Permit (3) CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT
Permit#: MST2023-00346
Date Issued: 01/11/2024
T i(3 Al 0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107DA04300
Jurisdiction: Tigard
Site address: 16590 SW PERTH RD
Subdivision: SOUTH RIVER TERRACE PHASE 2 Lot: 98
Project: South River Terrace, Lot 98
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: 781 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1094 sf Garage: 429 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 1875 sf Value: $342,338.67 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 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
9 Bckflw Prevntr: 0
Footing Drain: 100 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 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 W/Svc or Fdr: 0
Ea add!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
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 1875
Owner: Contractor:
TAYLOR MORRISON NORTHWEST LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
703 BROADWAY ST STE 710 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX:
Total Fees: $34,892.56
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTIO{J: Oregon law req ' u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
0c9-nn1-nn1n rhrn,inh()APO oc9-nnl-nnon Vnn nhfain n rnnu of tha ri Ileac nr rlirart ni inctinnc to ni Inv-.by Tallinn cin3 949 10R7 nr I Ran 439 92,1,1
` a
Issued By:
f"/Pg�✓Gr Permittee Signature: *C"e 732 ,1 e i 4 G p
Call 503. 39.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
Received Pe„/t 3_cj Z7046
city 25 of Tigard RECEIVE I Date By r[ _
t 13125 S��`Hall Blvd.,Tigard,OR 97223 I Plan Review Other Permt:
t Z. Phone: 503.718.2439 Fax: 503.598196 Date/By.
Inspection Line: 503.639-4175 Date Ready/By: luris a See Pate 2 for
Internet: wlvw.tigard-or.gov
Yl�i$lil'a JUL 1 1 2023 Notified/Method- Supplemental Information
TYPE OF WORK
CI I Y OF I( AHL) ; COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
— BUILDING DIVISION i Mechanical permit fees*are based on the value of the work -
ElNew construction ❑ Addition/al terationrep acement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑ Other: i mechanical materials,equipment,labor,overhead,and profit.
Value:$ 10,214
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist
i j Multi-family ❑
Master builder ❑ Other: Description Qty. Ea. Total
Heating/cooling:
JOB SITE LNFORMATION AND LOCATION .Air conditioning I 46-75
Job site address: (t S tS,,,.. 1 C:2;M iLip Furnace 100,000 BTU(duets/vents) I 1 _ 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts!veats) 54.91 I _
Heat pump 161.06
Suite/bldg-lapt_no.: Project name: J� t'Z.Ve2 l�•aQAe •-2— Duct work 1 I 23.32
Cross street/directions to job site: Hydronic hot water system I 23.32
Residential boiler(radiator or
hydrant) 23.32 I
Unit heaters(fuel-type,not electric),
in-wall in-duct,suspended,etc. 46.75
Flue/vent for any of above 23-32
Other. 23.32
Subdivision: South River Terrace Z I Lot no.:
l ',itOther 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
INew construction-Type SFU fireplace 23.32
I Log lighter(gas) I 23.32
Wood/pellet stove 33.39
Wood fireplace/insert . 23.32
Chimney/liner/flue/vent I 23.32
Other 23.32
® PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation:
I Name:Taylor Morrison Northwest LLC. Range hood/other kitchen 1
equipment I 3339
I Address:703 Broadway St.,Ste.510 Clothes dryer exhaust 1 33.39
Single-duct exhaust(bathrooms,
CirylState`G1P:Vancouver,WA 98660 toilet compartments,utility rooms) 1 23.32
Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON 1 Other I 1 2332 I
Fuel piping:
Business name:Taylor Morrison Northwest LLC. I $14.15 for first four;S4.03 for each additional
Contact name: CHQ.S 2. v,c.. S 1 Furnace,1 Gras heat etpuunp c. 1 I
I Address:703 Broadway St,Ste 510 Wall/suspended/unit heater
I
City/State/ZIP:Vancouver,WA 98660 Water heater 1
Phone:(360)695-7700 Fax: : (360)693-4442
Fireplace 1
Range 1
E-mail permitsubmittals@taylO1m0rrison.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other: I I
Business name:Pro Heating&Cooling MECHANICAL PERMIT FEES;
Address: NW Alociek Dr,Ste. 1104 Subtotal
Minimum permit fee($90.00) _
Ciry!State/Zll':Hillsboro,OR Plan review(25%of permit fee)
Phone:(360)270-1590 Fax:( ) State surcharge(12°10 of permit fee)
1 TOTAL PERMIT FEE
CCB lic.:209001
This permit application expires if a permit is not obtained within 180
C-(�19... t u days after it has been accepted as complete.
Authorized signature: *• Fee methodology set by Tn-Cotwry Building Industry Service Board
Print name: Elia Duran 1 Date: G/ZS/Z'?"
Electrical Permit Application FOR OFFICE USE ONLY
• City of Tigard Date/B :Rece elirI 0° ,(IMI
lig ■ 13125 SW Hall Blvd.,Tigard,OR 97223 RECEIVE L+ Related Permit#:
_ Phone: 503.718.2439 Fax: 503.598.1960
Inspection Line: 503.639.4175 Ready Date/By: Juns: 0 See Page 2 for
TIGARD Internet: www.tigard-or.gov JUL
1 1 2023 Notified/Method: Supplemental Information
®New construction ❑ Addltion/alteration/repaNeF TIGARD Please check all that apply(submit 2 sets of plans w/items checked):
BUILDING DIVISION ❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition El Other: where available a ds.
h re the fault current Marinas andboatyards
'' exceed 10 000 mps at I50 volts o Flo lino buildings.
.. less to ground.or exceeds 14,000 ❑Commercial use agricu tura
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑ Multi family ❑Master builder ❑Other: 0 Fire pump. 0 e Installation
la ion y env A
mergency syst m. largersepa of el50
KVA
o new mot orloadof system.
❑E
or
❑Addition f
Job#:; Job site address: t15 O Su,) } RiK lOOHP or more. ❑'.A„ 'E" °`1-2" "1-3"
❑Six or more residential units.
occupancy.
City/State/ZIP: Tigard OR 97224 ❑Health-care facilities. ❑Recreational vehicle parks.
❑Hazardous locations. 0 Supply voltage for more than
Sliite/bldg./apt.#: Project name: South River Terrace Z ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: ' i w 111S,;: F` sTI fir ' ��
Description Qty. Each - Total *'
New residential single-or multi-family dwelling unit.
Subdivision: South River Terrace'Z Lot#: 58 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'I 500 sq ft.or portion 33.92 1
v � > � to E .`' .4l # " ..- t'' � # � , Limited energy,residential
.,w.. i',,,;.t 75.00 2
(with above sq.ft.)
New home construction. Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
ilewx leill q " x i Renew En ❑ See 2
r. #l :'"$ t ' #s :` t '°' ;. • .. Services orable feedersergy installation,alteration,
Page and/or relocation
Name:Taylor Morrison Northwest LLC. 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address: 703 Broadway St., Ste 710 401 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 I Fax: ( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: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 1
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,per panel
S v r" 4 "` rs "'`� ` '•:"fin,.. A.Fee for branch circuits with
Business name: Taylor Morrison Northwest LLC. above service or feeder fee, 7.42 2
each branch circuit
Contact name: Chris Roberts B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: 703 Broadway St., Ste 710 branch circuit
Each add'1 branch circuit 7.42 2
City/State/ZIP: Vancouver WA 98660 Miscellaneous(service or feeder not included)
Phone: (503 )313-9449 Fax: : ( )
Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: permitsubmittals@taylormorrison.com Reconnect only 67.84 2
' is I ' .:: ,, ;u,, . Pump or irrigation circle 67.84 2
Business name: Portland Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: 1915 E 5th St., Ste D panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: Vancouver, WA 98661 Additional inspection(1 hr min) 66.25/hr
Phone:( 360)314-4915 Fax: ( )
Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:pawl@portlandelectric.biz Inspections for which no fee is
49205 90 00/hr
CCB Lic-: 194066 Electrical Li�c.:�QC/7�60 Suprv.Lie.:
s.ecificall listed('h hr mm)
V1.+a.C//cam 'r�"s.,,i:;. sr �aS:>«sa .� .�s .'v�, -��es x�'� a..
1501
Suprv.Electrician signature,required: Subtotal:
Gh/ w G 1452 El Plan Review Required(25%of permit fee):
Print name: Alex Shalya Date: State surcharge(12%of permit fee):
_A� 'f�/1 :t�l _ Q L TOTAL PERMIT FEE:
Authorized signature: XJ f I �4�IL(/ILl�t�l�
This permit application expires if a permit is not obtained within 180
Print name: Date: �J�(7073daysafterithasbeenacceptedascomplete.Sergey Mishehuk ( * Number of inspections allowed per permit.
CABuildingVPermitsVBLC_PermitApp_ELR_IiRG.doc Rev U6/ll/21115 440-4615T(II/05/COM/WEB ikv
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLI
RECEIV ' !-
Dal ived Permit No.: .V
City of Tigard Date/By: 4 `si�C7�"w✓�
•s 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439Date/By:
Fax: 503.598.1960 JUL 1 1 2023 Other Permit No.:
Inspection Line: 503.639.4175 Date Ready/By: him Pi See Page 2 for
TIGARD Internet: www.tigard-or.gov
CITY OF TIGARE'1 oiified'Mcthod: Supplemental Information TYPE OF WORK BUILDING DIVISION FEE* SCHEDULE
0 Demolition For special information use checklist.
t.� New constructionDescription L Qty. Ea.___I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft_for each utility connection)
CATEGORY OF CONS l'RUCTION SFR(1)bath 312.70
Xl-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.784 78
SFR(3)bath
❑Accessory building -Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(_-_sq.ft.) ( Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
SS o C \ +'L__ _ Catch basin or area drain 18.76
Job site address: JW1�1K
Drywell,leach line,or trench drain 18.76
City/StatelZT:Tigard,OR 97224 Footing drain(no.linear ft: ) Page 2
Suite/bldg./apt.no.: Project name:South River Terrace Z 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
. Water service(no.linear ft.: ) Page 2
Subdivision: South River r Terrace Z. Lot no.: g Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.:
Backwater valve 12.51
DESCRIPTION OF WORK 25.02
Clothes washer 1
New construction-Type SFU Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
C4 PROPERTY OWNER 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: Taylor Morrison Northwest LLC.
Floor drain/floor sink/hub 25.02
Address:703 Broadway St.,Ste 510 Garbage disposal 25,02
City/State/ZIP:Vancouver,WA 98660 Hose bib 25.02
Phone:(360)695-7700 I Fax:( ) Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:S ) Page 2
Business name: Taylor Morrison Northwest LLC. 12.51
Primer
Contact name: Citrag i?-0,�p t 5 Roof drain(commercial) 12.51
Address:703 Broadway St.,Ste 510 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
Urinal } 25.02
E-mail:permitsubmittals®polygonhomes.com 25 02
Water closet
CONTRACTOR Water heater 37.52
Business name:G&B Plumbing&Sons Inc Water pipingiDWV 56.29
Address:P.O.Box 92 Other. 25.02
City/State/ZIP:St.Paul,OR 97137 Subtotal
( )
Phone:(503)868-1417 Fax: 971 727-8170 Minimum permit fee: S72.50
Plan review (25%of permit fee)
CCB Lic.: 184372 Plumbing Lic.no.:pb634
State surcharge(12%of permit fee)Authorized signature: TOTAL PERMIT FEE
Date: G f 2f,/23 This permit application expires if a permit is not obtained within 180 days
Print name:Steve Fowler after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I+Buildine'\Pamits\PLMU-PamitApc.doc IO/o1/09 444-4616111002?COMJ'EB) 11/411
rort v 2LL`v--g
IN Building Division
One & Two-Family Dwelling
TIGARD Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION �J l 2o Zt
Permit #: Plan #: Floors:
03-D03CI� `f(832co�6
Valuation: L u--k Covered Porch: ___-- Basement
Bedrooms: Deck: ------ 1st Floor -7S
WC (toilets) Deck Cover: ------ 2"' Floor l
OCH
Lavatories 4 Patio Cover ------ 31d Floor
Tub/shower Accessory Struct. R-3 Total j '6--IS-
Laundry Tray Water Heater 1 / Gas / lec_D Garage LI29
Exhaust Vents l..( Gas Flue Vents Total for Elec.
Backflow Prey. , -.. ( Fur ace) Heat Pump I AC # for Electrical
BBQ Gas Fireplace #Fuel Lines 3
FEES: Description: Fee Applie : Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg$2.00 (over 11x17) 0
Info Proc/Arch: Sm$.50 (up to 11x17)
Metro CET: Residential Use
School CET: District: t
Tigard CET: Admin
Tigard CET: ODHCS
Tigard CET: AH t .
Electrical Permit: Permit Fee:
Limited Energy:
12% State Surcharge
Mech. Permit: Permit Fee:
12% State Surcharge
Plumbing Permit: Permit Fee:
12% State Surcharge
Erosion Control: w/Permit-Ping
I:\Building\Forms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
Page 1
City of Tigard
1111 x
'ICOMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
a
Building Permit #: tail7-63j-003ko
Site Address: 16590 SW Perth Road l Verified in Accela
Project Name: South River Terrace Lot/Unit #: 98
Proposal: New Single Detached Small Form Residential Zone: RES-D
Housing Type: igl SFR(IX Single Detached ❑ Duplex❑Triplex❑ADU) ❑ Rowhouse❑Cottage Cluster❑ CYU ❑Quad ❑Other
Required Site Plan Elements:
l 3 copies of site plan on max 11x17"
) 1 Drawn to standard scale ❑ Retained trccs, drip linc/tree protection
® North arrow ® Street and site trees shown / labeled
IR Site address, project name, lot # canopy at maturity
X Street names (N/A for SFR)
X Applicant name and phone #
X Lot and setback dimensions ❑ Visiui u deal once ti jangle
-Existing structures &square footage X Utility locations &easements
X Footprint of new structure and FFE X Property corner elevations
EX Sidewalk/driveway dimensioned ❑ LIDA (>1,000 sf disturbance)
® Lot area and lot coverage percentage X Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
X Drawn to standard scale ®Total façade area
IX Building height dimensioned ® Total window and door area
IX Façade dimensioned
IX Windows and doors dimensioned
alley-loaded garage, non street facing
Require Elements:
(Not required for SFR) ❑ Summary table that includes
❑ Each story dimensioned floor area
O Each story floor area calculated ❑ Floor area per
Planning Review
The following standards have been met:
Setbacks 0 Front: ,1po ch Rear: 0'alleySide: 3 Min/Max Street Side: 8' / Garage: 3'-5' alley
Height 0 Max. Height: 35' Proposed Height: 25' loaded garage
X Yes ❑ N/A Landscape
O Yes X N/A Screening (Quad only)
IX Yes ❑ N/A % Window Coverage
❑ Yes X N/A Garage (SFR Only) Parking (Other Res)
64 Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes ❑ N/A Other building design standards (Rowhouse only)
❑ Yes ❑ N/A Accessory Structure Standards
❑ Yes ❑ No Qualifying pre-existing unit exempt from standards (Cottage unit only)
Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
❑ Yes ❑ N/A Unit Count:
❑ Yes 0 N/A Lot Width and Size
O Yes ❑ N/A Pathway
Additional standards for Courtyard Units and Cottage Clusters only:
❑ Yes N/A Unit Area:
❑ Yes N/A Floor Area (per story)
❑ Yes N/A Courtyard
O Yes N/A Fence
❑ Yes ❑ No ®N/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
❑ Yes ❑ No ®N/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes ❑ No
Applied For: ❑ Yes ❑ No, stop intake
® Sensitive Lands: ❑ Yes 6a No
MI Main Land Use Case #s: PDR201$-00003/PDR2021-00003 ❑ Conditions met
❑Applicant notified of land use expiration permits by 11/3/2024, final occ by 11/3/2026
Approved By Planning: Date: 7/3/23
Notes garage is alley-loaded
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Building Permit Submittal
Original Submittal Date: 1 11 2
Site Plans #:
Building Plans #:
Building Permit #: t�J Building permit # entered on page 1
Workflow Routing: 'ErPlanning '®'Engineering Permit Coordinator 8'Building
Workflow Sign-off: CfSign-off for Planning (include notes from planning review)
Route Documents: VI Engineering: (1) copy of permit application, (1) site plan, (1) building plan
a d original plan review routing form.
44 Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
Permit Technician: P%4U1 ri' 6.01,ikuYt,i Date: 711,S J202i'
Notes: 0
Engineering Review
❑ PFI Permit:
Slope at building pad: ,d, 0/0
WAX/Conditions met prior to issuance of permit
❑ Easements (encroachments) per engineering conditions of approval and plat
(?1"Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes i;1'1So
Assess Water Quantity Fee in-lieu: ❑ Yes ltYNo
LIDA Facility on lot: ❑ Yes Er No Add Fee: ❑ Yes ❑ No
&Final Plat Recorded
❑ NOT Approved: Date:
Notes: ____------
Approved By Engineering: C -'' _ Date: 7/"C.//7 3
Revision 1: ❑ Approve ❑ Not Approved Date:
Revision 2: ❑ 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:
` .DC Exemption: ❑ Applied for ❑ Received 76oes not apply
4:1.(2DC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A Deferred f t
Parks SDC: Yes ❑ N/A J Deferred
LIDA Yes A 1 �7
)OK to Issue/Approved by Permit Coordinator: 'CI,. `Yl_, Date: - C Q " �i_
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
City of Tigard
" Deferral Until Occupancy Request
TIGARD 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: 8/14/2023 Site Address: 16590 SW Perth Rd
Project South RT Phase 2 Land Use Case or
Name: Lot 98 Building Permit#: MST2023-00346
Tax Lot 2S107DA04300 Total Parks $9,430.00
#: Amount*:
TDT Total TSDC $12,247.00
Amount: N/A Amount*:
*The total TSDC amount shown above is the sum of$ 7,917.00 for TSDC-Improvement,$457.00 for TSDC-
Reimbursement,and$3,873.00 for TSDC-River Terrace,if applicable..
*The total Parks SDC amount shown above is the sum of$ 7,384.00 for Parks-Improvement,$ 2,046.00 for Parks-
Reimbursement,and either$ N/A for Parks-Neighborhood or$ N/A 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.
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.
8/15/23
Property Owner: ira. 42 Date:
Developer: /ems?41 Date: 8/15/23
Permit Coordinator: Date: 8/14/2023