Permit (54) _ CITY OF TIGARD MASTER PERMIT
I. COMMUNITY DEVELOPMENTIII Permit#: MST2023-00209
T I t AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/01/2023
Parcel: 251060003300
Jurisdiction: Tigard
Site address: 13712 SW 166TH AVE
Subdivision: RIVER TERRACE TOWN CENTER Lot:
Project: River Terrace Town Center, Lot 93
Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN
PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 774
sf Basement: 0 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: 1958 sf Value: 5331,251.92 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 Bcktlw 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
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvdFeeders 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: 3 201-400 amp: 0 201-400 amp: 0 W/O SvdFdr: 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 SecurityAlarm: N
Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB
R-3 1958
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
250
PHONE: PHONE: 503-312-6213
FAX:
Total Fees: $21,804.05
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-rin1-nn1 O c Ihrnun44,✓h r1AR Oc9-11, non v,C,may nhfain a nnnv of Ihu rulac nr rlirurf nuoetinnc In!II'sir.M,Tallinn col999 1OR7 nr 1 ROO 11,9Rdd
Issued By: .Jy'ysl,/� s/(rJj// Permittee Signature: Gt 7 II'
C. I 'ia°~
,/ � 1503.639.4175 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 job site at the time of each inspection.
P
•
e Building Permit Applicatic ECEIVED X--t 4r6ah 5—/`tf2
Residential MAY 0 4 2023 FOR OFFICE USE ONLY
Received p__w/t, � 63DQ
City of Tigard Receive S 3 ' ")y r �fl
• 13125 SW Hall Blvd.,Tigard,OR 97Q TY OF TIGARD 111 I Phone: 503.718.2439 Fax: 503.5JttDlNG DIVISION DatPlane'ByReview ' oT§ ��-1D6I
TIGARD
Inspection Line: 503.639.4175 Date Ready/By: U r���� B See Page 4 for
Internet: wwn.tlgard-orgov otified/Methoc: (� Supplemental Information
`J
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑a New construction ❑ Demolition Permit fees*arc 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
CATEGORY OF CONSTRUCTION work indicated on this applica_tion. �
Valuation: " 561546 331f251• Q 2-
❑Q l-and 2-family dwelling ❑Commercial/industrial
❑ Accessory building ❑Multi-family Number of bedrooms: 4
❑ Master builder ❑Other: Number of bathrooms:�v
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 Z�(e b
Job site address:1 37 12 SW pig 166th AVE New dwelling area: 1958 square feet'+ t89
City/State/ZIP:Sherwood/OR/97140 Garage/carport area: 502 square feet /
Suite/bldg./apt.no.: Project name:River Terrace Town Center Covered porch area: G21 S square feet
Cross street/directions to job site: Deck area: square feet
SW Jean I n W 4P rd Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:River Terrace I Lot no.:93 Permit fees*arc 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: $
Requesting Deferred SDC fees
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ 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:
II APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Businessname:TNHC OREGON LLC
(Please refer mfeeschedute)
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: :( )
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 1310-7571 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:241108 Total fee due upon application: $201.60
Authorized signature: — Y This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Frank Sandoval Date: 5/y/Z02 3 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 01/25/2023 440-4613T(11/02/COM/WEB)
• Mechanical Permit ApplicationRECEIVE; FOR OFFICE USE ONLY
CityTigard Ti and I Received
Date/By: Pei bj — GG GR
•ill I 0 4 2023
13125 SW Hall Blvd.,Tigard,OR 97223 MAY Plan Review
Phone: 503.718 2439 Fax: 503.598.1960 Date/By: Other Permit
1 1 G A It I) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Suns'.
Y Y= See Page for
Internet: www.tigard-or.gov NotifieNMethod: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE—.USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYS LMSFEES*
® 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:13712 SW 166th ave Furnace 100,000 BTII(ducts/vents) 46.75
City/State/ZIP:Sherwood OR 97140 Furnace 100,000+BTU Owls/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
Subdivision:River Terrace Town Center Lot no.:93 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:2s 1 060003300 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 .1----- ❑ 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/crawlspace fans 23.32
t+a APPLICANT 0 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)
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)
Plan review(25%of permit fee)
Phone:(971)205 4989 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
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:3/17/2023
I:\Building'Permits\MEC PermitApp_040113.doe 440-4617r(I I/02/COM/WEB)
R
D
Electrical Permit Application E IVE
FOR OFFICE USE ONLY
City of Tigard ?j)Y 4 2023 a""`s1
Date/By: Pern;n- vhsTWZ3-OOZO'
13125 SW Hail Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1,St60, TIGARD DatmSy Related Permit#:
Inspection Line: 503.639.4175 ry tt in ,� �//�+ 11rr II Ready Date/By: taro: I ®See Pate 2 for
Internet www.tlgard-or gov .,"( 3 DIVISION Notified/Method: I Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wtitems checked):
0 Service or feeder 400 snips or more 0Building over three stories.
0 Demolition 0 Other:
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
14 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceed,14,000 °commercial-use agricultural
amps for all other installations. buildings.
ID Multi-family ID Master builder
Other: 0 Fire pump 0 Installation of 150 K V A or
JOB SITE INFORMATION AND LOCATION ❑Emergency system, larger separately derived
newJob#: Sob site address: 13712 SW 166th ave ❑Additionof 100HPormore_ road of system.
re_ ❑"A""E' 'l-2"'l3"
City/State/ZIP: Sherwood/OR/97140 0 Set or more residential tunts. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg.apt.#: Project name: RTTC 0 Haeardona locations. 0 Supply voltage for store than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
SW Jean Louise rd Description oty. .1E d, I Total 1
New residential single-or multi-family dwelling unit.
Subdivision: River Terrace Town Center Lot#:93 Includes attached garage.
Tax map/parcel#: 2s1060003300 l.000sq.8.orless 168.54 4
Ea,add'1500 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)
IR PROPERTY OWNER 0 TENANT Renewable Energy 0 See Page 2
Serviees or feeders installation,alteration,and/or relocation
Name: THNC OREGON LLC 200 amps or less 100.70 2
Address: 15231 Laguna Canyon Rd STE 250 201 amps to 400 amps 133.56 2 •
City/State/Z1P: Irvine CA 92618 401 amps to 600 amps 20034 2
601 amps to 1,000 amps 301.04 2
Phone:(503)310-7571 Fax:( ) Over 1.000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: Fsandoval@newhomeco.com
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 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
(4 APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A Fee for branch circuits with
Business name: THNC OREGON LLC a6oveservceorfeederfee,
each branch circuit 7.42 2
Contact name: Frank Sandoval B.Fee for branch circuits 144/howd
feed
Address: 15455 NW Greenbrier Parkway#240 branchh cirvicerc mfee,first 56.18 2
City/State/ZIP: Beaverton OR 97006 Eachadd'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)310-7571 Fax::( ) Each manufactured or modular 67.84 2
Email: Fsandoval@newhomeco.com dwelling,service vtd or feeder
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 Hwy Signal c alteration,
circuit(s)or extend-energy ❑ See Page 2 2
panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:Troutdale, OR, 97060
Additional inspection(I lv min) 66.25/hr
Phone:(503)853-9420 Fax:( ) Investigation(l hr min) 90.00/hr
Email:MWOLCOTT@WOLCOTT.PRO Industrial plant(1 lir min) 78.18/hr
Inspections for which no fee is
CCB Lie.:112220 Electrical Lic.:C1272 Suprv.Lic.:5782S specifically listed(4 hr min) 90.00/hr
Suprv.Electrician signature, ELECTRICAL PERMIT FEES
P required:9�.
s... o,.,,,a,r...«, Subtotal:
Print name:David Campbell Date:10/12/2023 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: ... /Q 8 TOTAL PERMIT FEE:
Print Mine:Malachi J. Wolcott Date: Thispermit application expires if a permit is not obtained within ISO
10/12/2023 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:11uilding1PemitntEl.C_PermitApp_ElR ERH.do<Rev 061/72015 440-4615I(11/05/COMIWEB
Plumbing Permit Applicati ECEIVED
Building Fixtures MAY 0 4 2023 FOR OFFICE USE ONLY
City of Tigard Received
t OF TIGARD Date/B. Permit No.:
111 13125 SW Hall Blvd.,Tigard,OR 9 ___ MST Zo2�3-OOZl,
1 Phone: 503.718.2439 Fak: 503.5�ING DIVISION Date�y:ew Otter Pesnit No.:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: heir: el See Page 2 for
Internet: wrnv.tigard-ocgov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
la New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION - SFR(I)bath 312.70
®I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 1 437.78
❑Accesso SFR(3)bath 500.32
rY buiidin g ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder El Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13712 SW 166th aye ._ Catch basin or area drain 18.76
City/State/ZIP: Sherwood/OR/97140 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) 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 IL:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: River Terrace Town Center I Lot no.: 93 Fixture or item:
Tax map/parcel no.: 2 s 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
lZ 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
Ill APPLICANT , IR CONTACT PERSON hrterceptor/greasettap 25.02
Business name: THNC OREGON LLC Medical gas(value:8_) Paget
Contact name: Printer 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: S72.50
CCB Lie.:112220 Plumbing Lic.no.:26824 PB Plan review(25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: Wr
TOTAL PERMIT FEE
Print name:Mark Baleme Date:10/12/2023 This permit application expires ifa permit is not obtained within 180 days
after it has been accepted as complete.
"Fee methodology sat by Tri-County Building Industry Service Board.
I:leuilding\PermitswLMu-Permitgpp.doc 10/01/09 440-4616T(l0/O2/COMAVEB)
-i-or r c:Kib4-'
i '`"'souci $ t Building Division
c
T AR One & Two-Family Dwelling
Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION -.SU(y 7,..-b2-Z--
Permit #: rS�zt,23 �OOa, Plan #: Jb C(4)Floors: (—
Valuation: ,531 'jr,S ¶Z Covered Porch: � ' S �_Basement
Bedrooms: 4 Deck: 1"Floor
WC (toilets) 3 Deck Cover: 2nd Floor I I ea
Lavatories .55' Patio Cover ----- 3`a Floor
Tub/shower 3 Accessory Struct. R-3 Total t Ci S�
Laundry Tray Water Heater ( / Gas Elec Garage Sb D-
Exhaust Vents Gas Flue Vents .-- -- Total for Elec. Zy(0b
Backflow Prey. (hurnace Heat Pumpq AC) # for Electrical 3
BBQ -----' Gas Fireplace )12_$ #Fuel Lines 3
FEES: Description: Fee Applipe Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg$2.00 (over. 11 x17)
Info Proc/Arch: Sm $.50 (up to 11x17) -
Metro CET: Residential Use
School CET: District: (.
Tigard CET: Admin
Tigard CET: ODHCS V.
Tigard CET: AHD//
Electrical Permit: Permit Fee: /
Limited Energy:
12% State Surcharge
Mech. Permit: Permit Fee:
12% State Surcharge / v
Plumbing Permit: Permit Fee: `"//
12% State Surcharge �j
Erosion Control: w/Permit- Ping it
Notes:
I:\Building\Foams\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
Page 1
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
olo
Building Permit #: /44?-c 3 --06 P-01
Site Address: 13712 SW 166th Ave 0 Verified in Accela
Project Name: RT Town Center Lot/unit #: 93
Proposal: New detached SFR Zone: RES-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"
O Drawn to standard scale ❑ Rclu J I.e..s, J; N Iii. / l N,vlection
0 North arrow 0 Street and site trees shown/ labeled
0 Site address, project name, lot # turity
0 Street names (N/A for SFR)
O Applicant name and phone # applicable)
0 Lot and setback dimensions
❑ti^„�l„ Vision clearance not required
&.Jy1.1611.. Ibv.uy.. 0 Utility locations &easements
0 Footprint of new structure and FFE 0 Property corner elevations due to tract/private access.
0 Sidewalk/driveway dimensioned
0 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 0 Total facade area
O Building height dimensioned 0 Total window and door area
0 Facade dimensioned
O Windows and doors dimensioned
0 Garage doors dimensioned
Regni 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
El Yes 0 N/A Screening (Quad only)
0 Yes ❑ N/A % Window Coverage 22%
❑ 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 El N/A Pat'' .
Additional standards for -• rtyard Units and Cottage Clusters only:
El Yes ❑ N/A Unit Area:
❑ Yes ❑ N/A Floor Area (per story)
❑ Yes ❑ N/A Courtyard
❑ Yes ❑ N/A Fence
Y
❑ Yes ❑ No ON/A Clean Water Services - Service Provider Letter(lot platted prior to 9/10/1995)
❑ Yes ❑ No ♦Z]N/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes 0 No
Applied For: ❑ Yes ❑ No, stop intake
0 Sensitive Lands: ✓a Yes ❑ No
VI Main Land Use Case #s: PDR2021-00004 ❑ Conditions met
m Applicant notified of land use expiration date: Submit development plans by 1/31/25. Final occupancy by 1/31/27
Approved By Planning: F. Date: 5/3/23
Notes -�.
Revision 1: 0 Ap./ed ❑ Not Approved Date:
Revision 2: 0 Ap:' .ved ❑ Not Approved Date:
Building Permit Submittal
Original Submittal Date: kf l
Site Plans #: ?y
Building Plans #: 37
i)1( ..
Building Permit #: Building permit # entered on page 1
Workflow Routing: Planning E4 Engineering Permit Coordinator 14 Building
Workflow Sign off: Sign-off for Planning (include notes from planning review)
Route Documents: tp Engineering:9� g: (1) copy of permit application, (1) site plan, (1) building plan
Q� and original plan review routing form.
�`�lt .Building: original permit application, site plans, building plans, engineer and
t beam calculations and trust details, if applicable, etc.
Permit Technician: Date: c/( 7 CC:
Notes:
p Engineering Review
1- ❑ PFI Permit:
Mope at building pad: ' ',J
Conditions met prior to issuance of permit
❑ Easements (encroachments) per engineering conditions of approval and plat
• ❑ Water Quality/Quantity Facility:
I Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes 0 No
LIDA Facility on lot: ❑ Yes ❑ No Add Fee: ❑ Yes ❑ No
0 Final Plat Recorded
0 NOT Approved: Date:
pp\ Notes:
NApproved By Engineering: Date: —5- 2 C/�
N. Revision 1: ❑ Approved ❑ Not A proved Date: <
Q Revision 2: 0 Approved ❑ Not Approved Date:
*Y'
q Permit Coordinator Review
ty onditions met prior to permit issuance
proved, NOT Released: V-A(14 applicant: 7- 1
Date notified ;a � ��J
■ ENG Revisions Required: Date notified applicant:
'(L] SDC Exemption: ❑ Applied for ❑ Received Does not apply
rDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A ❑ Deferred
Parks SDC: Yes is 1 A ❑ Deferred
LIDA Yes fl
/OK to Issue/Approved by Permit Coordinator: i+e Date: 10- 0' Z3
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
City of Tigard RECE1 /ED
Deferral Until Occupancy Request
JUL 1 S 2023
TIGARD Washington County Transportation Development Tax (TDT),Traniv C ei 4.44,Ecti 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: 6/15/2023 Site Address: 13712 SW 166th
Project River Terrace Town Center Land Use Case or
Name: Building Permit#: MST2023-00209
Tax Lot Lot 93 Total Parks
#: Amount*: $11,830.00
TDT Total TSDC
Amount: N/A Amount*: $12,004.00
*The total TSDC amount s�how -above is the sum of$ 7,760.00 for TSDC-Improvement,$ 448.00 for TSDC-
Reimbursement, and$ yw:uu for TSDC-River Terrace,if applicable..
4 317494.0 D Ar
*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.
IDT 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.
Property Owner: Date: 6 fi5 z 3
Developer: Date:
Permit Coordinator: Date: 6/15/2023