Permit (56) III CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2023-00239
TIC;A R Eli13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/06/2023
Parcel: 251060003301
Jurisdiction: Tigard
Site address: 13737 SW 165TH AVE
Subdivision: RIVER TERRACE TOWN CENTER Lot:
Project: River Terrace Town Center, Lot 81
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: 107 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1184
sf Garage: 502 sf Front: 12
Smoke
Dwelling Units: 1 Third: 0 sf Right 3 Detectors: Yes
Total: 2464 sf Value: $402,079.54 Rear: 3
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 LaundryTrays: 0
y Rain Drain: 1 Urinals: 0
Lavatories: 5
Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100
SF Rain Drains: Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 0 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr. 0
Drywall-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: 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
P 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 VB R-3 2464
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: $23,998.47
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTIO . Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
oc9_nn1_nnifl rhrn nnh A _nn1_nnon vni, nhtn. a rnn„of thn n!Inc nr rlimrt ell nefinnc fn(I mu,..hl:r,ilinn cirri 9't9 1087 nrr1'LRnn I-A9 91dd
Issued By: . Permittee Signature: SQP ,1C.( tOYV
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 n K
Residential ° .,_ \�4 "�
FOR OFFICE I I. ON I I
City of Tigard MAY L 2 2023 Received 5 �� -OO�
IN 13125 SW Hall Blvd.,Tigard,OR 97223 Date B
S Plan Review E + .\ , �_0 o (y
Phone: 503.718.2439 Fax: 503.598.10(1 OF TIti2f7 ®p Date/BnR r�ca i
TIGnRD Inspection Line: 503.639.4175 Bit;LDI NG DI,/1S!ON Date Ready/By S See Page for
Internet: www.tigard-orgov Notified/Method: 10 25 23 AFEMI Supplemental Information
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
a 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 ..41i
CATEGORY OF CONSTRUCTION work indicated on this application. (,.�l`2 is?`j 1
❑� I-and 2-family dwelling ElCommercial/industrial Valuation: 20 Full
❑Accessory building 0 Multi-family Number of bedrooms: 4
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 3 VI !tit
Job site address:13737 SW 165th ave New dwelling area: 2464 square feet l
City/State/ZIP:Sherwood/OR/97140 Garage/carport area: 502 square feet`t i3
Suite/bldg.lapt.no.: Project name:River Terrace Town Center Covered porch area: square feet l 07
Cross street/directions to job site: Deck area square feet 1
SW Jean Louise rd Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST •
Subdivision:River Terrace I Lot no.:81 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.
RP UP Valuation: $
q sung 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:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* •
Business name:TNHC OREGON LLC (Please refer mfee sebelule)
Structural plan review fee(or deposit):
Contact name:Frank Sandoval
Address:15455 NW Greenbrier Parkway Suite 240 FLS plan review fee.(if applicable):
City/State/ZIP:Beaverton/OR/97006 Total fees due upon application:
Phone:(503) 310-7571 Fax::( ) Amount received:
E-mail: fsandoval@nwhm.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* •
CONTRACTOR Commercial and residential prescriptive installation of
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%of permit fee): $21.60
CCB lic.:241108 •
Total fee due upon application: $201.60
Authorized signature: ''-L This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Frank Sandoval Date: 5/Z Z/Zp 2, *Fee methodology set by Tri-County Building Industry
Service Board.
C1Building1 Permits 1BUP-RESPermitApp.doc 01/25/2023 440-4613T(11/02/COM/WEB) .
Mechanical Permit Apglicat ECEIVED FOR OFFICE ESE ONLY
City of Tigard Received �r�Ayp�/ �w �L G�
13125DateBy: Pe/-" 1 °343 Do d� 1 Phone:
SW Hall Blvd.,Tigard,OR 97223 MAY
q 2023 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960MA L Date/By: Other Permit:
T I c;41t P Inspection Line: 503.639.4175 Date Read la and:
Internet: www.tigard-or.gov CITY OF TIGARD y od S See Pent i nr
Notified/Method: Supplemental demenfal Information
BUILDING DIVISION l l
TYPE OF WORK COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value$
RESIDENTIAL EQUIPMENT/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:13737 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
Suite bid .la t.no.: Project name: Heat pump 61 06
g p River Terrace Town Center Duct work 2332
Cross street/directions to job site: Hydronic hot water system 23,32
SW Jean Louise rd 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 Town Center Lot no.:81 Other: 23.32
Other fuel appliances:
Tax mapiparcel 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/otherkitchen
Address:15231 Laguna Canyon Rd STE 250 equipment 1 33.39
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: ( ) Anic/crawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:TNHC OREGON LLC Fuel piping:
$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 Fax: :( ) Fireplace
Range
E-mail:fsandoval@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)
(971 rL05 4989 ( ) Plan review(25$$of permit fee)
Phone: 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
"""' �1.��6� days after it has been accepted as complete.
L.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:3/17/2023
I.iBuild;ng\Permits1MEC_PermitApp_040113.doc 4404617r(1 I/02/COMIWEB)
RECEIVED
Electrical Permit Application
FOR Of TICE USE ONLY
City of Tigard MAY 2 2 2023 Received
N...„. Ha B , R 2 Date/By: Pmmit C n7S'1",2023- o02,39
Phone:13125SW 503.71ll8.2439lvd. Fax:
Tigard,soO359a.9721 3 Phut
OF TIGARD Review
InspectionLine: 503.639.4175 Date/By: RelaxdPe`n"ta'
TIGARLI. Internet: www.t; g BUILDING DIVISION NR nSeDlMctfrod: 111e IQ SeePage 2for
sand-or. oy
Suppt<meatal hohrrnatioa
TYPE OF WORK PLAN REVIEW
®New construction
❑Addition/alteration/replacement Please check all that apply(submit j sets of pis wiitems checked)
❑Demolition Other: 0 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault currant 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION
® I-and 2-famil n exceeds 10,000 amps at ISO volts or 0 Floating buildings.
Y dwflli g ❑Commerciallindustrial ❑Accessory building less to ground,or exceeds 14,000 ❑commercial-use agricultural
Other: amps for all other installations. buildings.
❑Multi-family 0 Master builder
JOB SITE INFORMATION AND LOCATION ['Fire pump. laeepa of 150 ydrivor
❑Emergency system larger
r separately derived
Job#: I Job site address: 13737 Sys/ 165th eve ❑Ad lto of new motor cad of system.
IOOHP or more. ❑"A""E""1 2""IJ"
city/State/ZIP: Sherwood/OR/97140 0 Sixor more residential units. occupancy.
Sllite/bld Ja t#; ❑Health-care facilities. ❑Reaxationsl vehicle parks.
g P I Project name: RTTC 0 Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: ❑Service or feeder 600 amps or more_ 600 volts non anal.FEE SCHEDULE
SW Jean Louise rd Description I on. I each I Total f ,
Subdivision: New residential single-or multi-family dwelling unit
River Terrace Town Center I Lot 14:81 Includes attached garage.
4
Tax map/parcel#: 2s1060003300 1,000 sq.it or less 168 4
DESCRIPTION OF WORK Es.add l 500 sq.ft or portion 33.92 1
NEW HOME CONSTRUCTION Limited energy,above sq,
(with above sq.R) 75.00 2
Limited energy,multi-family
residential(with above sq.ft) 75.00 2
IR PROPERTY OWNER i ❑ TENANT Renewable Energy 0 See Page 2
Name: THNC OREGON LLC Services or feeders installation,alteration,and/or relocation
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 401 amps to 600 amps 20034 2
601 amps to 1,000 amps 301.04 2
Phone:(503)310-7571 I Fax:( ) Over 1,000 amps or volts 552.26 2
Email: Fsandoval@newhomeco.com Temporaryationmicesor feeders installation,alteration,and/or
Owner installation:This installation is beingmade on propertyrelocation
intended for sale,lease,rent,or exchange,according to OR 449,670,and 701.not 200 amps toor less0 59.36 i
201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54
51 APPLIC I ❑
ANT 2
CONTACT PERSON Breach circuits—new,alteration,or extension,per panel
Business name: THNC OREGON LLC A.Fee for branch circuits with
above service or feeder fee,
Contact name: Frank Sandoval each branch circuit 7.42 2
B.Fee for branch circuits without
Address: 15455 NW Greenbrier Parkway#240 service or feeder fee,first
branch circuit 56.18 2
city/State/ZiP: Beaverton OR 97006 Each add'I branch circuit
7.42 2
Phone:(503)310-7571 I sax: ( ) Miscellaneous(service or feeder not included)
Each manufactured or modular
dwelling,servceand or feeder
Email: Fsandoval@newhomeco.com67.84 2
CONTRACTOR Reconnect only 67,84 2
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 Hwy Signal circuit(s)or limited-energy
panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP:Troutdale, OR, 97060 Each additional inspection over allowable in any of the above
Phone:(503)853-9420 J Fax:( ) Additional inspection(I hr ruin) 66.25/hr
Investigation(1 hr min) 90.001 hr
Email:MWOLCOTT@WOLCOTT,PRO Industrial plant(Ihrmin) 78.18/hr
Inspections for which no fee is
CCB Lic.:112220 I Electrical Lic.:C1272 I Suprv.Lie.:5782S specifically listed('G hr min) 90.00/hr
Suprv.Electrician signature,regrlired:'fl' ELECTRICAL PERMIT FEES
w..<..,..ia..ca,v..«'vu Subtotal:
Print name:David Campbell I Date:10/12/2023 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: 44--.4 AA TOTAL PERMIT FEE:
Print flame:Malachi J. Wolcott This permit application expires ifs permit is not obtained within 180
I Date:10/12/2023 I days after it has been accepted as complete.
I lauildingtp<mtits�ELCPamitApp_�-a�RE,<bc Rev 06/17/70 15 " Number of inspections allowed per permit. i
140-4615T(11/05/COMIWEB
I
Plumbing Permit Applicatiori IV
Building Fixtures MAY 2 2 2023 FOR OFFICE: I St trsil
City of Tigard Received Pen nil No.:
,� I3 t25 SW Hail Bivd.,Tigard,OR 97223 DaldBy: - MST 2o23-OO239
I Phone: 503.718.2439 Fax: 503.598.„ ITY OF TIGARD Plan Review Other Pomsit No.:
InspectionLine: 503.639.4175 ILDING DIVISIOI'�ak/BY'
Ready/By: Jura Ed Page 2 for
I'GAR!). Sc
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
la New construction 0 Demolition For special information use checklist
Description I Qty. f Ea. 1 Total
❑Addition/alteration/replacement 0 Other: New 1.2-family dwellings(includes 100 R.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
®I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 1 - 437.78
❑Accessory building 0 Multi-family SFR(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 She utilities:
Job site address: 1 3737 SW 165th ave Catch basin or area drain 18.76
City/Stale/ZIP: Sherwood/OR/97140 Drywall,leach line,or trench drain 18.76
Footing drain(no.linear 11.: ) Page 2
Suite/bldg./apt.no.: 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 ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: River Terrace Town Center I Lot no.: 81 Fixture or item:
Tax map/parcel no.: 2s1060003300 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
ad PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: TNHC OREGON LLC Fixture/sewer cap 25.02
Address: 15231 Laguna Canyon Rd STE 250 Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: Irvine CA 92618 Hose bib 25.02
Phone:(503)310-7571 Fax:( ) Ice maker 12.51
IBI APPLICANT IN CONTACT PERSON Interceptor/grease trap 25.02
Business name: THNC OREGON LLC Medical gas(value $_) Page 2
Contact name: Primer 12.51
Frank Sandoval 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 25.02
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 Lie.:112220 Plumbing Lic.no.:26824 PB Plan review (25%ofpermit fee)
t� t State surcharge(12%of permit fee)
`�7"Authorized signature:4)I 1\ TOTAL PERMIT FEE
Print name:Mark Baleme Date:10/12/2023 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set by Tr-County Building Industry Service Board.
IU3aldinglPerminlPLMU-PeroitApp.doc IsalaN 440.4616T(Io/o2/COMAVaa)
W0.. , for c- -A l 0
wiAt NATO PAM
A OEOTECHNIR:< Building Division
• " REPORT IS REQUIRE.
'BEFORE THE FOOTIN, One & Two-Family Dwelling
rIG , ECTION IS APPROt� Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION 7e `i c
Permit#: iwL,ion r co 2,31 Plan #: e mil'C o IO Floors: 3
Valuation: y02�0"Iq 5y Covered Porch: Basement I b�
Bedrooms: 14
Deck: �— 1"Floor t`17 3
WC (toilets) 3 Deck Cover: _ 2nd Floor 1 1.Ea Ll
Lavatories S Patio Cover 3'd Floor
Tub/shower, 3 Accessory Struct. _— R-3 Total I l
Aso Tray Water Heater l / Gas / Garage 5t2
Exhaust Vents 5 Gas Flue Vents _— Total for Elec. 2q
Backflow Prey. AP/ Heat Pump • # for ElectricalLI
BBQ _ Gas Fireplace vim- #Fuel Lines 3
FEES: Description: Fee Applies• Fee Entered:
DC Prov Revw: Planning ✓/
Info Proc/Arch: Lg$2.00 (over 11x17) 1-(e
Info Proc/Arch: Sm$.50 (up to 11x17) 2.-Metro CET: Residential Use
School CET: District: fi
�C
Tigard CET: Admin JJ
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 1//
Erosion Control: w/Permit- Ping vr-
I:\Building\Forms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
Page 1
City of Tigard
■
" COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: 14yT.)-c,477 - op,,--)7
Site Address: 13737 SW 165th Avenue i Verified in Accela
Project Name: River Terrace Town Center-New Home Co. Lot/Unit #: 81
Proposal: New Detached SFR Zone: Res-C
Housing Type: E SFR(E Single Detached 0 Duplex❑ Triplex 0 ADU) El Rowhouse ElCottage Cluster El CYU ❑Quad ❑Other
Required Site Plan Elements:
E 3 copies of site plan on max 11x17"
E Drawn to standard scale ❑ Rctaincd trccs, drip linc/trcc protcction
E North arrow E Street and site trees shown / labeled
® Site address, project name, lot # ❑ Table calcilating trcc canopy at maturity
E Street names (N/A for SFR)
E Applicant name and phone # ❑ Courtyord rectangle dimensioned (if applicablc)
E Lot and setback dimensions E Vision clearance triangle
❑ Cxisting structerea &squarc footagc E Utility locations &easements
E Footprint of new structure and FFE E Property corner elevations
E Sidewalk/driveway dimensioned E LIDA (>1,000 sf disturbance)
E Lot area and lot coverage percentage E Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
E Drawn to standard scale E Total facade area
E Building height dimensioned ® Total window and door area
E Facade dimensioned
E Windows and doors dimensioned
E Garage doors dimensioned
or Plan Elements:
(Not required for mary table that includes
❑ Each story dimensio I floor area
oor area calculated ❑ Floor area p
Planning Review
The following standards have been met:
8'(porch)
Setbacks E Front: 12' Rear: 3' Side: 3' Min/Max Street Side: N/A / N/A Garage: 3'(alley-loaded)
Height E Max. Height: 35' Proposed Height: 25' 11 1/2"
® Yes 0 N/A Landscape
❑ Yes E N/A Screening (Quad only)
E Yes ❑ N/A % Window Coverage Garage standards not applicable-not fronting a public street
O Yes E N/A Garage (SFR Only) Parking (Other Res)
E Yes El N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes E N/A Other building design standards (Rowhouse only)
❑ Yes E N/A Accessory Structure Standards
❑ Yes ® No Qualifying pre-existing unit exempt from standards (Cottage unit only)
nal standards for Co Units, Cottage Clusters, Rowhouses, and Quads:
❑ Yes ❑ it
❑ Yes ❑ of WI Size
N/A Pathway
'tional standards for Court nits and Cottage Clusters only:
❑ Yes Unit Area:
❑ Yes 0 N/A ea (per story)
El Yes ❑ Courtyar
N/A Fence
❑ Yes ❑ No ®N/A Clean Water Services - Service Provider Letter(lot platted prior to 9/10/1995)
El Yes ❑ No I N/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes ❑ No
Applied For: ❑ Yes ❑ No, stop intake
Il Sensitive Lands: ® Yes ❑ No
® Main Land Use Case #s: PDR2021-00004 ❑ Conditions met
i Applicant notified of land use explra I f1 date: Submit and pay for all applicable dev permits by 1/31/2025.Final occ by 1/31/2027
Approved By Planning: — Date: 5/16/2023
Notes Permit can be issued prior o final plat approval but not prior to conditions being melon PDR
Revision 1: ❑ Approved 0 Not Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date:
Building Permit Submittal /
Original Submittal Date: cJ J -a-( -?-4
Site Plans #: '���jjj
Building Plans #: 7
Building Permit #: I -Building permit # entered on page 1
Workflow Routing: I�.Planning C Engineering 14..Permit Coordinator 1 Building
Workflow Sign-off: E .Sign-off for Planning (include notes from plannirfg review)
Route Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan
�` and original plan review routing form.
1� 4,Building: original permit application, site plans, building plans, engineer and
ay beam calculations and trust details, if applicable, etc.
q Permit Technician: Date: ��7 I
Engineering Review
,kvU yN
❑ PFI Permit:
1r/Slope at building pad: 24".,,e, 0/0
S' t ae
❑ asements onditions met(encroachmentspriorissu) pernce of engineerprmit
❑ Water Quality/Quantity Facility: ing conditions of approval and plat
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
... Assess Water Quantity Fee in-lieu: El Yes CI No
LIDA Facility on lot: ❑ Yes ❑ No Add Fee: ❑ Yes ❑ No
❑ inal Plat Recorded
0 NOT Approved: Date:
Notes:
Approved By Engineering: Date: <! %/4
Revision 1: 0 Approved 0 Not Approved Date:
Revision 2: ❑ Approved CI Not Approved Date:
Permit Coordinator Review
S conditions met prior to permit issuance
Q Approved, NOT Released: ta.. Date notified applicant:(0(29120e,7
(V ❑ ENG Revisions Required: Date notified applicant:
,'SDC Exemption: ❑ Applied for ❑ Received Does not apply
p'SDC Fees Entered: Wash Co Trans Dev Tax: . Yes ❑ N/A ,
Tigard Trans SDC: 'Yes ❑ N/A ?Deferred
Parks SDC: 7 Yes ❑ N/A )Y Deferred
LIDA ❑ Yes N/A
teK to Issue/Approved by Permit Coordinator: Date: I(" IS -23
Revision 1: ❑ Approved 0 Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
City of Tigard
' Deferral Until Occupancy Request
M2ill
t
TIGARD Washington County Transportation Development Tax (TDT),Transportation and Parks System
a Development Charges (SDCs)
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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: 6/26/2023 Site Address: 13737 SW 165th Ave
Project River Terrace Town Center Land Use Case or
Name: Building Permit#: MST2023-00239
Tax Lot Lot 81 Total Parks
#: Amount*: $11,830.00
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,$ 448.00 for TSDC-
Reimbursement,and$ 3 • for TSDC-River Terrace,if applicable..
1,1014.00
*The total Parks SDC amount shown above is the sum of$ 6,812.00 for Parks-Improvement,$ 1,887.00 for Parks-
Reimbursement,and either$ N/A for Parks-Neighborhood or$ 3,131.00 for Parks-Neighborhood River Terrace.
This constitutes my request to defer payment of the TDT, TSDC, and Parks SDCs, as provided above,
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.
.-, _ Cam' ,. 26-�.3
Property Owner: t Date:
!---- r—r :, Date: .��6`��
Developer:
Permit Coordinator: ATM ()(.iV114-.i Date: 6/26/2023