Permit (92) CITY OF TIGARD MASTER PERMIT
e COMMUNITY DEVELOPMENT Permit#: MST2023-00408
Datelssued: 10/20/2023
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107AD05400
Jurisdiction: Tigard
Site address: 14666 SW 165TH AVE
Subdivision: SOUTH RIVER TERRACE Lot: J
Project: South River Terrace, Building 22, Unit 2 of 3
Project Description: New attached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN
PAID.
BUILDING
Floor Areas Required Setbacks Reauired
Stories:
3 Bedrooms: 4 First: 947 sf Basement: 64 sf Left: 0 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1007 sf Garage: 448 sf Front: 12 Smoke Yes
Ri ht: 0 Detectors:
Dwelling Units: 1 Third: 0 sf 9
Total: 2018 sf Value: $369,397.14 Rear: 0
PLUMBING
Sinks: 1 Water Closets:
3 WashingMach: 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: Catch Basins: 0
100
BckFlw Prevntr. 0
100 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Footing Drain: Other Fixtures: 0
Drywell-Trench Drain: 0 Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K:
1 Vents: 0 Woodstoves: 0 Gas Outlets: 2
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 addl 500 sf: 3 201-400 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
Ecompasing:
Other: N Other Description:
BUILDING INFO
Type of Work:
T e of Use: Type of Constr: Occupancy Group: Square Feet:
2018
NEW
SF VB R-3
Owner: Contractor:
Required Items and Reports(Conditions)
TAYLOR MORRISON NORTHWEST LLC WILLIAM LYON HOMES INC
703 BROADWAY ST STE 710 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-41752 Fire Rated Conditions
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $25,326.56
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
o69_nn1_rim n thrni I n P 05911MVol; mC, htain�rnm,of tho ndoc nr riirnrt ni,actinne In ni INC.by roalnn 5M 919 10A7 or 1 Ann 119 914d
Issued By: Permittee Signature: 1! I
a 1503.639. 5i 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
Residential RECEIVE I FOR OFFICE USE ONLY
Cityof Tigard AUG RaceiBed PennitNo
MI
• 13125 SW Hal Blvd.,Tigard-OR 97223 ���� Plan R 02 J5 � �! 00�
Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD Date/By 9 Z3j 06
Other (2._ .z3'60 a55
Inspection Line:503.639.4175 Date Ready By ,ee�� Luis 1111 See Page 4 for
TIGARD [ntemet: www.tigard-or.gov BUILDING DIVISION Notified Method i Oil b?j Supplemental Information
v, *
TYPE OF WORK REQUIRED DATA:I- AND 2-FAMJLY DWELLING
[!)New construction D Demolition Permit fees*are based on the value of the work performed.
' Indicate the value(rounded to the nearest dollar)of all
D Addition/alteration/replacement D Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
l] 1-and 2-family dwelling Commercial/industrial
$ ! 139� iti
i
D Accessory building 0 Multi-family Number of bedrooms: 4
D Master builder D Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number offlo ors: 3 29(i(Q
Job site address: 14666 SW 165's Ave New dwelling area: 2018 square feet « l
City State.ZIP:Tigard,OR 97224 Garage carport area: 448 square feet Cil-k"[
g.�Suite/bldapt.no.: I Project name:South River Terrace,Building 22 Covered porch area: square feet 1�l.0 II
Cross street/directions to job site: Deck area: S4 square feet 1
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.:2 Permit lets*are based on the value of the work performed.
Tax map parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor.overhead.and the profit for the
DESCRIPTION OF WORK work indicated on this application.
new SFR Triplex Valuation: $
Existing building area: square feet
New building area: square feet
i PROPERTY OWNER 0 TENANT Number of stories:
' Name:Taylor Morrison Northwest LLC Type of construction:
Address:703 Broadway St, Ste 710 Occupancy groups:
City/State/ZIP:Vancouver, WA 98660 Existing:
Phone: (360 ) 946-8674 Fax:( Sox
APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Taylor Morrison (Please refer to fee schedule)
' Structural plan review fee(or deposit):
Contact name:Tonja Morris
FLS plan review fee(if applicable):
Address:703 Broadway St, Ste 710
Total fees due upon application:
City'State/ZIP:Vancouver, WA 98660
Phone:(360 )946-8674 I Fax::( Amount received:
E-mail:perm itsubtnittals@taylormorrison.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Tay lot Morrison Northwest LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:703 Broadway St, Ste 710 Solar Installation Specialty Code checklist.
City'State,ZIP:Vancouver, WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone: (360 )695-7700 I Fax. State surcharge(12%of permit fee): $21.60
CCB lic.:207247 Total fee due upon application: $201.60
Authorized signature I This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Tonja Morris Date:8/14 *Fee methodology set by Tri-County Building Industry
Service Board.
I:'Building Pennits\BUP-RESPennitApp.doc 01/25/2023 440-4613T(I 1/02/COM/WEB)
Mechanical Permit Application FOR OFFI( t. t-V ' ONI.v
City of Tigard Received
Permit, CAI F
• 13125 SW Hall Blvd.,Tigard,OR 97223 �
Phone: 503.718.2439 Fax: 503.598.1960 lan Review Date/By Other Permit.
D
T IG A R D Inspection Line: 503.639.4175 Date Read aB mdr.
Internet: wow ti and-or. ov y y Supplemental
See Page 2 for
g g Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
® New construction ❑Addition/alteration/replacement performed. Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value.$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 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 46.75
Job site address: 14666 SW I65th Ave Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
' Heat pump 61.06
Suite/bldg./apt.no.: Project name: South River Terrace,Building 22 Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: South River Terrace Lot no.: 2 Other: 23.32
Other fuel appliances:
Tax map/parcel no Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
New home construction. fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
II PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name. Taylor Morrison Northwest LLC Range hood/other kitchen
euipment 33.39
Address: 703 Broadway St.,Ste 710 Clothes dryer exhaust 33.39
City/State/ZIP: Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( 360 ) 695 7700 Fax_( ) Attic/crawlspace fans 23.32
VI APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: Taylor Morrison Northwest LLC $14.15 for first four;54.03 for each additional
Contact name: Tonja Morris Furnace,etc.
Address: 703 Broadway St.,Ste 710 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Vancouver,WA 98660 Water heater
Phone:( 360) 695 7700 Fax: :( ) Fireplace
Range
E-mail PermitSubmittals@taylormorrison.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Development Northwest Inc. dba Wolcott HVAC Other.
MECHANICAL PERMIT FEES*
Address: 1075 W Historic Columbia River Hwy Subtotal
City/State/ZIP:Troutdale/OR/97060 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(971)256-4584 Fax:(503 ) 667-9891 State surcharge(12%of permit fee)
CCB lie.:112220 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within ISO
�^ ,'r, days after it has been accepted as complete.
Authorized signature: JAL/Ih/$L ,Dil11h/h9 " Fee methodology set by Tri-County Building Industry Service Board
Print name:Dennis Dunning Date:8/14/23
I BwldlngvPermitlMEC_PermitApp_040113.doc 440-4617'(I I)02ICOMIWEB)
Electrical Permit Application FOR OFFICE. LSE ONLY
City of Tigard Received �
Mill
• 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Pe744 1— D 3 -00'08 '
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Related Permit 7.
Date/By:
T!l ARD Inspection Line: 503.6394175 Ready DatesBy' Saris• RI See Page 2 for
m Internet www tigard-or.gov Notified Method: Supplemental Information
TYPE OF WORK PLAN REVIEW '
XI New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wiitems checked):
['Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other:
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 snips at 150 volts or 0 Floating buildings.
IN 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less toground,or exceeds 14,000 ❑Commerc al-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: 14666 SW I b5th Ave ❑Addition of new motor load of system.
100HP or more. ❑"A" "E" "1-2" "1-3"
City/State/ZIP: Tigard OR 97224 0 Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.4: Project name: South River Terrace ,Building 22 0 Hazardous locations. Cl Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I t.arh I Total I '
New residential single-or multi-family dwelling unit.
Subdivision: South River Terrace Lot 4: 2 Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168,54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
New home construction.
(with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy
Cl PROPERTY OWNER 0 TENANT ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name:Taylor Morrison Northwest LLC. 200 amps or less 100.70 2
Address: 703 Broadway St., Ste 710 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200,34 2
City/State/ZIP: Vancouver, WA 98660 601 amps to 1,000 amps 301.04 2
Phone:(360 )695-7700 Fax:( ) Over 1,000 amps or volts 552.26 2
Email: Temporary services or feeders installation,alteration,and/or
permitsubmittals@taylormorrison.com relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 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
Branch circuits—new,alteration,or extension, er panel
El APPLICANT ❑ CONTACT PERSON
A.Fee for branch circuits wailBusiness name: Taylor Morrison Northwest LLC. above service or feeder fee,
each branch circuit 7.42 2
Contact name:Tonja Morris B.Fee for branch circuits wirhou!
Address: 703 Broadway St., Ste 710 service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Vancouver WA 98660 Each add'l branch circuit 7.42 2
Phone: 360 816-7800 Miscellaneous(service or feeder not included)
( ) Fax: :( ) Each manufactured or modular 67.84 2
Email: permitsubmittals@taylormorrison.com dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Portland Electric Sign or outline lighting 67.84 2
Address: 1915E 5th St., Ste D Signal circuit(s)or limited-energy 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP: Vancouver, WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:( 360)314-4915 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:paul@portlandelectric.biz Industrial plant(lhrmin) 7818lhr
Inspections for which no fee is 90.00-hr
CCB Lie.: 194066 Electrical Lie.: C760 Suprv. Lie.: 49205 specifically listed('o hr min)
Suprv.Electrician signature,required: itz ELECTRICAL PERMIT FEES
bl
Subtotal_
Print name: Alex Shalya D e: 8/14/23 0 Plan Review Required(25%of permit fee).
y� State surcharge(12%of permit fee).
Authorized signature: utitt,- / / t,(,Q.�j,(j�tt.k. TOTAL PERMIT FEE.
(J 8/14/23 This permit application it has expirbeees ifn a permitaccepted isas notcomplete.obtained within ISO
Print name: Sergey Mishchuk Date:
a Number of inspections allowed per permit.
[/Bwlding/Permns\ELC PermtApp_ELR_ERE don Rev 06/17/2015 440-46151(11/05/COM/WEB
4'
Plumbing Permit Application
Building Fixtures FOR OFFICE USE oil l
I _ City of Tigard Received
III • 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Parma-Da'7.--O O�06
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Ins action Line: 503.639.4175 BDate/By: Other Permit No.
prnet:
TIGARD Internet: :
Date Readyy. I„ru
Su Sec Page 2 for
Notified Method. Supplemental Information
TYPE OF WORK FEE* SCHEDULE
® New construction ❑Demolition For special inJormalion use checklist
❑Addition/alteration/replacement _ Description Qty. Ea. i Total
❑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 437 78
IIIAccessory building 0 Multi-family SFR(3)bath 500.32
III 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: 14666 SW 165th Ave Catch basin or area drain 18.76
Drywall,leach line,or trench drain 18.76
City/State/ZIP: Tigard OR 97224
Suite bed .!a t.no.: Footing drain(no. linear ft.: ) Page 2
g p I Project name:South River Terrace, Building2
Manufactured home utilities 50.03
Cross street/directions to job site:
Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no linear ft.: ) Page 2
Subdivision: Water service(no.linear ft.: ) Page 2
South River Terrace I Lot no.: 2
Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
New home construction. Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
In PROPERTY OWNER j ❑ TENANT Expansion tank 12.51
Name: Taylor Morrison Northwest LLC Fixture/sewer cap 25.02
Address:703 Broadway St.,Ste 710 Floor drain floor si d tub 25.02
City/State/ZIP: Garbage disposal 25.02
Vancouver,WA 98660 Hose bib
2
Phone:(360 )695 7700 Fax,( ) 12.5
Ice maker 2.51
MI APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: Taylor Morrison Northwest LLC Medical gas(value:$ ) Page 2
Contact name: Tonja Morris Primer 12.51
Address: 703 Broadway St,Ste 710 Roof drain(commercial) 2.51
Sinklbasin/lavatory 25.02
City/State/ZIP: Vancouver.WA 98660
Solar units(potable water) 62.54
Phone:( 360 )695 7700 I Fax: :( ) Tub/shower/shower pan 12.51
E-mail: Perm itSubmittalsra?tayIormorrison.com Urinal 25.02
CONTRACTOR Water closet 25.02
Business name: Wolcott Plumbing Water heater 37.52
Wate
Address: 1075 W Historic Columbia River Hwy OtherrpipingDWV 25.02
02
City/State/ZIP:Troutdale, OR 97060 Z
Subtotal
Phone:(503)-667-1781 Fax:(503)-667-9891 Minimum permit fee $72.50
CCB Lie.: 112220 (AJ Plumbingr� Lie.no.:26-824PB Plan review (25%of permit fee)
Authorized signature: � l 1. 4(J 3g-6,/ �L
State surcharge(12%of permit fee)
TOTAL PERMIT FEE
Print name: Cliff Bow Date: 8/14/23 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry'Service Board.
Fdsuilding\Pennies\PLMC-permitApp.doe 10/0I/09 440-46I6T(10/02/COM/WEB)
City of Tigard
„ COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: hl(; >t, j- Oci oE}
Site Address: 14666 SW 165th Ave Verified in Accela
Project Name: South River Terrace (Tract J), Building 22 Lot/Unit #: Unit 2
Proposal: New SFR Triplex
Zone: RES-C
Housing Type: 0 SFR(0 Single Detached ❑ Duplex 0 Triplex❑ADU) 0 Rowhouse ❑Cottage Cluster❑CYU OQuad❑Other
Required Site Plan Elements:
0 3 copies of site plan on max 11x17"
O Drawn to standard scale ❑ R t :.. J 1. J.:,, I:...../ 1. Jtection
0 North arrow 0 Street and site trees shown/ labeled
O Site address, project name, lot #
0 Street names (N/A for SFR)
0 Applicant name and phone # (if applicable)
O Lot and setback dimensions ❑ V: : ., I ,, 1.;....,1..
O 1-nlav11 1y au uu1.11...a e:oyiaui%. tivwy� 0 Utility locations &easements
O Footprint of new structure and FFE
O Sidewalk/driveway dimensioned i_lun ��� ��� „ ihxuivan-C)
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
0 Garage doors dimensioned
Require Elements:
(Not required for SFR) ❑ Summary table that includes
0 Each story dimensioned loor area
❑ Each story floor area calculated ❑ Floor area per s
Planning Review
The following standards have been met:
Setbacks 0 Front: 12/8 Rear: 0 (alley)Side: 0 Min/Max Street Side: 8/3 / Garage: 4/20
Height 0 Max. Height: 35' Proposed Height: 27'
0 Yes ❑ N/A Landscape
0 Yes ❑ N/A Screening (Quad only) `Required for parking, but buildings provide screening
❑ Yes ❑ N/A % Window Coverage
0 Yes ❑ N/A Garage (SFR Only) Parking (Other Res)
0 Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
O Yes ❑ N/A Other building design standards (Rowhouse only) *Facade Offset, Porch, Roof, no exterior staircase
❑ Yes 0 N/A Accessory Structure Standards
❑ Yes 0 No Qualifying pre-existing unit exempt from standards (Cottage unit only)
Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
0 Yes ❑ N/A Unit Count: 3
O Yes ❑ N/A Lot Width and Size Tract J = 114,586sf
0 Yes ❑ N/A Pathway (Ped Access)
Additional standards for Courtyard Units and Cottage Clusters only:
❑ Unit Area:
❑ Yes ❑ N/A F oo er story)
❑ Yes ❑ N/A Courtyard
❑ Yes ❑ N/A Fence
❑ Yes ❑ No C[IN/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
❑ Yes ❑ No IN/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes ❑ No
Applied For: ❑ Yes ❑ No, stop intake
I Sensitive Lands: ❑ Yes 0 No
o Main Land Use Case #s: PDR2018-00003, PDR2021-00003 ❑ Conditions met
o Applicant notified of land use expiration date: Permi s by 11/2/24, CofO by 11/2/26
Approved By Planning: _ Date: 8/9/23
Notes PDR applied rowhouse standards for these u i . 6
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date:
*PDR referred these as rowhouses, but does not fit current definition.
Building Permit Submittal //
Original Submittal Date: 8/(E.1�3
Site Plans #: "g
Building Plans #: '4
Building Permit #: 14 Building permit # entered on page 1
Workflow Routing: qZ Planning p Engineering Di Permit Coordinator j'd(Building
Workflow Sign-off: 0-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.
I$,Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc. r
Permit Technician: Date: 41161
Notes:
Engineering Review
❑ PFI Permit:
.-Slope at building pad: 7
®,Conditions met prior to issuance of permit
I.YEasements (encroachments) per engineering conditions of approval and plat
I 'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes C4 No
Assess Water Quantity Fee in-lieu: ❑ Yes vYNo
LIDA Facility on lot: ❑ Yes I' No Add Fee: ❑ Yes ❑It/final Plat Recorded
0 NOT Approved: Date:
Notes:
Approved By Engineering: 1. --d. Date: /Z't
Revision 1: ❑ Approved 0 N Approved Date:
Revision 2: El Approved ❑ Not Approved Date:
Permit Coordinator Review
Conditions met prior to permit issuance
Approved, NOT Released: Date notified applicant: _
❑ ENG Revisions Required: Date notified applicant:
OS.gDC Exemption: ❑ Applied for ❑ Received 0€oes not apply
146C Fees Entered: Wash Co Trans Dev Tax: d Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A L Deferred .�r 1 Hit`1-['
Parks SDC: El Yes 0 N/A d Deferred `
LIDA ❑ Yes NZ)9N//A �/
OK to Issue/Approved by Permit Coordinator: \ 2 \\cw6 _ Date: _ - `17 Z3
Revision 1: G Approved ❑ Not Approved _ - Date:
Revision 2: 17 Approved 0 Not Approved — Date: _
INBuildin g Division U L r t
One & Two-Family Dwelling
TIGARD Fees Checklist
i
PERMIT INFORMATION: Application Date - FEE VERSION L� J `/ Z(2
Permit #: fnSr ,Z5-oo�{ Plan #: a O eOIloors: 3
Valuation: J^21 ,5p/ . ihf Covered Porch: Basement f 0 LI
Bedrooms: -,t ` Deck: �/ 1"Floor �p` (1 -7
WC (toilets) � Deck Cover: ,__, 2°d Floor 1
001
Lavatories Patio Cover r--- 3`d Floor
Tub/shower Accessory Struct. _ R-3 Total
Laundry Tray Water Heater ` / Gas /d Garage L1 4 (>
Exhaust Vents - GasFlue Vents ---�-- Total for Elec. 4�/ _
r
Backflow Prey. '� � Heat Pump # for Electrical lP
BBQ Gas Fireplace #Fuel Lines 0-
FEES: Description: Fee Ap s: Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg$2.00 (over 11x17) '/ (‘\.
Info Proc/Arch: Sm$.50 (up to 11x17)
Metro CET: Residential Use r
School CET: District: ‘, le----
Tigard CET: Admin ‘/--
Tigard CET: ODHCS
Tigard CET: AH
Electrical Permit: Permit Fee: L....V.'
Limited Energy: `.'''.
12% State Surcharge
Mech. Permit: Permit Fee:
12% State Surcharge
l
Plumbing Permit: Permit Fee: t.."----
12% State Surcharge
Erosion Control: w/Permit Plug
I:\Building\Forms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
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