Permit (21) III CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2023-00641
Date Issued: 02/06/2024
T l GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DD06000
Jurisdiction: Tigard
Site address: 13738 SW 165TH AVE
Subdivision: RIVER TERRACE TOWN CENTER Lot: 60
Project: River Terrace Town Center, Lot 60
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: 29 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: 15
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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
oc ..nn1-nn1n thrni,nh(lAR oc9-nnl-nnon vni i maw nhtaina rnnw of tha n!lac nr rlirant ni iacfinnc to(II INC hw rallinn cm 9'19 10R7 nr'I RCM 119 91d4.
1
Issued By: /'� Permittee Signature: .
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.
f
Building Permit Application RECEIVE
It
Residential IOR OFrict: I St:O\t.\
City of Tigard DEC 2023 RDa[e/By eceived lti Y
113 t413. tin Permit No.:MS'(�ti3.04b41
III
° 13125 SW Hall Blvd.,Tigard,OR 97223
11 Phone: 503.718.2439 Fax: 503.598.1960 Plan Review `-'n A
CITY OF TIGARD Date/By: fatrZy Other Permit SW 1 Y•tet2
TIGARD
Inspection Line: 503.639.4175 3UILDING Date Ready/By: Juris: ® See Page 4 for
Internet: www.ttgard-or.gov DIVISION Notified/Method: I 117/7�i W I Supplemental Information
C Yl'1A i h-4f e-11 t. r&t'�,l.,- •
TYPE OF WORK REQUIREDOoNa;.:-Aro)1.F.Amax DWELLING
0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OFCONSTRUCTION work indicated on this application. ZA,
ri 1-and 2-family dwelling 0 Commercial/industrial Valuation: $2, Q „']I (� 0 I
D Accessory building ❑Multi-family Number of bedrooms: 5 cJ�1✓ J 1
❑Master builder ❑Other: Number of bathrooms: (.•1.
JOR SITE INFORMATION AND LOCATION Total number of floors: 2 -25 7'Pe.,e
Job site address:13738 SW 165th Avenue New dwelling area: 3150 square feet 1
City/State/ZIP:Sherwood, OR 97140 Garage/carport area: 576 square feet ,'7)
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 Louise Road Other structure area: square feet
REQUIRED DATA!.COMMETICULVSE CRECKI ST
Subdivision:River Terrace Lot no.:60 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
. DESCRIPTION OF WO work indicated on this application.
Requesting Deferred SD( fees Valuation: $
Existing building area: square feet
New building area: square feet
PROPE F O R. 1E1 AN . 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:
li APPLICANT ' C CO '.Ik'a ii.o$O I BUILDING PERMIT FEES*
Business name:TNHC OREGON LLC . > aeel4errtrte}:
Contact name:Frank Sandoval
Structural plan review fee(or deposit):
Address:15455 NW Greenbrier Parkway Suite 240 FLS plan review fee(if applicable):
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.comACSOLARAEE *
Commercial and residential prescriptive installation of
CON f RACTOR , . . 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
Aadress:15231 Laguna Canyon RD STE 250
Solar Installation Specialty Code checklist.
City/State/ZIP:Irvine/CA/92618 Permit Fee(includes plan review
and administrative fees): $180.00
Phone:(503 )310-7571 Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.:241108
Total fee due upon application: $201.60
Authorized signature:
e-CV 1V4449.- This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Frank Sand al/Jennifer ermott Date: 12-Z �f>�3 *Fee methodology set by Tri-County Building Industry
!/� Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 01/25/2023 440-4613T(I 1/02/COM/WEB)
r
Mechanical Permit ApplicatiRECEIVE D FOR OFFICE USE ONI,ti
Received
Cl of Tigard Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 DEC 27 2023 Date/By: MS vVAt tJq
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 �I OF TIGARD Date Ready/By: ions ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* EDULE--IJS ITECKUST'
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
ATI trORY CIF GUl' Intl"I. RESIDENTIAL.EQUIPMEI!TJSYSTEMSFEES*
dwelling ❑ ❑Accessory building For special information use checklist.
® 1-and 2-familyCommercial/industrial
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
. Air conditioning 1 46.75 Job site address:13738 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.:60
Other fuel appliances:
Tax map/parcel no.:2s1060003300 Water heater 23.32
DESC
RIPTIONOF 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
PROPERTY OWNER El T NANi Other: 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 1 33.39 _
City/State/ZIP:Irvine CA 92618 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) b 23.32
Phone:(503 810-7571 Fax:( ) Attic/crawlspace fans 23.32
APPLICANT ID:CONTACT 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. A
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 i
Range 1
E-mail:fandoval@nwhm.com Barbecue
.. N TRA TOLt . '.. ' Clothes dryer(gas)
Business name:Pro Heating and Cooling, INC Other:
'. hll(. A tiiii F +'
Address:4200 NW Leisy rd Subtotal 1
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: De 441-' * Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:3/17/2023
1.\Building\Permits\MEC_PermitApp_040113_doc 440-4617T(1 l/02/COM/WEB)
Electrical Permit Application RECEIVE
FOR OFFICE USE ONE)`
City of Tigard DEC 2 2023 Receivey:
Pe—it k:d MS'l1,oti3 6o�A1
p Review
13125 SW Hall Blvd.,Tigard,OR 97223
Plan Plan R
Phone: 503.718.2439 Fax: 503.598.1960III
Tv �t p Date By: Related Permit#:
Inspection Line: 503 639.4175 CITY i OF I IGf1f7^Ip Ready Date/By: Ions- ® See Page 2 for
TIOARD Internet. www.tigard-or.gov 3UILDiNG DIVISION NotifiediMethod: Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition Other; 0 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.
0 I-and 2-family dwelling ❑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 ❑Other: ❑Fire pump.
0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
.lob#: .lob site address: 13738 SW 165th Ave ❑Addition of new motor load of system.
104HP or more. ❑"A","E","1-2',"l-3",
❑Six or more residential units. occupancy.City/State/ZIP: Sherwood/ OR/ 97140
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: RTTC ❑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 l Total I
New residential single-or multi-family dwelling unit.
Subdivision: River Terrace Town Center Lot#:60 Includes attached garage.
I,000 sq.ft.or less 1 16$.54 4
Tax map/parcel#: 2s1060003300
Ea add'l 500 sq.ft or portion 14 33.92 1
DESCRIPTION OF WORK Limited energy,residential
NEW HOME CONSTRUCTION (with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
54 PROPERTY'OWNER 0 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 to4Q0amps 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 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 0 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 ancrfuederfee,first
y br branchh c circuit 56.18 2
City/State/ZIP: Beaverton OR 97006 Each add'l branch circuit 7.42 2
Phone:(503)310 7571 Miscellaneous(service or feeder not included)
Fax:;( ) Each manufactured or modular
67.84 2
dwelling,
Email: Fsandoval@newhomeco.com iceand'orfeeder
Reconneectct o onlnly 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 Hwypanel,alteration,Signal terat(s)or limited-energy
tion,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(1 hr min) 90.00/hr
Email:MWOLCOTT@WOLCOTT.PRO Industrial plant(I ltr min) 78.18i hr
Inspections for which no fee is
CCB Lic.:112220 Electrical Lie.:C 1272 Suprv.Lie.:5782S specifically listed 04.hr min) 90.00/hr
ELECTRICAL
Suprv.Electrician signature,required: PERMIT FEES
'Q=�..
a
°" a`°"" Subtotal:
Print name:David Campbell Date:10/12/2023 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: 4 TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name:Malachi J. Wolcott Date:10/12/2023 days after it has been accepted as complete.
' Number of inspections allowed per permit.
I:\Budding\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM,WEB
c t
Plumbing Permit ApplicatictECEI /E
Building Fixtures �✓G V
City of Tigard DEC 2 2023 Received DatelB MS�tiO1�. QD\ A\
111 "I y: Permi No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
ti Phone: 503.718.2439 Fak: 503.598. :
qY OF TIGARD Date/By: Other Permit No.
Inspection Line: 503.639.4175 g ,` /�PIGARI� Internet: www.tigard-or.gov 3UILDING DIVISION' NotifedJlvlet od: tans. FL1 See Page 2 for
Supplement(Information
1 YPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist.
Description i Qty. i Ea. 1 Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
® I-and 2-family dwelling Q Commercial/industrial SFR(2)bath 1 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family Each additional bath kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13738 SW 165th Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Sherwood/OR/97140
Footing dram(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 4 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 I Lot no.: 60 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
123 PROPERTY OWNER 1 0 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
( .APPLICANT ($i CONTACT.PERSON Interceptor/grease trap 25.02
Business name: THNC OREGON LLC Medical gas(value:$ ) 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)31 0-7571 Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
CONTRACTORWater closet 25.02
Water heater 37.52
Business name:Wolcott Plumbing Water PP�
tP m 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
Plan review (25%of permit fee)
103
CCB Lic.:112220
Plumbing Lie.no.:26824 PB
t State surcharge(12%of permit tee)
Authorized signature: �`yN\1\ TOTAL PERMIT FEE
Print name:Mark Baleme �" 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.
i:\Building\Permits1 PLMtJ.PermitApp.doe 10/01/09 440-4616T(10/02/COMVWEB)
'' Building Division
One & Two-Family Dwelling
T I nRD Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION AL( ZDZJ
Permit #: si, 3 _ b ( Plan #: 0 g Floors: o-
Valuation: Covered Porch: -7 Basement
Bedrooms: 5 Deck: 1" Floor 35 2-
WC (toilets) 9 Deck Cover: ,----_— 2'd Floor t _9 06
LavatoriesCA Patio Cover —_ 3'd Floor
Tub/shower 9 Accessory Struct. R-3 Total c�
Laundry Tray -[ — Water Heater 1.1 Gas E ec Garage 57 c
Exhaust Vents b Gas Flue Vents Total for Elec. 3---P(40
Backflow Prey. _ / Heat Pump / # for Electrical CO
BBQ Gas Fireplace 9 #Fuel Lines
FEES: Description: Fee Applies: Fee Entered:
DC Prov Revw: Planning vV
Info Proc/Arch: Lg$2.00 (over 11 x 17) a
Info Proc/Arch: Sm $.50 (up to 11x17) La
Metro CET: Residential Use 1 -
School CET: District:
Tigard CET: Admin
Tigard CET: ODHCS
Tigard CET: AH
Electrical Permit: Permit Fee:
Limited Energy:
12% State Surcharge 1.7
Mech. Permit: Permit Fee: v''
12% State Surcharge
Plumbing Permit: Permit Fee: k". -
12% State Surcharge
Erosion Control: w/Permit - Ping
1:A Building\Forms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
Page 1
City of Tigard
itCOMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: MS11613 • 6O r'41
Site Address: 13738 SW 165th Ave c'Verified in Accela
Project Name: River Terrace Town Center Lot/unit #: 60
Proposal: New Single Detached SFR Zone: RES-C
Housing Type: vi SFR(Er Single Detached ❑ Duplex❑Triplex❑ADU) ❑ Rowhouse❑Cottage Cluster❑ CYU ❑Quad❑Other
Required Site Plan Elements:
El 3 copies of site plan on max 11x17"
PI Drawn to standard scale ❑ Relaii it J h ees, di ip bile/ h ee pi oteLlion
vI North arrow V Street and site trees shown / labeled
V Site address, project name, lot # ❑ -rabic calculating trcc canopy at maturity
V Street names (N/A for SFR)
V Applicant name and phone # R-courtyard rcctanglc dimcnsioncd (if applicable)
Lot and setback dimensions
❑ Existing sti aLtures &square f„otage V Utility locations &easements
{i Footprint of new structure and FFE Property corner elevations
Sidewalk/driveway dimensioned VLIDA (>1,000 sf disturbance)
V Lot area and lot coverage percentage 62'Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
se Drawn to standard scale gr Total facade area
vi Building height dimensioned C/Total window and door area
ci Facade dimensioned
vi Windows and doors dimensioned
vi Garage doors dimensioned
Requir an Elements:
(Not required for SFR ❑ Summary table that includes
❑ Each story dimensioned otal floor area
❑ Each story floor area calculated ❑ Floor ar
Planning Review
The following standards have been met:
8'porch 15'building Setbacks vi Front:12'building Rear: 10'patio Side: 3' Min/Max Street Side: 7 / Garage: 20'
Height Max. Height: 35' Proposed Height: 28' 5 1/4"
i Yes ❑ N/A Landscape 47% cov'g
❑ Yes [:1 N/A Screening (Quad only)
21 Yes ❑ N/A % Window Coverage 19%
vYes ❑ N/A Garage (SFR Only) Parking (Other Res) Garage <50% total facade width
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:
❑ 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:
❑ Yes N/A Floor Area (per story)
❑ Yes N/A Courtyard
❑ Yes N/A Fence
El Yes ❑ No 6t'N/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
O Yes ❑ No iz1N/A Public Facilities Improvement (PFI) Permit:
Required: 0 Yes ❑ No
Applied For: ❑ Yes 0 No, stop intake
t'Sensitive Lands: ❑ Yes V No
'Main Land Use Case #s: PDR2021-00004 ❑ Conditions met
'Applicant notified of land use X • dater Submit and pay for all applicable dev permits by 1/31/2025.Final occ by 1/31/2027
Approved By Planning: � , v\ G'<,t 0 iS Date: 12/20/2023 ZIZ-7 I Z3
Notes
Revision 1: 0 A roved El Not Approved Date:
Revision 2: 0 Approved El Not Approved Date:
Building Permit Submittal
Original Submittal Date: 14 :111411,3
Site Plans #:
Building Plans #:
Building Permit #: Building permit # entered on page 1
Workflow Routing: ilPlanning "Engineering I "Permit Coordinator Building
Workflow Sign-off: 1"Sign-off for Planning (include notes from planning review)
Route Documents: 'Engineering: (1) copy of permit application, (1) site plan, (1) building plan
aryl original plan review routing form.
Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
Permit Technician: ikt('k (A., Y Date: \'L(1 ('1o1i3
Notes:
Engineering Review
❑ PFI Permit: i
[12(Slope at building pad: ,t/. oh
/09 al/Conditions met prior to issuance of permit
Lt"Easements (encroachments) per engineering conditions of approval and plat
Lf3'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 'No
Assess Water Quantity Fee in-lieu: ❑ Yes VNo
LIDA Facility on lot: ❑ Yes 1'No Add Fee: ❑ Yes 0 No
final Plat Recorded
❑ NOT Approved: Date:
Notes:
Approved By Engineering: Date: ,�Qle---y
Revision 1: 0 Approved ea,vproved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Permit Coordinator Review
�nditions met prior to permit issuance
❑ Approved, NOT Released: Date notified applicant:
❑ NG Revisions Required: Date notified applicant:
DC Exemption: 0 Applied for 0 Received ' Does not apply ,I,)
SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A �v' AJA/1"%if-
Parks '
Tigard Trans SDC: Yes ❑ N/A Deferred SDC: Yes ❑ N/A Deferred e
LIDA 0 Yes /A
/OK to Issue/Approved by Permit Coordinator: He Date: t .G2' ZCf
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date: