Permit (14) CITY OF TIGARD MASTER PERMIT
I
II
I ' COMMUNITY DEVELOPMENT Permit#: MST2023-00623
T I(;A I:I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/06/2024
Parcel: 2S 106DD03700
Jurisdiction: Tigard
Site address: 13910 SW 166TH AVE
Subdivision: RIVER TERRACE TOWN CENTER Lot: 37
Project: River Terrace Town Center, Lot 37
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: 3 First: 667 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 30 Bathrooms: 3 Second: 949 sf Garage: 390 sf Front: 12 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 1616 sf Value: $297,959.40 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: 2 Garbage Disp: 1 Water Heaters: 1 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: 5 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 1616
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: $21,354.53
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 accordan ith 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. ATT ION: , regon law re uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
ac nn _nrvin the nh(1GR 9_nn1-nno a Lain a rnnu of tha rnlac nr dinar}ni lactinnc to(ll WC by Tallinn, FM 71/91 10R7 nPpr��11(--{{Ann 111 7%14
Issued By: ��,,,, Permittee Signature: Vee, 6WPW �A.LC)h
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 Application
Residential
City of Tigard RECEIVE ceived
,� y / Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:: 60 (J cr3 r.1 17�,00��
li Plan Review J +r J
Phone: 503.718.2439 Fax: 503.598.1960 2023 Date/By: I-, i�C,/Z?j' - Other Permit: i ti 4 7.3.-n 0"t i-).
I I G,�I;I> Inspection Line: 503.639.4175 DECl� 9 Date Ready/By `I/�� /��/� �� rid ® See Page 4 for
Internet www hgard or gov 1 1� Supplemental Information
Notified/Method: orma on
CITY Of TIGARD �1 1 i A •
2 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
flagallta,. ; . y` a r z e ." , F..:: : 1, >,: `fir' �,r;, �; `t, , - work indicated on this application. 0
❑■ 1-and 2-family dwelling 0 Commercial/industrial Valuation:`!.1��
0 Accessory building ❑Multi-family Number of bedrooms: 3 I ,
El Master builder ❑Other: Number of bathrooms:
*,`�t, .y-.c,, �`'4`*t 5",?^,v"7 `:; ,l'X ID,t� 3o 4 ,.,y. ✓v - xv a,. �7�
< N ;". r v , t ,� Total number of floors: 2 (�-�.�•
`tof ... g, .... ,*z. ' P .. ..O F.: „:0 :,,::
Job site address:13910 SW 166TH AVE New dwelling area: `�( uare feet 1 t.il
City/State/ZIP:Sherwood/OR/97140 Garage/carport area: 390 square feet t/lo'7
Suite/bldg./apt.no.: Project name:River Terrace Town Center Covered porch area: 47 square feet
Cross street/directions to job site: Deck area: square feet
SWJFAN LOU ISF RD Other structure area: square feet
Subdivision:River Terrace Lot no.:37 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
l /x
,�.,.,,,,.,�.. ��a .;r ,.�r�� , y4 �, , r work indicated on this application.
Requesting Deferred SDC fees Valuation: $
Existing building area: square feet
New building area:
squar
e feet
' : € 4 t h "C, :f.; p *t 4,,,Fain
Number of stories:„ d , ; j .:r, v ,;, : :1' ).... " . ..,':�� i ' L..:;TWA
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:
e Y .:, x # M, 4wygN" { .. tlfit"""_, t ,-
Business name:TNHC OREGON LLC „F.. �_ - w
Structural plan review fee(or deposit):
Contact name:Frank Sandoval
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.co y WV)h > 'oi t x '� �i' , �r ..A.R.,,," Commercial and residential prescriptive installation of
, >.
, ' .r.-u : . -, ,.. . ;„ ' ..` 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
and administrative fees): $180.00
Phone:(503 )310-7571 Fax:( State surcharge(12%of permit fee): $21.60
CCB 1ic.:241108
Q Total fee due upon application: $201.60
Authorizedsignature: _ 0 l/I/1!/�gJ This permit application expires if a permit is not obtained
t within 180 days after it has been accepted as complete.
Print name:Frank Sandov *Fee methodology set by Tri-County Building Industry
h e. �� 202�1 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doe 01/25/2023 440-4613T(l1/02/COM/WEB)
Mechanical Permit Application FOR OH FWCE 1 si ONLY
City of Tigard D PermitNo.: (0
. " 13125 SW Hall Blvd.,Tigard,OR 97223 RECEIVE �i/
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
1`I G A R D Inspection Line: 503.639.4175 DEC19 2023 Date Ready/By: md5
Internet: www.tigard-or.gov " Y Y See Page 2 for
Notified/Method: Supplemental Information
CITY OF TIGARD
I'm O1 WO11 ILDING t3WVISI Commt# IAL *;'SCHEDUl -Us CHECKLIST
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 $
CATECCIIR% OF CONSTRUCTION
SIOP4 IAI.EQltl'IPMENT/SY TEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
40B.S1TE I} tl tATi(JIIIY Al LCAiIU. ... Heating/coaling:
Air conditioning 1 46.75
Job site address:13910 SW 166th 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:River Terrace Town Center Lot no.:37 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:2s1060003300 Water heater 23.32
' O OF WO 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
#'Rtl it'Y'#J9"I'i`,' I .''I*1 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) 5 23.32
Phone:(503)310-7571 Fax:( ) Attic/crawlspace fans 23.32
Al' C 1/41" ; tout'`ACT 1''w soi . ... 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 1
Range
E-mail:fandoval@nwhm.com Barbecue
tiiii CT0 Clothes dryer(gas)
Business name:Pro Heating and Cooling, INC Other:
Address:4200 NW Leisy rd Subtotal
City/State/ZIP:Hillsboro, OR 97124 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(CJ71)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
~/7 Z)C1A4,+L days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:3/17/2023
I.\Building\Permits\MEC_PernutApp_040113.doe 440-4617r(t 1/02/COM/WEB)
,
Electrical Permit ApplicatioRECEIVED FOR OFFICE 1 SE ONLY
' City of Tigard Received
• 13125 SW Hall Blvd.,Tigard,OR 97223 SEC 19 2023 Date/By: Permit 4: v!,'�)--h3-3 , 6,13
Q Phone: 503.718.2439 Fax: 503.598.196 Plan Review J p%�i/
Date/By: Related Permit#:
TIGARD Inspection Line: 503 639.4175 Ready DateiBy: huts
Internet. www.tigard-or.gov CITY OF TIGARD Notified/Method: See Page 2 for
Supplemental information
TYPE OF WBLLILDING DIVISION PLAN REVIEW
ib!New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
or more
0 Demolition E Other: ❑Service or feeder 400 amps P 0 Building over three stories.
where the available fault current ❑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-family 0 Masterbuilderamps for all other installations. buildings.
Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: , Job site address: 13910 SW 166th Ave O Addition of new motor toad of system.
100HP or more. ❑"A","E","I-2","I-3",
City/State/ZIP: Sherwood/OR/97140 ❑Six or MOM residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: , Project name: RTTC ❑Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal.
FEE SCHEDULE
SW Jean Louise Rd Description I Qty. I Each 1 Total 1
Subdivision: River Terrace Town Center New residential single-or multi-family dwelling unit.
Lot#:37 Includes attached garage.
Tax map/parcel#: 2s 1060003300 1'000 sq.ft.or less I 168.54 4
DESCRIPTION OF WORK Ea.add'! sq.ft.or portion 3 33.92 1
Limited energy,residential
NEW HOME CONSTRUCTION (with above sq.R) 75.00 2
Limited gy,mlti-fam
residential(with
u above sq.ft.} 75.00 2
til
PROPERTY OWNER I, t�.TENANT
Renewable Energy 0 SeePage2
Name: THNC OREGON LLC Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
Address: 15231 Laguna Canyon Rd STE 250 201 amps to 400 amps 133.56 2
City/State/ZIP: Irvine CA 92618 401 amps to 600 amps 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
Owner installation:This installation is beingmade on propertyrelocation0amps
or 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
Owner signature: Date: 401 amps to 599 amps 168.54
2
12,1 APPLICANT I 0 CONTACT PERSON A
Braee nchfor circuitsbranch alteration
h ,or extension,per panel
.F
Business name: THNC OREGON LLC above service or feeder fee,
Contact name: Frank Sandoval each branch circuit 7.42 2
B.Fee for branch circuits without
Address: 15455 NW Greenbrier Parkway#240 service or feeder fee,first
branch circuit 56.18 2
City/State/ZIP: Beaverton OR 97006 Each add']branch circuit 7_42 2
Phone:(5Q3)310 7571 Miscellaneous(service or feeder not included)
Fax::( )
Each manufactured or modular
Email: Fsandoval@newhomeco.com dwelling,service and/or feeder 67.84 2
CONTRACTOR Pump
only 67.84 2
Pump or irrigation circle 67.84 2
Business name:Development Northwest Inc., DBA Wolcott Electrical Sign or outline lighting 67.84
Address:1075 W Historic Columbia River Hwy Signal circuit(s)or limited-energy
panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP:Troutdale, OR, 97060 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(503)853-9420 ( Fax:( )
Investigation(1 hr min) 90.00/hr
Email:MWOLCOTT@WOLCOTT.PRO Industrial plant(I hr min) 78.18/hr
CCB Lic.:112220 I Electrical Lic.: Inspections for which no fee is
I Suprv.Lic.:5782S specifically listed(%hr min) 90.00/hr C 1272
Suprv.Electrician signature,required:'IT.i ELECTRICAL PERMIT FEES
ae<yonu.azsrnuRon Subtotal:
Print name:David Campbell I Date:10/12/2023 0 Plan Review Required(25%of permit fee):
/� State surcharge(12%of permit fee):
Authorized signature: �2 TOTAL PERMIT FEE:
Print name:Malachi J. Wolcott This permit application expires if a permit is not obtained within 180
Date:10/12/2023 1 days after it has been accepted as complete.
C\BuildinglPermitskELC_PermitA ` Number of inspections allowed per permit.
pp_ELR ERE.doe Rev 06/17/2015 440-46t5T(i1f05/COM/WEB
r
Plumbing Permit Application
Building Fixtures
City of Tigard RECEIVE eeeived
ate1B Permit No.: ry�`' j �,�F, �
a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Re iew ✓ J ) VV
• C Phone: 503.718.2439 Fax 503.598.196QhrC 19 2023III
pate By: Other Permit No.:
Tic, It D Inspection Line: 503.639.4175 �JJ Date Ready/By
Internet: www tigard-or.gov Notified/Method: orris: Supplemental See Page 2 for
�+pupplemental Information
TYPE OF WORE yl f T TIGARD ' FEE* SCHEDULE
la New construction 0 B+ DNG DIVISION For special information use checklist.
Description i Qty. i Ea, i Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
[2] I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 1 437.78
❑Accessory building ❑Multi-family SFR(3)bath 50032
0 Master builder Each additional bath/kitchen 25.02
❑Other: Fire sprinkler( sq.ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13910 SW 166th 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 11:�) 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 I Lot no.: 37 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
►, PROPERTY OWNER I ' 0 TENANT Expansion tank 12.51
Name: TNHC OREGON LLC Fixture/sewercap 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 CS1 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
CONTRACT 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
CCB Lie,: 4 g26824 PB Plan review (25%of permit fee)
112220 Plumbin Lie-no.:
' State surcharge(12%of permit fee)
Authorized signature: -�1 A (20
TOTAL PERMIT FEE
Print name:Mark Baleme �T" 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.tHullding'Permirs\PLMO•PermitApp_doc 10/01/09 440-4616T(I 0/02/COM/WEB)
City of Tigard
ill 2t'" COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
T I GAR D
Building Permit #: 0`5j,}-`3--abe„ -,3
Site Address: 13910 SW 166th Avenue 7 Verified in Accela
Project Name: River Terrace Town Center Lot/Unit #: 37
Proposal: New Single Detached SFR Zone: RES-C / C-C
Housing Type: 1 SFR(P'Single Detached ❑ Duplex❑Triplex❑ADU)0 Rowhouse❑Cottage Cluster 0 CYU ❑Quad ❑Other
Required Site Plan Elements:
'3 copies of site plan on max 11x17"
ii(Drawn to standard scale ❑ Retained bees, diiN Bile/ Li cc piUleLlion
izi North arrow EZ Street and site trees shown / labeled
f Site address, project name, lot # t cc canopy at maturity
'Street names (N/A for SFR)
'Applicant name and phone # plicable)
'Lot and setback dimensions 121 Vision clearance triangle
0 Existing structures & quaie luoluye VUtility locations &easements
i2f Footprint of new structure and FFE tzf Property corner elevations
IX Sidewalk/driveway dimensioned ❑ LIDA (>1,000 sf disturbance)
kf Lot area and lot coverage percentage 6'Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
VDrawn to standard scale 'Total façade area
(Building height dimensioned VTotal window and door area
'Façade dimensioned
'Windows and doors dimensioned
Vf 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 0 Floor ar
Planning Review
The following tandards have been met:
8'porch
Setbacks Fr�t:12'building Rear: 3'alley Side: 3' Min/Max Street Side: 7' / Garage: 3' alley
Height E 'Max. Height: 35' Proposed Height: 29'-6 5/8"
❑ Yes It N/A Landscape
❑ Yes $ N/A Screening (Quad only)
V1 Yes ❑ N/A % Window Coverage
I 'Yes ❑ N/A Garage (SFR Only) Parking (Other Res)
I 'Yes 0 N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes N/A Other building design standards (Rowhouse only)
O 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:
❑ YesI
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
O Yes N/A Fence
❑ Yes ❑ No 'N/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
❑ Yes ❑ No iZIN/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes ❑ No
Applied For: ❑ Yes ❑ No, stop intake
❑ Sensitive Lands: I Yes ❑ No
'Main Land Use Case #s: PDR2021-00004, ❑ Conditions met
❑Applicant notified of land use expiratio e: Submit and pay for all applicable dev permits by 1/31/2025.Final occ by 1/31/2027
Approved By Planning: i n n Date: 11/9/23 IZ-(!t(z�
Notes
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Building Permit Submittal
Original Submittal Date: '. (i ill i 2
Site Plans #:
Building Plans #: /
Building Permit #: 1/Building perjnit # entered on page 1
Workflow Routing: Ni/Planning llEngineering 0 Permit Coordinator 0 Building
Workflow Sign-off: IliatiSign-off for Planning (include notes from planning review)
Route Documents: ® Engineering: (1) copy of permit application, (1) site plan, (1) building plan
ar)d original plan review routing form.
g U! Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
n
Permit Technician:' � vvvVki Date: 1/0 t /1/6' -5
Notes:
Engineering Review
❑ PFI Permit:
'Slope at building pad: 34
'Conditions met prior to issuance of permit
VEasements (encroachments) per engineering conditions of approval and plat
V'Water Quality/Quantity Facility: �
Assess Water Quality Fee in-lieu: ❑ Yes Itt No
Assess Water Quantity Fee in-lieu: ❑ Yes CVNo
� LIDA Facility on lot: ❑ Yes 1No Add Fee: ❑ Yes 0 No
l 19nal Plat Recorded
❑ NOT Approved: Date:
Notes:
Approved By Engineering: -/ Date: /2/2
Revision 1: ❑ Approved ❑ t Approved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Permit Coordinator Review
f 'bnditions met prior to permit issuance
❑ Approved, NOT Released: Date notified applicant:
❑ ENG Revisions Required: Date notified applicant:
elLI'SDC Exemption: ❑ Applied for 0 Received C/Does not apply 0f.,/;)41. 7�
SDC Fees Entered: Wash Co Trans Dev Tax: tI Yes ❑ N/A /2�� "N/�
Tigard Trans SDC: /Yes 0 N/A 0 Deferred 0,
Parks SDC: /2'Cfes ❑ N/A 0 Deferred
LIDA ❑ Yes (0'N/A I (
zeOK to Issue/Approved by Permit Coordinator: 4e Date:
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
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II
_ Building Division
One & Two-Family Dwelling
TIGARD
Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION --S.)L-C 2-07---
Permit #: m` T2,(YZ3_ LeZ3 Plan #: 2jt t DD Floors: 2
Valuation: Covered Porch: Basement
441
Bedrooms: .3 Deck: - 1" Floor / 7
WC (toilets) Deck Cover: 2''d Floor
1.�`{
Lavatories Patioa `�
Cover 3 Floor
Tub/shower /2.-- Accessory Struct. R-3 Total ( IP f(Y
Laundry Tray Water Heater A / Gas(�Llec'')-- Garage 39
Exhaust Vents Gas Flue Vents , __ Total for Elec.
c.°
Backflow Prey. 441:0/ Heat Pump # for Electrical
BBQ Gas Fireplace 3
-)IS
Lines 3
FEES: Description: Fee Appli : Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg$2.00 (over 11x17) a `7
Info Proc/Arch: Sm $.50 (up to 11x17) Y
Metro CET: Residential Use
School CET: District: \t
Tigard CET: Admin
Tigard CET: ODHCS
Tigard CET: AH
Electrical Permit: Permit Fee:
Limited Energy:
12°l0 State Surcharge
Mech. Permit: Permit Fee:
12% State Surcharge
Plumbing Permit: Permit Fee:
12% State Surcharge
Erosion Control: w/Permit - Ping /
1:A Building\Forms\KesPlanCheckFees_Dec2022_AA.doc 12/21/22
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