Permit (133),
R CITY OF TIGARD MASTER PERMIT
Permit#: MST2023-00527
COMMUNITY DEVELOPMENT Date Issued: 11/06/2023
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 251060003300
Jurisdiction: Tigard
Site address: 13773 SW 166TH AVE
Subdivision: RIVER TERRACE TOWN CENTER Lot:
Project: River Terrace Town Center, Lot 135
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: 667 sf Basement:
0 sf Left: 3 Parking Spaces: 0
12 Smoke
Height: 30 Yes
Bathrooms: 3 Second: 949 sf Garage: 390 sf Front:
Dwelling Units: 1
Third: 0 sf Right: 3 Detectors:
Total: 1616 sf Value: $297,959.40 Rear: 3
PLUMBING
Trays: 0 Rain Drain: 1 Urinals: 0
1 Laundry
Sinks: 1 Water Closets: 3 Washing Mach:
0 Sewer Lines: 100 SF Rain Drains: Storm Sewer: 100
Lavatories: 4 Dishwashers: 1 Floor Drains: 0
1 Water Lines: Catch Basins: 0
1 Water Heaters: 100
Tubs/Showers'. 2 Garbage Disp: Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0
Drywell-Trench Drain: 0 Other Fixture Units:
MECHANICAL
5 Clothes Dryers: 1
Y Vent Fans:
Fuel Types Air Conditioning:Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents:
0 Woodstoves: 0 Gas Outlets: 3
Fum>=100K: 0
ELECTRICAL
Residential Unit
Service Feeder Temp SrvcfFeeders 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: 2 201-400 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
Ecompasing:
Other: N Other Description:
BUILDING INFO
Type of Constr: Occupancy Group: Square Feet:
Class of Work: Type of Use: 1616
NEW SF
VB R-3
Owner: Contractor: d Items and Reports(Conditions)
AG EHC II(NWHM)MULTI STATE 2 LLC TNHC OREGON LLC 1 Ersn Cntrl 50 Requireequire 175
BY THE NEW HOME COMPANY INC 15231 LAGUNA CANYON ROAD
BY KAWANAMI,MARK SUITE 250
15231 LAGUNA CANYON RD STE IRVINE,CA 92618
250
PHONE: PHONE: 503-312-6213
FAX:
Total Fees: $21,353.03
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
Q49-nn1_mmn thrni in nAR o nn1-noon vn,, ' „nht ,rnmi of rho,rnio,e nr rllro,nt nu"bone rn C I MC by roam,, in 949 1Q737 nr 1 ann'349 9'ldd
Permittee Signature: Z .-.e. lop r t ca t.‘,.)
Issued By:
Call 503.639.41 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the lob site at the time of each inspection.
Building Permit Application
Residential RECEIVED FOR OFFICE USEONL1 r��
Received 10 I10122 Perini[No.: '�Vyv1)'0t/5Z—1
City of Tigard Date/By: y Ll `'•' nqy r
13125 SW I tall Blvd.,Tigard,OR 97219 -s T 10 2023 Plan Review k er A yob os other Permit:9A) �� 'OO 17
Phone 503.71 S 2439 Fax: 503.598 19 Date/By: [/ Y /,1
Date Ready/By. Jens 65 See Page 4 for
T I G \R[� Inspection Line: 50 4175 �3 �23 A P Tct3 Supplemental Information
Internet: www.tigard-or.-or.gov CITY OF TIGARD Notified/Method:10 O
�I GII r)I�IO DIViglON e A•I �.na . {c.
T1'PE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
❑Demolition Permit fees*are based on the value of the work performed.
New construction Indicate the value(rounded to the nearest dollar)of all
❑ Additionlalterationireplacement ❑Other
work equipment,materials,a on t labor,
application.
overhead,and the profit for the
CATEGORY OF CONSTRUCTION �°1 I//:5-l i
Valuation: 1
mI-and 2-family dwelling ❑Commercial/industrial
Number of bedrooms: 3
❑Accessory building ❑Multi-family VT
2
Number of bathrooms: /'� 7
❑ Master builder ❑Other: M
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 W
,'•�� ^��
ca
New dwellingarea. V. quare feet Ir
Job site address:13773 SW 166th ave ( —7
City/State/ZIP:Sherwood/OR/97140 Garage/carport area: 390 square feet l( il 1
Suite/bldg./apt.no.: I Project name:River Terrace Town Center Covered porch area: 47 square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
SW Jean LouicPtd
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:River Terrace I Lot no.:135 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no..parcel no: 2S 1060003300 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Requesting Deferred SDC fees Existing building area: square feet
New building area: square feet
® PROPERTY OWNER I 0 TENANT Number of stories:
Name:TN HC 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:
II APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* -"
(Please refer to fee schedule :':',,
Business name:TNHC OREGON LLC Structural plan review fee(or deposit):
Contact name:Frank Sandoval FLS plan review fee(if applicable):
Address:15455 NW Greenbrier Parkway Suite 240 Total fees due upon application:
City/State/ZIP:Beaverton/OR/97006 Amount received: j
Phone:(503) 310-7571 I Fax: :( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: fandoval@nwhm.eom Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name:TNHC OREGON LLC and fire department access,along with the 2010 Oregon
Address:15231 Laguna Canyon RD STE 250 Solar Installation Specialty Code checklist.
Permit Fee(includes plan review $180.00
e;Ty/State/ZIParvine/CA!92618 and administrative fees):
Phone:(503 )310-7571 I Fax:( ) State surcharge(12%ofpermit fee): $21.60
CCB lic.:241108 Total fee due upon application: $201.60
/> I This permit application expires if a permit is not obtained
Authorized signature: v within 180 days after it has been accepted as complete.
I *Fee methodology set by Tel-County Building Industry
Print name:Frank Sandoval I Date:10/10/2023 Service Board.
1:1Building\Permits1BUP-RESPermitApp.doc 01/25/2023 440-4613T(11/02/COM/WEB)
Mechanical Permit ApplicatioRECEIVE.I FOR OFFICE USE ONLY DateBy:
0 2023
City Tigard
Received Pennit Vo.'. STZdZ3�Ql7JKr
2�
• 13125 SWW Hall Blvd.,Tigard,OR 97223 OCT 1 Plan Review Other Permit:
• Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
Ins ection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: urn H See Page 2 for
I I G A K O P Supplemental Information
Internet www.tigard-or.gov BUILDING DIVISIONb'otited/Method: pP
.,: TYPE.OF WORK COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
� - - Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Other: mechanical materials,equipment,labor,overhead,and profit.
❑ Demolition Value'$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT t SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist
❑ Multi-family ❑Master builder ❑Other:
Description Qty. Ea. Total
Heating/cooling:
JOB SITE INFORMATION AND LOCATION Air conditioning 1 46.75
Job site address:1 3773 SW 166th 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
Hydronic hot water system 23.32
Cross street/directions to job site: 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
Other: 23.32
Subdivision:River Terrace Town Center Lot no.:135 Other fuel appliances:
Tax map/parcel no..2s1060003300 Water heater 23.32
Gas fireplace/insert 1 33.39
DESCRIPTION OF WORK 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
Other: 23.32
® PROPERTY OWNER 0 TENANT . ; Environmental exhaust and ventilation:
Name:TNHC OREGON LLC Range hood/other kitchen 1
equipment 33.39
Address:15231 Laguna Canyon Rd STE 250 Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
City/State/ZIP:IrVlne CA 92618 toilet compartments,utility rooms) 23.32
Phone: (503)310-7571 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT 0
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.
Gas heat pump
Address:15455 NW Greenbrier Parkway#240 Wall/suspended/unit heater
City/State/ZIP:Beaverton OR 97006 Water heater
Fireplace
Phone:(503)310 7571 Fax ( ) Range
E-mail:fandoval@nwhm.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other.
Business name:Pro Heating and Cooling, INC MECHANICAL PERMiT FEES*
Address:
4200 NW Leisy rd Subtotal
Minimum permit fee($90 DO)
City/State/ZIP:Hillsboro, OR 97124 Plan review(25%of permit fee)
Phone:(971)205 4989 Fax:( ) State surcharge(12%of permit fee)
TOTAL PERMIT FEE
GCB lie.:209001 This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Authorized signature: Z7 * Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:3/17/2023
I:\BuildingTerrnas\MEC_PerrnitApp 040113.dor 440-4617 (tl/02/COSUWEB)
RECEIVED
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard OCT 10 2023 Received
Date/By,y. %CAW,3'OIIS1,1
111=
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Related Permit#
Phone: 503.718.2439 Fax: 503.59(3 f OF TIGARD DateBv:
Inspection Line: 503639.4175 BUILDING DIVISION Ready DateiBy: bun: I See Pege2 for
t 1 l..\1.U Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK ..:PLAN REVIEW
El New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked)
0 Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings_
lessto ground,or exceeds 14,000 0 Cormnercial-use agricultural
® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#: Job site address:13773 SW 166th aveIOOHP or more. ❑'A",
0 Six or more residential units. occupancy.
City/State/ZIP: Sherwood/ OR/97140 0 Health-care facilities. 0 Recreational vehicle parks.
0 Hazardous locations. ElSupply voltage for more than
Suite bldgJapL#: Project name: RTTC
❑Service or feeder 600 amps or more. 60o volts nominal.
Cross street/directions to job site: - FEE SCHEDULE
SW Jean Louise rd Desenpaoa 1 Qty. i Each 1 Toed I "
New residential single-or multi-family dwelling unit.
Subdivision: River Terrace Town Center Lot#:135 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: 2S 1060003300 Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
NEW HOME CONSTRUCTION (with abovesq.ft.)
Limited energy,multi-fatuity 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
W PROPERTY OWNER 0 TENANT 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 13356 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Irvine CA 92618 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,alteration,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 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
Branch circuits-new,alteration,or extension,per panel
IQI.APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with
Business name: THNC OREGON LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name: Frank Sandoval B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: 15455 NW Greenbrier Parkway#240 branch circuit
City/State/ZIP: Beaverton OR 97006 Eachadd'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)310-7571 Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Fsandoval@newhomeco.com 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
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address:1075 W Historic Columbia River Hwy panel,alteration,or extension.
Each additional inspection over allowable in any of the above
city/state/zrP:Troutdale, OR, 97060 Additional inspection(I hr min) 66.25/hr
Fax:( ) Investigation(1 hr min) 90.00/hr
Phone:( $53-9420 Industrial plant(t hr min) 78.t 8/hr
Email:MWOLCOTT�WOLCOTT.PRO Inspections for which no fee is
(Y.hr min) 90.00/hr
CCB Lic.:112220 Electrical Lic.:C1272 Suprv.Lie.:5782S specifically listedELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:',,,— m,w.,Ar, Subtotal:
Print name:David Campbell DaLe:10/12/2023 0 Plan Review Required(25%01'permit fee):
State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name:Malachi J. Wolcott Date:1 0/12/2023 days after it has been accepted as complete.
Number of inspections allowed per permit.
I:\Budding\Permits\ELC PerrtutApp_ELR_ERE.daa Rev 06/172015 440.4615T(1 U05/COM/WEB
Plumbing Permit Applie DEIVED
Building Fixtures FOR OFFICE USE ONLY
City of Tigard OCT 1 O 2023 Received W 1/Mc-VY51..A
Deceive Permit No
el 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fait: 50 Other Permit No.:
Date/By:
Inspection Line: 503.639A 17 '�F TIGARD Date Ready/By: orris: ® See Page 2 roe
Ic;nRD BUILDINGDIVISION a
Internet: Line:Bard-or.gov Not Supplemental I nrm ntinn
- TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist-
- Description Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New t-2-family dwellings(includes 100 It for each utility connection) •
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
piI-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 1 437.78 j SFR(3)bath 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25.(12
❑Master builder ❑Other: Fire sprinkler(_sq.fl.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13773 SW 166th Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP. 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: Manholes 18.76
SW Jean Louise Rd Rain drain connector 18.76
Sanitary sewer(no.linear tt:_) Page 2
Storm sewer(no.linear fl.: ) Page 2
Water service(no.linear fl.:_) Page 2
Subdivision: River Terrace Town Center I Lot❑o.:135 Fixture ar item:
Tax map/parcel no.: 2s1060003300 Backflow preventer 31.27
•
DESCRIPTION OF WORK Backwater valve 12.51
New Home Construction Clothes washer zs.o2
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
I. PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name: TNHC OREGON LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 15231 Laguna Canyon Rd STE 250
Garbage disposal 25.02
City/State/ZIP: Irvine CA 92618 Hose bib 25.02
Phone:(503)310-7571 Fax:( ) Ice maker 12.51
($I APPLICANT 51 CONTACT PERSON Interceptor/grease trap 25.02
Business name: THNC OREGON LLC Medical gas(value:$_) Paget •
Primer 12.51
Contact name' Roof
Frank Sandoval i
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
-
--- Water closet 25.02
CONTRACTOR
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
Minimum permit fee: $72.50 •
Phone:( 503-667-1781 Fax:( ) Plan review (25%of permit fee)
CCB lie:112220 Plmnbing Lie.no.:26824 PB
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Mark Baleme Date:10/12/2023 This permit application expires if a permit B not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
IAauildingiPermils\PLMU-PcrmitApp.doc 10/01/09 440.4616TO 0/OZ/COMAVEB)
a il II Building Division
One & Two-Family Dwelling
TIGARD Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION J•1 L/ 70.7i3
Permit#: mS"11-6L� ^ QC)5a7 Plan #: Zlf 1 O D Floors: ^-
Valuation: �q� 1, . 440 Covered Porch: Lf- Basement c� „__ ,
Bedrooms: 3 Deck: 1"Floor 1 La-7
WC (toilets) 2 Deck Cover: 2°d Floor �9
Lavatories t- J Patio Cover 3`d Floor -------
Tub/shower 1- Accessory Struct. _.------ R-3 Total l L
le
Laundry Tray .----, Water Heater / Gas al010 Garage 2l O
Exhaust Vents Gas Flue Vents s— `C
Total for Elec. J��( n
Backflow Prey. 410/ Heat Pump /CO # for Electrical
BBQ Gas Fireplace ` Is #Fuel Lines 3
FEES: Description: Fee Ap : Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg$2.00 (over 11x17)
Info Proc/Arch: Sm$.50 (up to 11x17)
Metro CET: Residential Use
School GET: District:'-'-
istrict:�
Tigard CET: Admin
Tigard CET: ODHCS V.
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 ,�i
Erosion Control: w/Permit- Ping 1../
I:\Building\Forrns\ResPlanCheckFees_Dec2A22_AA.doc 12/21/22
Page 1
City of Tigard
■
II COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARI) 1,
Building Permit#: M.51/60)- On St1
Site Address:
13773 SW 166th Ave 0 verified in Accela
Project Name:
RT Town Center Lot/Unit #: 135
Proposal:
New detached SFR Zone: C-C
Housing Type: 0 SFR(0 Single Detached❑ Duplex❑Triplex❑ADU)❑ Rowhouse❑Cottage Cluster❑CYU ❑Quad El Other
Required Site Plan Elements:
0 3 copies of site plan on max 11x17"
0 Drawn to standard scale ❑ Rela;, .J 1.1= , d.;N lilt/ l.« F,,Vlection
O North arrow 0 Street and site trees shown / labeled
name, lot # turity
O Site address, project (N/q for SFR)
O Street names _ R applicable)
E ` ar^,re-^- t-„.7,-
0 Applicant name and phone #
O Lot and setback dimensions Vision clearance not required
O hotly au 61%.1.41�, &Jyuu, rtJUI.uy� 0 Utility locations&easements due to tract/private access.
O Footprint of new structure and FFE
0 Property corner elevations
O Sidewalk/driveway dimensioned 0 Erosion control
O Lot area and lot coverage percentage
Required Elevation Plan Elements: ae with calculations for:
(For SFR: caics needed only on street-facing) 0 Total Summrya table
area
El Drawn to standard scale
O Building height dimensioned 0 Total window and door area
O Facade dimensioned
O Windows and doors dimensioned
0 Garage doors dimensioned
Re • loor Plan Elements:
(Not required for ❑ Summary table that includes
❑ Each story dimensioned ❑ Total floor area
❑ Each story floor area calculated ❑ r story
Planning Review
The following standards have been met:
Setbacks 0 Front: 8/12 Rear: 3 alley Side: 3 Min/Max Street Side: 7 / Garage: 3 alley
Height 0 Max. Height: 35 Proposed Height: 29' 6 5/8
0 Yes ❑ N/A Landscape
❑ Yes 0 N/A Screening (Quad only)
0 Yes 0 N/A % Window Coverage LS- /-
❑Yes 0 N/A Garage (SFR Only) Parking (Other Res)Alley load garage
0 Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes 0 N/A Other building design standards (Rowhouse only)
❑ Yes 0 N/A Accessory Structure Standards
❑ Yes 0 No Qualifying pre-existing unit exempt from standards (Cottage unit only)
•ditional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
❑ Ye 5 N/A Unit Count:
❑ Yes 0 N i of Width and Size
❑ Yes ❑ N/A Pat' ,
Additional standards for .. rtyard Units and Cottage Clusters only:
❑ Yes ❑ N/A Unit Area:
❑ Yes ❑ N/A Floor Area (per story)
❑ Yes ❑ N/A Courtyard
0 Yes 0 N/A Fence
❑ Yes ❑ No ❑N/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
❑ Yes ❑ No ON/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes ❑ No
Applied For: ❑ Yes ❑ No, stop intake
m Sensitive Lands: I?J Yes ❑ No
m Main Land Use Case #s: PDR2021-00004
Conditions met
m Applicant notified of land e ex 'ration date: Submit development plans by 1/31/25. Fin❑a occupancy by 1/31/27
Approved B Planning: A> l Date: 9/25/2023
Notes Onlyy34 permits can a issued prior to recording of final plat
Revision 1: ❑Approved ❑ Not Approved
Date:
Revision 2: ❑ Approved ❑ Not Approved
Date:
Building Permit Submittal
Original Submittal Date: 40 I10 ''k3
Site Plans #: 3
Building Plans #: g
Building Permit #: 'Building permit # entered on page 1
Workflow Routing: 'Planning q1 Engineering
g 9 Vt Permit Coordinator ZBuilding
Workflow Sign-off:
fQ Sign-off for Planning (include notes from planning review)
Route Documents: VI 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: �i-V'L Date: ID I31 l�3
Notes:
U
Engineering Review
❑ PFI Permit:
/1l Slope at building pad: g 2 %
ti-tonditions met prior to issuance of permit
Elasements (encroachments) per engineering conditions of approval and plat
ifr rater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes rNVo
Assess Water Quantity Fee in-lieu: ❑ Yes ArNo
LIDA Facility on lot: ❑ Yes ilo Add Fee: ❑ Yes ❑ No
l4'inal Plat Recorded
❑ NOT Approved:
Notes: Date:
Approved By Engineering:
Revision 1: ❑ Approved o Approved Date: /b�/Z 12
Revision 2: ❑ Approved ❑ Not Approved Date: c
Date:
Permit Coordinator Review
nditions met prior to permit issuance
Approved, NOT Released:
o : Date notified applicant:
❑ ENG Revisions Required:
Date notified applicant:
C Exemption: ❑ Applied for ❑ Received noes not apply
'SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: C Yes ❑ N/A Deferred
Parks SDC: Yes ❑ N/A Deferred
n LIDA ❑ Yes /A
�yOK to Issue/Approved by Permit Coordinator: (.�'7 Revision 1: ❑ Approved El Approved Date: i t-
Revision 2: ❑ Approved 0 Not Approved Date:
Date: