Permit 114 CITY OF TIGARD MASTER PERMIT
= COMMUNITY DEVELOPMENT Permit#: MST2023-00585
T I i`;A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/05/2023
Parcel: 2S106DD06400
Jurisdiction: Tigard
Site address: 13626 SW 165TH AVE
Subdivision: RIVER TERRACE TOWN CENTER Lot:
Project: River Terrace Town Center, Lot 65
Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN
PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1352 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 28.5 Bathrooms: 4 Second: 1798 sf Garage: 576 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 3150 sf Value: $567,901.26 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 2 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: 6 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: 6 201-400 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 3150
Owner: Contractor:
AG EHC II(NWHM)MULTI STATE 2 LLC TNHC OREGON LLC Required Items and Reports(Conditions)
BY THE NEW HOME COMPANY INC 15231 LAGUNA CANYON ROAD 1 Ersn Cntrl 503-639-4175
BY KAWANAMI,MARK SUITE 250
15231 LAGUNA CANYON RD STE IRVINE,CA 92618
250
PHONE: PHONE: 503-312-6213
FAX:
Total Fees: $29,273.35
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. ATTEN : 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 thrroi nA oc ..nn1_nnan v nhtain a rnnv of tha n Jac nr rdirart nnoctinne to nl INr:by Tallinn Fn4 9Q9 10R7 nr 1 Ann T19 94dd
Issued By: Un.c.- Permittee Signature: At, a?pltrucion
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.
Ir
Building Permit Application
Residential RECEIVED FOR OFFICE I'SE O\1.1
City of Tigard Received VIA A i
g 2�23 Ee '
II , g , 3NOV 3 /By: �1/� !/'� Other Permit:S VZ 10 cosgs
T I G A R n Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Suns: I Id See Page 4 fo:
Internet www tgard or gov Notified/Method: 1 '-r Supplemental Information
BUILDING DIVISION 112-1/2 AF
eivyvem:3...e.01
iJ New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indi
❑Addition/alteration/replacement 0 Other equipment,p l(rounded to e h theprofit for
nearest dollar)of all
materials,labor,overhead,and r the
" OF , work indicated on this application. 'V.
■ 1-and 2-family dwelling Valuation: $ �( j 9 o I t
❑ y g 0 Commercial/industrial 1
IDAccessory building El Multi-familyNumber of bedrooms: 5
❑Master builder ❑Other Number of bathrooms: .VJ
��' ,JNyAO Total number of floors: 2 (��`f0
Job site address:13626 SW 165th Avenue New dwelling area: 3150 square feet a
City/State/ZIP:Sherwood,OR 97140 Garage/carport area: 576 square feet 13 52_
Suite/bldg./apt.no.: Project name:River Terrace Town Center Covered porch area: 72 square feet
Cross street/directions to job site: Deck area: square feet
-SW Jean Loise Road Other structure area: square feet
Subdivision:River Terrace Town Center Lot no.:65 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:parcel no: 2S1060003300 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
*.:„ work indicated on this application.
Valuation: $
Requesting Deferred SDC fees
Existing building area: square feet
? New building area: square feet
. .u�. r'O4N� y $ r I r
fr......:. r,:..v f...,,:., .... .. 'r ' a..,, :,.: T Number of stories:
Name:TNHC OREGON LLC Type of construction:
Address:15231 Laguna Canyon RD STE 250 Occupancy groups:
City/State/ZIP:Irvine/CA/92618 Existing:
Phone:(503)310-7571 Fax:( ) New:
J... .::,,? ....? .,,,.,�,,..�„ r.,, .:r '' '' , :„:1 .`,.:... .. .,, : r ` ro 7 � '�f`' a``
esslacto
"' ' r
Business name:TNHC OREGON LLC '` ''`
Structural plan review fee(or deposit):
Contact name:Frank Sandoval
FLS plan review fee(if applicable):
Address:15455 NW Greenbrier Parkway Suite 240
City/State/ZIP:Beaverton/OR/97006
Total fees due upon application:
Phone:(503) 310-7571 Fax::( ) Amount received:
E-mail: fsandoval@nwhm.com/oregonpermits@newhomeco.comIii . . ,,f...:: , . x, .
i "€ Commercial and residential prescriptive installation of
P
r r ... ....: ...... . roof-top mounted Photo Voltaic Solar Panel System.
Business name:TNHC OREGON LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:15231 Laguna Canyon RD STE 250 Solar Installation Specialty Code checklist.
City/State/ZIP:Irvine/CA/92618 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503 )310-7571 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB 1ic.:241108
Total fee due upon application: $201.60
Authorized signature: Q.__ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Jennifer McDe Ott Date:11/9/2023 *Fee methodology set by Tri-County Building Industry
Service Board.
1:ABuilding\Permits\BUP-RESPermitApp.doc 01/25/2023 440-4613T(I1/02/COM/WEB)
* t
Mechanical Permit Applicat CEI�Q (�� Received
FOR OFFICF USE()Ni.)
City of Tigard {t n%I\��Date/By: Permit No.: tv, _•
5
�)lX)
13125 SW Hall Blvd.,Tigard,OR 97223!PI Plan Review
_ Phone: 503.718.2439 Fax: 503.598.1960NQV Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 aj V Date Ready/By:y y: Juris. lif See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
-
BUILDING DMS#ON GOI II; I .EEE : DI)I E l3s' . aT
TYPE OF WORK
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY CIF CONSTRUCTION R WEr4TIAI Q MEN1C/SYSTE S PEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB sat'I) `0RMA'T'IO1w1'ANIlt LOCATION .
Heating/cooling:
Air conditioning 1 46.75
Job site address:13626 SW 165th ave Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Sherwood OR 97140 Furnace 100,000+BTU(ducts/vents) 1 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:River Terrace Town Center Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
SW Jean Louise rd hydronic) 23.32
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:River Terrace Town Center Lot no.:65 Other fuel appliances:
Tax map/parcel no.:2s1060003300 Water heater 23.32
DESCRIPTION OF WORK
. ' Gas fireplace/insert 1 33.39
Flue vent for water heater or gas
NEW HOME CONSTRUCTION fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
21 PROPERTY OWNEROther: 23.32
. - - Environmental exhaust and ventilation:
Name:TNHC OREGON LLC Range hood/other kitchen
equipment 1 33.39
Address:15231 Laguna Canyon Rd STE 250 Clothes dryer exhaust 33.39
City/State/ZIP:Irvine CA 92618 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503 X310-7571 Fax:( ) Attic/crawlspace fans 23.32
Arptic rcf':' C i itki,PERSON. Other: 23.32 I
Business name:TNHC OREGON LLC Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Frank Sandoval Fumace,etc.
Address:15455 NW Greenbrier Parkway#240 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Beaverton OR 97006 Water heater
Phone:(503)310-7571 Fax: :( ) Fireplace
Range
E-mail:fsandoval@nwhm.com Barbecue
E litAttOR Clothes dryer(gas)
Business name:Pro Heating and Cooling, INC Other:
I. 4JI PER UI'fl *
Address:4200 NW Leisy rd . Subtotal
City/State/ZIP:Hillsboro, OR 97124 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(971)205 4989 Fax:( ) State surcharge(12%of permit fee)
CCB lie.:209001 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: DZ1-4-C * Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:3/17/2023
I.\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(I 1/02/COM/WEB)
t
Electrical Permit Application RECEIVE
L FOR OFFICE(.SSE ONLY
City of Tigard •eceBy'd
DatelBy: Permit#: j���2•M %�
9
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review W
Phone. 503.718.2439 Fax: 503.598.1960II
NOV 9 2023 Date/By: Related Penult#:
Inspection Line: 503.639.4175 Readyy: 0 See Page 2 for
T l GA RD. Date/By: Ions'
Internet. www.tigard-or.gov CITY OF TIGARD Notified/Method:
Supplemental Information
TYPE OF W;r-'LDING DIVISION PLAN REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition ID Other: ❑Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION. exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-familyamps for all other installations, buildings
0 Master builder 0 Other: 0 Fire pump.
JOB'SITE INFORMATION AND LOCATION 0 Emergency s stem. 0 Installation a oe l5d KVA or
y larger separately derived
Job#: Job site address: 13626 SW 165th Ave ❑Addition of new motor load of system.
100HP or more. ❑`A"°`E""1-2'°"I-3»
City/State/ZIP: Sherwood/ OR/97140 0 Six or more residential units, occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: . Project name: RTTC 0 Hazardous locations. 0 Supply voltage for more than
JJJJ 0 Service or feeder 600 amps or more. 600 volts nominal..
Cross street/directions to job site:
FEE SCHEDULE
SW Jean Louise Rd. Description I Qty. I Each I Total i =
New residential single-or multi-family dwelling unit.
Subdivision: River Terrace Town Center I Lot#:65 Includes attached garage.
Tax map/parcel#: 2s1060003300 1,000 sq.ft.or less t6s.s4 4
DESCRIPTION"OF WORK Ea.add]500 sq.ft.or portion 33.92 1
Limited energy,residential
NEW HOME CONSTRUCTION (with above sq.ft.) 7500 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
(� PROPERTY OWNER 'TENANT Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name: THNC OREGON LLC 200 amps or less 100.70 2
•
Address: 15231 Laguna Canyon Rd STE 250 201 amps to400amps 133 56 2
City/State/ZIP: Irvine CA 92618 401 amps to600amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone:(503)310-7571 I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: FSandoVal@neWhomeCO.COm
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
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
APPLICANT I CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
THNC OREGON LLC A.Fee for branch r feederfee,
Business name: above service or fee,
each branch circuit 7.42 2
Contact name: Frank Sandoval B.Fee for branch circuits without
service or feeder fee,first
Address: 15455 NW Greenbrier Parkway#240
branch circuit 56.18 2
City/State/ZIP: Beaverton OR 97006 Each add'I branch circuit 7.42 2
Phone:(5Q3)310 7571 Fax::( ) Miscellaneous(service or feeder not included)
Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
Fsandoval@newhomeco.com
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Development Northwest Inc., DBA Wolcott Electrical Sign or outline lighting 67.84 2
Address:1075 W Historic Columbia River Hwy Signal circuit(s)or limited-energy
panel,alteration,or extension. ❑ See Page 2 2
Each additional inspection over allowable in any of the above
City/State/ZIP:Troutdale, OR, 97060
Additional inspection(1 hr min) 66.25/hr
Phone:(503)853_9420 I Fax:( ) Investigation(1 hr min) 90.00/hr
Email:MWOLCOTT@WOLCOTT.PRO Industrial plant(l hr min) 78.18,hr
Inspections for which no fee is
CCB Lie.:112220 I Electrical Lie.:C 1272 I Suprv.Lie.:5782S specifically listed(A hr min) 90.00/hr
Suprv.Electrician signature,required:'D'�. EI.ECTRICAL;PERIV#Tr FEES
Way�ti�t ,,r„3,.,.,,, Subtotal:
Print name:David Campbell I Date:- 0/12/2023 ❑Plan Review Required(25%of permit fee):
4 State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
Print name: This permit application expires if a permit is not obtained within 180
Malachi J. Wolcott I Date:10/12/2023 I days after it has been accepted as complete.
` Number of inspections allowed per permit.
IaBuilding\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(1 t/05/COMIWEB
. Y
Plumbing Permit Application
Building Fixtures RECEI�1 Folz OFFICE 1.SE. ()NIA'
City of Tigard Received
NO4 13125 SW Hall Blvd.,Tigard,OR 97223 V 9 23Date/B': t `�` 1 iS
II- Plan Review V
Phone 503.718.2439 Fax' 503.598.1960 Other Permit No.:
Date By:
T I GAR1) Inspection Line: 503.639.4175 pCITY OF TICA ►ate Ready/By tuns: RI See Page 2 for
Internet wwwtigard-or.gov BUILDINGDlvlgl• rifled/Method: Supplemental Information
TYPE OF WORK Ll I 1FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 II for each unlity connection)
CATEGORY OF CONSTRUCTION ' ' SFR(I)bath 312.70
® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 1 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ftJ Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 1 3626 SW 1 65th Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Sherwood/OR/97140
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: RTTC Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
SW Jean Louise Rd. 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: River Terrace Town Center ( Lot no.: 65 Fixture or item:
Tax map/parcel no.: 2s1060003300 Backflow preventer 31,27
iscRIP,TiON orWORK '
Backwater valve 12.51
New Home Construction Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
19 PROPEL OWNER" I Q J EN '' Expansion tank 12.51
Name: TNHC OREGON LLC Fixture/sewer cap 25.02
Address: 15231 Laguna Canyon Rd STE 250 Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: Irvine CA 92618 Hose bib 25.02
Phone:(503)310-7571 Fax:( ) Ice maker 12.51
APPLICANT .I -'CONTACT PERSON Interceptor/grease trap 25.02
Business name: THNC OREGON LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Frank Sandoval
Roof drain(commercial) 12.51
Address: 15455 NW Greenbrier Parkway#240 Sink/basin/lavatory 25.02
City/State/ZIP: Beaverton OR 97006 Solar units(potable water) 62.54
Phone:(503)310-7571 Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
CONTRAC Ui Water closet 25.02
Water heater 37.52
Business name:Wolcott Plumbing Water piping/DWV 56.29
Address:1075 West Historic Columbia River Hwy Other: 25.02
City/State/ZIP:Troutdale OR. 97060 Subtotal
Phone:( 503-667-1781 Fax:( ) Minimum permit fee: $72.50
26824 PB Plan review (25%of penult fee)
CCB Lie.:112220 L Plumbing Lie.no.:
State surcharge of permit fee)
Authorized signahtre: TOTAL
PERMIT FEE
Print name:Mark Baleme M Date:10/12/2023 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
°Fee methodology set by Tri-County Building Industry Service Board.
1.\BuildingiPerents\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
II 1
Building Division
One & Two-Family Dwelling
T i A}i Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION 'Ti I(i 7.4)2,3
Permit#: i ya3 �uoGi — Plan #: 5 04 ,b Floors:
Valuation: Covered Porch: �1��Q✓� Basement
if5U1,9oi•24,
Bedrooms: Deck: 1"Floor
WC (toilets) ? Deck Cover: 2 d Floor ��
Lavatories 4 Patio Cover 3'd Floor
Tub/shower 4 Accessory Struct. R-3 Total 2 1 C D
Laundry Tray Water Heater / Gas Garage Jcl7JLP
Exhaust Vents Le Gas Flue Vents Total for Elec. 3„7 r
Backflow Prey. .------- F ace Heat Pump CAC) # for ElectricalLe
�P
BBQ ----- Gas Fireplace �� #Fuel Lines 3
FEES: Description: Fee Appli s: Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg$2.00 (over 11x17)
Info Proc/Arch: Sm$.50 (up to 11x17)
Metro CET: Residential Use o
School CET: District: ti'SL-c-B"
Tigard CET: Admin
Tigard CET: ODHCS
Tigard CET: AH
Electrical Permit: Permit Fee:
Limited Energy: ✓
12% State Surcharge le
Mech. Permit: Permit Fee: .
12 State Surcharge V
%
Plumbing Permit: Permit Fee:
12% State Surcharge
Erosion Control: w/Permit-Ping
I:\Building\Forms\ResPlanCheckFees_Dec2o22_AA.doc 12/21/22
Page 1
ADDITIONAL PEREVIITS REQUIRED
Fire Sprinkler
Fire Alarm
Mechanical
Plumbing
Electrical
Truss Engineering
Shop Drawincv
Other
City of Tigard
71 0
NI COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: MSA V(A/3'OG 5%
Site Address: 13626 SW 165th Avenue 7 Verified in Accela
Project Name: River Terrace Town Center Lot/Unit #: 65
Proposal: New Single Detached Zone: RES-C
Housing Type: iZi SFR(E'Single Detached ❑ Duplex❑Triplex 0 ADU) El Rowhouse❑Cottage Cluster❑ CYU :Quad ❑Other
Required Site Plan Elements:
I'3 copies of site plan on max 11x17"
V Drawn to standard scale ❑ Relained Li CC , di ip lint/ Li ec pi olcLlion
vi North arrow V Street and site trees shown / labeled
V Site address, project name, lot # ❑Tablc calculating trcc canopy at maturity
1 Street names (N/A for SFR)
VApplicant name and phone # ❑ Courtyard rcctanglc dimcnsioncd (if applicable)
l'Lot and setback dimensions
❑ Cxisting sti uctures &squai a footage V Utility locations &easements
vS Footprint of new structure and FFE 'z1 Property corner elevations
cif Sidewalk/driveway dimensioned 8+4-(>1,000 sf disturbance)
V Lot area and lot coverage percentage IV Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
V Drawn to standard scale vTotal façade area
vi Building height dimensioned vTotal window and door area
V Façade dimensioned
vi Windows and doors dimensioned
v Garage doors dimensioned
Requir an Elements:
(Not required for SFR ❑ Summary table that includes
0 Each story dimensioned otal floor area
El Each story floor area calculated 0 Floor ar
Planning Review
The following standards have been met:
Setbacks gf Front:1'b d ng Rear: 10'patio Side: 3' Min/Max Street Side: 7' / Garage: 20'
Height V Max. Height: 35' Proposed Height: 28' 5 1/4"
{ 'Yes 0 N/A Landscape
O Yes III N/A Screening (Quad only)
Qf Yes 0 N/A % Window Coverage I°('I-
vSYes 0 N/A Garage (SFR Only) Parking (Other Res)
V 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:
El Yes N/A Lot Width and Size
O Yes N/A Pathway
Additional standards for Courtyard Units and Cottage Clusters only:
O Yes N/A Unit Area:
❑ Yes N/A Floor Area (per story)
❑ Yes N/A Courtyard
El Yes N/A Fence
❑ Yes ❑ No f 'N/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
O Yes ❑ No ON/A Public Facilities Improvement (PFI) Permit:
Required: V Yes 0 No
,,_/
Applied For: KJ Yes ❑ No, stop intake
V Sensitive Lands: ❑ Yes 42'No
'Main Land Use Case #s: PDR20 1-00004 ❑ Conditions met
'Applicant notified of Ian xp te: Submit and pay for all applicable dev permits by 1/31/2025.Final occ by 1/31/2027
Approved By Planning: Date: 11/1/2023
Notes
Revision 1: ❑ A roved 0 Not Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date:
Building Permit Submittal
Original Submittal Date: „l"1'A/VuS
Site Plans #: 3
Building Plans #: �3
Building Permit #: 19 Building permit # entered on page 1
Workflow Routing: gilanning 'ngineering hermit Coordinator I9icuilding
Workflow Sign-off: sign-off for Planning (include notes from planning review)
Route Documents: Vngineering: (1) copy of permit application, (1) site plan, (1) building plan
and original plan review routing form.
Eil/Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
Permit Technician: P'w`'u, Date: It (G 126 Z5
Notes:
Engineering Review
❑ PFI Permit:
fZYSlope at building pad: day %
N/A-eConditions met prior to issuance of permit
E'Easements (encroachments) per engineering conditions of approval and plat
e'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes to
Assess Water Quantity Fee in-lieu: ❑ Yes CeNo
' LIDA Facility on lot: ❑ Yes kJ'No Add Fee: ❑ Yes ❑ No
t5 Final Plat Recorded
❑ NOT Approved: Date:
Notes:
Approved By Engineering: ' Date: (//,S�(Z_3
Revision 1: ❑ Approved ❑ N Approved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Permit Coordinator Review
71 cPeonditions met prior to permit issuance
❑ Approved, NOT Released: Date notified applicant:
❑ ENG Revisions Required: Date notified applicant:
SDC Exemption: ❑ Applied for ❑ Received 'hoes not apply
SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A Deferred
Parks SDC: ❑ Yes ❑ N/A Deferred
LIDA ❑ Yes RN/A
OK to Issue/Approved by Permit Coordinator: \ Date: \\-\U 3
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date: