Permit (88) •
CITY OF TIGARD MASTER PERMIT
111111 j; . COMMUNITY DEVELOPMENT Permit#: MST2023-00397
Date Issued: 10/25/2023
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107AD05400
Jurisdiction: Tigard
Site address: 14654 SW 165TH AVE
Subdivision: SOUTH RIVER TERRACE Lot: J
Project: South River Terrace, Building 21, Unit 3 of 3
Project Description: New attached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN
PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 5 First: 1092 sf Basement: 33 sf Left: 0 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1138 sf Garage: 526 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 0 Detectors:
Total: 2263 sf Value: $416,053.59 Rear: 0
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 gckflw Prevntr: 0 Catch Basins: 0
Footing Drain: 100 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0
Drywell-Trench Drain: 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: 2
Fum>=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'l 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 2263
Owner: Contractor:
TAYLOR MORRISON NORTHWEST LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
703 BROADWAY ST STE 710 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660 2 Fire Rated Conditions
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $26,329.80
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 req ' •u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
0c9_nn1_not n in., n 0S9_nn111non vni, a rnnv of tha nJac nr.Iiru't nnaefinne to nI INf:Flu Tallinn cn' 949 10A7?Ir.!Ann'SQ9 9'idd
Issued By: Permittee Signature: 'td'P if)
l `1
Call 503.6 .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.
1 Building Permit Application
Residential RECEIVE I FOR OFFICE USE ONLY
City of Tigard AUG2023 Received 7
• 13125 SW Hall Blvd.,Tigard,OR 97223 AG PDIan Review G! a� J� Pj►�°�� �OD �4
illq ■ Phone: 503.718.2439 Fax: 503.598.1960 Date;By: y 1(�(119, " ��t j -00� 7
r i c,.1 n n [n met nwwwa503.639.4175
gard Al�5 CITY OF TIGARD Date R a Meu,oaa ri 1 ,uns SupSee
le enta for
Format on
g BUILDING DIVISION i(��a3
('.�M sc t ( tci ;l i `
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
[!) New construction D Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
D Addition/alteration/replacement D Other: equipment,materials,labor.overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. !�
Valuation: $ (-Wet J 1-and 2-family dwelling D Commercial industrial
053 5 I
D Accessory building 0 Multi-family Number of bedrooms: 5
D Master builder D Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number offlo ors: 3 2 78,
Job site address:14654 SW 165th Ave New dwelling area: 2263 square feet L t 5`g
City/State/ZIP:Tigard,OR 97224 Garage carport area: 5 2 6 square feet i(AL
Suite/bldg./apt.no.: I Project name: South River Terrace,Building 21 Covered porch area: square feet 33
Cross street/directions to job site: Deck area: 7 7) square feet
I Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.:3 Permit fees*are based on the value of the work performed.
Tax map parcel no.: 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 Triplex Valuation: $
Existing building area: square feet
New building area: square feet
PROPERTY OWNER 0 TENANT Number of stories:
Name:1aytor Morrison Northwest LLC Type of construction:
Address:703 Broadway St, Ste 710 Occupancy groups:
City'State/ZIP:Vancouver, WA 98660 Existing:
Phone: (360 ) 946-8674 Fax:I Ne "
APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Taylor Morrison
(Please refer io fee schedule)
Structural plan review fee(or deposit):
Contact name:Tonja Morris
FLS plan review fee(if applicable):
Address:703 Broadway St, Ste 710
Total fees due upon application:
City/StateiZIP:Vancouver, WA 98660
Phone:(360 ) 946-8674 I Fax::( Amount received:
E-mail:perm itsubmittals(7a,taylormorrison.com r PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRA(.IOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Taylor Morrison Northwest LLC Submit two(2)sets of roof plan with connection details
and fire department access.along with the 2010 Oregon
Address:703 Broadway St, Ste 710 Solar Installation Specialty Code checklist.
City!State/ZIP:Vancouver, WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone: (360 )695-7700 I Fax:( State surcharge(12%of permit fee): $21.60
CCB lic.:207247 - Total fee due upon application: $201.60
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Tonja Morris Date: 4 *Fee methodology set by Tn-County Building Industry
Service Board.
I:ABuilding'vPennits`.BUP-RESPennitApp.doc 01/25/2023 440-4613T(1 1/02/COM/WEB)
i t
Mechanical Permit Application FOR OFFICE USE()NIA.
ilhCity of Tigard Received : 1-d —OD 3q
_ Date/By Permt CVa•3 f
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Read /B orris.
Internet. wwvw.tigard-or.gov y y
Notified/Method See Page 2 for
. Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
® New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ l-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
® Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating cooling:
Air conditioning 46.75
Job site address: 14654 SW 165th Ave Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard OR 97224 Furnace 100,000+BTU(dnctsivenrs) 54.91
Suite/bldg./apt.no.: Project name: South River Terrace, Building 21 Heat pump 61.06
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: South River Terrace Lot no.: Other. 23.32
3 Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 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: Taylor Morrison Northwest LLC Range hood/other kitchen
equipment 33.39
Address: 703 Broadway St.,Ste 710 Clothes dryer exhaust 33.39
City/State/ZIP: Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( 360 )695 7700 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other 23.32
Business name: Taylor Morrison Northwest LLC Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Tonja Morris
Furnace,etc.
Address: 703 Broadway St.,Ste 710 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Vancouver,WA 98660 Water heater
Phone:( 360) 695 7700 Fax: :( ) Fireplace
E-mail: PermitSubmittals@taylormorrison.com Range
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Development Northwest Inc. dba Wolcott HVAC Other:
MECHANICAL PERMIT FEES*
Address: 1075 W Historic Columbia River Hwy Subtotal
City/State/ZIP:Troutdale/OR/97060 Minimum permit fee($90.00)
(971>256 4584 (503 ) 667 9891 Plan review(25%of permit fee)
Phone. 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: D2hh/J L. au1MiMq * Fee methodology set by Tri-County Building Industry Service Board
Print name:Dennis Dunning Date:8/14/23
I'BuddingiPermiisiMEC_PerniiApp_040113.doe 440-461 Tr(11/02/COM/WEB)
Electrical Permit Application
FOR OFFICE,USE ONLY
City of Tigard Received
MII
• 13125 SW Hall Blvd.,Tigard,OR 97223 Date/B.. Er` !f
Plan Review
Phone: 503.718.2439 Fax 503.598.1960 Date/B !•r "Oo3 IRelated Permit n:
TIGARD Inspection Line' 503.639.4175 Ready Date/By. Juus la See Page 2 for
a Internet: www.tigard-orgov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW -
® Nell construction ❑ Addition/alteration/replacement Please check all that apply(submit 2 sets of plans witems checked).
❑Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF.CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations- buildings.
❑Multi-family 0 Master builder ❑ Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#: Job site address: 14654 SW 165th Ave 100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP: Tigard OR 97224 ❑Six or more residential units. occupancy
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: South River Terrace ,Building 21 0 Hazardous locations_ 0 Supply voltage for more than
O Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qtv. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: South River Terrace Lot#: 3 Includes attached garage.
Tax map/parcel#:
1,000 sq.ft.or less 168.54 4
Ea.add'I 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.)
Renewable Energy 0 See Page 2
$] PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name:Taylor Morrison Northwest LLC. 200 amps or less 100.70 2
Address: 703 Broadway St., Ste 710 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Vancouver, WA 98660 601 amps to 1,000 amps 30104 2
Phone:(360 )695-7700 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:permitsubmittals@taylormorrison.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 I I APPLICANT ❑ CONTACT PERSON
A.Fee for branch circuits with
Business name: Taylor Morrison Northwest LLC. above service or feeder fee, 742 2
each branch circuit
Contact name:Tonja Morris B.Fee for branch circuits without
Address: 703 Broadway St., Ste 710 service ocit furcuitit fee,first
branch 56.18 2
City/State/ZIP: Vancouver WA 98660 Each add't branch circuit 742 2
Miscellaneous(service or feeder not included)
Phone:(360 )816 7800 Fax: :
( ) Each manufactured or modular 67.84 2
Email: permitsubmittals@taylormorrison.com
dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Portland Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 1915 E 5th St., Ste D panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: Vancouver, WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66 25!hr
Phone:( 360)314-4915 Fax:( ) Investigation(I hr min) 9000/hr
Email:paul@portlandelectric.biz Industrial plant(I hr min) 78.181nr
Inspections for which no fee is WOO/hr
CCB Lie.: 194066 Electrical Lie.: C760 Suprv.Lie.: 49205 specifically listed i1,hr mini
Suprv.Electrician signature,required: lil.Gfi�• � � q � ELECTRICAL PERMIT FEES
Subtotal.
Print name: Alex Shalya Date: 8/14/23 ❑Plan Review Required(25%of permit fee):
7/1—
'►/� 0 0 State surcharge(12%of permit fee):
Authorized signature: / I I—f�4�l 4,11.44.4. TOTAL PERMIT FEE:
8/14/23 This permit application expires if a permit is not obtained within 180
Print name: Sergey Mishchuk Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
193uilding'Permits\ELC_Permit App_ELR_ERE.dot Rev 06/172015 440-46 15T(11/05/COM/WEB
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
.11111 City of Tigard Received
• 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: vec ;6y�a'o �?- ��
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
TIGARD Inspection Line: 503.639.4175
Date.By: Other Permit No.:
R Date Ready/By: lnro HI See Page 2 for
Internet www.tigard-or.gov Notified/Method.
Supplemental Information
TYPE OF WORT{ FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist.
❑Addition/alteration/replacementDescription I Qty. I Ea. I Total
0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen
0 Master builder ElOther: 2
Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address 14654 SW 165th Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 1g.76
City/State/ZIP: Tigard OR 97224
Suite Bldg,/apt.no.: I Projectname: Footing drain(no.linear ft.:_) Page 2
South River Terrace, Building 21 Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision:South River Terrace I Lot no.: 3
Fixture or item:
Tax map/parcel no.: Backflow 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
►+ PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name: Taylor Morrison Northwest LLC Fixture/sewer cap 25 02
Address:703 Broadway St.,Ste 710 Floor drain/floor sink/hub 25 02
Garbage disposal 25,02
City/State/ZIP: Vancouver,WA 98660
Hose bib 25.02
Phone:( 360 )695 7700 Fax:( ) Ice maker
12.51
El APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25 02
Business name: Taylor Morrison Northwest LLC Medical gas(value:$ ) Page 2
Contact name: Tonja Morris Primer 12.51
Address: 703 Broadway St.,Ste 710 Roof drain(commercial) 2 5l
Sink/basin/lavatory 25.02
City/State/ZIP: Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:( 360 )695 7700 Fax: :( ) Tub/shower/shower pan 12.51
E-mail: PermitSubmittalsiPtaylormorrison.corn Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:
Wolcott Plumbing Waterpiping/DWV 56.29
Address: 1075 W Historic Columbia River Hwy Other
zsoz
City/State/ZIP:Troutdale, OR 97060 Subtotal
Phone:(503)-667-1781 Fax:(503)667-9891 Minimum permit fee $72s0
CCB Lie.: 112220 Plumbing Lic.no.:26-824 PB Plan review (25%of permit fee)
Authorized signature: (12%
Cna t . t964). LCLlL State surcharge
TOTTALAL of permit fee)
PERMIT FEE
Print name: Cliff Bow n Date: 8/14/23 This permit application expires if a permit is not obtained within ISO days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
tV3uilding'Permits\PLML-PermitAppdoe 10/01/09
440-0616f(I 0/02/COMM1VEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: /1/11- op
Site Address: 14654 SW 165th Ave 0 Verified in Accela
Project Name: South River Terrace, Building 21 Lot/Unit #: Unit 3
Proposal: New SFR Triplex Zone: RES-C
Housing Type: 0 SFR(❑ Single Detached ❑ Duplex 0 Triplex❑ADU)❑ Rowhouse ❑Cottage Cluster❑CYU ❑Quad❑Other
Required Site Plan Elements:
0 3 copies of site plan on max 11x17"
O Drawn to standard scale ❑ R l ;.._J 1. J.:,, I:.. / 1. _ ,..Jtection
0 North arrow 0 Street and site trees shown / labeled
0 Site address, project name, lot #
O Street names (N/A for SFR)
O Applicant name and phone # (if applicable)
0 Lot and setback dimensions ❑ V .. I ,, 1,; ,,,1
❑tiA.1.24.111y & tau, ti E Utility locations &easements
O Footprint of new structure and FFE
O Sidewalk/driveway dimensioned J.,uuu of unwiva n�. )
O Lot area and lot coverage percentage 0 Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
0 Drawn to standard scale ❑ Total facade area
O Building height dimensioned ❑ Total window and door area
0 Facade dimensioned
El Windows and doors dimensioned
❑Garage doors dimensioned
Require Elements:
(Not required for SFR) El Summary table that includes
❑ Each story dimensioned oor area
❑ Each story floor area calculated ❑ Floor area per s
Planning Review
The following standards have been met:
Setbacks 0 Front: 12/8 Rear: 0 (alley)Side: 0 Min/Max Street Side: 8/3 / Garage: 4/20
Height 0 Max. Height: 35' Proposed Height: 27
0 Yes ❑ N/A Landscape
O Yes ❑ N/A Screening (Qu.d enl)f) *Required for parking, but buildings provide screening
❑ Yes 0 N/A % Window Coverage *Is not street facing
0 Yes ❑ N/A Garage (SFR Only) Parking (Other Res)
O Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
0 Yes ❑ N/A Other building design standards (Rowhouse only) *Facade Offset, Porch, Roof, no exterior staircase
❑ Yes 0 N/A Accessory Structure Standards
❑ Yes 0 No Qualifying pre-existing unit exempt from standards (Cottage unit only)
Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
0 Yes ❑ N/A Unit Count: 3
O Yes ❑ N/A Lot Width and Size Tract J = 114,586sf
0 Yes ❑ N/A Pathway (Ped Access)
Additional standards for Courtyard Units and Cottage Clusters only:
❑ Unit Area:
El Yes El N/A Flo er story)
❑ Yes ❑ N/A Courtyard
❑ Yes ❑ N/A Fence
❑ Yes ❑ No ON/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
O Sensitive Lands: ❑ Yes 0 No
❑ Main Land Use Case #s: PDR2018-00003, PDR2021-00003 ❑ Conditions met
o Applicant notified of land use expiratio dat : ermits b 11/2/24, CofO b 11/2/26
Approved By Planning: O _ Date: 3// /ao13
Notes PDR applied rowhouse standar for these units.
Revision 1: ❑ Approved O Not Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date:
`PDR referred these as rowhouses, but does not fit current definition.
Building Permit Submittal 8//� ��
Original Submittal Date:
Site Plans #: 3
Building Plans #:
Building Permit #: if Building permit # entered on page 1
Workflow Routing: I Planning A Engineering 4 Permit Coordinator .Building
Workflow Sign-off: SJ Sign-off for Planning (include notes from planning review)
Route Documents: ft Engineering: (1) copy of permit application, (1) site plan, (1) building plan
and original plan review routing form.
If Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc. u
Permit Technician: Date: 8/I "( (-
Notes:
Engineering Review
❑ PFI Permit:
-Slope at building pad: j6 ok
'Conditions met prior to issuance of permit
g'Easements (encroachments) per engineering conditions of approval and plat
124Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes P-No
Assess Water Quantity Fee in-lieu: ❑ Yes ®'No
LIDA Facility on lot: ❑ Yes ®'No Add Fee: ❑ Yes 0 No
a4inal Plat Recorded
0 NOT Approved: Date:
Notes: —_
Approved By Engineering: Date: _�72. 2
Revision 1: ❑ Approved ❑ N Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date:
Permit Coordinator Review
`Conditions met prior to permit issuance
❑ Approved, NOT Released: Date notified applicant:
❑ ENG Revisions Required: Date notified applicant:
• DC Exemption: ❑ Applied for ❑ Received Loes not apply
7 1.,C Fees Entered: Wash Co Trans Dev Tax: p Yes ID N/A ��`��L�
l Tigard Trans SDC: {� Yes 0 N/A Deferred
�� i G
Parks SDC: Yes ❑ N/A
LIDA ❑ Yes N/A
4,K to Issue/Approved by Permit Coordinator: Date: ( ,- I` v�
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
III U__ Building Division
One & Two-Family Dwelling
TicnuD Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION --jJ L y Zo7�3
7
Permit #: C�� ,f/v�2 ��2q Plan #: S1 ��S Floors: (�
Valuation: Coveredl Porch: Basement 3-
Bedrooms: S Deck: 70 ls`Floor Z
WC (toilets) -5 Deck Cover: 2nd Floor l l 3`e)
Lavatories S` Patio Cover ...,------ 3" Floor
Tub/shower Accessory Struct. ,..------ R-3 Total 22 .R3
Laundry Tray __---- Water Heater \ / Gas�ec Garage SZ! _
Exhaust Vents 5- Gas Flue Vents Total for Elec. 2--��1349
Backflow Prey. —_—__^ F nac / Heat Pump �1� # for Electrical14
BBQ __--_ Gas Fireplace - #Fuel Lines
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 i�se
School CET: District: ( 6S �r0'G
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 /
r. /
Plumbing Permit: Permit Fee: ✓
12% State Surcharge
Erosion Control: w/Permit-Ping
1:\Building\Forms\ResPlanCheckFees_Dcc2022_AA.doc 12/21/22
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