ocuafaned by:
CKuSS lit,t�.t.Msau, 6/6/2023
Property Owner: UEA?Fc557;OMF11 Dare:
w
Developer: _....)1-----4t
`,!1` Date: -. (. Z=-2
Permit Coordinator: Date: