Permit CITY OF TIGARD MASTER PERMIT
,III CITY
DEVELOPMENT Permit MASTER
MST2023-00277
Date Issued: 08/03/2023
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108DC30000
Jurisdiction: Tigard
Site address: 15627 SW MISSOURI AVE
Subdivision: CROSSING AT BULL MOUNTAIN Lot: 155
Project: River Terrace Crossing, Lot 155
Project Description: New detached dwelling. 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: 22 Bathrooms: 3 Second: 1614 sf Garage: 440 sf Front: 8 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2872 sf Value: $459,887.84 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
Bckflw Prevntr: 0
Fooling Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywall-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
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvciFeeders 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: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC:
N SecurityAlarm: 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: $25,662.34
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. ATTENTIO - regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
oc9_nn1_nntn rhrni in t59_nn1_nnan v ,nMoin o rnn,,of 1ha ruin nr air-pH n,maflnne in ni inir.by rollinn coe 9g9 1o0.7 nr 1 ann 119 91da II
Issued By: Nam" Permittee Signature:
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 p ect.
Approved plans are required on the job site at the time of each Inspection.
Building Permit Application
0
Residential FOR OFFICE USE ONLY
City of Tigard Received y��/}�
DateB : i 1 ' II' 1 ra iw /I_ ,
111 ii 13125 SW Hall Blvd.,Tigard,OR 97223 '"'9�I l_D Plan Review
II Phone: 503.718.2439 Fax: 503.598.1960'„„/ V C DateB : _'Mein
Other Permit:% , t r .16 6,
T I G A R D Inspection Line: 503.639.4175 Date ReadyBy. Julia: ® See Page 2 for
Internet www_tigard-or.gov - - a "- ^'7 N� �
o�tifified/Metphood:? i 2 • toSupplemental Information
TYPE OF Wtfi1 -Ntt(IF Ti(•An J REQUIRED DATA:I-AND 2-FAMILY DWELLING
I♦New construction Den1 ition 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. 1
Valuation:IIIII I-and 2-family dwelling 0 Commercial/industrial $ (15q, F/t
❑Accessory building 0 Multi-family Number of bedrooms: 4
❑Master builder 0 Other:
Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 3.- 1 D.--
Job site address: 15627 SW M I SSO U R I AVE New dwelling area: 2872 square feet l I,(„4
City/State/ZIP: Tigard / OR / 97224 Garage/carport area: 440 square feet 119?)
Suite/bldg./apt.no.: Project name:River Terrace Crossing Lot 155 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: 1p4411,square feet
REQUIRED DATA:COMNtERClAL-USE CHECKLIST
Subdivision: Crossing At Bull Mountain lot no.: 155 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 2S 108 DC TL#155 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
Request the Transportation and Parks SDCs to be deferred to occupancy New building area: square feet
■ 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*
(Please refer to fee scheduleBusiness 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. 131
Total fees due upon application:
City/State/ZIP: Beaverton/OR/97005
Phone: (503)430-7413 Fax: :(503)430-7621 Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: na0@IChijousa.COm
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 lie.: 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 Yam aoka Date: 06/15/2023 *Fee methodology set by Tn-County Building Industry
Service Board.
1:\Building\Permits\BUP-RESPennitApp.doe)02/242011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist ' y
One- and Two-Family Dwelling roa orricE I sl: mi.i
- City of Tigard Received Permit No.:
v 13125 SW Hall Blvd.,Ti ard,OR 97223 Date/By:
g Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
TIGARD 24-Hour Inspection Line: 503 639 4175 0 ElecMeal ❑ Plumbing 0 Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l es No \L‘
1 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. ❑ ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district approval required. Name of district: . ❑ ❑ 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 El
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 ❑ 0
9 Erosion control ❑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 ❑
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 il 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 U ❑ ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, U 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
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
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 0 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 j ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. • ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required Q ❑ 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 • ❑ ❑
architect licensed in Ore•on and shall be shown to be a.,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". • ❑ ❑
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. ❑ ❑
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. • ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, U ❑ ❑
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, ❑ ❑ •
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.
LiBuildinglPermits1BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONI,Y
City of Tigard Received
i Date/By: Permit No.:M •?7
IIII.
13125 SW Hall Blvd.,Tigard,OR 9722R EC E 1 V E' plan Review ST y '�
Phone: 503.718.2439 Fax: 503.598.19 0 ` Date/By: Other Permit:
T I G ARD Inspection Line: 503.639.4175 I!t 1I 07 Date Ready/By: kris: 0 See Page 2 for
Internet: www.tigard-or.gov J,,,=i'7 15 2u_.3 Notified/Method: Supplemental Information
TYPE OF WOR,i i Y (-Th I IGARD COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
'-" "�' — Mechanical permit fees*are based on the value of the work
New construction ❑Addition/al lc rat ion/replacement performed_Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
---- Value:$
CATEGORY OF CONSTRUCTION
---- RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
In I-and 2-family dwelling 0 Commercial/industrial ❑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: 15627 SW M I SSO U R I AVE Fumace 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 155 Duct work 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: Crossing At Bull Mountain Lotno.: 155 Other: 23.32
Other fuel appliances:
Tax map/parcelno.: 2S108DC TL#155 Water heater 1 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
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 I Other: 23.32
❑ TENANT _ Environmental exhaust and ventilation:
Name: ICHIJO USA CO., LTD. Range hood/other kitchen
equipment 1 33.39
Address: 3800 SW Cedar Hills Blvd. Ste. 131 Clothes dryer exhaust 1 33.39
City/State/ZIP: Beaverton/OR/97005 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32
Phone:(503) 430-7413 Fax:(503) 430-7621 Attic/crawlspace fans 23.32
• APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: ICHIJO USA CO., LTD.
- ---- $14.15 for first four;$4.03 for each additional
Contact name: Naoki Yamaoka Furnace,etc.
heat
Address: 3800 SW Cedar Hills Blvd Ste. 131 Gap
WalUsusUsuspendeded/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)
Phone:(503)333-3213 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lie.: 221270 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: t` Fee methodology set by Tri-County Building Industry Service Board
Print name: Naoki Yamaoka Date: 06/15/2023
I:IBuildingWermits1MEC_PemtitApp_040113.doc 440-4617T(ll/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 S500.00 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:1Building'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: ,
Description
e
Fee for all residential systems combined: $75.00 Renewable Q F.el Teter
electrical energy systemm•s:
5 kva or less 100.70 2
Check Type of Work Involved:
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 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 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
❑ 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
peciti cal ly listed(i hr mm)
COMMERCIAL WORK ONLY: _', 4 gym" ELECTRICALtot (Enter on Paget)
PERMIT FEES
Fee for each commercial system: $75.00 subtotal :
3r " Number of inspections allowed per permit
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I\Building7Permits\ELC_PermrtApp_ELR_ERE.doc Rev 06/17/2015
yv.--€J ,-,=e-r" ge\-c-1- 1----A—
cX �-g��
_ Building Division
One & Two-Family Dwelling
TIGARD
Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION JJ
Permit#: pn,S--11,07,2j c -7-.7 Plan #: g--Z� Floors: 42
Valuation: y 1 7 € 7 , 'ay Covered Porch: Basement
Bedrooms: l / 9 Deck: 15L Floor
WC (toilets) 3 Deck Cover: - - 2'd Floor ((a G l
Lavatories Patio Cover 3'Floor _
Tub/shower4 Accessory Struct. R-3 Total Z.€7 a
Laundry Tray Water Heater ( / as Elec Garage Li((O
Exhaust Vents 5 Gas Flue Vents Total for Elec. 3312-
Backflow Prey. - Furnace / eat Pum AC # for Electrical s
BBQ __./ Gas Fireplace #Fuel Lines 3
FEES: Description: Fee Applies: Fee Entered:
DC Prov Revw: Planning t'
Info Proc/Arch: Lg$2.00 (over 11x17) ZZ
Info Proc/Arch: Sm$.50 (up to 11x17) Fge
Metro CET: Residential Use q0.,--.0^-
1Z
School CET: District: t c i., .'
Tigard CET: Admin
Tigard CET: ODHCS
Tigard CET: AH C------
Electrical Permit: Permit Fee:
Limited Energy:
12% State Surcharge
Mech. Permit: Permit Fee:
12% State Surcharge
Plumbing Permit: Permit Fee:
12% State Surcharge r/
Erosion Control: w/Permit- Ping
es--3Z /
Notes: 1 — v1a t .D• ��- Ci 33) Zq .
G)a -� - y X 1-kg US) . = 2Cei 5S9
I:\Building\Forms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
Page 1
City of Tigard
:1 . ° COMMUNITY DEVELOPMENT DEPARTMENT 11
Building Permit Review - Residential
TIGARD
Building Permit #: MM I,QI/3'Q 1j1
Site Address: 15627 SW Missouri Ave X Verified in Accela
Project Name: River Terrace Crossing Lot/Unit #: 155
Proposal: New Single Detached SFR Zone: RES-C'
Housing Type: X SFR(X Single Detached ❑ Duplex❑Triplex❑ADU) ❑ Rowhouse❑Cottage Cluster❑ CYU ❑Quad ❑Other
Required Site Plan Elements:
M 3 copies of site plan on max 11x17"
X Drawn to standard scale
X North arrow X Street and site trees shown / labeled
X Site address, project name, lot #
X Street names (N/A for SFR)
X Applicant name and phone # ❑ CC,..11,..,J ,,...L.."l., di,.:.....i,.,...J (Ir uNF,t;,.uble)
X Lot and setback dimensions
❑ C.,;.,G y ..L,.,.L,..,,,, Q..,,,...,,. f.,,,I., . X Utility locations &easements
X Footprint of new structure and FFE g Property corner elevations
X Sidewalk/driveway dimensioned ❑ LIDA ( -1,000 cf dicturbanco)
X Lot area and lot coverage percentage X Erosion control
Re ' levation Plan Elements:
(For SFR: caics only on street-facing) Summary table with calculations for:
❑ Drawn to standard sc ❑ Total façade 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) El Summary table that includes
❑ Each story dimensioned oor area
❑ Each story floor area calculated ❑ Floor area pe
Planning Review
The following standards have been met:
Setbacks Front: 8' Rear: 10' Side: 3' Min/Max Street Side: 8' / Garage: 20'
Height Y Max. Height: 35' Proposed Height: 22
❑ Yes ❑ N/A Landscape
❑ Yes ❑ N/A Screening (Quad only)
❑ Yes El N/A % Window Coverage
El Yes El N/A Garage (SFR Only) Parking (Other Res)
❑ Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
El 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:
❑ 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
El Yes N/A Fence
❑ Yes ❑ No XN/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
El Yes ❑ No PSiN/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes ❑ No
Applied For: 0 Yes ❑ No, stop intake
X Sensitive Lands: ❑ Yes No
❑ Main Land Use Case #s: PDR2016-00016/PDR2018-00005 ❑ Conditions met
X Applicant notified of land use expiration 3/ 2/26 _
Approved By Planning: Date: -6/7/23 L/1 S/2-`3
Notes
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: ❑ Approved 0 Not Approved Date:
Building Permit Submittal
Original Submittal Date: J
Site Plans #:
Building Plans #:
Building Permit #: 'Building permit # entered on page 1
Workflow Routing: Planning C'Engineering 5/Permit Coordinator 5/Building
Workflow Sign-off: dSign-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.
'Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
Permit Technician: Vl/1't'a Date: bl o/ ifti
Notes:
Engineering Review
❑ PFI Permit:
Slope at building pad: `
p^Conditions met prior to issuance of permit
'Easements (encroachments) per engineering conditions of approval and plat
m'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes JP-No
Assess Water Quantity Fee in-lieu: ❑ Yes gNo
LIDA Facility on lot: ❑ Yes INo Add Fee: ❑ Yes ❑ No
'inal Plat Recorded
❑ NOT Approved: Date:
Notes:
Approved By Engineering: Date: c7�0
Revision 1: ❑ Approved ❑ N pproved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Permit Coordinator Review
. onditions met prior to permit issuance
❑ Approved, NOT Released: Date notified applicant:
ENG Revisions Required:4
Date notified applicant:
SDC Exemption: ElApplied for ❑ Received 'Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A ❑ Deferred
Parks SDC: Yes ❑ N/A ❑ Deferred
LIDA ❑ Yes Ft/A
/'BK to Issue/Approved by Permit Coordinator: A c V Mk►V` Date: I'S '13
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date:
RECEIVED
JUN 15 2023
City ofTigard BUILDING t OF I V SRON
Deferral Until Occupancy Request
T I G A R D Washington County Transportation Development Tax (VDT),Transportation and Parks System
Development Charges (SDCs) 1
This form is to be signed and submitted prior buildingpermit issuance or,if no buildingpermit is required, then
upon land use approval(TMC 3.24,as amended by Ordinance No. 21-09).
Date: 6/2/2023 Site Address: 15627 SW MISSOURI AVE
Project River Terrace Crossing Land Use Case or
Name: Ichijo Building Permit#: \ B ( CCJ2��
Tax Lot 2S108DC Ti#155 Total Parks !J
$11,830.00
#: Amount*:
Lot 155
TDT Total TSDC
N/A
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
1 prior to final inspection.
1 Payment of the TDT,TSDC,and Parks SDCs maybe deferred until issuance of the occupancy permit. In
Y ry rnv
P P
requesting this option,I understand that any deferred TDT,TSDC,and Parks SDCs must be paid prior to final
I 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: `//C,/�` Val Date: 6/2/2023
Developer: Date: K`-) - 2°
II
Permit Coordinator: Date: -
1 \