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Permit (2) CITY OF TIGARD MASTER PERMIT 1011 if- COMMUNITY DEVELOPMENT Permit#: MST2022-00411 T I.G A R.O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/24/2023 Parcel: 2S 107AD 11300 Site address: 14736 SW 169TH AVE Jurisdiction: Tigard Subdivision: CREEKVIEW AT SOUTH RIVER TERRACE Lot: 25 Project: Creekview at South River Terrace, Lot 25 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: 925 sf Basement: 0 Height: 23.5 Bathrooms: 3 Second: 1341 sf sf Left: 3 Parking Spaces: 0 Garage: 421 sf Front: 8 Dwelling Units: 1 Third: 0 Smoke sf Right: 3 Detectors: Yes Total: 2266 sf Value: $370,936.45 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 LaundryTrays: 0 Y Rain Drain: 1 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Urinals: 0 Sewer Lines: 100 SF Rain Drains: Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 0 Storm Sewer: 100 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 0-200 amp: 0 P W/Svc or Fdr: 0 Ea add'I 500 sf: 4 201-400 amp: 0 201-400 amp: 0 P 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 SecurityAlarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: 1' Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: p Y p: Square Feet: NEW SF VB R-3 2266 Owner: Contractor: TAYLOR MORRISON NORTHWEST LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions) 703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98660 VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: Total Fees: $22,879.62 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 hc9-nn1-nnln thrnl Inh(lAR CA9-nn On II may nhtai a nnm/of tha rn nr riirort ell IPCtinnc to(ll Irvin hi/nalilnn nnz 919 10R7 nr 1 eon 119 9344 r Issued By: ` 7 Permittee Signature: 5 - .v7/1/4e4 Call 503.639.4175 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. • Building Petmit Applicatio IVED Ldr5 Residential C FOR OFFICE USE ONLY City of Tigard OCT 2022 Received Date/By: Permit No.: `,0?2 —CO t I I � 13125 SW Hall Blvd.,Tigard,OR 9722 P1anReview� �� a - [.i/l.L. CiIJ`'L �. Phone: W Hall Blvd. Fax: 503.598 2tilI Y O F T I GAR Ci ? q ,,, R��_ bit Da[eBY tO Z �i. /d� DtherPermit: �] WIG\RD Inspection Line: 503.639.4175 DING DIVISION DateRead B / Jars: Internet: www.tigard-or.gov Notified/Method: I/ en aInformation ( � I l� See Page 2 for Supplem t I Inf WimtCtom( -ttc{AvLe N. __. ; O+FORiC TYPE' { ,REQUIRED DAT i,4:-AA 1 ANk T 7 DWELLJNG ®New construction 0 Demolition Permit fees*are based on the value of the work performed. M Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the " ; CATEGORY OF CO itioTIOIV a` ;g work indicated on this application. 37 D/ ' 3 _ LI ® 1-and 2-family dwelling 0 Commercial/industrial Valuation: 88466.-130" ❑Accessory building 0 Multi-family Number of bedrooms: 4 ❑Master builder 0 Other: Number of bathrooms: ) , , JOB SIT. INF RMATION AN'D L Total number of floors:2 Z(e$� CATION-;�;. ' c-.�..� . �� .�. . r .� � � �.."':'�. §,. ., . .ter Job site address: 14736 SW 169TH AVE New dwelling area: 2,266 square feet 3ii City/State/ZIP:Sherwood,OR 97140 Garage/carport area: 421 square feet Cr/6 Suite/bldg./apt.no.: Project name:Creekview at South River Terrace Covered porch area: square feet Cross street/directions to job site: Deck area: 12D L7 square feet _. t Other structure area: square feet 2EQlIIL1 C+I)DATA COIt4MER IAT,175 CHECKLIST Subdivision: Creekview at South River Terrace Lot no.: 25 Permit fees*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 c p „ .,; ".,�a. DESCRIP I I o WORK :Ir.tv work indicated on this application. New Construction/Type: SFU (3040BR) Valuation: $ Please defer TSDC and Parks SDC until occupancy. Existing building area: square feet Projected start: January 2022 New building area: square feet PROPERTY OER, , 0TENA rr F " Number of stories: Name:Taylor Morrison Northwest LLC Type of construction: Address:703 Broadway St., Ste 710 Occupancy p y groups: City/State/ZIP:Vancouver, WA 98660 Existing: Phone:(360) 946-8674 Fax ( ) a ®1 LI AN tliv New: APPL ' ,` CONTACT PERSON ;. B,UIL DING PERMITFEES* Business name:Taylor Morrison Northwest LLC '' - aserejertoleeschedulee) Contact name:Omar Alami Abouhafs Structural plan review fee(or deposit): FLS plan review fee(if applicable):Address:703 Broadway St., Ste 710 City/State/ZIP:Vancouver,WA 98660 Total fees due upon application: Phone:(360)946-8674 Fax::( )360 693-4442 Amount received: E-mail OAlamiAbotlhafs@taylormorrison.com PHAOTOVOLTAIC$DEAR PANEL SYSTEM FEES* "CO1V°Rai C1 OTt Commercial and residential prescriptive installation of . =.. " S ` '. "` ,,,,4,... " , - * 8 roof-top mounted PhotoVoltaic Solar Panel System. Business name:Taylor 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:VarICOUVer, WA 98660 Permit Fee(includes plan review $180.00 and administrative fees): Phone:( )360 695-7700 Fax:( )360 693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 /� Total fee due upon application: $201.60 Authorized signature: 21n4.t�,f41Q,yyp AO, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Omar Alami Abouhafs Date: 10/12/2022 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB) ' Electrical Permit Application FoR OFFICE ESE ONI.I•City of Tigard Received Datezfiv 114 a 13125 SW Hall Blvd.,Tigard,OR 97223 " : Permit u. i I Phone: 503.718.2439 Fax: 503.598.1960 '�� a [ T I G A R D Inspection Line: 503.639.4175 Iiiinni Ready Date Related Permit Si Internet: wuw tigard-orgov Metlio. Notified/Methodd l�See Page 2 for ', F�PE O1c. Supplemental Information ®New construction 0 Addition/alteration/replacement at mil se of le Please check all that apply(submit sets of plans whtems checked). Demolition ❑Other: ❑Service or feeder 400 amps or more where the available fault current oMmMarnasg over bthree dories. IX] I-and 2-family dwellingMO exceeds 10.000 amps at ISO volts or 0 0 atg and boatyards. 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14.000 Floating buildings ❑Multi-family 0 Master builder ❑Commercial-use agricultural 0 Other: amps for all other installations buildings. �tot!'Sr1P1 B,eINFUItMATtC}A1 0 Fire pump AND trot c ❑largerseallation t 15drise or ❑Emergency system_ larger separately derived Job site address: 14736 SW 169TH AVE ❑,aitw ste City/State/Z.IP: Tigard,OR 97140 100ddHPion or of mornee. motor load of p ys�•,..m E„ .,l`„•.l . 0 Six or more residential units. nccupancy.SUite,bldg.Japt.?}: ❑Health-care facilities. ❑Recreational vehicle parks. Project name:Creekv ie -at SRT Cross street/directions to job site: ❑Hazardous locations CI Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal • '.` T*"1:CI F.t) Deaeii.lion < - Subdivision: Creekview at SRT New residential single•or maltl-f dwelling nit°lal p Lot#: 15 Includes attached garage. Tax map/parcel# 1,000 sq.ft.or less 168.54 111.1® IMI -D.E.SM `t ttkO .`W R Ea.Limiaddted energy,sq. s or portion ;3 42 101T6 -,_t. New construction.Type SFU Limited residential III with above sr.ft. 75.00 M® Limited energy,multi-family Illential with abovest.ft) 500 Mil - {�:t!�L?P�'' ,>� � Renewable Ene Name: Taylor Morrison Northwest LLC. Pa.e ��Services or feeders installation,alteration and/or relocation Address: 703 Broadway St.,Ste 710 200 amps or less MI100 70 ++ 201 amps to 400 amps - 13 .56 City/State/ZIP: Vancouver,WA 98660 3 _�401 amps to 600 amps 1111 Phone:( 360 )946 8674 NM 301 0 34 �® 601 amps to 1,000 amps Email; OAIamiAbouhafs a taylormarrison.cam-PermitSubmittalsrvr taylormorrison.com 153011 aver 1,000 amps or volts 5,alte Owner installation:This installation is being made on property that I own which is not 200 amps a les or feeders installation,alteration,and/or relocation intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. less IIIII 59.36MIMI Owner signature 201 amps to400 amps 125.08 1111111111.3 Date: 401 amps to 599 amps . 7 =r '> "''^,-; a.a� P i Branch circuits .new,alteration,or extension, •r.anal Business name:Taylor Morrison Northwest LLC. A.Fee for branch circuits with Ill Contact name: Omar Alami Abouhafs above service or feeder fee, each branch circuit1742 .1 Address: 703 Broadway St.,Ste 710 B.Fee for branch circuits withoutservice or feeder fee,first II City/State/ZIP: Vancouver,WA 98660 branch circuit 568 I Phone:(360 )946 8674 Each add'I branch circuit ®_© Miscellaneous service or feeder not included Email:OAlamiAbouhafs@r taylormorrison.com-PermitSubmittals@ taylormorrison.com Each manufactured or modular Illdwellin•,service and/or feeder 67.84 �� -",, s ,. ,,,,,„, ., ,A Reconnect only xC` 1[tAllIt:` 11111 67.84 _a Business name; Al Pump or irrigation circle lf��fl Sign or outline lighting - " Signal circuit(s)eratio or limited-energy City/State/ZIP: s' .anel alteration,or extension. O SeePage2 -® � � ` ( ► ? ! Each additional ins tion over allowable in env of the above Phone:( c } �i r Additional inspection(1 hr min) t 90.00/hr �. Investigation(I hr min) t -� -. 90o0f hr �� '� Industrial plant(I hrmin) -� ■ CCB LiC.: • r # y Inspections for which no fee is tame Suprv. ■ j►a p Lie.: sr-cificaliv listed Y:hr min 90.00/hr M. Suprv.Electrician signature,required: `� Cl �. {, t Print name: . Ti "� Date: Subtotal $202.46 Io""5-2.1 0 Plan Review Required(25%of permit fee): Authorized signatur State surcharge(12%of permit fee): Print name: "�� r, TOTAL PERMIT FEE: - t ti { �?.5 e?..." Date: �� j-2� This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. t\Buildinyipermiis\ELC_PermitApp ELR_ER6.doc Rev obit 7ii6I5 Number of inspections allowed per permit. 440-4615T(I t rQS;COht WEB • Mechanical Permit Application City of Tigard Received FOR OFFICE USE ONLY 't 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit No ,!/ Phone: 503.718.2439 Fax: 503.598.1960 ' 3�3 1 Plan Review T 1{iA 1;i7 Inspection 503.639A1 75 Dalc/By; Other Permit: Internet: Line:igard-or.gov Noti6edimethodDate RcadyBy: mr s; . ® See Page 2 for Supplemental Information TYPE OF WORK COMME1(CIAL FEE* SCFl'D U-E USE CHECK?IST 1 41 New construction 0 Addition/alteration/replacement Mechanical permit fees"are bated on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑Other: mechanical materials a ui men labor overhead,and rofit. CATEGORY OF CONSTRUCTION Value:S ® 2-family1-anddwelling RES7DE.NTIALEQUIPMENT/SYSTEMSFEES* g 0 Commercial/industrial ❑Accessory building I-an-family For speciol fnjornmdon use eGecklist ❑Master builder ❑Other: Description JOB SITE INFORMATION AND LOCATIONQty' Ea. Total Heatinolcooli 0: Job site address: 14736 SW 169TH AVE Air conditioiun 46.75 . Furnace 100.000 BTU(duets/vents City/State/ZIP;Tigard,OR 97224 46.75 46.75 Furnace 100 000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: ( Project name: Creekview at South River Terrace Heatun 61.06 61. Cross street/directions to job site: Duct work 23.32 H dronic hot waters tern 23.32 Residential boiler(radiator or h drank 23,32 Unit heaters(fuel-type,not electric), in-wa in-duct sus ded-etc. 46.75 Flue/vent for an of above 23.32 Subdivision: Creekview at South River Terrace Other: Lot no.: 25 23.32 Tax map/parcel no.: Other fuel a .fiances: Water heater 23.32 DESCRIPTION OF WORK Gas . •lace/insert 11111 New construction- Flue for water heater or gas 33.39 Type SFU fire.lace 1111 23.32 Lo' lister 23.32 Wood/. Iles stove EMI33,39 Wood fire.lace/insen 1111123.32 Chimne /liner/flue/vent ►' PROPERTY OWNERI nil l . ❑ TENANT Other. 23.32 Name:Taylor Morrison Northwest LLC. Environmental exhaust and ventilation: Range bond/other kitchen 1 Address:703 Broadway St.,Ste.510 equipment 33 39 33.39 City/State/ZIP:Vancouver,WA 98660 Clothes dryer exhaust 1 33 39 33 39 Single-duct exhaust(bathrooms, Phone:(360)695-7700 toilet co fitments utiG rooms 1 23.32 Fax:( ) 23.32 ® APPLICANT Arne/crawls ce fans 23.32 0 CONTACT PERSON Fuel Other: Business name:Taylor Morrison Northwest LLC. 23.,2 plpings Contact name: Omar Alami Abouhafs 514.15 for first four $4.03 for each additional Fumace etc. 1 Address:703 Broadway Si,Ste 510 4 Gas beat pump 1 City/State/ZIP:Vancouver,WA 98660 WalUsuspendedlunrtheoter Water heater 1 Phone:(360)695-7700 I Fax::(360)693 4442 Fireplace 1 E-mail:permit submittals taylormorrisorl.corn Range 1 CONTRACTOR Barbecue Clothes dryer(star) Business name:Pro Heating&Cooling Otber. Address: NW Alociek Dr,Ste.1104 MECHANICAL PERMIT FEES• City/State/ZEE':Hillsboro,OR Subtotal $262.84 M_____um permit fee($90.00) Phone:(360)270-1590 I Fax:( ) Plan review(25°!°of permit fee) CCB lie.:209001 State surcharge(12%ofpetmit fee) TOTAL PERMIT FEE GQ; a �t ,, This permit application expires if a permit is not obtained 7-in uni Authorized signature: w wt.t t./t, days after it has been accepted as complete. Fee methodolog set by Tn County Building Industry Service Board I Print name:Elia Duran Date: 10/30/20 I t lTinadmokPrimF,\MFI'P'rmn cnn Mat i 1 dnr • Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of Tigard Received IIM 13125 SW Hall Blvd.,Tigard,OR 97223 Dale/By: Permit No.AA ST .A- _f t l ` Phone: 503,718.2439 Fax: 503.598,1960 Plan Review nii In lion Line: 503.639,4175 Date/By; Other Permit No.: 1'I G A R D Date Ready By: Jura: ® See Page:for Internet: www,tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ►tee New construction ❑Demolition For special information use checklist. ❑Addition/alteration/replacement 0 Other: Description I Qty. I Ea. f Total New 1-I-family dwellings(includes I00 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312,70 I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building Multi-family SFR(3)bath 1 500.32 500.32 Each additional bath/kitchen 25,02 ❑Master builder El Other: JOB SITE INFORMATION AND LOCATION Site Fire uprinkler( sq.ft.) Page 2 utilities: Job site address: 14736 SW 169TH AVE Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Suite/bldg./apt.no.: I Project name:Creekview at South River Terrace Footing drain(no,linear ft.:_) 1 Page 2 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: Creelcview at South R1Ver Terrace Water service(no.linear ft.: ) Page 2 J Lot no.: 45 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 New construction-Type SFU Clothes washer 1 25.02 25.02 Dishwasher 1 25.02 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: Taylor Morrison Northwest LLC. Fixture/sewer cap 25.02 Address:703 Broadway St.,Ste 510 Floor drain/floor sink/hub 25.02 City/State/Z1P:Vancouver,WA 98660 Garbage disposal 25,02 Hose bib 2 25.02 50.04 Phone:(360)695.7700 Fax:( ) ice maker 12.51 4 APPLICANT 0 CONTACT PERSON Interceptor/grease tmp 25.02 Business name: Taylor Morrison Northwest LLC. Medical gas(value:S�) Page 2 Contact name: Omar Alami Abouhafs Primer 12.51 Address:703 Broadway St.,Ste 510 Roof drain(commercial) 12.51 Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:permitsubmittals©taylormorrison.com Urinal 25.02 CONTRACTOR Water closet 25,02 Business name:G&B Plumbing&Sons Inc Water heater 37.52 Water piping/DWV 56.29 Address:P.O.Box 92 Other. 25.02 City/State/ZiP:St.Paul,OR 97137 Subtotal 600.40 Phone:(503)868-1417 Fax:(971)727-8170 Minimum permit foe: $72.50 CCH Lic.:184372 Plumbing Lic,no.:pb634 Plan review (25%of permit fee) Authorized signature: �.. State surcharge(12%of permit fee) TOTAL PERMIT FEE l Print name:Steve Fowler Date: 1 O/3O/2O This permit application expires If a permit is not obtained within 180 days after II has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:tBuilding1PermitslPLMU-PermitApp.dac I0/01,09 44046 16T(I0,02/COM/WEa) City of Tigard I' COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review - Residential TIGARD Building Permit #: frigr2C22.7 OOL(( Site Address: 14736 SW 169th Ave Verified in Accela Project Name: Creekview(South River Terrace) Lot/Unit #: 25 Proposal (include housing type): New Small Form Residential Unit(detached) Zone: RES-D Required Site Plan Elements: /3 copies of site plan on min 11x17" Drawn to standard scale - Retained trees, drip line/tree protection North arrow sViStreet and site trees shown/ labeled Site address, project name, lot # -$Table calculating tree canopy at maturity Street names (N/A for SFR) Applicant name and phone # -1;1-Courtyard rectangle dimensioned (if applicable) Vdr Lot and setback dimensions - Vision clearance triangle -8-Existing structures &square footage VUtility locations&easements Footprint of new structure and FFE 441 Property corner elevations Sidewalk/driveway dimensioned -2-LIDA (>1,000 sf disturbance) Lot area and lot coverage percentage VErosion control Required Elevation Plan Elements: (For S R: calcs needed only on street-facing) Garage doors dimensioned Drawn to standard scale Syjmary table with calculations for: Npf Building height dimensioned V Total façade area VFagade dimensioned _ Total window and door area Windows and doors dimensioned '1 Total garage area Required Floor Plan Elements: Summary table that includes Each story dimensioned Total floor area Each story floor area calculated Floor area per story Planning Review The following standards have been met: Setbacks 0 Front: 8 Rear: 15 Side: 3 Min/Max Street Side: NA / NA Garage: 20 Height 0 Max. Height: 35 Proposed Height: 23.5 V(Yes ❑ N/A Landscape ❑Yes'N/A Screening (Quad only) V(Yes 0 N/A % Window Coverage N/Yes ❑ N/A Garage (SFR Only) Parking (Other Res) NJ/Yes 0 N/A Entrance (SFR, Rowhouse, Quad only) 0 Yes''N/A Other building design standards (Rowhouse only) 0 YesVN/A Accessory Structure Standards ❑ YesgNo Qualifying pre-existing unit exempt from standards (Cottage unit only) Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads: ❑ Yes 0 N/A Unit Count: ❑Yes 0 N/A Lot Width and Size ❑Yes 0 N/A Pathway Additional standards for Courtyard Units and Cottage Clusters only: 0 Yes ❑ N/A Unit Area: 0 Yes ❑ N/A Floor Area (per story) ❑ Yes ❑ N/A Courtyard 0 Yes 0 N/A Fence ❑ Yes ❑ NoV61/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995) CIYes ❑ NoN/A Public Facilities Improvement (PFI) Permit: Required: ❑Yes ❑ No Applied For: ❑ Yes 0 No, stop intake 0 Sensitive Lands: 0 Yes c/No Land Use Case #: PDR2021-00003 ❑ Conditions met prior permit issuance Approved By Planning: zfi» Date: 10/11/2022 Notes Revision 1: ❑ Approved 0 Not Approved Date: Revision 2: ❑ Approved 0 Not Approved Date: Building Permit Submittal Original Submittal Date: Iola I 202? Site Plans #: Building Plans #: Building Permit #: 'Building permit # entered on page 1 Workflow Routing: p'PI nning 2-Engineering p-Permit Coordinator building Workflow Sign-off: 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. J213uilding: original permit application, site plans, building plans, engineer and beam calculations and trust details, if applicable, etc. Permit Technician: Date: /0/1?/2022- Notes: En ineering Review Slope at building pad: C/ oh N ''Conditions met prior to issuance of permit ffl'Easements (encroachments) per engineering conditions of approval and plat 'Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Cl•fQo Assess Water Quantity Fee in-lieu: ❑ Yes WIVo LIDA Facility on lot: ❑ Yes If'(Vo Add Fee: 0 Yes ❑ No 3 Final Plat Recorded ❑ NOT Approved: Date: Notes: ___...----, Approved By Engineering: Date: 6 41/9A 2 Revision 1: ❑ Approved 0 N t Approved Date: Revision 2: ❑Approved 0 Not Approved Date: Permit Coordinator Review Conditions met prior to permit issuance ❑ Approved, NOT Released: Date notified applicant: ❑ ENG Revisions Required: Date notified applicant: ,e'SDC Exemption: ❑ Applied for El Received 0 Does not apply ,SDC Fees Entered: Wash Co Trans Dev Tax: XYes ❑ N/A Tigard Trans SDC: /Yes ❑ N/A , (Deferred Parks SDC: L�'Yes 0 N/A /1f Deferred LIDA ❑ Yes /LZ(N/A yOK to Issue/Approved by Permit Coordinator: nfh'wii. Date: tC)ti5l'�Z7i Revision 1: ❑ Approved 0 Not Approved ((�J Date: Revision 2: ❑ Approved 0 Not Approved Date: