Permit (6) CITY OF TIGARD MASTER PERMIT
IN
' : '` COMMUNITY DEVELOPMENT Permit#: MST2023-00349
Date Issued: 01/11/2024
T j{;,rti RTj 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107DA04400
Jurisdiction: Tigard
Site address: 16578 SW PERTH RD
Subdivision: SOUTH RIVER TERRACE PHASE 2 Lot: 99
Project: South River Terrace, Lot 99
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: 23 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: 3
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
Footing Drain: 100 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Bckflw Prevntr: 0
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'I 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: $34,895.56
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
oc9-nnl-nnln thrni inh rCAP oc9-nn9-nnon V htain a rnny of thn rnlac nr riirort niiactinnc to(II INC by rairnn cry 919 1QR7 nr 1 Ann 3'9 94ad
Issued By: / Permittee Signature: i' � ' <`; t,!/i
Call 5 . 9.4175 by 7:00 a.m.for the next available inspection date.
t/ This permit card shall b' ept 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 �j Received Pe ��� r} /
City of Tigard Date/By: L
't 13125 SW Hall Blvd.,Tigard,OR 97223 RECEIV .n Review Other Permit:
1 = Phone: 503.718.2439 Fax: 503.598.1960 �i c/By:
Inspection Line: 503.639.4175 ate Ready/By: Juris- El See Page 2 for
Y1 i:i ltl'! p
Internet: w�rzv.ugard-or.gav JU+ 1 1 2023 NotiSed/;v[ethed I
Supplemental Information
TYPE OF WORK (•CITY OF TIGARD
FEE* SCHFDULE - USE CHECKLIST
I Mechanical permit fees*are based on the value of the work
d ILDING DIVISION®New construction ❑ Adr.tnon/alterat.on;' performed.Indicate the value(rounded to the nearest dollar)of all
❑ Other: mechanical materials,equipment,labor,overhead,and profit.
❑ Demolition Value:S 10,214
CATEGORY OF CONSTRUCTIfl` RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑ Co nmercial(industrial ❑ Accessory building For special information use checklist
j Multi-family ❑
Master builder ❑ Other: -Description Qty. Ea. Total
Heating/cooling:
JOB SITE LNFORMATION AND LOCATION I 46.75
r� - Air conditioning
Job site address: j C S? t S,A T 'Kam'_ Furnace 100,000 BTU(ducts/venu) I 1 46.75
City/State/ZIP:Tigard,OR 97224
Furnace 100,000+BTU(ducts/vents) 54.91
Heat pip 61.06
Suite/bldg./apt.no.: Project name: SDyTx 2.uL2 i satzA ,Z- Duct work , 1 I 23.32
Cross street/directions to job site: Hydronic hot water system I 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit beaters(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 -2_ (�1 Lot no.: /
Other fuel appliances:
Tax map/parcel no.: Water beater 23.32
DESCRIPTION OF WORK Gas fireplace/insert _ 33.39
Flue vent for water heater or gas
New construction-Type SFU fireplace I 23.32
Logue(gas) 23.32
Wood/pellet stove 33.39 I
Wood fireplace/insert I 23.32
Chimney/liner/flue/vent 23.17
Other I 23.32
® PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation:
Name:Taylor Morrison Northwest LLC. Range hood/other kitchen 1
equipment 33.39
I Address:703 Broadway St.,Ste.510 Clothes dryer exhaust 1 33.39
I
Single-duct exhaust(bathrooms,
City'/State/ZIP:Vancoaver,WA 98660 toilet compartments,utility rooms) 1 23.32
Phone:(360)695-7700 Fax:( ) Attic/crawlspace fans I 23.32
® APPLICANT ❑ CONTACT PERSON I Other: 1 l 23-32 I
Fuel piping:
Business name:Taylor Morrison Northwest LLC. l 514.15 for first four;S4.03 for each additional
1 1 I I
Contact name: Cv%Q,,S --4:z ,, I Furnace,etc.
Gas heat pump I
Address:703 Broadway St,Ste 510 Wa1L'suspended/unit heater
City/State/GIP:Vancouver,WA 98660 Water heater I
' ( Fireplace 1
Phone:(360)695-7700 Fax: :(360)693-4442 -
Range 1
I E-mail:permitsubmittals(taylormO1riSOn.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other: l I
{ Business name:Pro Heating&Cooling MECHANICAL PERMIT FEES*
Address: NW Alociek Dr,Ste. 1104 Subtotal
Minimum permit fee(S90.00)
City/State/ZIP:Hillsboro,OR Plan review(25%of permit fee)
Phone:(360)270-1590 Fax:( ) State surrharge(12%of permit fee) _
TOTAL
lie.:209001 PERMIT FEE
This permit application expires if a permit is not obtained within 180
f �Qi he.,t days after it has been accepted as complete.
Authorized Sigltature: a Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date: G/2 S/Z 3 N/
Electrical Permit Application FOR OFFICE USE ONLY
Received City of Tigard �.,to/B
� �
II 'I13125 SW Hall Blvd.,Tigard,OR 97223 RECEIVE 1Tan Review
2 Phone: 503.718.2439 Fax: 503.598.1960 Date/B Related Permit#:
Inspection Line: 503.639.4175 JUL 2023
Ready Date/By: llurk ® See Page 2 for
TIGARD Internet: www.tigard-or.gov Notified/Method: Supplemental Information
® New construction ❑ Addition/alteration/reBUILi-
Please check all that apply(submit 2 sets of plans w/items checked)
BB � G DIVISION ❑Service or feeder 400 amps or mare ❑Building over three stories.
❑ Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
:,; CAT ' ? W .k 8 , $ exceeds 10,000 amps at 150 volts or ❑Floating buildings.
- " less to ground,or exceeds 14,000 ❑Commercial-use agricultural
.1 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑ Multi family ❑ Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
1 ... 11°vt i ,. ,, o ne em larger
separately
derived
❑Emergency syst m el�� ❑Addition f otor load of Y
Job#: i Job site address: /(p S 9-6 g 1,j I4 I�> 100HP 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
Suite/bldg./apt.#: Project name: South River Terrace'', 600 volts nominal.
❑Service or feeder 600 amps or more.
Cross street/directions to job site: _, . a ., .d .., } "' i. '. ;: y e l' 'r.. .�,r),a'
Description Qty. Each Total ' *
New residential single-or multi-family dwelling unit.
Subdivision: South River Terrace Z Lot#: CJ / 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
s•
e 1:: ` C ; i 1 fl &"`' . f� �
t ' k > iejli.k Limited energy,residential 75.00 2
(with above sq.ft.)
New home construction. Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
r, Renewable Energy ❑ See Page 2
.k 14 # 4;i 1 Xf 1: 11 �u=�;1 ` '`'; ' * , �.. Services or feeders installation alteration 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, er panel
�F v.��;�. �+ �' . 1,N_ , �'�� 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)
Each manufactured or modular 67.84 2
Phone: ( 503 )313 9449 Fax: : ( ) dwelling,service and/or feeder
_ Email: permitsubmittals@taylormorrison.com Reconnectoaly 67.84 2
# i1 s' ' s ' >, �` Pump or irrigation circle 67.84 2
Business name: Portland Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 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
Fax:( ) Investigation(1 hr min) 90.00/hr
Phone:( 360>314-4915 Industrial plant(1 hr min) 78.18/hr
Email:pawl@portlandeleetric.biz Inspections for which no fee is
49205 90 00/hr
s.ecificall listed(i hr min)
CCB Lic.: 194066 Electrical Lic.: C760 Suprv.Lic.: .
Suprv.Electrician signature,required: att,X, Subtotal:
— Print name: Alex Shalya Date: c/Ze /�er) ❑Plan Review Required(25%of permit fee):
( " State surcharge(12%of permit fee):
�Qi� '']FYI Q „ ,Q . , L TOTAL PERMIT FEE:
Authorized signature: XXJJ I Lv�Iu/nw/t�l�
This permit application expires if a permit is not obtained within 180
Print name: Sergey Mishchuk Date: 6/u/len,1 days after it has been accepted as complete.
* Number of inspections allowed per permit.
i\Building\I'ermits\I:LC_PcrmitApp_hi.R_IiRfi.doc Rev 06/l7/2015 440-4615T(I l/(JS/COM/WtiB A
Plumbing Permit Application
Building Fixtures >�
City of Tigard CEIVED RoeeiveDatelBy:
d Perm4 .1t 'Vlw J t
.74 .s 13125 SW Hall Blvd.,Tigard,OR 7 Plan Review
2 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 JUL 1 2023 Date Ready/By: ruris: 0 See Page 2 for i
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF woRltl-ryn OFA TIGARD FEE* SCHEDULE
®New construction [IBI DM DIVISION For special information use checklist
i Description 1 Qty. i Ea. _1 Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
1-and 2-family dwelling 0 Commercial/industrial
SFR(2)bath 437.78
SFR(3)bath 1 500.32
IElAccessory building -Multi-family Each additional bath/kitchen 1 25.02
❑Master builder 0 Other: Fire sprinkler(__sq.ft.) 1 Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: /45" 5,A..) Q�"1 e Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2
Suitelbldg./apt.no.: Project name:South River Terrace ' 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.: ) t Page 2
Subdivision: South River Terrace Z. Lot no.: 5? Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 1 25.02
New construction-Type SFU
Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® 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 Fax:( ) Ice maker 12.51
- ® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: Taylor Morrison Northwest LLC. Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: C40..kg i O U't2 i 5 Roof drain(commercial) 12.51 I
Address:703 Broadway St.,Ste 510 Sink/basin/lavatory 25.02 1
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:permitsubmittalsrtipolygonhomes.com
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:G&B Plumbing&Sons Inc Water piping/DWV 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: $72.50
Plan review (25%of permit fee)
CCB Lie.: 184372 Plumbing Lic.no.:pb634 n
State surcharge(12%of permit fee)
Authorized signature: 2 TOTAL PERMIT FEE
Date: G/2 S/27 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:\BuiidiarTe mits'PLMU-PernitApp.doc 10/01 ,9 440-4616T(I0/02/COM/WEB) 11/4V
aeei„ -1-0 .e-rvi-- -. 6 tA,1 66,,,- 1-1-(-4, 1--)\-.
11111
Building Division
One & Two-Family Dwelling
T c A RD Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION J l 1 UJ
Permit#: i✓ 1.(>7i5 C6-2 (--/ p Plan #: (4(6.�at) c_ Floors:
Valuation: ✓ Covered Porch: �� Basement ____,
Bedrooms: Li Deck: ____._______ _ 1st Floor t
WC (toilets) S Deck Cover: _ 2"d Floor l O QL y
Lavatories LA Patio Cover 3'Floor _
Tub/shower 3 Accessory Struct. R-3 Total I g 7 S
Laundry Tray Water Heater l / Gas 0 Garage
Exhaust Vents 1
4 Gas Flue Vents ____------- Total for Elec. lJ °
Backflow Prey. urnac / Heat Pump AC # for Electrical 3
BBQ Gas Fireplace #Fuel Lines
FEES: Description: Fee Applie Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg$2.00 (over 11x17) cti
Info Proc/Arch: Sm$.50 (up to 11x17) 9Z
Metro CET: Residentiae j
School CET: District: L t,�
Tigard CET: Admin
Tigard CET: ODHCS
Tigard CET: AH l7
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
B
COMMUNITY DEVELOPMENT DEPARTMENT
11111 Building Permit Review - Residential
TIGARD .
Building Permit #: MSza73-0O3 t6
Site Address: 16578 SW Perth Road Verified in Accela
Project Name: South River Terrace Lot/Unit #: 99
Proposal: New Single Detached Small Form Residential Zone: RES-D
Housing Type: 6d SFR(®Single Detached 0 Duplex 0 Triplex 0 ADU) 0 Rowhouse❑Cottage Cluster 0 CYU ❑Quad 0 Other
Required Site Plan Elements:
g 3 copies of site plan on max 11x17"
— XI Drawn to standard scale 0 Retained trccs, drip line/ tree protection
IX North arrow ® Street and site trees shown/ labeled
R Site address, project name, lot #
X Street names (N/A for SFR)
® Applicant name and phone # tangle dimensioneu (if plicz bl
IX Lot and setback dimensions 0 Vision Llealance tiitnig}e
X Utility locations &easements
XI Footprint of new structure and FFE X Property corner elevations
X Sidewalk/driveway dimensioned 0 LIDA (>1,000 sf disturbance)
X 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:
- kI Drawn to standard scale IX Total façade area
X 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) 0 Summary table that includes
❑ Each story dimensioned floor area
❑ Each story floor area calculated ❑ Floor area per
Planning Review
The following standards have been met:
Setbacks 0 Front: 1 ch Rear: 0'alleySide: 3 Min/Max Street Side: 8' / Garage: 3'-5' alley
Height 0 Max. Height: 35' Proposed Height: 23' g loaded garage
x Yes 0 N/A Landscape
❑ Yes X N/A Screening (Quad only)
I& Yes ❑ N/A % Window Coverage
❑ Yes X N/A Garage (SFR Only) Parking (Other Res)
X Yes 0 N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes 0 N/A Other building design standards (Rowhouse only)
❑ 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:
❑ Yes ❑ N/A Unit Count:
❑ Yes ❑ N/A Lot Width and Size
❑ Yes 0 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
❑ Yes N/A Fence
❑ Yes ❑ No INN/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
❑ Yes ❑ No I&N/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes ❑ No
Applied For: ❑ Yes ❑ No, stop intake
I Sensitive Lands: ❑ Yes X No
N Main Land Use Case #s: P - PDR2021 D0003 ❑ Conditions met
❑Applicant notified of land use expiration permits by 11/3/2024. final occ by 11/3/2026
Approved By Planning: Date: 773/23
Notes garage is alley-loaded
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: ❑ Approved 0 Not Approved Date:
Building Permit Submittal
Original Submittal Date: 1 111114 3
Site Plans #:
Building Plans #:
Building Permit #: VBuilding permit # entered op page 1
Workflow Routing: C 'Planning Engineering 11 Permit Coordinator iBuilding
Workflow Sign-off: Sign-off for Planning (include notes from planning review)
Route Documents: L 'Engineering: (1) copy of permit application, (1) site plan, (1) building plan
anid original plan review routing form.
N Building: original permit application, site plans, building plans, engineer and
beam calcu
lations and
trust details, if applicable, etc.
Permit Technician: 41JfU - t2 4/ 161iIWhr Date: 3 islih21i
Notes:
Engineering Review
❑ PJI Permit:
LSlope at building pad: 2Z
4'/9t Conditions met prior to issuance of permit
[[ I rEasements (encroachments) per engineering conditions of approval and plat
VA/ater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes PIVo
Assess Water Quantity Fee in-lieu: ❑ Yes Yfio
LIDA Facility on lot: ❑ Yes f'No Add Fee: ❑ Yes ❑ No
nal Plat Recorded
❑ NOT Approved: Date:
Notes: .................
Approved By Engineering: Date: / /7e 3
Revision 1: 0 Approved ❑ of 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: 2 Date notified applicant:
DC Exemption: ❑ Applied for ❑ Received woes not apply
DC Fees Entered: Wash Co Trans Dev Tax: Yes 0 N/A '^
Tigard Trans SDC: Yes ❑ N/A Deferred
Parks SDC: Yes ❑ N/A Deferred
LIDA ❑ Yes `` Date:
?a. , 7i 7
/30K to Issue/Approved by Permit Coordinator: \1! A Ck1 .
Revision 1: ❑ Approved ❑ Not Approved _ Date:
Revision 2: 0 Approved 0 Not Approved _ Date:
City of Tigard
Deferral Until Occupancy Request
T I G A R D Washington County Transportation Development Tax (TDT),Transportation and Parks System
' Development Charges (SDCs)
r„ _, r.....r x,n...:.. .,..< >:4 tim. ✓a;..'v..,-0 a;,�W, .. -.....c;rar5,. s.:#=.».. a.'a:.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: 16578 SW Perth Rd
Project South RT Phase 2 Land Use Case or
Name: Lot 99 Building Permit#: MST2023-00349
Tax Lot 2S107DA04400 Total Parks
#: Amount*: $9,430.00
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.
Property Owner: /67a. 1A..4- Date: 8/15/23
Developer: 2d/v�'� 71/1,3, - - Date: 8/15/23
Permit Coordinator: Date: 8/14/2023