Permit (52) „ CITY OF TIGARD MASTER PERMIT
-7 COMMUNITY DEVELOPMENT Permit#: MST2023-00207
T I.C]AR;D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/01/2023
Parcel: 2S1060003300
Jurisdiction: Tigard
Site address: 13754 SW 166TH AVE
Subdivision: RIVER TERRACE TOWN CENTER Lot:
Project: River Terrace Town Center, Lot 90
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: 657 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 940
sf Garage: 390 s/ Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 1597 sf Value: $264,507.09 Rear: 3
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 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 Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0
p. 0-200 amp: 0 W/Svc or Fdr: 0
Ea addl 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
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 1597
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
15231 LAGUNA CANYON RD STE IRVINE,CA 92618
250
PHONE: PHONE: 503-312-6213
FAX:
Total Fees: $19,890.40
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
Qc9-On1Anin fhrm in n P g69_nnt_nnon V,-. in nnn,i of fhp nilac nr rlirant nimefinne fn(II IAIC hu Tallinn Rill 917 10R7 nr 1 Rim 739 914i
Issued By: g Y�+ 7? f r0 , 0,...,Permittee Signature: /Y
Call 503.639.417 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept i a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application RECEIVRIi
Residential MAY
//� ((�7 FOR OFFICE USE ONLYY-�
MA i 0 -d 2023 Received G� 1� Permit'V '7'��.Tj '"'DO��
- City of Tigard Date By: ✓ '{ J3
Illqn 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Permit
ether �Qa -pa(a1
Phone: 503.718.2439 Fax: 503.598 19 CITY OF TIGAHD DatelB : rl
Inspection Line: 503.639.4175 BUILDING DIVISIO -. Date Ready/By: Ii I ,�1,�\rA lure H See Page 4 for
TIGARD Potified/Method: �1 1`]/�'71` Ti3 I Supplemental Information
Internet www.[igard-orgov �tpp�,11 �IrMII � r
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
❑Demolition Permit fees*are based on the value of the work performed.
0 New construction Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION t4 l 5a
Valuation: S 0 Ii
0 1-and 2-family dwelling 0 Commercial/industrial
Number of bedrooms: 3
❑Accessory building 0 Multi-family 2
❑Other: Number of bathrooms:l2!5-J
❑Master builder i _lrST
JOB SITE INFORMATION AND LOCATION Total number of floors: 2197
A New dwelling area: square feet 99 0
Job site address: SW 166th ave
City/State/ZIP:Sherwood/OR/97140 Garage/carport area: 390 square feet 197-1
Suite/bldg./apt.no.: Project name:River Terrace Town Center Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
SW _ rman I mice rri Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:River Terrace I Lot no.:90 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: 2S1060003300 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Requintin rfed-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:
III APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedrl
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:
Phone:(503) 310-7571 Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
F.-mail: fsandoval@nwhm.com 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.
Permit Fee(includes plan review $180.00
City/State/ZtParvine/CA/92618 and administrative fees):
Phone:(503 )310-7571 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:241108 �� Total fee due upon application: $201.60
This permit application expires if a permit is not obtained
Authorized signature'. within 180 days after it has been accepted as complete.
*Fee methodology set by Tr-County Building Industry
Print name:Frank Sandoval Date: / 2�7j� Service Board.
1..1Building1 Permits\BUP-RESPermitApp.doc 01/25/2023 440-461 (11/02/COM/WEB)
i
•
• Mechanical Permit ApplicationRECEIVE FOR OFFICE I-SE ONLY
Cityof Tigard Received Pern �.p�j_06�7
. MAY 0 4 2023 Deceived
III13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY OFA TIGAR
1��Dfale Ready/By: inns: I See Page 2 for
Internet: www.tigard-or.gov (?l-III.,.DING DIVISI!t Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑ Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑CommerciaL'industrial ❑Accessory building For special information use checklist.
D Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
Heating/cooling:
a.,3Z $ SITE INFORMATION AND LOCATION Air conditioning 1 46.75
Job site address SW 166th ave Furnace 100,000 BTU(duersivents) 46.75
City/State/ZIP:Sherwood OR 97140 Furnace 100,000+BTU(duets/vents) 1 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:River Terrace Town Center Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
SW Jean Louise rd hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision:River Terrace Town Center Lot no.:90
Other fuel appliances:
Tax map/parcel no.:2s1060003300 Water heater 23.32
DESCRIPTION OF WORK
Gas fireplace/insert 1 33.39
Flue vent for water heater or gas
NEW HOME CONSTRUCTION fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
® PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation:
Name:TNHC OREGON LLC Range hood/other kitchen 1 33.39
equipment
Address:15231 Laguna Canyon Rd STE 250 Clothes dryer exhaust 33.39
City/State/ZIP:Irvine CA 92618 Single-duct exhaust(bathrooms,
ty toilet compartments,utility rooms) 23.32
Phone:(503)310-7571 Fax: ( ) Attic/crawlspace fans 2332
0 APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:TNHC OREGON LLC $14.15 for first four;$4.03 for each additional
Contact name:Frank Sandoval Furnace,etc.
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 00)
City/State/ZIP:Hillsboro, OR 97124 Plan review(25%ofpermitfee)
Phone:(971)205 4989 Fax:( ) State surcharge(12%of permit fee)
TOTAL PERMIT FEE
cca lie.:209001
This permit application expires if a permit is not obtained within 190
/�p�,/� days after it has been accepted as complete.
Authorized signature: t ' Z7 f * Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:3/17/2023
r\Building\Permits MEC PermitApp 040113.doc 440-4617r(1 UO2JCOM/WEB)
.- C I F E a
Electrical Permit Application Y 0 4 2023 FOR oFFiCe USE ONLY
City of Tigard OF TIGARD d
Receive
ttdBByy: Perm":Msr2oz3-00207 !
71 s • l3125SWllaIIBlvd.,Tigard,OR 97223 �'vG DIVISION Plan Review Relakd Permit#:Phone: 503.7182439 Fax: 503.598:1968/ Date/By:
Inspection Line: 503.639.4175 Ready Date/By: heie 0 See Page 2 for
TIC At in Internet: www.tigard-orgov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
l New construction 0 Addition/alteration/replacement Please check all that apply(submit j sets of plans wlitems checked).
❑Service or feeder 400 amps or more 0 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 ❑Floating buildings.
Ki 1-and 2-family dwelling ❑Commt rciaVindustrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-me agricultural
amps for an other installations. buildings.
❑Multi-family 0 Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 13750 SW 166th ave 100HPormore. ❑"A","E","l•2","1-3",
City/State/ZIP: Sherwood! OR/97140 D Six or more residential units occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldgJapt.#: Project name: RTTC ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
SW Jean Louise rd Description I sad• I Each I Total I '
residential New residential single-or multi-family dwelling unit
Subdivision: River Terrace Town Center Lot#:90 Includes attached garage.
Tax map/parcel#: 2s1060003300 a.addq.5 or less • 133.9254 4
Pa.add'l 500 sq.ft or portion 33.92 I
DESCRIPTION OF WORK Limited energy,residential 75.00 2
NEW HOME CONSTRUCTION (with above sq.ft)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
154 PROPERTY OWNER ❑ TENANT Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name: THNC OREGON LLC 200 amps or less 100.70 2
Address: 15231 Laguna Canyon Rd STE 250 201 amps m400 amps 133.56 z
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 1 own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
ti) 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 fbrbrancb circuits without
service or feeder fee,first 56.18 2
Address:
15455 NW Greenbrier Parkway#240 branch circuit
City/State/ZIP: Beaverton OR 97006 Each add'I 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 circuits)or limited-energy 0 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/ZIP:Troutdale,OR,97060
Additional inspection(1 hr min) 66.25/hr
Phone:(503)853-9420 Fax:( ) Investigation(1 to min) 90.00/hr
Industrial plant(1 hr min) 78.18!hr
Emai1:MWOLCOTT@WOLCOTT.PRO Inspections for which no fee is 90.00/hr
CCB Lie.:112220 Electrical Lie.:C 1272 Suprv.Lic.:5782S specifically listed(v'hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:'O'/ Subtotal:
Print name:David Campbell Date:10/12/2023 in Plan Review Required(25%of permit fee):
4
State surcharge(12%of permit fee):
Authorized signature: ma TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained wilbin 180
Print name:Malachi J. Wolcott Date:10/12/2023 days after it hes been accepted as complete.
• Number of inspections allowed per permit.
I:(Building`PerminlELC_PermhApp_ELR_ERE.doc Rev 06/172015 450-4615T(11/05/COM/WEB
I
• RECEIVED
Plumbing Permit Application
Building Fixtures MAY 0 4 2023 FOR OFFu•E USE, mu,-
City of Tigard CITY OF TIGARDReceived
III �t�BY. MST9.OZ3—p02C"e
• 13 Ph125 SW Hall Blvd.,Tigard,O gING DIVISION plan Review
permit No
a one: 503.718.2439 Fait: 50375W.r9 Date/By: Other Permit No.:
-i C7 A IL l Inspection Line: 503.639.4175 Date Ready/By: tans: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE*SCHEDULE
®New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
SFR(2)bath 1 437.78
® 1-and 2-family dwelling IDCommercial/industrial 500 32
SFR(3)bath
•
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2
JOE SITE INFORMATION AND LOCATION Site utilities:
13750 SW 166th aye Catch basin or area drain 18.76
•
Job site address: Drywell, each line,or trench drain 18.76
City/State/ZlP: Sherwood/OR/97140 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: RTTC Manufactured home utilities 50.03
Cross street/directions to job site: SW Jean Louise rd Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(na 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.: 90 Fixture or item:
Backflow preventer 31.27
Tax map/parcelno.. 251060003300 12.51
Backwater valve
DESCRIPTION OF WORK Clothes washer 25.02
New Home Construction Dishwasher 25.02 •
Drinking fountain 25.02
Ejectors/sump 25.02
aii PROPERTY OWNER ❑
TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: TNHC OREGON LLC 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 12.5125.02
Ill APPLICANT Ill CONTACT PERSON Interceptor/grease trap
Medical gas(value:S ) Page 2
Business name: THNC.OREGON LLC Primer 12s1
Contact name: 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
Urinal 25.02
E-mail: 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
cayrsurle/zIP:
Troutdale OR. 97060 Subtotal
Minimum permit fee. $72.50
Phone:( 503-667-1781 Fax:( ) a
Plan review(25%of permit fa)
CCB Lie,;112220 �` Plumbing Lie,no.:26824 PB State surcharge(12%ofpermit fee)
Authorized signature: r. TOTAL PERMIT FEE
Date:10/12/2023 This permit application expires if permit is not obtained within ISO days
Print name:Mark Baleme after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Booed.
•
•
IrBeildingWermilaWLMLLPennitdpp.doc 10/0009 440-4616T(10/021COMIWEB)
City of Tigard
111 ■
" COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit#: ft/lST-D 277 — 7O'D-t 7
Site Address: 13754 SW 166th Ave 0 Verified in Accela
Project Name: RT Town Center Lot/unit #: 90
Proposal: New detached SFR Zone: RES-C
Housing Type: 0 SFR(0 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"
0 Drawn to standard scale J,:N III IC/ p.t,tection
O North arrow 0 Street and site trees shown / labeled
0 Site address, project name, lot # ❑ TeLlc __I__I t:..9 t, _ __.. , -I ....Aurity
O Street names (N/A for SFR)
-_a applicable)
O Applicant name and phone # 10-C,l,^n
O Lot and setback dimensions Vision clearance not required
❑ EA„ ,,,y lreLIJ,�,�,yu� n,.,«y.. 0 Utility locations & easements due to tract/private access.
O Footprint of new structure and FFE 0 Property corner elevations
O 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 façade area
O Building height dimensioned 0 Total window and door area
O Facade dimensioned
O Windows and doors dimensioned
0 Garage doors dimensioned
Re ' 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 °A) Window Coverage 26%
❑ Yes 0 N/A Garage (SFR Only) Parking (Other Res)
O 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 : /A Unit Count:
❑ Yes ❑ N/ of Width and Size
❑ Yes ❑ N/A Pat', -
Additional standards for -• rtyard Units and Cottage Clusters only:
❑ Yes 0 N/A Unit Area:
❑ Yes ❑ N/A Floor Area (per story)
❑Yes ❑ N/A Courtyard
0 Yes 0 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
0 Sensitive Lands: 0 Yes ❑ No
0 Main Land Use Case #s: PDR2021-00004 ❑ Conditions met
0 Applicant notified of land use expiration date: Submit development plans by 1/31/25. Final occupancy by 1/31/27
Approved By Planning: Date: 5/1/23
Notes -—
Revision 1: ❑ Apo/ ed CI Not Approved Date:
Revision 2: ❑ A►, oved ❑ Not Approved Date:
Building Permit Submittal 5( �
Original Submittal Date:
Site Plans #:
Building Plans #: 77
Building Permit #: lA Building permit # entered on page 1
Workflow Routing: l Planning 4� Engineering A Permit Coordinator Building
Workflow Sign off: SignLife
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.
1 64 Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
pg' Permit Technician: Date: S/l��
Notes:
Engineering Review
k0 PFI Permit: 2,Slope at building pad:
0 onditions met prior to issuance of permit
SV ❑ asements (encroachments) per engineering conditions of approval and plat
❑ ater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
\ ` Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: CI Yes ❑ No Add Fee: CI Yes ❑ No
❑ inal Plat Recorded
❑ NOT Approved: Date:
Notes: '____f-
Approved By Engineering: Date: ---.`/
Revision 1: 0 Approved ❑ N t Approved Date: f
Revision 2: 0 Approved ❑ Not Approved Date:
Permit Coordinator Review
41i1 onditions met prior to permit iss ance
!wwpproved, NOT Released: fj(kk\r Date notified applicant: - 'Z ' Z 3
❑ ENG Revisions Required: Date notified applicant:
4.
SDC Exemption: 0 Applied for ❑ Received ❑ Does not apply
r SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
I Tigard Trans SDC: Yes ❑ N/A $ Deferred
Parks SDC: Yes CI N/A qhDeferred
LIDA ❑ Yes 12li^N/A
AZ
CI to Issue/Approved by Permit Coordinator: fkke
/ Revision 1: Approved Not Approved Date:
Date: I� l� ` �3
Revision 2: 0 Approved 0 Not Approved Date:
City of Tigard RECEIVED
N . .. MAY 2 Z 2023
Deferral Until Occupancy Request (�2 T
CITY OF -
TEGARD Washington County Transportation Development Tax (TD"I),Transr 0 ttypg 4114i. 9 System
• Development Charges (SDCs)
This form is to be signed and submitted prior building permit issuance or, if no building permit is required,then
upon land use approval(TMC 3.24,as amended by Ordinance No. 21-09).
Date: 5/22/2023 Site Address: 13754 SW 166th
Project Land Use Case or MST2023-00207
River Terrace Town Center Building Permit#:
Name:
Tax Lot Total Parks A $11,830.00
Lot 90 mount*:
TDT Total TSDC $12,004.00
Amount: N/A Amount*:
*The total TSDC amount sho above is the sum of$ 7,760.00 for TSDC-Improvement,$ 448.00 for TSDC-
Reimbursement,and$ 3,7 0 for TSDC-River Terrace,if applicable..
3 �-o-o -ftfi6,812.00 for Parks-Improvement,$ 1,887.00 for*The total Parks SDC amounts own above is the sum of$ $ 3,r Parks for Parks-Neighborhood1,887 0 River Terrace.
Parks-
Reimbursement,and either$ N/A for Parks-Neighborhood or
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.
1'DT may only be deferred if the TDT is greater than the amount for a single-family residence. I further
understand that the amount of 1'DT 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.
'a ` - Dater-%tea-��
Property Owner:_
—1�` Date:
5-3�.2.c
Developer:_
At---ii
Date: 5/22/2023
Permit Coordinator:
944...-tLls' c 0( ICJ ..C4J.d.t-('
II 11 Building Division
NW
One & Two-Family Dwelling
T I G^R D Fees Checklist
PERMIT INFORMATION: Application Date -FEE VERSION ..5y,1 7 OZ2-
Permit#: jl jo2,3 - OD dp,D 7 Plan #: 2 (0 C Floors:
Valuation: (ii SEI,VA Covered Porch: Basement
Bedrooms: Deck: 1s`Floor (,Q S7
WC (toilets) '?j Deck Cover: 2°a Floor 9 L/p
Lavatories Patio Cover 3'Floor
Tub/shower Accessory Struct. R-3 Total ( Sq-7
Laundry Tray Water Heater l / Gas /LO Garage S1 d
Exhaust Vents S Gas Flue Vents — Total for Elec. 1 113 7
Backflow Prey. Atigil." / Heat Pump /® # for Electrical Z
BBQ Gas Fireplace \ '�(/c- #Fuel Lines
FEES: Description: Fee Applies: Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg$2.00 (over 11x17) 2(-.p
Info Proc/Arch: Sm$.50 (up to 11x17) gy/
Metro CET: Residential Use ✓
School CET: District: r ✓
Tigard CET: Admin
Tigard CET: ODHCS
Tigard CET: AH 1/1----
Electrical Permit: Permit Fee:
Limited Energy:
12% State Surcharge
Mech. Permit: Permit Fee:
12% State Surcharge tZ
Plumbing Permit: Permit Fee:
12% State Surcharge //
Erosion Control: w/Permit-Ping %./
Notes:
I:\Building\Forms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
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