Permit CITY OF TIGARD MASTER PERMIT
N . . . COMMUNITY DEVELOPMENT Permit#: MST2023-00643
Date Issued: 02/06/2024
T i t;A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DD06200
Jurisdiction: Tigard
Site address: 13714 SW 165TH AVE
Subdivision: RIVER TERRACE TOWN CENTER Lot: 62
Project: River Terrace Town Center, Lot 62
Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL ENGINEERING APPROVES&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: 3
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
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Tvpes 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
Fum>=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: $29,272.85
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. ATTE . Oregon law r 'es ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
oc7-nn1-nnin fh,,,' r oc _nn1-n n maxi n in rnm,of the n,lac nr Airart no ioctinnc fn(1I!Mr.by rniiinn 601 739 1QR7 nr 1 Ann 1'37 7144
Issued By: '" Permittee Signature: Ol1 AVIACIaLti .
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 Permit ApplicationRECEIVED
Residential `� FOR OFFICE USE ONLY
Cl of Tigard DEC 2 2023 Received ' ll ^ _^n AD
MS11.�ti3 00b93
II 01 1 w,L S D Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
e Phone: 503.718.2439 Fax: 503.598.196cCITY OF TIGARD Plan Review 1 i 1 2,i/ C`^`�A _�� `^
Date/By: 41, Other Permit: J,V •w A11
Y
T I(, .R D Inspection Line: 503.639.4175 3UILDING DIVISION Date Ready/By: ,, / 1 rjs H See Page 4 for
Internet: www.tigard-or.gov Notified/Method r y ice/, /l\' I Supplemental Information
f y
E New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other equipment,materials,labor,overhead,and the profit for the
i �' p c0 �� O , M.,, work indicated on this application. fl tp
■ 1-and 2-famil dwelling Valuation: $ 5 Zo�rgI ,
❑ y g ❑Commercial/industrial w got ,
❑Accessory building ❑Multi-family Number of bedrooms: 5
0 Master builder ❑Other Number of bathrooms: ,3-3'�
SIFE INFORMATIONCA Total number of floors: 2
Job site address:13714 SW 165th Avenue New dwelling area: 3150 square feet ( B
City/State/ZIP:Sherwood,OR 97140 Garage/carport area: 576 square feet 135a,
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 I ouise Rnad Other structure area: square feet
Subdivision:River Terrace Lot no.:62 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:parcel no: 2S 1060003300 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
Plkaeaenaa;''? t ON ,, t� :: ,. ,,,.: work indicated on this application.
Valuation: $
Requesting Deferred SDC fees
Existing building area: square feet
New building area: square feet
1� 111 � )y , . : ``SIVONU N '/ 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 ( ) N
thi
,,, a, :. ..,,, ...e.,M .,w/u..... , Meg , , ,.y.,.: , ,. ; +:;<, , .mac,', :.. 2 m
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.com A �` � ' ^� ` , r .,.
, Commercial and residential prescriptive installation of
.-T m
,,;, F ,, ..... roof-top mounted Photovoltaic 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 Fa ) State surcharge(12%ofpermit fee): $21.60
CCB lie.:241108 , Total fee due upon application: $201.60
Authorized signatut �'1. 'C 1/' A//�, Q This permit application expires if a permit is not obtained
jV� IC�� �� within 180 days after it has been accepted as complete.
Print name:Jennifer McD rmott Date: 8�023' i2,1 temethodology set by Tri-County Building Industry
tce Board.
C\Building\Permits\BUP- SPermitApp.do 1/25/2023 440-4613T(11/02/COM/WEB)
Mechanical Permit ApplicatiRECEl�E FOR OFt 1( : USE Oyl.)
City of Tigard and Received
IIg Date/By: Permit No.: th
,, .060A
II 13125 SW Hall Blvd.,Tigard,OR 97223DEC 2 r` 2023 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
Date/By:
TIGARD Inspection Line: 503.639.4175 DateReady/By: saris: 0 See Page 2 for
Internet. www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE*SC1 EI)EEE-IISL cicia'
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value $
CATEGORY Y OF CO CS tUC C 1N RESIDENTIAL EQ1 ME '/SYS"I l4 S'F�*..
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/caoling:
Air conditioning 1 46.75
Job site address:13714 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
Subdivision: Other: 23.32
River Terrace Town Center Lot no.:62 Other fuel appliances:
Tax map/parcel no.:2s1060003300 Water heater 23.32
I)ESCRtP IU1S. OF WORI€. 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
Other: 23.32
I 'PROPERTY OWNER a TENANT Environmental exhaust and ventilation:
Name:TNHC OREGON LLC Range hood/other kitchen
Address:15231 Laguna Canyon Rd STE 250 Clothesdt 33.39
Clothes dryer exhaust 33.39
City/State/ZIP:Irvine CA 92618 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)3 10-7571 Fax:( ) Attic/crawlspace fans 23.32
0 APPUcANT, Q; o met PERSON Other: 23.32
Business name:TNHC OREGON LLC Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Frank Sandoval Furnace,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:fandoval@nwhm.com Barbecue
.. .. cO cTOR 1. Clothes dryer(gas)
Business name: Pro Heating and Cooling, INC Other:
) CAE .
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. D1 44"1-' * 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(11/02/COM/WEB)
RECEIVED
DEC 2 7 2023
Electrical Permit Application FOR OFFICE t::SE ONLY
City of Tigard CITY OF TIGARD Received /�I���/t
II '1 13125 SW Hall Blvd.,Tigard,OR 9711'D1NG DIVISION Daten R Bev iew
y: Permit#:��1 W V�•OOIoA3
pla.�
Phone: 503.718.2439 Fax: 503.598.1960Related Permit#:
_ Date/By:
r 1 Ci A R D Inspection Line: 503.639.4175 Ready Date/By: Saris: 0 See Page 2 for
Internet. www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
/:1 I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump
0 Installation of 150 KVA or
JOB SITE INFORMATION AND i'LOCATION ❑Emergency system. larger separately,derived
Job 4: Sob site address: 13714 SW 165th Ave ❑Addition of new motor load of system.
100HP or more. ❑`A°' "E""l-2""t-3"
City/State/ZIP: Sherwood/ OR/ 97140 ❑Sixor more residential units occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.4: Project name: RTTC 0 Hazardous locations. 0 Supply voltage for more than
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 A
New residential single-or multi-family dwelling unit.
Subdivision: River Terrace Town Center Lot 4:62 Includes attached garage.
Tax map/parcel 4: 2s1060003300 1,000 sq.ft.or less 168.54 4
Ea.add'!500 sq.ft,or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
NEW HOME CONSTRUCTION (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00
residential(with above sq.ft.) 2
RI PROPERTY OWNER El TENANT
Renewable Energy ❑ 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 •
401 amps to 600 amps 200.34 2
City/State/ZIP: Irvine CA 92618 601 amps to 1,000 amps 301.04 2
Phone:(503)310-7571 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 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
APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: THNC OREGON LLC aboveserviceorfeederfee,
each branch circuit 7.42 2
Contact name: Frank Sandoval B.Fee for branch circuits without
Address: 15455 NW Greenbrier Parkwa #240 ranir feeder fee,srst
y b branchh c circuit 56.18 2
City/State/zIP: Beaverton OR 97006 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)310 7571 per;:
( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder Email: 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 circuits)or lextensionergy
panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP:Troutdale, OR, 97060 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)853_9420 Fax:( ) Investigation(Y hr min) 90,00/hr
Email:MWOLCOTT@WOLCOTT.PRO Industrial plant(Ihrmin) 78.18/hr
Inspections for which no fee is
CCB Lic.:112220 Electrical Lic.:C 1272 Suprv.Lic.:5782S specifically listed('h hr min) 90.00/hr
Su rv.Electrician signature, ELECTRICAL PERMIT FEES
p gnature,required:
'P"'� °�"""°" Subtotal:
Print name:David Campbell Date:10/12/2023 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: w 4 TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within ISO
Print name:Malachi J. Wolcott Date:1 0/1 2/2023 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/I720I5 440-4615T(1 if05/COML'WEB
a , r
RECEIVED
Plumbing Permit Application DEC 2 ` 2023
Building Fixtures CITY OF TIGARD t FO1Z orrlcr; USE ov'Ll'
BUILDING DIVISION
City of Tigard Received \�t / �3 In W'`J
•r Permit No.: \V` l(J
a 13125 SW Hall Blvd.,Tigard,OR 97223 Date By:
IPhone: 503.718.2439 Far: 503.598.1960 Plan Review Other Permit No:
Date/By:_
Inspection Line: 503.639.4175
1 I G A It D Internet. wtvw.ti and-or. ov Date Ready/By: inns: See Page 2 for
g g Notified/Method: Supplemental Information
TYPE OF WORK FEE*SCREDLtLE
®New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF, CONSTRUCTION SFR(I)bath 312.70
® I-and 2-family dwelling ElCommercial/industrial SFR(2)bath 1 437.78
buildingSF1Z(3)bath 500.32
❑Accessory ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION:AND LOCATION` Site utilities:
Job site address: 1 3714 SVV 165th Ave Catch basin or area drain 18.76
City/State/ZIP: Sherwood/OR/97140 Drywell,leach line,or trench drain 18.76
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 It.:,.) Page 2
Water service(no.linear II._) Page 2
Subdivision: River Terrace Town Center I Lot no.: 62 Fixture or item:
Tax map/parcel no.: 2s 1060003300 Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
New Home Construction Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
iliII PROPERTY OWNER ' I p TENANT Expansion tank 12.51
Name: TNHC OREGON LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 15231 Laguna Canyon Rd STE 250 Garbage disposal 25.02
City/State/ZIP: Irvine CA 92618 Hose bib 25.02
Phone:(503)310-7571 Fax:( ) Ice maker 12.51
61 A''PLICAT CONTACT PERSON Interceptor/grease trap 25.02
Business name: THNC OREGON LLC Medical gas(value:$ ) Page 2
Contact name: Primer 12.51
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
Water closet 25.02
CONTRACTOR
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 tee: $72.50
CCB Lie.: • Plumbing 26824 PB Plan review (25%of permit fee)
112220 L Lie.no.: State surcharge(12°10 of permit fee)
Authorized signature:4U to� TOTAL PERMIT FEE
Print name:Mark Baleme Date:10/12/2023 This permit application expires if a permit is not obtained within t8tt days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
I:\Budding iPermas\PLMU•PermilApp.doc 10/01/09 440.4616T(10/02/COM/WEB)
Ili ..s Building Division
One & Two-Family Dwelling
TIGARD Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION 1-.1/4)(1 i6Za
Permit #: ���wt Q 0(,43 Plan #: %Li4:61)(0 Floors:
Valuation: Covered Porch: -7D.- Basement --....—
Bedrooms: 5 Deck: 1" Floor 5-D-
WC (toilets) Li Deck Cover: - 2°d Floor
Lavatories Patio Cover - .—__. 3rd Floor
Tub/shower Accessory Struct. _________., R-3 Total 3 l co
Laundry Tray Water Heater / Gas Elec Garage 57( _
Exhaust Vents 6 Gas Flue Vents Total for Elec. ' -'7 0-C°
Backflow Prey. urnace / Heat Pump /QC ') # for Electrical
BBQ - Gas Fireplace -t.--S #Fuel Lines
FEES: Description: Fee Ap : Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg $2.00 (over 11x17) 022.
Info Proc/Arch: Sm $.50 (up to 11x17) b
Metro CET: Residential Use
School CET: District: %.
Tigard CET: Admin
Tigard CET: ODHCS
Tigard CET: AH
Electrical Permit: Permit Fee: 1 .:
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�//
I:A Building\Forms\Res PlanCheckFees_Dec2022_AA.doc 12/21/22
Page 1
City of Tigard
a
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
p,
Building Permit #: MS1 /OVS • OD Co43
Site Address: 13714 SW 165th Avenue 7 Verified in Accela
Project Name: River Terrace Town Center Lot/unit #: 62
Proposal: New Single Detached SFR Zone: RES-C
Housing Type: VI SFR(L(Single Detached ❑ Duplex❑Triplex❑ADU) ❑ Rowhouse❑Cottage Cluster 0 CYU ❑Quad ❑Other
Required Site Plan Elements:
13 copies of site plan on max 11x17"
Pf Drawn to standard scale ❑ Relaii ied Li ees, di iN Gi le/ ii ec Ni oieLlion
z1 North arrow VS Street and site trees shown / labeled
V Site address, project name, lot # 0 Tablc calculating trcc canopy at maturity
t 'Street names (N/A for SFR)
'Applicant name and phone # plicable)
'Lot and setback dimensions 14 l
❑ Existing structui.s &squai a footage V Utility locations &easements
V Footprint of new structure and FFE vf Property corner elevations
'vi Sidewalk/driveway dimensioned VLIDA (>1,000 sf disturbance)
V Lot area and lot coverage percentage 6a'Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
g'Drawn to standard scale VTotal façade area
Building height dimensioned vTotal window and door area
V Façade dimensioned
V Windows and doors dimensioned
VT Garage doors dimensioned
Requir an Elements:
(Not required for SFR ❑ Summary table that includes
❑ Each story dimensioned otal floor area
0 Each story floor area calculated ❑ Floor ar
Planning Review
The following standards have been met:
8'porch
Setbacks 0 Front:12'building Rear: 3'alley Side: 3' Min/Max Street Side: 7' / Garage: 20'
Height 0 Max. Height: 35' Proposed Height: 28' 5-1/4"
❑ Yes Xl N/A Landscape
❑ Yes Et N/A Screening (Quad only)
vi� Yes ❑ N/A 0/0Window Coverage
K1 Yes ❑ 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
LI 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 N/A Lot Width and Size
❑ Yes N/A Pathway
Additional standards for Courtyard Units and Cottage Clusters only:
❑ Yes N/A Unit Area:
O Yes N/A Floor Area (per story)
O 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 VN/A Public Facilities Improvement (PFI) Permit:
Required: 0 Yes 0 No
Applied For: ❑ Yes 0 No, stop intake
❑ Sensitive Lands: vf Yes 0 No
'Main Land Use Case #s: PDR2021-00004 ❑ Conditions met
❑Applicant notified of land use expiratio e: Submit and pay fo.all applicable dev permits by 1/31/2025.Final occ by 1/31/2027
Approved By Planning: 4 C. , l' :S Date: 9/26/2023 71 Z-1173
Notes
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
Building Permit Submittal
Original Submittal Date: 1�13
Site Plans #:
Building Plans #:
Building Permit #: 'Building permit # entered on page 1
Workflow Routing: W lanning "Engineering l4�Permit Coordinator Building
Workflow Sign-off: I 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.
'f 'Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc. g
Peemit`Technician: Y kin/ad Date: 11i1v (74Z3
Notes:
Engineering Review
❑ PFI Permit:
Slope at building pad: o
/fi//9' "Conditions met prior to issu nce of permit
"Easements (encroachments) per engineering conditions of approval and plat
Or-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes t'No
Assess Water Quantity Fee in-lieu: 0 Yes Gno
LIDA Facility on lot: ❑ Yes No Add Fee: ❑ Yes ❑ No
it/Final Plat Recorded
❑ NOT Approved: Date:
Notes:
Approved By Engineering: _ Date: //2/2 4'
Revision 1: ❑ Approved 0 of Approved Date: `
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DC Exemption: 0 Applied for 0 Received foes not apply
taDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A Deferred
Parks SDC: Yes CIN/A Op Deferred /�... 6 t.
LIDA Yes eN/A �l
tiePOK to Issue/Approved by Permit Coordinator: t4*-e Date: '* (O./"1
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