10-October (10) CITY OF TIGARD MASTER PERMIT
' 1 2 ' COMMUNITY DEVELOPMENT Permit#: MST2023-00526
Date Issued: 11/07/2023
I[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel 2S1060003300
Jurisdiction: Tigard
Site address: 13781 SW 166TH AVE
Subdivision: RIVER TERRACE TOWN CENTER Lot:
Project: River Terrace Town Center, Lot 134
Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN
PAID.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 657 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 940 sf Garage: 390 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 1597 sf Value: $294,779.37 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
Bckflw Prevntr: 0
Footing Drain; 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 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>=10OK: 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!500 sf: 2 201-400 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
System: N Garage Opener: N All Y
N Vaccuum S
Audio&Stereo: N HVAC: N Security Alarm: 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 1597
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: $21,214.82
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
1
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
oc9-nfN-rw11n fhrni inh 4R oc ..on -nnon Vni hfoin o rnnv of thn ri line nr riirerl ni iocfinnc to Cll INr:h,ro iIinn crrA 719 10A7 nr 1 Ann 149 97dd
Issued By: Permittee Signature: d ee G,)� '; c .l"01.1
Call 503.63�4175 by 7:00 a.m.for the next available Inspection date. V
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 lob site at the time of each inspection.
• Building Permit Application
, a-i �0 '�Residential F
FOR OFFICE USE ONLY
City of Tigard �U t Received �
I + 2�23 Date/B- I I, Permit Na: i 00
4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review i
Phone: 503.7182439 Fax: 503.598.1960 ��*� OtherPermit,S 3+00'34
Inspection Line: 503.639.4175 / OF TIGARII Dace/Ba. (,
TI GARD P CIIY to Ready/By: See Page 4 for
Internet: www.tigard-or.gov BUILDING DIVISI(�Ntified/Merhod: I '31 'Z3 tit Supplemental Information
�"tid-cRa� rJ-II.A�Ys.IC.
T1'PF. OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
l 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�profitf for the
CATEGORY OF CONSTRUCTION work indicated on this application. ((I-1^19 t3�
■ 1-and 2-familydwellingValuation: $ 0 1 1
❑ ❑Commercial industrial
El Accessory building El Multi-familyNumber of bedrooms 3
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 I I el
Job site address:13781 SW 166th ave New dwelling area: square feet 94 d
City/State/ZIP:Sherwood/OR/97140 Garage/carport area: 390 square feet teS-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
SW Jean Louise rd Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:River Terrace l.ot no.:134 Permit fees*arc 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 WORK work indicated on this application.
Valuation: $
RPquestinj Deferred SDC fetes
Existing building area: square feet
Ncw building area: square feet
if PROPERTY OWNER 0 TENANT Number of stories:
Name:TNHC OREGON LLC Type of construction:
Address:15231 Laguna Canyon RD STE 250 Occupancy groups:
City/State/ZIP:Irvine/CAI 92618 Existing: .r....
Phone:(503)310-7571 Fax:( ) New:
A APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:TNHC OREGON LLC (Please refer eofeeseheWte) '1�
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: fandova@nwhm.cOm PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
•
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name:TNHC OREGON LLC Submit two(2)sets of roofplan with connection details
Address:15231 LagunaCanyon RD STE 250 and fire department access,along with the 2010 Oregon
g y Solar Installation Specialty Code checklist.
City/State/ZIP:Irvine/CA/92618 Permit Fee(ncludes plan review $180.00
and administrative fees):
Phone:(503 )310-7571 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Iic.:241108
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Frank Sandoval Date:10/10/2023 *Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits 1BUP-RESPermitApp.doe 01/25/2023 440-4613T(I 1/02/COM/WEB)
Mechanical Permit Applicatid�"EIVED FOR OFFICE USE ONI.Y
City of Tigard OCT 1 0 2023 Received
,� • Date/By: Permit No.:m5T 023—O�S2(p
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review G
I Phone: 503.718.2439 Fax: 503.598.19 Other Permit:
Inspection Line: 503.639417s °ITY OF TIGARD nam/By.
rill A FD g g BUILDING DIVISION Date Ready/By: how ® See Page 2 for
Internet: www.ti and-or. ov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special isifornmtion use checklist.
❑Multi-family ❑ Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1 46.75
Job site address:13781 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 2332
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.: 134
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
® PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:TNHC OREGON LLC Range hood/other kitchen
Address:15231 Laguna Canyon Rd STE 250 Clotheess dry
1 33.39
Cler exhaust 33.39
City/State/ZIP:Irvine CA 92618 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503 310-757 1 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:TNHC OREGON LLC Fuel piping:
S14.15 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:fsandoval@nwhm.com Barbecue
CONTRACTOR Clothes dryer(gas) I
Business name:Pro Heating and Cooling, INC Other.
MECHANICAL PERMIT FEES*
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 ISO
/�p�y� %7 days after it has been accepted as complete.
Authorized signature: ""�`' *�u '4t- • Fee methodology set by Tri-County Building Industry Service Board
Print name:Elia Duran Date:3/17/2023
11Building\Pernrn'.,MEC PemutApp_040113.doc 440-4617T(I I/02/COM/WEB)
Electrical Permit Applica C E IVE D FOR OFFICE USE ONLY
City Tigard Received Wilk 1 S.OOS I�
13125 SW Hall Blvd.,Tigard,OR 97�T 10 2023 Plan Review
Permit p
■ Phone: 503.718.2439 Fax: 503.598.19fi0 Plan Rev
Date/By: Related Permit 4:
I G n F D Inspection Line: 503.639.4175 Ready Date/By: Innis: I et See Page 2 for •
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method:
a t. j iNG DIVISION Supplemental Information
TYPE PLAN REVIEW •
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition Other: 0 Service or feeder 400 amps or more 0 Building over three stones.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
I I-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings
El Multi-family 0 Master builder
0 Other: 0 Fire pump_ 0 Installation of 150 KV.A or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately denved
Job#: Job siteaddress:13781 SW 166th ave 0 Addition of new motor load of system.
I00HP or more. ❑"A""E"
❑Six or more
City/State/ZIP: Sherwood/OR/97140
units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apL#: I 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 Oh. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: River Terrace Town Center I Lot#:1 34 Includes attached garage.
Tax map/parcel#: 2s1060003300 I,000sq.ft.or less 168.54 4
Fa
DESCRIPTION OF,WORK add'I 500 sq.ft.or portion 33.92 1
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
Da PROPERTY OWNER 0 TENANT Renewable Energy El 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 zol amps to lino 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 , 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
Branch circuits-new,alteration,or extension,per panel
al APPLICANT j ❑ CONTACT PERSON
THNC OREGON LLC A.Fee for branch circuits with
Business name: above service or feeder fee,
each branch circuit 7.42 2
Contact name: Frank Sandoval B.Fee forbrastch circuits without
Address: 15455 NW Greenbrier Parkway#240 branch
circuit
brfeederfee first 5618 2
branch
City/State/ZIP: Beaverton OR 97006 Each add'I branch circuit 7.42 2
Phone: 503 310 7571Miscellaneous(service or feeder not included)
( ) I Fax::( ) Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
Fsandoval@newhomeco.com
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84
2
Business name:Development Northwest Inc., DBA Wolcott Electrical Sign or outline lighting 67.84 2
SAddress:1075 W Historic Columbia River Hwy panel, lterat(s)orlextensionergy 0 See Paget 2
-cruel,alteration,or extension.
City/State/ZIP Troutdale, OR, 97060 Each additional inspection over allowable in any of the above
Phone:(503)853-9420 I Fax:( ) Additional inspection(1 hr min) 66.25/hr
• Investigation(1 hr min) 90.00/hr
Email:M WOLCOTT@WOLCOTT.PRO Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.:112220 I Electrical Lie.:C 1272 I Suprv.Lie.:5782S specifically listed('/hr min) 90.00i hr
Suprv.Electrician signature,required: D ELECTRICAL PERMIT FEES
o.:4omro..i;m n.xnwrro., Subtotal:
Print name:David Campbell Date:10/12/2023 ❑Plan Review Required(25%of permit fee):
�f. n State surcharge(12%of permit fee):
Authorized signature: 4%W i TOTAL PERMIT FEE:
Print name: This permit application expires if a permit is not obtained within 180
Malachi J. Wolcott Date:10/12/2023 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\9oildiaglPermits1ELC PemiitApp_ELR ERE.doc Rev 06/17/2015 440-4615T(I I/05/COMIWEB
Plumbing Permit Application
Building Fixtures RECEIVE ' rOR OFFIt l: tsE o:NI,Y
� City of Tigard Received
n 13125 SW Hall Blvd.,Tigard,OR 97223 O C T 0 2023 Platdt3y: Permit No.: t iillai • hA no
C , Phone: 503.718.2439 Fax: 503.598.1960 Plan Review w" UU �`v
.fi GAR D Inspection Line: 503.639.4175 •
Date/By: Other Permit No.:
Internet: wsa-w tigard-or CITY fOF TIGARD Dnle yc lwis: I ®See Page Zfor
r�l IILBIIVLI DIVISION.NotifiedRcad/Meth/B)od: Supplemental Information
TYPE OF WO FEE* SCHEDULE
I171. New construction 0 Demolition For special information use checklist
❑Addition/alteration/replacement tacemelt! Description I Qty. I Ea. I Total
P ❑Other New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
® I-and 2-faintly dwelling ❑Commercial/industrial SFR(2)bath 1 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
--- Each additional bath/kitchen 25.02❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
SOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13781 SW 166th Ave Catch basin or area drain I I 18.76
City/State/ZIP: Sherwood/OR/97140 Drywall,leach line,or trench drain 18.76
Suite/bldg./apt.no.: I Project name: RTTC Footing drain(no.linear ft.: ) Page 2
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.:
134 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
12) 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
City/State/ZIP: Irvine CA 92618 Garbage disposal 25.02
Hose bib 25.02
Phone:(503)310-7571 I Fax:( 1 Ice maker
12.51
t$I APPLICANT MI CONTACT PERSON Interceptor/grease trap 25.02
Business name: THNC OREGON LLC Medical gas(value:$_) Page2
Contact name: Frank Sandoval Primer 1251
Address: Roof drain(commercial) 12.51
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 piping/DWV 56.29
Address:1075 West Historic Columbia River Hwy Other:
25.02
City/Stale/ZIP:Troutdale OR. 97060 Subtotal
Phone:( 503-667-1781 Fax:( ) Minimum permit fee: $72.50
CCR hie.:112220 Plumbing no.: Plan review (25%ofpermit fee)
26824 PB
Authorized signature:4 1\ '[� State surcharge(12%of permit fee)
``I`�G�C77`"" ���...111 TOTAL PERMIT FEE
Print name:Mark Baleme I Date:10/12/2023 This permit application expires if a permit is not obtained within ISO days
after it has been accepted as complete.
Fee methodology set by Tri-County Building Industry Service Board.
intuildingNeemils1pLMII PermitApp.der 10/01/09 4/0-t616T(INOLCOMAv6B)
City of Tigard
111 ° COMMUNITY DEVELOPMENT DEPARTMENT
sa
Building Permit Review - Residential
TIGARD
Building Permit #: MSC2-01,1 - 06 S2So
Site Address: 13781 SW 166th Ave 0 Verified in Accela
Project Name: RT Town Center Lot/unit #: 134
Proposal: New detached SFR Zone: C-C
Housing Type: 0 SFR(0 Single Detached ❑ Duplex 0 Triplex❑ADU)❑ Rowhouse❑Cottage Cluster❑ CYU ❑Quad❑Other
Required Site Plan Elements:
0 3 copies of site plan on max 11x17"
O Drawn to standard scale ❑ RclaiiicJ L.cc� J N I... / L IJIVlection
O North arrow 0 Street and site trees shown / labeled
O Site address, project name, lot # turity
O Street names (N/A for SFR)
0 Applicant name and phone # ❑ Courtyard rectangle dimcnsioncd (if applicable)
O Lot and setback dimensions
❑ L..I.=J11y u«u �� &,,,,.LA, A «y 0 Utility locations & easements Vision clearance not required
0 Footprint of new structure and FFE 0 Property corner elevations due to tract private access.
O Sidewalk/driveway dimensioned
O Lot area and lot coverage percentage 0 Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
O Drawn to standard scale 0 Total facade area
O Building height dimensioned 0 Total window and door area
O Facade dimensioned
O Windows and doors dimensioned
0 Garage doors dimensioned
Regviro loor Plan Elements:
(Not required for ❑ Summary table that includes
❑ Each story dimensioned ❑ Total floor area
❑ Each story floor area calculated ❑ r story
Planning Review
The following standards have been met:
Setbacks Front: 8/12 Rear: 3 alley Side: 3 Min/Max Street Side: 7 / Garage: 3 alley
Height 0 Max. Height: 35 Proposed Height: 26' 10 3/8"
0 Yes ❑ N/A Landscape
❑Yes 0 N/A Screening (Quad only)
0 Yes ❑ N/A % Window Coverage
❑ Yes 0 N/A Garage (SFR Only) Parking (Other Res)Alley load garage
❑ Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes 0 N/A Other building design standards (Rowhouse only)
❑ Yes 0 N/A Accessory Structure Standards
❑ Yes 0 No Qualifying pre-existing unit exempt from standards (Cottage unit only)
• .ditional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
❑ Ye N/A Unit Count:
❑ Yes ❑ N/• of Width and Size
❑ Yes ❑ N/A Pat''
Additional standards fo -• rtyard 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
❑ Yes ❑ No ON/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
❑ Yes 0 No ON/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes ❑ No
Applied For: 0 Yes ❑ No, stop intake
O Sensitive Lands: 0 Yes 0 No
O Main Land Use Case #s: PDR2021-00004 ❑ Conditions met
0 Applicant notified of land a ex iro date: Submit development plans by 1/31/25. Final occupancy by 1/31/27
Approved B Planning: Date: 9/25/2023
Notes Onlyx34 permits can a issued prior to recording of final plat
Revision 1: 0 Approved 0 Not Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date:
Building Permit Submittal
Original Submittal Date: tO1l 113
Site Plans #:
Building Plans #: .:2
Building Permit #: ,LI Building permit # entered on page 1
Workflow Routing: KPlanning engineering fd'Permit Coordinator Building
Workflow Sign-off: O Sign-off for Planning (include notes from planning review)
Route Documents: lg.-Engineering: (1) copy of permit application, (1) site plan, (1) building plan
/and 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: Date: ' 0r 3� /ij
Notes:
Engineering Review
❑pFI Permit:
'/ ('f Slope at building pad: .---2) %
/ Ai onditions met prior to issuance of permit
ljYEasements (encroachments) per engineering conditions of approval and plat
1iANater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes kNo
Assess Water Quantity Fee in-lieu: ❑ Yes i 'No
LIDA Facility on lot: ❑ Yes ( 'No Add Fee: ❑ Yes ❑ No
Final Plat Recorded
0 NOT Approved: Date:
Notes:
O
Approved By Engineering: Date: 10/)212
Revision 1: 0 Approved of Approved Date:
Revision 2: ❑ Approved ❑ Not Approved Date:
Permit Coordinator Review
7^conditions met prior to permit issuance
/❑ Approved, NOT Released: Date notified applicant:
ENG Revisions Required: Date notified applicant:
SDC Exemption: ❑ Applied for ❑ Received �7Does not apply
rSDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: EI Yes CIN/A Deferred
Parks SDC: Yes ,❑ N/A Deferred
CIy.Y LIDA Yes N/A
OK to Issue/Approved by Permit Coordinator: �� (
V
iDate: ' (� ��
Revision 1: ❑ Approved ❑ Not Approved Date:
Revision 2: ❑ Approved CI Not Approved Date:
NI r ' Building Division
One & Two-Family Dwelling
TIGARD Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION 1J l 2 o 7---3Permit#: Plan #: a(i I b A 6.')Floors: `
Valuation: . 1 -y O.,` .3 ) Covered _I Porch: ' -7 Basement
Bedrooms: 3 Deck: 1s`Floor Le 57
WC (toilets) 3 Deck Cover: 2nd Floor q Li Q
Lavatories 1 Patio Cover �— 3`d Floor - l
Tub/shower .2 Accessory Struct. ...-- R-3 Total l q 59 7
Laundry Tray — Water Heater ( / Gas /OP Garage r3Q1 O
Exhaust Vents 5 Gas Flue Vents —� U
— Total for Elec. t g3 7
Backflow Prey. / Heat Pump 411E011 # for Electrical ^
BBQ ...------ Gas Fireplace 1 #Fuel Lines 3
FEES: Description: Fee App ' s: Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg$2.00 (over 11x17) 267
Info Proc/Arch: Sm$.50 (up to 11x17) 2 2
Metro CET: Residential Use(
School CET: District: \i
Tigard CET: Admin
Tigard CET: ODHCS l./
Tigard CET: AH
Electrical Permit: Permit Fee: ,1,
Limited Energy: ✓
12% State Surcharge
Mech. Permit: Permit Fee: t/
12% State Surcharge
•
Plumbing Permit: Permit Fee:
12% State Surcharge �...----
Erosion Control: w/Permit- Ping /
I:\Building\Forms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
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