05-May (10) MASTER PERMIT
q CITY OF TIGARD
COMMUNITY DEVELOPMENT1111
Permit#: MST2023-00216
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/01/2023
Parcel: 2S1060003300
Jurisdiction: Tigard
Site address: 13680 SW 166TH AVE
Subdivision: RIVER TERRACE TOWN CENTER Lot:
Project: River Terrace Town Center, Lot 94
Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN
PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 774 sf Basement: 0
Height: 29 sf Left: 3 Parking Spaces: 0
g Bathrooms: 3 Second: 1184 sf Garage: 502 sf Front: 12
Smoke
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes
Total: 1958 sf Value: $325,739.32 Rear: 3
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
FootingDrain: 0 Ice Maker: 1 Bckflw Prevntr: 0
Hose Bib: 2 Backwater Value: 1
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 1958
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 2 1-HR Fire Rated Eaves
15231 LAGUNA CANYON RD STE IRVINE,CA 92618
250
PHONE: PHONE: 503-312-6213
FAX:
Total Fees: $21,695.87
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
QS9_nrN_min Ihrnn (1AP oc9_nni_MQn Vn Mein s nnnu of fho n loc or rliront nnocfione fn Ill INC by nallinn RITI 919 1QA7 or 1 Ann 117 Tidd r
Issued By: . `��' / -- Permittee Signature: 4�'t o�p �c l'ck �t�i7
Call 503.63 175 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 RECEIVED FOR OFFICE USE ONLY
Received City of Tigard Date/By: ' Pe �a3 _,� -tY
Ilhil • 13125 SW Ilall Blvd.,Tigard,OR 97223 IA AY 8 2023 y C. gar Plan Review vie /�11i xszstaxa _Q0 it-3/
Phone: 503.718.2439 Fax: 503.598.1960 Date/By I �/ /�fJ W
T I t:a R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: / r Jens: ® See Page 4 for
Internet: www.tigard-ocgov BUILDING DIVISION Notified/Method: 101 3/23 Ac t t,Q Supplemental Information
e/P
TYPE OF WORK RREEQKUIIR/ED+C/DATA:✓1--'AGND 2-FAMILY DWELLING
❑' New construction 0 Demolition Permit fees*arc based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ 2jrj 159
❑� I-and 2-family dwelling D Commercial/industrial J
•
❑Accessory building 0 Multi-family Number of bedrooms: 4
❑ Master builder ❑Other: Number of bathrooms: „..2.Ff*3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 li{(20
Job site address:13680 SW 166th ave New dwelling area: 1958 square feet ' I
City/State/ZIP:Sherwood/OR/97140 Garage/carport area: 502 square feet -71
Suite/bldg./apt.no.: Project name:River Terrace Town Center Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
4W jean Louise rd Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:River Terrace Lot no.:94 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.:parcel no: 2S1060003300 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Requesting Deferred SDC fees
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Namc: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:
I l APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:TNHC OREGON LLC
Structural plan review fee(or deposit):
Contact name: Sandoval
Frank Sa d
FLS plan review fee(if applicable):
Address:15455 NW Greenbrier Parkway Suite 240
Total fees due upon application:
City/State/ZIP:Beaverton/OR/97006
Amount received:
Phone:(503) 310-7571 Fax :( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: fsandoval@nwhm.com
Commercial and residential prescriptive installation of
CONTRACTOR 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 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:241108 Total fee due upon application: $201.60
Authorized signature: / This permit application expires if a permit is not obtained
!� within 180 days after it has been accepted as complete.
Print name:Frank Sandoval Date:3120170'f3 'Mae *Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Permits 1BUP-RESPermitApp.doc 01/25/2023 440-4613T(I I/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
Cityof Tigard . Received Pen it4 }CI'�, --('�
g iECEIV Received /_ ✓T
q 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
3 Phone: 503-718.2439 Fax: 503.598.1960 A� Date/By: Other Permit:
Inspection Line: 503-639 4175 MAY 8ry11 i�)7 Date Ready/By: Jam: la See Page 2 for
TIGARU Internet: www.tigard-or.gov GULJ Notified/Method: Supplemental Information
CITY OF TIGARD COMMERCIAL FEE* SCHEDULE—USE CHECKLIST
TYPE OF wwfwiNGD V! ION Mechanical permit fees*are based on the value of the work 1
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist.
❑ Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total
JOB STTE INFORMATION AND LOCATION Heating cooling:
Air conditioning 1 46.75
Job site address:1 3680 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
Other: 23.32
Subdivision:River Terrace Town Center Lot no.:94
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
Other: 23.32
® PROPERTY OWNER 0 TENANT Environmental exhaust and ventilation:
Name:TNHC OREGON LLC Range hood/other kitchen 1
equipment 33.39
Address:15231 Laguna Canyon Rd STE 250 Clothes dryer exhaust 33.39
City/State/ZIP:Irvine CA 92618 Single-duct exhaust(bathrooms,
Y toilet compartments,utility rooms) 23.32
Phone:(503)31 0-7571 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name.TN HC OREGON LLC $14.15 for first four;S4.03 for each additional
Contact name:Frank Sandoval Furnace,etc.
Gas heat pump
Address:15455 NW Greenbrier Parkway#240 Walususpended/unitheater
City/State/ZIP:Beaverton OR 97006 Water heater
Phone:(503)310-7571 Fax: :( ) Fireplace
Range
E-mail:fandoval@nwhm.eom Barbecue
CONTRACTOR Clothes dryer(gas)
Other.
Business name:Pro Heating and Cooling, INC MECHANICALPERMITFEES*
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: PUAZZ- - ' Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:3/17/2023
11Buildinglermits\MEC_PernutApp 040113.doc 440-46171'(11/02/COMIWEB)
•
RECEIVED
Electrical Permit Application MAY 0 d 2023
FOR OFFICE USE ONLY
ty 0/Tigard CITY OF TIGARD "a Pew t�:
13125 SW Hell Blvd.,Tigard,OR �t DING DIVISION Plan Review
MST 2fa2.3 002t to
Phone:Ci 503.7182439 Fax: 503.5 8. Dg By. Related Permit ll:
Inspection Line: 503.639.4175 Ready Date/By: - taro: I 0 See Pace 2 for
Internet: www.tigard-or gov Notified/Method: Supplemental Information
TYPE OF WORK
PLAN REVIEW
El New construction ❑Addition/alteration/replacement Please check all that apply(submit j sets of plaza w/iterm checked)!
0 Service or feeder 400 amps or more in Budding over three stories.
El Demolition El Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
El I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,orexceeds 14,000 ❑Commercial-use agricultural
El Multi-family 0 Master builder amps for all other installations. buildings.
❑Other: ❑Fire pump. 0 Installation of ISO KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system larger separately derived
Job#: Job site address: 13680 SW 165th ave ❑Addition of new motor load of system.
100HP or more. ❑"A'"E""J-2""IJ"
City/State/ZIP: Sherwood/OR/97140 0 six o more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldgJapt.#: Project name: RTTC 0 Hazardous locations. 0 Supply voltage far more than
❑service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
SW Jean Louise rd Description I o r. I Each a I Tara i
New residential single-or multi-family dwelling unit.
Subdivision: River Terrace Town Center Lot#:94 includes attached garage.
Tax map/parcel#: 2s1060003300 1,000 sq.R.or less 168.54 4
Ea.add'l 500 sq.ft or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
NEW HOME CONSTRUCTION (with above so.ft) 75.00 2
Limited energy,multi-family 75,00 2
residential(with above sq.ft)
IR PROPERTY OWNER ID 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 250 203 amps m4W amps 33.56 2
City/State/ZIP: Irvine CA 92618 40l amps
to600amps
20034 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
Eil
APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: THNC OREGON LLC above service or feeder fee,
each branch circuit 7.42 2
Contact name: Frank Sandoval B.Fee for branch circuits wirho d
serviAddress: 15455 NW Greenbrier Parkway#240 branch circuit
fee,first 56.18 2
City/State/ZIP: Beaverton OR 97006 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)310-7571 Fes;;( )
Each manufactured or modular 67.84 2
Email: Fsandoval@newhomeco.com dwelling service and or feeder
CONTRACTOR Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
Business name:Development Northwest Inc., DBA Wolcott Electrical Sign or outhne lighting 67.84 2
Address:1075 W Historic Columbia River Hwy pinellei )°rfixeesion. 0 See Page 2 2
panel,alteration,or extension.
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(1 hr min) 78.18/br
Inspections for which no fee is 90.00/hr
CCB Lie.:112220 Electrical Lie.:C1272 Suprv.Lie.:5782E specifically listed(%,hr min)
Suprv.Electrician signature,required ELECTRICAL PERMIT FEES
,°.„='a„`e'°" Subtotal:
Print name:David Campbell Date:1 0/12/2023 0 Plan Review Required(25%of permit fee):
/l
State surcharge(12%of permit fee):
2
Authorized signature: 41..a, TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained witbin 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:tBaiidingl'ermifs\ELC_PermitApp tLR ERE.do<Rev 06/17/2015 440-4615TO11 AM/CON/.EH
Plumbing Permit ApplicatiJECEIVED
Building Fixtures MAY 0 ti 2023 FOR OFFICE USE (Nix
City of Tigard Received
oate/BY: Permit No.: MST2.D23-OO21fo
13125 SW Hall Blvd.,Tigard,OR 9722e Ty OF TIGARD plan Review
B Phone: 503.718.2439 Fax: 503.59 Date/BY: Other Permit No.:
Inspection Line: 503.639.4175 �tl�ft-DING DIVISION
T 1 i 7 11, Date Ready/By: heir H See Page 2 for
Internet: W1Vw.ligard-Dr.goV
Notified/blethod: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction 0 Demolition For special in formadon use checklist
Description 1 Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes IOD ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(l)bath 312.70
® I-and 2-famil y dwellin SFR(2)bath 1 437.78
g ❑Commercial/industrial
❑Accessory building 0 Multi-family SFR(3)bath 500.32
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: 13680 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 ft.: ) Page2
Suite/bldg./apt.no.: Project name: RTTC Manufactured home utilities 50.03
Cross street/directions to job site: SW Jean Louise rd Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(na linear ft.:.___) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: River Terrace Town Center I Lot no.: 94 Fixture or item:
Tax map/parcel no.: 2s1060003300 Backllowpreventer 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
al PROPERTY.OWNER 0 TENANT Expansion tank 12.51
Name; TNHC OREGON LLC Fixture/sewer cap 25.02
Address: 15231 Laguna Canyon Rd STE 250 Floor drain/ftaorsinkPoub 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
IN APPLICANT ($I CONTACT PERSON Interceptor/grease trap 25.02
Business name: THNC OREGON LLC Medical gas(value:$_) Paget
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
CONTRACTOR Water closet 25.02 •
Water heater 37.52
Business name:Wolcott Plumbing Water PiP g1 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: S7250
g 26824 PB Plan review(25%of permit fee)
CCB Lie.:112220�- Plumbing Lie.no.:
JtVA��}- \\ State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Mark Baleme Date:10/12/2023 This permit eppliealiun expired if a permit is not obtained within 180 days
after it has been accepted as complete.
°Fee methodology sot by Tri-County Building Industry Service Board. •
t/Budding\Permita\PL.MU-PeroutApp.dor 10/01/09 440-4616Tt IW02/COMAVGBl
City of Tigard
IN
_ " COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
a
Building Permit #: .4�7( o 2- ' 00 e?-6‘9
Site Address: 13680 SW 166th Ave v Verified in Accela
Project Name: River Terrace Town Center Lot/Unit #: 94
Proposal: New Single Detached SFR Zone: RES-C
Housing Type: V SFR(E'Single Detached ❑ Duplex❑Triplex❑ADU)❑ Rowhouse❑Cottage Cluster❑CYU :Quad❑Other
Required Site Plan Elements:
11 3 copies of site plan on max 11x17"
El Drawn to standard scale ❑ Retail led LICCS, Jiip line/ tree-c1rcrte,ton
North arrow V Street and site trees shown / labeled
21 Site address, project name, lot # ❑ Table calculating trcc canopy at maturity
Ef Street names (N/A for SFR)
2Applicant name and phone # ❑ Courtyard rcctonglc dimensioned (if applicable)
'Lot and setback dimensions l7(Vision clearance triangle
0 Cddsti.,g stI ui.tul as &squat a fuotago 21 Utility locations &easements
V Footprint of new structure and FFE 21 Property corner elevations
V Sidewalk/driveway dimensioned VLIDA (>1,000 sf disturbance)
21 Lot area and lot coverage percentage 6'Erosion control
Required Elevation Plan Elements:
(For SFR: caics needed only on street-facing) Summary table with calculations for:
VDrawn to standard scale 'Total facade area
21 Building height dimensioned VTotal window and door area
21 Façade dimensioned
V Windows and doors dimensioned
2 Garage doors dimensioned
Requl n Elements:
(Not required for SFR ❑ Summary table that includes
❑ Each story dimensioned tal floor area
❑ Each story floor area calculated ❑ Floor ar
Planning Review
The following standards have been met:
/ 8'porch 3' alley
Height liMax. Height: 35' Proposed Height: 29'-3/8"
'I Yes ❑ N/A Landscape
❑ Yes 41 N/A Screening (Quad only)
21 Yes ❑ N/A % Window Coverage
E1Yes ❑ N/A Garage (SFR Only) Parking (Other Res)
21Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
O Yes J N/A Other building design standards (Rowhouse only)
❑ Yes N/A Accessory Structure Standards
0 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
O Yes N/A Fence
•
4,
❑ Yes ❑ No 6'N/A Clean Water Services - Service Provider Letter(lot platted prior to 9/10/1995)
O Yes 0 No'IN/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes ❑ No
Applied For: ❑,. Yes 0 No, stop intake
❑ Sensitive Lands: t,,t Yes 0 No
'Main Land Use Case #s: PDR2021-00004 CI Conditions met
❑Applicant notified of land use expiratio 4�e: Submit and pay fforr alll ap I'cable dev permits by 1/31/2025.Final occ by 1/31/2027
Approved By Planning: li°�T�c.- Date: 5/4/23 S �1 -3
b ,
Notes Permit can be issued prior to fin I at approvallbut not p jor to conditions being met on PDR
Revision 1: 0 Approved ❑ Not Approved Date:
Revision 2: 0 Approved CI Not Approved Date:
' Building Permit Submittal
l) Original Submittal Date: S/ 17( 3-T
4 Site Plans #:
Building Plans #:
$.), _
Building Permit #: V Building permit # entered on page 1
Workflow Routing: X Planning I, Engineering rk Permit Coordinator It Building
Workflow Sign-off: 1Q Sign-off for Planning (include notes from planning review)
��d.oA.� Route Documents: $j Engineering: (1) copy of permit application, (1) site plan, (1) building plan
and original plan review routing form.
I$Building: original permit application, site plans, building plans, engineer and
i beam calculations and trust details, if applicable, etc. / !!
Permit Technician: .'' Date: C7/17 I -'
Notes:
Engineering Review
Q El Engineering
Permit:
V Slope at building pad: -3$ ok
❑ onditions met prior to issuance of permit
ss' •,
h ❑ asements (encroachments) per engineering conditions of approval and plat
O ater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes t'No
Assess Water Quantity Fee in-lieu: ❑ Yes 1No
4 LIDA Facility on lot: ❑ Yes FrNo Add Fee: 0 Yes El No
CY
❑ Final Plat Recorded
O NOT Approved: Date:
Notes:
Approved By Engineering: Date: /p-/Z..S
\I Revision 1: ❑ Approved of Approved Date: `` (l
Revision 2: 0 Approved ❑ Not Approved Date:
P mit Coordinator Review
onditions met prior to permit issuance ^^
c'hpproved, NOT Released: AZ- Date notified applicant:(/IV J t 003
❑ ENG Revisions Required: Date notified applicant:
4'SDC Exemption: ❑ Applied for ❑ Received /Does not apply
ZSDC Fees Entered: Wash Co Trans Dev Tax: [ 'Yes El N/A
Tigard Trans SDC: Yes ❑ N/A ❑ Deferred
Parks SDC: /le Yes ❑ N/A ❑ Deferred
LIDA ❑ Yes /N/A rr,,
OK to Issue/Approved by Permit Coordinator: Date: I O \1.)
.73
Revision 1: ❑ Approved 0 Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
City of Tigard
Deferral Until Occupancy Request
T I G A RD Washington County Transportation Development Tax (TDT),Transportation and Parks System
* Development Charges (SDCs)
This form is to be signed and submitted prior building permit issuance or,if no building permit is required,then
upon land use approval (TMC 3.24,as amended by Ordinance No.21-09).
Date: 5/23/2023 Site Address: 13680 SW 166th
Project River Terrace Town Center Land Use Case or
Name: Building Permit#: MST2023-00216
Tax Lot Lot 94 Total Parks $11,830.00
#: Amount*:
TDT Total TSDC
Amount: N/A Amount*: $12,004.00
*The total TSDC amo nt shown above is the sum of$ 7,760.00 for TSDC-Improvement,$ 448.00 for TSDC-
Reimbursement,and S 00 for TSDC-River Terrace,if applicable..
S,-19 6.00 Af
*The total Parks SDC amount shown above is the sum of$ 6,812.00 for Parks-Improvement,$ 1,887.00 for Parks-
Reimbursement,and either S N/A for Parks-Neighborhood or$ 3,131.00 for Parks-Neighborhood River Terrace.
This constitutes my request to defer payment of the TDT,TSDC, and Parks SDCs, as provided above,
until occupancy.
Payment of the TDT,TSDC, and Parks SDCs may be deferred until issuance of the occupancy permit. In
requesting this option, I understand that any deferred TDT,TSDC, and Parks SDCs must be paid prior to final
inspection or issuance of an occupancy permit.
TDT may only be deferred if the TDT is greater than the amount for a single-family residence. I further
understand that the amount of TDT due on deferred obligations shall be the amount in effect at the time of
issuance of the building permit.
For a deferral request to be accepted both the Property Owner and the Developer must sign this request.
Property Owne Date: S-3O' e9:3
Developer: ice �' Date:
5/23/2023
Permit Coordinator: Date:
p-c..c.'17-f.a.c....L....:<-0:2 A 1
III q Building Division
One & Two-Family Dwelling
T I GA RD Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION dU( cl-ba.-~
Permit #: vM,S�207-3—0021 ( D Plan #: Z(e J)(j)Floors: `-
Valuation: 11,325 -1- 32_Covered Porch: Basement
Bedrooms: Li Deck: --, 1s`Floor /-7(4
WC (toilets) Deck Cover: ----- 2°d Floor
Lavatories 5 Patio Cover ---- • 3`d Floor
Tub/shower '.-.) Accessory Struct. R-3 Total I 1 S—g
Laundry Tray Water Heater ` / Gas / lec Garage .D a
Exhaust Vents S Gas Flue Vents �� Total for Elec. 2 0
Backflow Prey. -_ Heat Pump /CAZ ) # for Electrical
BBQ Gas Fireplace '-e-'v #Fuel Lines S
FEES: Description: Fee Applies: Fee Entered:
DC Prov Revw: Planning v
Info Proc/Arch: Lg$2.00 (over 11x17) D 6'
Info Proc/Arch: Sm$.50 (up to 11x17) G tc
Metro CET: " Residenti L11se f
School CET: District: ` t�
�
Tigard CET: Admin
Tigard CET: ODHCS 1-------
Tigard CET: AH 1----"---
Electrical Permit: Permit Fee:
Limited Energy:
12% State Surcharge
Mech. Permit: Permit Fee: t-------
12% State Surcharge 1/---
Plumbing Permit: Permit Fee: ti�
12% State Surcharge
1---
Erosion Control: w/Permit-Ping L------'
Notes:
I:\Building\Forms\ResPlanCheckFees_Dec2022_SA.doc 12/21/22
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