Permit (60) 1114CITY OF TIGARD MASTER PERMIT
_ COMMUNITY DEVELOPMENT Permit#: MST2023-00212
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/06/2023
Parcel: 2S1060003301
Jurisdiction: Tigard
Site address: 13709 SW 165TH AVE
Subdivision: RIVER TERRACE TOWN CENTER Lot:
Project: River Terrace Town Center, Lot 79
Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN
PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 4 First: 1173 sf Basement: 112
sf Left: 3 Parking Spaces: 0
Height: 29 Bathrooms: 3 Second: 1184 sf Garage: 502
g sf Front: 12 Smoke
DwellingUnits: 1 Yes
Third: 0 sf Right: 3 Detectors:
Total: 2469 sr Value: $402,833.89 Rear: 3
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: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bcktlw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 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<10OK: 1 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: 4 201-400 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 2469
Owner: Contractor:
AG EHC II(NWHM)MULTI STATE 2 LLC TNHC OREGON LLC Required Items and Reports(Conditions)
BY THE NEW HOME COMPANY INC 15231 LAGUNA CANYON ROAD 1 Ersn Cntrl 503-639-4175
BY KAWANAMI,MARK SUITE 250 2 1-HR FIRE RATED EAVES
15231 LAGUNA CANYON RD STE IRVINE,CA 92618 3 Geo Tech Required
250
PHONE: PHONE: 503-312-6213
FAX:
Total Fees: $24,006.66
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. ATTENT regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
oc9Jln1_nnin rhrn„ fAP 9_nn1_nncn Vnii in a rnn,,nfthc race nr rlirart niicctinnc to fit Ihlr:ha raliinn FM 9'i9 10R7 nr 1 Ann R'i9 9Rdd
Issued By: l s1 (c /g�117, Permittee Signature: SP.,. app1v *\Oh.
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 . ,-.-. 5/A2-.3 . //-
Ann
Residential 11itt„ li L—
FOR OFFICE USE ONLI
Cityof Tigard / 0 7 Received `.. AAC-. .0?
?_ �t�
.I g 1 U LI�L� Da /By: l J P"/'1Y't`r�t b Ot7
• 13125 SW Hall Blvd.,Tigard,OR 9 223 Plan Review /
Phone: 503.718.2439 Fax: 503.5 $ �¢Q Date/By .D 3//v Dt Z-' —00 o
TIGARD Inspection Line: 503.639.4175 �1�1 `..J{- TIGARD Date Ready/By: ((( Junn% H See Page for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method:IQ/2.4)23 fiF 1`Q supplemental Information
o .e.,1 t .SLAM k., J
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
I]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/altcration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. v�)8�� C
El I-and 2-family dwelling ElCommercial/industrial Valuation: 20
❑Accessory building 0 Multi-family Number of bedrooms: 4
El Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 3 2`r1 I
Job site address:13709 SW 165th ave New dwelling area: 2469 square feet 111:64
City/State/ZIP:Sher-Weed/OR/97140 Garage/carport area: 502 square feet 1173
Suite/bldg./apt.no.: Project name:River Terrace Town Center Covered porch area: square feet 1.1 d�
Cross street/directions to job site: Deck area: square feet
_SW J eali I OuiSP rd Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:River Terrace Lot no.:79 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:parcel no: 2S1060003300 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.
Valuation: $
Requectiog Deferred SDC fees
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:TNHC OREGON LLC Type of construction:
Address:15231 Laguna Canyon RD STE 250 Occupancy groups:
City/State/ZIP:Irvine/CA/92618 Existing
Phone:(503)310-7571 Fax: ( ) New:
,r , ,1: ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:TNHC OREGON LLC (Please refer ro fee schedule)
Structural plan review ice(or deposit):
Contact name:Frank Sandoval
FLS plan review fee(if applicable):
Address:15455 NW Greenbrier Parkway Suite 240
City/State/ZIP:Beaverton/OR/97006 Total fees due upon application:
Phone:(503) 310-7571 Fax: :( ) Amount received:
E-mail: fandoval@nwhm.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:TNHC OREGON LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:15231 Laguna Canyon RD STE 250 Solar Installation Specialty Code checklist.
City/State/ZIP:Irvine/CA/92618 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503 )310-7571 Fax:( ) State surcharge(12%ofpermit fee): $21.60
CCB lic_:241108
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Frank Sandoval Date: 5/8 j2UZj *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 01/25/2023 440-4613T(I 1/02/COM/WEB) -
Mechanical Permit ApplicatiJ ECEIVE 1 FOR OFFICE UST ONLY
�
City of Tigard Received �r
'3--U a-'1
• 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 1 0 2023 Date/By: Pe e)O
Plan Renew
'
I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: it:Other Perm
1 I G A It D Inspection Line: 503.639 4175 CITY OF TIGARD Date Ready/By: Suris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISIO Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition El Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT t SYSTEMS FEES*
® I-and 2-family dwelling ❑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 1 46.75
Job site address: 13709 SW 165th ave Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Sherwood OR 97140 Furnace 100,000+BTU(ducts/vents) 1 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:River Terrace Town Center Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
SW Jean Louise rd 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 Town Center Lot no.:79 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:2s1060003300 Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 1 33.39
Flue vent for water heater or gas
NEW HOME CONSTRUCTION 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 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name TNHC OREGON LLC Range hood/other kitchen
equipment 1 33.39
Address:15231 Laguna Canyon Rd STE 250 Clothes dryer exhaust 33.39
City/State/ZIP:Irvine CA 92618 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)310-7571 Fax:( ) Attic/crawlspace fans 23,32
® APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
TNHC OREGON LLC
$14.15 for first four;$4.03 for each additional
Contact name:Frank Sandoval Furnace,etc.
Address:15455 NW Greenbrier Parkway#240 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Beaverton OR 97006 Water heater
Phone:(503)310 7571 Pax::( ) FireplaceRange
E-mail:fandoval@nwhm.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Pro Heating and Cooling, INC Other
MECHANICAL PERMIT FEES*
Address:4200 NW Leisy rd Subtotal
City/State/ZIP:Hillsboro, OR 97124 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(971 )205 4989 Fax( ) State surcharge(12%of permit fee)
CCB lie.:209001 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Jf days after it has been accepted as complete.
Authorized signature: ( et0-- Hut. • Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:3/17/2023
DElu iding\Permits\MEC_PermitApp_040113_doc 440-4617r(1 I/02/COM/WEB)
RECEIVED
Electrical Permit Application MAY 1 0 2023 FOR Ott ICE USE ONLY
City of Tigardgl
Received
13125 SW Hall Blvd.,Tigard,OR 972C1TY OF TIGARD Date/By: k. �-�23_O�1%d-
Phone: 503JI82439 Fax 503.59 Plan Review
Inspection Line: 503.639.4175
BALDING DIVISION DatecBy: Related Permit it:
Ready Ltste/By: lure: See Page 2 for S —
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK
Ed New constructionPLAN REVIEW •
0 Addition/alteration/replacement Please check all that apply(submit j sets of plans w/items checked):
❑Demolition 0 Other: 0 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑
Floating buildings.1-and 2-familydwelling 0 Commercial/industrial 0Accessory building less to ground,or exceeds 14,000 0 Commercial-use
agricultural
❑Multi-family ❑Master builder amps for all other installations. buddings.
❑Other: ❑Fin pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system larger separateydenved
Job#: lob site address: 13709 SW 165th ave ❑100Addition motef new motor load of system.
I90f@or more. ❑••q'`E^•1-p,••ld„
City/State/ZIP: Sherwood/OR/97140 ❑s x ormore residential sn ts. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks
Suite/bldgJapt.#: Project name: RTTC 0 Hazardous locations. 0 Supply voltage for more than
['Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
SW Jean Louise rd nvrpar.aa I o i Each I Total 1 •
New residential single-or multi-family dwelling unit.
Subdivision: River Terrace Town Center Lot#:79 Includes attached garage.
Tax map/parcel#: 2s1060003300 1•0°° ft.or less t68.s4 4
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF•WORK Limited energy,residential
NEW HOME CONSTRUCTION (with above SQ.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft)
PROPERTY OWNER ❑ TENANT Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name: THNC OREGON LLC 200 amps or less 100.70 2
Address: 15231 Laguna Canyon Rd STE 250 201 amps to 400 amps 33.56 2
City/State/ZIP: Irvine CA 92618 col amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone:(503)310-7571 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation. and/or
Email: Fsandoval@newhomeco.com
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
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
al APPLICANT I 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
THNC OREGON LLC Aabo Fee for branch circuitseerfe,
Business name: above service or feeder fee,
each branch circuit 7.42 2
Contact name: Frank Sandoval a Fee for branch circuits soohed
Address: 15455 NW Greenbrier Parkway#240 servicebrunch circuit
fee,first
branch circuit 56.18 2
City/State/ZIP: Beaverton OR 97006 Each add.'branch circuit 7,42 2
Miscellaneous(service or feeder not included)Phone:(503)310-7571 Fax::( )
Each manufactured or modular 67.84 2
Email: Fsandoval@newhomeco.com dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Development Northwest Inc., DBA Wolcott Electrical Sign or outline lighting 67.84 2
Address:1075 W Historic Columbia River HwySignal nee,alteration,t(s)
r limited-energyxensi 0 �Page 2 2
panel,alterrioq or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:Troutdale, OR, 97060
Additional inspection(I hr min) ' 66.25/hr
Phone:(503)853-9420 Fax:( ) Investigation(I hr min) 90.00/hr
Email:MWOLCOTT@WOLCOTT.PRO Industrial plam(Ihrmin) 78,18/hr
Inspections for which no fee is
CCB Lie.:112220 Electrical Lie.:C1272 Suprv.Lic.:5782S specifically listed(4n hr min) 90.00 hr
Suprv.Electrician signature,required:' ELECTRICAL PERMIT FEES
«c..r,o.«,,„
Subtotal:
Print name:David Campbell Date:10/12/2023 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: 4.-.;40i6=0 TOTAL PERMIT FEE:
Print name:Malachi J. Wolcott This permit application expires if a permit is not obtained within Igo
Date:10/12/2023 days after it ban been accepted as complete.
• Number of inspections allowed per permit
1113rildinglPennite LC PermitApp_ELREREdoe Rev 06//7/2015 440.4615T(11/05/COMMEB
•
Plumbing Permit Application "'
Building Fixtures MAY 1 0 2023 Foil oFFicE USE °Ni,v
City of Tigard GARD Received Permit No.:
■ 13125 SW Hall Blvd.,Tigard,14 ff DF I V SION �t�y ��T�z3-Do2)2
Phone: 503.718.2439 Fait. 7: AlT1l 1 i; Plan Review
ri GARD Inspection Line: 503.639A175
DatelBy: Other Permit No.:
Internet: www.tigard-or.gov Date ed/MReady hy; furls: B See Supplemental
Ifor
nformation
Sobbed/Method: Supplemental Inf
TYPE OF WORK FEE* SCHEDULE
is New construction 0 Demolition For special informelien use checklist.
Description I Qty. ] Ea. I Total
❑Addition/alteration/replacement 0 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 0 Commercial/industrial SFR(2)bath 1 437 78
❑Accessory building CI Multi-familySFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13709 SW 165th ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/Z1P: Sherwood/OR/97140
Footing drain(no,linear ft.:_) Page 2
Suite/bldg./apt-no.: I Project name: RTTC Manufactured home utilities 50.03
Cross street/directions to job site: SW Jean Louise rd Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear It.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: River Terrace Town Center I Lot no.: 79
Fixture or item:
Tax map/parcel no.: 2S 1060003300 Backnow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
New Home Construction Clothes washer 25.02
Dishwasher 25.02
--- _ Drinking fountain 25.02
Ejectors/sump 25.02
Cil PROPERTY OWNER ❑ TENANT Expansion tank
12.51
Name: TNHC OREGON LLC Fixture/sewercap 25.02
Address: 15231 Laguna Canyon Rd STE 250 Floor drain/floorsinklhub 25.02
City/State/ZIP: Irvine CA 92618 Garbage disposal 25.02
Hose bib 25.02
Phone:(503)310-7571 Fax:( ) Ice maker 12.51
Et APPLICANT aj CONTACT PERSON Interceptor/grease trap 25.02
Business name: THNC OREGON LLC Medical gas(value:$ ) Paget
Contact name: Frank Sandoval Primer 12.51
Roof drain(commercial) 12.51
Address: 15455 NW Greenbrier Parkway#240 Sink/basin/lavatory 25.02
City/State/ZIP: Beaverton OR 97006 Solar units(potable water) 62,54
Phone:(503)310-7571 Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
CONTRACTOR Water closet 25.(IZ
Water heater 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 112220•-•00At
Plumbing Lie,no.:26824 PB Plan review (25%of permit fee)
Authorized signature:
State surcharge(12%of permit fee)
r.
TOTAL PERMIT FEE
Print name:Mark Baleme Date:10/12/2023 This permit application expires if permit is not obtained within IRO days
after it has been accepted as complete.
°Fee methodology set by Tri-County Building Industry Service Board.
I:V3mlding5PermilsWLMU-PermitApp.doc 10/01/09 440-4616T(10/02ICOM/wrdt)
Building Division
.� �¢F . i.. mac. , . ? e & Two-Family Dwelling
TicnaD A �E,IAECHN1FC I Fees Checklist
Rt:PoR l L REOU.rtF.ED
P +-'09F THE FOOTING
PERMIT INFORMATION: 3 0ppt _ Application Date - FEE VERSION "3U(.1/4,p 7-6Z-2--
Permit#: pr\, --176�J" 002_ I'D - Plan #: Z(a9>D Floors: 3
Valuation: L/Z 833, Bn Covered Porch: ___-----> Basement t ('D-
Bedrooms: 4 Deck: ____-- 1"Floor 173
WC (toilets) 3 Deck Cover: - 2nd Floor l 1 I $4
Lavatories 5 Patio Cover 3`d Floor
Tub/shower 3 Accessory Struct. - R-3 Total 1 L QCt
Laundry Tray .c-- Water Heater ( / Gas lec Garage Z
Exhaust Vents S— Gas Flue Vents Total for Elec. Pei—7 r
Backflow Prey. um&/ Heat Pump /(C) # for ElectricalLi
BBQ _ Gas Fireplace ),R-- #Fuel Lines 3
FEES: Description: Fee Applies: Fee Entered:
DC Prov Revw: Planning v
Info Proc/Arch: Lg$2.00 (over 11x17) UP
Info Proc/Arch: Sm$.50 (up to 11x17) '7$
Metro CET: Residential Use
School CET: District: ��
Tigard CET: Admin
Tigard CET: ODHCS
Tigard CET: AH
Electrical Permit: Permit Fee:
Limited Energy:
12% State Surcharge
Mech. Permit: Permit Fee:
12% State Surcharge
Plumbing Permit: Permit Fee:
12% State Surcharge
Erosion Control: w/Permit-Ping
Notes:
I:\Building\Forms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
Page 1
"7
E City of Tigard
IN . " COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD Building Permit #: /p�n
'Tr -1:,, -77r OO g-, ?--
Site Address:
13709 SW 165th Avenue i'Verified in Accela
Project Name:
River Terrace Town Center Lot/unit #: 79
Proposal: New Single Detached SFR Zone: RES-C
Housing Type: V SFR(V Single Detached ❑ Duplex❑Triplex❑ADU) ❑Rowhouse OCottage Cluster O CYU ❑Quad❑Other
Required Site Plan Elements:
V 3 copies of site plan on max 11x17" F„ t etion
Mc Drawn to standard scale
V North arrow V Street and site trees shown / labeled
ty
V Site address, project name, lot # (N/A for SFR)
VStreet names plicable)
VApplicant name and phone #
Lot and setback dimensions
Vision clearance triangle
Utility locations &easements
Property corner elevations
V Footprint of new structure and FFE (>1,000 sf disturbance)
V Sidewalk/driveway dimensioned cr V'LIDA Erosion control
V Lot area and lot coverage percentage
Required Elevation Plan Elements: Summary table with calculations for:
(For SFR: calcs needed only on street-facing) Su Total table area
V Drawn to standard scale
V Building height dimensioned
Total window and door area
V Facade dimensioned
21 Windows and doors dimensioned
V Garage doors dimensioned
Reqw an Elements:
(Not required for SFR ❑ Summary table that includes
❑ Each story dimensioned otal floor area
0 Each story floor area calculated ❑ Floor ar
Planning Review
The following standards have been met: 3' alley
[�/ 8 pornGarage:
Setbacks /�ront:1rnwlding Rear: 3'alley Side: 3' Min/Max Street Side: 7 /
Height l'� Max. Height: 35' Proposed Height: 29'-3/8"
cel Yes ❑ N/A Landscape
❑ Yes N/A Screening (Quad only)
V Yes ❑ N/A % Window Coverage
2Yes ❑ N/A Garage (SFR Only) Parking (Other Res)
a Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes ttrr��
❑Yes N/A Accessory Structure Standards
N/A Other building design standards (Rowhouse only)
❑ 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
0 Yes N/A Fence
❑ Yes ❑ No f fN/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: 'I Yes ❑ No
'Main Land Use Case #s: PDR2021-00004 0 Conditions met
❑Applicant notified of land use expiratio `� e: Submit and qay for a licable dev permits by 1/31/2025.Final occ by 1/31/2027
Approved By Planning: [� Date: 5L4/23 5/ 77-3
Notes Permit can be issued prior to fin I at approval but not rior to conditions being met on PDR
Revision 1: ❑ Approved 0 Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
Building Permit Submittal
Original Submittal Date: Sc>(,)-3
(�
Site Plans #:
,kBuilding Plans #:
st Building Permit #: til Building permit # entered on page 1
Workflow Routing: JQ Planning IK1 Engineering IX Permit Coordinator f Building
Workflow Sign-off: .151 Sign-off for Planning (include notes from planning review)
Route Documents: X1 Engineering: (1) copy of permit application, (1) site plan, (1) building plan
.. and original plan review routing form.
AZ Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
Permit Technician: Date: 5/ l u1
Notes:
Q Engineering Review
V CIPFI Permit:
: d�Slope at building pad: 2 oh
}T` rff C.onditions met prior to issuance of permit
❑ Easements (encroachments) per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No Add Fee: ❑ Yes ❑ No
0 Final Plat Recorded
4
\ 0 NOT Approved: Date:
st Notes:
( Approved By Engineering: Date: ,<72. 2 3
( Revision 1: ❑ Approved 0 of Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
1: riit Coordinator Review
Conditions met prior to permit Asuan e
Approved, NOT Released: kA kb NoC) Date notified applicant: S/- ; %7
ENG Revisions Required: Date notified applicant:
SDC Exemption: ❑ Applied for ❑ Received Cisees not apply
DC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
I Tigard Trans SDC: Yes ❑ N/A ❑ Deferred
Parks SDC: Yes ❑ N/A 0 Deferred
LIDA ❑ Yes rN/A
7e0K to Issue/Approved by Permit Coordinator: Date: '('. \0 Z3
Revision 1: ❑ Approved 0 Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
City of Tigard
. " Deferral Until Occupancy Request
TIGARD
Washington County Transportation Development Tax (I"DT),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: 6/15/2023 Site Address: 13709 SW 165th Ave
Project Land Use Case or
Name: River Terrace Town Center Building Permit#: MST2023-00212
Tax Lot Lot 79 Total Parks $11,830.00
#: Amount*:
TDT 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,S 448.00 for TSDC-
Reimbursement, and for TSDC-River Terrace,if applicable..
3/196.00 1,887.00 for*The total Parks SDC amount shown above is the sum of$ 6,812.00 for Parks-Improvement,$
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,
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.
Property Owner: Date:
G/l5/w23
Developer: Date:
6/15/2023
Permit Coordinator: Date: