Report (2) DocuSign Envelope ID:08ABE211-D9F2-4DA5-9780-855038MA0011 RECEIVED
City of Tigard CITY OF TIGARD
BLil:DXING8D1 2:323i N
14 Deferral Until Occupancy Request
Washington County Transportation Development Tax(TIM),Transportation and Parks 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(*MC 3.24,as amended by Ordinance No.21-09).
Date: . ...--76-22-5 Site Address: 15544 SW VANDERWOOD AVE
Project Land Use Cue or
Name; River Terrace Crossing Bustin Pernik#: 00
(Pacific Lifestyie Homes)
Tax Lot 2S108DC‘5100 Totd Parka
$1183000
st: Lot 16 Amount*:
TDT Total Tux $12,004.00
Amount: N/A Amount*:
'The total TSDC amount shown above is the nun of$7.760.00 for TSDC-Improvernent,$448.00 for TSDC-
Reimbursement,and$3.796.IX) for TSDC-River Tame.if applicable..
'The total Parks six amount shown shove is the stun of;6.8121X) for Parks-ImprovementA 1. %SW 00 for Parks-
Reimbursement.and either$ N/A for Parks-Neighborhood or$3.131.00 for Parks-Neigliborhoosl Waver Terrace.
This constitutes my request to defer payment of the TDT,TSDC,and Puke SDCes,as pomaded above,
until occupancy.
Payment of the TDT,TSDC,and Parks SDCs may be deferred until issuance of the occupancy pew In
requesting this options I understand than say deferred 11>T,TSDC,and Packs SDCs must toe paid prior to final
inspection or issuance of an occupancy permit.
TDT may only be deferred I further
understand that the amount of TOT due on deferred obligations shall be the amount in effect smite time of
issuance of the building permit.
For a deferral request to be accepted hgth the Property Owner and the Developer noun sign this request.
Desatigned by;
ItitAUtik.
Date: 5/4/2023
Property Owner: DEANC55711190111.
Devebpe Date -r/ /t7
Permit Coordinator: Date:
741-15