Permit (81) t
CITY OF TIGARD MASTER PERMIT
2 , COMMUNITY DEVELOPMENT Permit#: MST2023-00359
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/18/2023
Parcel: 2S108DC25100
Jurisdiction: Tigard
site address: 15209 SW FLATCREEK LN
Subdivision: RIVER TERRACE CROSSING Lot: 116
Project: River Terrace Crossing, Lot 116
Project Description: New detached dwelling w/140sf patio cover. NO FINAL INSPECTION UNTIL DEFERRED SDC
FEES ARE PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1204 sf Basement: 0
Height: 25 sf Left: 3 Parking Spaces: 0
9 Bathrooms: 3 Second: 1323 sf 580 Garage:
Dwelling Units: 1 Third: 0 sf g sf Front: 12 Smoke Yes
Right: 3 Detectors:
Total: 2527 sf Value: $468,615.75 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach; 1 Laundry Trays: 1 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
FootingDrain: 0 Ice Maker: 1 Bckflw Prevntr: 1
Hose Bib: 3 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1
Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
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
Other: N Other Description: Y
Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF
V B 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: $51,375.87
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 h in OAR
0c2.nn1JM1n thrn„nh('iAR QFAnni-nfon Vni,mmi nn„nr the'Iliac nr rlirart m,actinnc fn CV OJT.hs,Tallinn Sn9 979 10a7 nr 1 Ann'3Q9 91
Issued By: — Permittee Signature:
(es
all 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.
Building Permit Application
Residential RECEIVEs
FOR OFFICE USE ONLY
City of Tigard Received Penn it No.:
" 13125 SW Hall Blvd.,Tigard,OR 97223 t1`^ PlateBy: �� Zk CSC�G,{ CK��Jr
$� .II1(. i) �_ l�!✓1 Phone: 503.718.2439 Fax: 503.598.1960 Plan Review s zz_ J,rJ, der p64 4p c">, 0016..Date/By:
TIGARD Inspection Line: 503.639.4175 I'�n, /'t Date Rcady/ey: mr:. ® See Page 2far
Internet: www.tigard-orgov "I' ` v� j IUp�I� Notlfied/Mcthod: Q 111j,��2'��� I Supplemental Information
BUILDING DIVISION EYY1.Ltaai
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 ['Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
1-and 2-family dwelling ❑Commercial/industrial
Valuation: $ 0 I lit lit 5 r
ElAccessory building ❑Multi-family Numbef of bedrooms: 4
El Master builder ❑Other: Numbed'of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 '51 b 7
Job site address:15209 SW Flatcreek Ln New dwelling area: 2527 square feet` V2-)23
City/State/ZIP:Tigard,OR Garage/carport area: 580 square feet I abl
Suite/bldg./apt.no.: Project name:River Terrace Crossing Covered porch area: 74 square feet l
Cross street/directions to job site: Deck area: square feet
Covered Patio: 140 square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:River Terrace Crossing Lot no.: 116 Permit fees*are based on the value of the work performed.
Tax map/parcel no:2S108DC10800 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 ❑ TENANT Number of stories:
Name:Pacific Lifestyle Homes Type of construction:
Address: 11815 NE 99'Street,Suite 1200 Occupancy groups:
City/State/ZIP:Vancouver,WA 98682 Existing:
Phone:(360)573-8081 Fax: New:
® APPLICANT C. CONTACT PERSON BUILDING PERMIT FEES*
Business name:Pacific Lifestyle Homes (gea�refe 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
Total fees due upon application:
City/State/ZIP:Vancouver,WA 98682 p
Phone:(360)213-0809 Fax::( ) Amount received:
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: $201.60
Authorized signature: K �, ,JZ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Kellie Franklin Date:7/28/2023 *Fee methodology set by Tri-County Building Industry
Service Board.
1:1Building\Permitsl3UP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit APPlicati CEIVED FOR OFFICE I'SE ONI.1
City of Tigard Received •
DateBy: Permit I,_+_ — i_ t.3 i
13125 SW Hall Blvd.,Tigard,OR 97223 J U L 3 1 2023 Plan Review ��/rrr LLL
Phone: 503.718.2439 Fax: 503.598.1960 Date/By Other Permit
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Tuns: Ed See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/re lacement
P performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF.CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75
Job site address: 15209 SW Flatcreek Ln Furnace 100,000 BTU(dactsivents) I 46 75
• City/State/ZIP:Tigard,OR Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:River Terrace Crossing Duct work 2332
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.:116 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:2S108DC10800 Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 1 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
ElPROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Pacific Lifestyle Homes Range hood/other kitchen
' equipment 1 33.39
Address: 11815 NE 99th St.,Suite 1200 Clothes dryer exhaust 1 33.39
City/State/ZIP:Vancouver,WA 98682 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32
Phone:(360)573-8081 Fax:( ) Attic/crawlspace fans 23.32
er APPLICANT ® CONTACT PERSON Other: 23.32
Business name:Pacific Lifestyle Homes Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Permit Coordinator-Kellie Franklin Furnace,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 1
Range I
E-mail:permits@buildplh.com Barbecue 1
CONTRACTOR Clothes dryer(gas) ,
Other:
Business name:Wolcott Plumbing MECHANICAL PERMIT FEES*
Address: 1075 West Historic Columbia River HWY Subtotal
Minimum permit fee($90.00)
City/State/ZIP:Troutdale,OR 97060 Plan review(25%of permit fee)
Phone:(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
days after it has been accepted as complete.
Authorized signature:A;zigi, f21 L * Fee methodology set by Tri-County Building Industry Service Board
Print name:Kellie Franklin Date:7/28/2023
I:1BuildinglPermits1MEC_PemdtApp_040113.doc 440-4617T(11/02/COM/WEB)
' Electrical Permit A licatio ECEIVED FOR OFFICE USE ONLY
Cityand Received
o f Tigard JUL 3 1 2023 Date/B ! •� i,
,111 • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
1 0: Phone: 503.718.2439 Fax: 503.598.1960 Dywa : Related Permit a:
InspectionPage 2TIGARD
www.tigard-ougov CITY OF TIGARD Notified/Method'
e Inte Supplemental Information
BUILDING DIVISION
TYPE OF WORK PLAN REVIEW
® New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked).
ElService or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other:
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
® 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.
0 Multi-family ❑Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
ElJob 4: Job site address: 15209 SW Flatcreek Ln 0141'Addition new motor load of system.
m
100EIP or more. ❑"A" "E" ••1-2" "1-3"
Ci /State/Z[P:Tiard, OR ❑Six or more residential units. occupancy.
ty g 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:River Terrace Crossing 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
• Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
• Subdivision:River Terrace Crossing Lot 4: 116 Includes attached garage.
1,000 sq.ft.or less 3 168.54 4
Tax map/parcel 4: 2S108DC10800 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 0 See Page 2
El 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 St., Suite 1200 201 amps to 400 amps 1 133.56 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 )573-8081 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 ® CONTACT PERSONBranch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with •
Business name:Pacific Lifestyle Homes above service or feeder fee, 742 2
each branch circuit
Contact name:Kellie Franklin B.Fee for branch circuits without '
Address:11815 NE 99th Si, Suite 1200 an ah circuit t feeder fee,first
branc 56.18 2
br
City/State/ZIP:Vancouver, WA 98682 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360-213-0809 Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:permits@buildplh.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Garner Electric Sign or outline lighting 67.84 2
Address:2890 SE Brookwood Ave. Signaln it(s)orlextension. ❑ 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:permitsgggarnerelectric.com Industrial plant(1 hr min) 78.I8/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 121159 Electrical Lic.: 34-305C Suprv.Lic.: 3707-S specifically listed('G hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Charles Gamer Date: 7/28/2023
0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: a ac K TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Brittany Burian Date 7/28/2023 days after it has been accepted as complete.
* Number of inspections allowed per permit.
i:\Building\PermilskELC_PennilApp_ELR_ERE doe Rev 06/17/2015 440-0615T(11/05/COM/WEB
• Plumbing Permit APplicatiOyECEIVE
Building Fixtures fl FOR OFFICE USE ONLY
City of Tigard JUL 3 1 2023 E P �l�- -0635 1
MI13125 SW Hall Blvd.,Tigard,OR 97223 Finn R,Review
• v� �J
Plan Review
Phone: 503.718.2439 Fax: 503.598.1Other Permit No.
cryOF TIGARD Date/By:
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date ReadyBginns
: ® See Page 2 for
Internet: www_tigard-orgov NotifiediMethod: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)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 sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:15209 SW Flalcreek Ln Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) 1 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 8 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:River Terrace Crossing I Lot no.: 116 Fixture or item:
Tax map/parcel no.: 2S 108DC 10800 Backflow preventer 1 31.27
DESCRIPTION OF WORK Backwater valve 1 12.51
Clothes washer 1 25.02
New SFR
Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER Expansion tank 12.51
El PROPERTY
I
Fixture/sewer cap 25.02
Name:Pacific Lifestyle Homes
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 3 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
Contact name:Permit Coordinator-Kellie Franklin Primer 12.51
Roof drain(commercial) 12.51
Address: 11815 NE 99th Street,Suite 1200 Sink/basin/lavatory 8 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
CCB Lic.: 112220 Plumbing Lic.no.: 'l,4- 0%A 1'tJ Plan review (25%of permit fee)
fizz/A State surcharge(12%of permit fee)
Authorized signature; �X• I I tiV TOTAL PERMIT FEE
Print name:Kellie Franklin Date:7/28/2023 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,
1:1Building\Penniu\PLMU-PennitApp.doc 10/01/09 440.4616T(10/02/COM/WBB)
. Building Division
One & Two-Family Dwelling
T k c n u n Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION DJ! 1 1-O2 3
aAG I
Permit #: IDS l 2,623_0"b351 Plan #: 5a-7 Floors:
Valuation: Li cldA I 1.t c. 75- Covered Porch: --lii Basement
Bedrooms: Deck: ` ----- 1st Floor ' 6-^'� �T
6
WC (toilets) 3 Deck Cover: - 2"d Floor 2773
Lavatories 5 Patio Cover 1 e I b 3`d Floor
Tub/shower 3 Accessory Struct. � R-3 Total a-7
Laundry Tray i�..is Water Heater ` / Gas 40 Garage Cp o
Exhaust Vents 5 Gas Flue Vents �-- Total for Elec. 31 0-7
—1
Backflow Prey. z F> ___ Heat Pump SAC # for Electrical
S
BBQ \I Gas Fireplace �S #Fuel Lines 2
FEES: Description: Fee Applies: Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg$2.00 (over 11x17) j\
Info Proc/Arch: Sm$.50 (up to 11x17) (V 0
Metro CET: Residential Use ✓'
School CET: District: (ro�
Tigard CET: Admin so
f
Tigard CET: ODHCS -/
Tigard CET: AH
Electrical Permit: Permit Fee:
Limited Energy:
12% State Surcharge L7
Mech. Permit: Permit Fee:
12% State Surcharge
Plumbing Permit: Permit Fee: /,
12% State Surcharge ��/
Erosion Control: w/Permit- Ping
CO C,rr,..�� \ 5 �.c,�- ,'r t` c -l.C�La--k-i. I ci-ri', e 1—
o"� Y--� �,1 CID c,res
�` \ i
Pa Bu ding\Fomns\ResPlanChec ees_Dec2022 AA.doc 12/21/22 JA C- ) J
�-'(e v -- 1-✓(`-e- O„ 1'". 1.T{.G S
City of Tigard
" COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: /VI6YD4)a-3— 003 SZ
Site Address: 15209 SW Flatcreek Ln _ Verified in Accela
Project Name: RT Crossing Lot/Unit #: 116
Proposal: New SFR zone: RES-C
Housing Type: Q SFR(G2 Single Detached ❑ Duplex❑Triplex 0 ADU) ❑ Rowhouse❑Cottage Cluster❑CYU ❑Quad❑Other
Required Site Plan Elements:
0 3 copies of site plan on max 11x17"• Drawn to standard scale L likR U1G1110 ucc , d111.1 I111C/uca Nl vwi.tlOn
O North arrow 0 Street and site trees shown /labeled
O Site address, project name, lot # ❑ T LI i L 1l .y L , , .l...Aurity
O Street names (N/A for SFR)
O Applicant name and phone # ❑ Courtyard rcctanglc dirwenoienod (if applicable)
O Lot and setback dimensions
❑ C C„y L t U , f l 7 p.441,114. °
B Footprint of new structure and FFE 0 Property corner elevations
O Sidewalk/driveway dimensioned e)
O Lot area and lot coverage percentage 0 Erosion control
R 'red Elevation Plan Elements:
(For SF . Ics needed only on street-facing) Summary table with calculations for:
❑ Drawn t ndard scale ❑ Total facade area
❑ Building heigh ' ensioned ❑ Total window and door area
❑ Facade dimensioned
❑ Windows and doors dimensi
❑ Garage doors dimensioned
Required Floor Plan Elements:
(Not required for SFR) ❑ Sum table that includes
❑ Each story dimensioned ❑Total floor a
❑ Each story floor area calculated ❑ Floor area per sto
Planning Review
The following standards have been met:
Setbacks 0 Front: 12/8 Rear: 15/10 Side: 3 Min/Max Street Side: 8 / Garage: 20
Height 0 Max. Height: NA Proposed Height: 25ft
• -s ❑ N/A Landscape *RTC did not apply optional design standards. 2016
❑ Yes a N/A Screening (Quad only) TCDC Ch 18 codes apply.
❑ Yes ❑ A % Window Coverage
❑ Yes ❑ N/A arage (SFR Only) Parking (Other Res)
❑ Yes ❑ N/A En' = ce (SFR, Rowhouse, Quad only)
❑ Yes ❑ N/A Other b.. .ing design standards (Rowhouse only)
❑ Yes El N/A Accessory cture Standards
❑ Yes ❑ No Qualifying pre-e ing unit exempt from standards (Cottage unit only)
Additional standards for Courtya < Units, Cottage Clusters, Rowhouses, and Quads:
❑ Yes ❑ N/A Unit Count:
❑ Yes ❑ N/A Lot Width and Size
❑ Yes 0 N/A Pathway
Additional standards for Courtyard Units and Co .e Clusters only:
❑ Yes ❑ N/A Unit Area:
❑ Yes 0 N/A Floor Area (per story)
❑ Yes 0 N/A Courtyard
0 Yes 0 N/A Fence
10 Yes ❑ No ❑N/A Clean Water Services - Service Provider Letter(lot platted prior to 9/10/1995)
❑ Yes ❑ No ❑N/A Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes ❑ No
Applied For: ❑ Yes ❑ No, stop intake
❑ Sensitive Lands: ❑ Yes ❑ No
o Main Land Use Case #s: PDR2016-00016, PDR2018-00005 0 Conditions met
Er Applicant notified of land use expiration date: 3/22/26
Approved By Planning: _ Date: 7/27/23
Notes
Revision 1: LI Approved ❑ Not Approved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Building Permit Submittal
Original Submittal Date: 7/ �7! /?-3
Site Plans #: ,
Building Plans #: 3
Building Permit #: (8I Building permit # entered on page 1
Workflow Routing: 1kt Planning fa,Engineering &Permit Coordinator l Building
Workflow Sign-off: 4 Sign-off for Planning (include notes from planning review)
Route Documents: J'iil Engineering: (1) copy of permit application, (1) site plan, (1) building plan
and original plan review routing form.
ICI Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
Permit Technician: ', Date:
Notes:
Engineering Review
❑ PFI Permit:
jd Slope at building pad: 2;
i/�ft VConditions met prior to issuance of permit
drEasements (encroachments) per engineering conditions of approval and plat
la'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑Yes tpYNo
Assess Water Quantity Fee in-lieu: ❑Yes frTlo
LIDA Facility on lot: ❑Yes 1 No Add Fee: ❑ Yes ❑ No
❑ Final Plat Recorded
O NOT Approved: _ Date:
Notes:
Approved By Engineering: Date: 4/2-/2,
Revision 1: El Approved ❑ N pproved Date:
Revision 2: ❑ Approved 0 of Approved Date:
Permit Coordinator Review
ft/Conditions met prior to permit issuance
❑ Approved, NOT Released: Date notified applicant:
❑ ENG Revisions Required: Date notified applicant:
-SDC Exemption: ❑Applied for ❑ Received /O'Does not apply
.DC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A l Deferred
Parks SDC: Yes ❑ N/A p Deferred
D LIDA ❑ Yes eN/
WOK to Issue/Approved by Permit Coordinator: Date: U 3
(((/ Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date: