Permit (124) I CITY OF TIGARD MASTER PERMIT
_ ' COMMUNITY DEVELOPMENT Permit#: MST2023-00523
T I Ci A HD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/07/2023
Parcel: 2S1060003300
Jurisdiction: Tigard
Site address: 16591 SW JEAN LOUISE RD
Subdivision: RIVER TERRACE TOWN CENTER Lot:
Project: River Terrace Town Center, Lot 88
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
DwellingUnits: 1 Yes
Third: 0 sf Right: 3 Detectors:
Total: 2464 sf Value: $449,59524 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
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!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 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 Geo Tech Required
15231 LAGUNA CANYON RD STE IRVINE,CA 92618
250
PHONE: PHONE: 503-312-6213
FAX:
Total Fees: $25,762.88
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 re uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
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Issued By: / / Permittee Signature: If
G!L'�' 1 �cr v.7
Call 50; .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 RECEIVED
Residential FOR OFFICE USE O\I,'
. - Cityof Tigard OCT O Received 1ft 4(140)
g 2023 Date/By: �(�//�,2.3 Permit No.: 1'fS\We./-O0SZ.�
IIIn 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.196�ITM OF TIGARD Date/By: 11) 23123 Other Permit:9JIJQJ)t'1,3-00343
TIGAAD Inspection Line: 503.639.4175 BUILDING IGARDN Date ReadylBy: Juri% -See,Page 4for
Internet: www.tigard-or.gov Notified�Method: -�(]-'-'�j^D/at23�_LpFT L� Supplemental Information
`ter^ -mil r.
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
E 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/alterationtreplacement ❑Other: equipment,materials,labor,overhead,and the profit for the Li 2
CATEGORY" OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling I:Commercial/industrial Valuation: 9',7IN 51 5*
❑Accessory building 0 Multi-family Number of bedrooms: 4
❑ Master builder ❑Other: Number of bathrooms: .
JOB SITE INFORMATION AND LOCATION Total number of floors: 3 2611(B(..e
Job site address:16591 SW Jean Louise rd New dwelling area: 2464 square feet t`try
City/State/ZIP:Sherwood/OR/97140 Garage/carport area: 602 square feet %"')
Suite/bldg./apt,no.: Project name:River Terrace Town Center Covered porch area: 115 square feet `O'1
Cross street/directions to job site: Deck area: square feet
SW River TerracP blvd Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:River Terrace Lot no.:88 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: $
Requesting 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/CAI 92618 Existing:
Phone:(503)310-7571 Fax:( ) New
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:TNHC OREGON LLC (Please refer ro fee schedule)
Structural plan review fee(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: fsandoval@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%of permit fee): $21.60
CCB lic.:241108
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Frank Sandoval Date: 10l((7 MO 2 *Fee methodology set by Tn-County Building Industry
a` Service Board.
I:1Building\Permits\BUP-RESPermitApp.doe 01/25/2023 440-4613T(11/02/COM/WEB)
Mechanical Permit ApplicatRECEIVED FOR OFFIc F ESL OSEI
City of Tigard ReceivedElifirgII OCT 1 0 2023 Date By: MAIM
i 13125 SW Hall Blvd.,Tigard,OR 97223Plan Review
x Phone: 503.718.2439 Fax: 503.598.1960Other Permit:
Inspection Line: 503.639.4175 Date/By:
TIC;ARU g g CITY OF TIGARD DDate Readfehod: Jwls. Supplementallnforma8on
See Page 2 for
Internet: www.ti and-or. ov
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
' Mechanical permit fees"are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 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:16591 SW Jean Louise rd 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 River Terrace blvd
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.:88 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 NEW HOME CONSTRUCTION fireplace 23.32
water heater or gas
eplace 2332
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
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/crawlspacc fans 23.32
0 APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name:TNHC OREGON LLC Fuel piping:
$14.15 for first four;S4.03 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: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
City/State/ZIP:Hillsboro, OR 97124 Minimum permit fee($90.00)
Phone:(971 )205 4989 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lie.:209001 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: Pea-e • Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:3/17/2023
IdBuildingiPermitsMEC PernutApp 040113.doc 440-461 Tr(I I/02/COMfWEB)
•
Electrical Permit Applicatloi C E IVE D FOR OFFICE USE ONLY
City of Tigard (�'r Received /'�I �L
C 1 0 2023 Date/By Permit ti: MS'1 A t/3 l y iSti,�i 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review W�7
Phone. 503.718.2439 Fax: 503.598 1960 Date/By: Related Permit 5:
Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: Avis:i if., l if t% Internet: www.tigard-orgov BUILDING DIVISION Notified/Method: I ®SeePene2 for
Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wiiterns checked).
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition El Other:
where the available fault Harem 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
IZJ I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: 16591 SW Jean Louise rd ❑ltlP Addition mof cw motor load of system.
IOOHP or more. ❑`A""E""t-2""1-3"
City/State/ZIP: Sherwood/OR/97140 ❑Six or more residential units. occupancy.
o Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: RTTC 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
SW River Terrace blvd Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: River Terrace Town Center Lot#:88 Includes attached garage.
Tax map/parcel#: 2s1060003300 1,000sq.ft.orless 168.54 4
Ea.add'I 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-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
N PROPERTY OWNER El TENANT
Services or feeders installation,alteration,and/or relocation
Name: THNC OREGON LLC 200 amps or less 10070 2
Address: 15231 Laguna Canyon Rd STE 250 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Irvine CA 92618 601 amps to 1,000 amps 30104 2
Phone:(503)310-7571 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,andfor 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
53
APPLICANT El CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: THNC OREGON LLC above service or feeder fee,
each branch circuit 7.42 2
Contact name: Frank Sandoval B.Fee for branch circuits without '
Address: service or feeder fee,first
15455 NW Greenbrier Parkway#240 branch circuit 56.18 2
City/State/ZIP: Beaverton OR 97006 Each add'l brooch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)310-7571 Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
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
Address:1075 W Historic Columbia River Hwypanl, lte anons)or limited-energyxe 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Troutdale, OR, 97060 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(503)853-9420 Fax( ) Investigation(1 hr min) 90.00/hr
Email:MWOLCOTT@WOLCOTT.PRO Industrial plant(Ihrmin) 78.18/hr
Inspections for which no fee is CCB Lie.:112220 Electrical Lie.:C1272 Suprv.Lic.:5782S specifically listed 04 hr min) 90.00i hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:'—� Subtotal:
0.r0000601:on n1000* A„
Print name:David Campbell Dale:10/12/2023 ❑Plan Review Required(25%of permit fee):
t //1� State surcharge(12%of permit fee):
Authorized signature: 44...t 4KAI TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within ISO
Print name:Malachi J. Wolcott Date:10/12/2023 days after it has been accepted as complete.
* Number of inspections allowed per permit.
l:FBuildinglPermitslELC PerrsitApp_ELRERE.doc Rev 06/172015 440.4615T(t l/05/COM/WEB
Plumbing Permit ApplicatREC E IVE D
Building Fixtures OCT 10 2023 FOR OFFI( F: I SF; o I.1.
City of Tigard Received 11015•d 0SIA
■ 13125 SW Hall Blvd.,Tigard,OR 9 Dan Review
Permit No.: 11
•, Phone: 503.718.2439 Pak: 503 OF TIGARD Plan Review
DaleBy: Other Permit No.:
l 1,::;,.',,RI1 Inspection Line: 503.639.4175 ING DIVISION
Internet: sysvw.ligard-or gov Date
ied Meiho Janis: ®See Page 2 for
•
Notified/Method: Supplemental Infnrma limn
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special ifrjormafiau use checklist.
CIAddition/alteration/replacement 0 Other: Description I Qty. I Ea. Total
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 ❑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 ❑Other:
Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16591 SW Jean Louise Rd Catch basin or area drain 18.76
Drywall,leach line,or trench drain I8.76
City/State/TAP: Sherwood/OR/97140
Footing drain(no.linear fl.:_) Page 2
Suite/bldg./apt.no.: Project name: RTTC
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
SW River Terrace Blvd Rain drain connector 18.76
Sanitary sewer(no.linear R.:_) Page 2
Storm sewer(no linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: River Terrace Town Center 1 Lot no.:
88 Fixture or item:
Tax map/parcel no.: 2s 1060003300 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 :
0 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 sinkPoub 25.02
Garbage disposal 25.02
City/Slate/ZIP: Irvine CA 92618
Hose bib 25.02
Phone:(503)310-7571 Fax:( ) Ice maker 12.51
® APPLICANT ($f CONTACT PERSON Interceptor/grease trap 25.02
Business name: THNC OREGON LLC Medical gas(value:8 ) Page 2
•
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 25.02
Water heater
Business name:Wolcott Plumbing 37.52 •
Water piping/D W V 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.:2gg24 PB Plan review (25%of permit fee)
, �� •
� State surcharg of permit fee)
Authorized signature:•"\
TOTAL PERMIT FEE I
Print name:Mark Baleme Dale:10/12/2023 This permit application expires ifa permit is not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
IU1mldingiPermils1PLMU•PermitApp.doc 10/01/09 440.4616T(10/02/COM/WEa{
City of Tigard
11/ . " COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
e
Building Permit #: MST7OL- )- DOS C
Site Address: 16591 SW Jean Louise Rd o Verified in Accela
Project Name: RT Town Center Lot/Unit #: 88
Proposal: New detached SFR Zone: RES-C / C-C
Housing Type: 0 SFR(0 Single Detached ❑ Duplex❑Triplex❑ADU) ❑ Rowhouse❑Cottage Cluster❑CYU ❑Quad ❑Other
Required Site Plan Elements:
0 3 copies of site plan on max 11x17"
as Drawn to standard scale ❑ Rcta6icd hc-c�, 1.111N IllIG/ t,cc Ni uieCti011
O North arrow 0 Street and site trees shown / labeled
O Site address, project name, lot # turity
O Street names (N/A for SFR)
0 Applicant name and phone # ❑ Courtyard roctanglc dimcnoioncd (if applicable)
O Lot and setback dimensions 0 Vision clearance triangle
❑ CnIOuIIy D1.1 ul•.0 c.D &ayuw.. 11,vwy.. 0 Utility locations &easements
O Footprint of new structure and FFE 0 Property corner elevations
0 Sidewalk/driveway dimensioned
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:
O Drawn to standard scale 0 Total facade area
O Building height dimensioned 0 Total window and door area
O Facade dimensioned
O Windows and doors dimensioned
Alley load
Regvi oor 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: 26'
0 Yes ❑ N/A Landscape
❑ Yes 0 N/A Screening (Quad only)
0 Yes ❑ N/A % Window Coverage 26% t3'1.
❑ Yes 0 N/A Garage (SFR Only) Parking (Other Res)
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 /A Unit Count:
❑ Yes ❑ N/, 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 0 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: 0 Yes 0 No, stop intake
m Sensitive Lands: m Yes El No
❑ Main Land Use Case #s: PDR2021-00004 fl Conditions met
la Applicant notified of land use expiration date: Permits by 1/31/25. Final by 1/31/27
Approved By Planning: Date: 10/2/23
Notes
Revision 1: 0 Ap ed ❑ Not Approved Date:
Revision 2: ❑ A roved ❑ Not Approved Date:
Building Permit Submittal
Original Submittal Date: loI1b (Z'ti
Site Plans #: 3
Building Plans #: 3
Building Permit #: 'Building permit # entered on page 1
Workflow Routing: Er Planning p Engineering 0 Permit Coordinator .zlBuilding
Workflow Sign-off: y1 Sign-off for Planning (include notes from planning review)
Route Documents: '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: Date: 17)/31 / 3
Notes:
Engineering Review
v❑ Permit:
Slope at building pad: 24%./3
4//¢ ICKConditions met prior to issuance of permit
I Casements (encroachments) per engineering conditions of approval and plat
El/Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes IvJ No
Assess Water Quantity Fee in-lieu: ❑ Yes ip,No
LIDA Facility on lot: ❑ Yes ad'Flo Add Fee: ❑ Yes ❑ No
iimnal Plat Recorded
0 NOT Approved: Date:
Notes: o
Approved By Engineering: Date: /o�°•2
Revision 1: ❑ Approved ❑ Not ApprovedDate:
Revision 2: 0 Approved ❑ Not Approved Date:
Permit Coordinator Review
•
o.r.nditions met prior to permit issuance
❑ Approved, NOT Released: Date notified applicant:
❑ ENG Revisions Required: Date notified applicant:
OASDC Exemption: ❑ Applied for ❑ Received Does not apply
I3'SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
( Tigard Trans SDC: Yes ❑ N/A Deferred
Parks SDC: Yes ❑ N/A L Deferred
LIDA ❑ Yes FN/A
OK to Issue/Approved by Permit Coordinator: 0.0"(,J, Date: '
Revision 1: 0 Approved 0 Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
Rif ; ' ?bi s
e '� r :1f70ICIPF14
G ,T 3 flf !)I U Ea BEFORE THE FOOTING `
1111 .,, ccTioN is AoppovED ' Building Division
'.`' , 6 ne & Two-Family Dwelling
TIGARD Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION S"k1 2,oz3
Permit#: YY\., ,i7 .,,_J—���_JJ Plan #: Z�sa�3 Floors: 3
Valuation: 1 I IA I � a4 Covered Porch: !1/= Basement 6-7
-111
Bedrooms: L'l Deck: 1"Floor I-
13
WC (toilets) rl Deck Cover: 2'd Floor 1 t (8(I
Lavatories 5 Patio Cover 3=d Floor �I
Tub/shower Accessory Struct. .---_ R-3 Total VI
t _ t
Laundry Tray Water Heater 1 / Gas Elec Garage 5aa`1
Exhaust Vents 5 Gas Flue Vents Total for Elec. 2`I� P
Backflow Prey. llrllac (
/ Heat Pump / AC # for Electrical l I
BBQ ...--- Gas Fireplace d Q #Fuel Lines
3
FEES: Description: Fee Apps: Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg$2.00 (over 11x17) a(P
Info Proc/Arch: Sm $.50 (up to 11x17) -
Metro CET: Residential Use
School CET: District: ` f
Tigard CET: Admin O
Tigard CET: ODHCS
Tigard CET: AH
Electrical Permit: Permit Fee:
Limited Energy:
12% State Surcharge IV
Mech. Permit: Permit Fee: f
12% State Surcharge ✓
Plumbing Permit: Permit Fee:
12% State Surcharge IV
Erosion Control: w/Permit-Ping
I:\Building\Forms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
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