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Report (3) DocuSign Envelope ID:08ABE211-D9F2-4DA5-97BD-855CB8A1A009 _: rq FiFc MAY i 2023 City of Tigard CITY Deferral Until Occupancy Request T i(i A R I) Washington County Transportation Development Tax(TDT),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(TMC 3.24,as amended by Ordinance No.21-09). Date: 5/1/2023 Site Address: 15779 SW BLUEWATER TER.,Tigard,OR 97224 Project River Terrace CrossingLand Use Case or Name: MST2023-00171 Building Permit#: (Pacific Lifestyle Homes) Tax Lot 2S108DC25500 Total Parks $11,830.00 #: Lot 120 Amount*: TDT Amount: NIA Ammol TSDC $12,004.00 *The total TSDC amount shown above is the sum of$7,760.00 for TSDC-Improvement,$ 448.00 for TSDC- Reimbursement,and$3,796.00 for TSDC-River Terrace,if applicable.. *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 Rives Terrace. This constitutes my request to defer payment of the TDT,TSDC,and Parks SDCs4 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. TDT 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. DocuSigned by: E4ss 111.46104A., 4/7/2023 Property Owner: DEA7Fc5571DA4F8... Date: Developer: Date: �}/—/o— Z3 { Permit Coordinator: Aliall1,3 �2AJVl Date: 5/1/2023