Permit CITY OF TIGARD MASTER PERMIT
a COMMUNITY DEVELOPMENT Perri MST2015-00243
Date Issued: 01/06/2016
s 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S136AA12000
Jurisdiction: TIGARD
Site address: 10106 SW 67TH AVE
Subdivision: OAK STREET ESTATES Lot: 15
Project: Oak Street Estates, Lot 15
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms. 4 First: 1256 sf Basement: 0 sf Left. 5 Parking Spaces. 0
Height: 25 Bathrooms: 3 Second'. 1376 at Garage: 663 sf Front: 20 Smoke
Dwelling Units: 1 Third. 0 sf Right: 5 Detectors: Yes
Total. 2634 sf Value: $326,358.03 Rear: 15
PLUMBING
Sinks 1 Water Closets: 3 Washing Mach t Laundry Trays: 0 Rain Drain: 1nna s: 0
Lavatories. 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain 0 Storm Sewer: 100
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains. 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
Fum<1001(: 1 Vents: 0 Woodstoves'. 0 Gas Outlets: 4
Fur,=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Smc/Feedere 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 5 201400 amp: 0 201400 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 Vacuum System: N Garage Opener N All
Ewmpasing: Y
Other: N Other Description.
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VS R-3 2634
Owner: Contractor:
LENNAR NORTHWEST INC LENNAR NORTHWEST INC Required Items and Reports(Contlltions)
11870 NE 99TH ST,STE 1170 11807 NE 99TH STREET SUITE 1170 1 Ersn Chid 503-639-4175
VANCOUVER,WA 98682 VANCOUVER,WA 98682
PHONE: PHONE: 360-216-6423
FAX 360-258-7901
Total Fees: $23,752.84
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those are set forth in OAR
952-001-0010 through 0 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 3.232. �orra.2344.
Issued By: .r �� Permittee Signature:
Call 603.639.417$by 7:00 a.m.for the next available Ins n date.
This penny care shall be kept In a conspicuous place on the job site until cc lotion of a project
Approved plans are required on the job site at the time of each Ins
Building Permit Application
Residential
City of Tigard Received\'�D Date/By: PermtNo" 1 r—
13125 SW Hall Blvd.,Tigard,OR 9722 {y/ V V Plan Review
Phone: 503.718.2439 Fax: 503.598.1 E� Date1B : Other Permit W _
Inspection Line: 503.639.4175 9 2Q15 Daze Ready/By: Hum ® See Page 2 for
Internet: www.tigard-otgov D�C NotifiedNethod: i (y— supplemental Information
`P'
TYPE OF R'O Q,Y REQUl tEDDATA:l-AND2-FAMII.YDWELLING
®New construction ❑D� Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteratiordreplacement I ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling ElCommercial/industrial Valuation: /
❑Accessory building ❑Multi-fancily Number of b ooms:
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATIO
rN
7�AND LOCATION Total number of Floors: 2
Job site address: �(7!O G, _514/ /G 5-N Ale New dwelling area: 2,624 square feet 3 kV
City/State/ZIP: -t C I) G 'i72 Garage/carport area: la3 square feet
SuitePoldg./apt.no.: Project name: - Covered porch area square feet ,
Cross street/directions tojob site: Deck area: square feet lag
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: S —-T '.S AT=5 Lot no.: l5 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 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.
NSFR _,. Valuation: $
Existing building area: square feet
New building area: square feet
M PROPERTY OWNER, - ❑ TENANT Number of stories:
Name:LENNAR NW,Inc. Type of construction:
Address: 11807 NE 99th Street,Suite 1170 Occupancy groups:
City/State/ZIP:Vancouver,WA 98682 Existing:
Phone:(360)258-7900 Fax:(360)258-7901 New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMITFEES*
le
Business Warne:Lennar NW,Inc. Please refa two fee schedu
Structural plan review fee(or deposit):
Contact name:Charles Webb
Address: 11807 NE 99"Street,Suite 1170 FLS plan review fee(if applicable):
City/State/ZIP:Vancouver,WA 98672 Total fees due upon application:
Phone:(360)258-7900 Fax::(360)258-7901 Amount received:
E-mail:PORPermits@lennar.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:same as above Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
EPhone:(
Solar Installation Spec Code checklist.
Permit Fee(includes plan review $180.00
and administrative fees):
Fax:( ) State surcharge(12%ofpermit fee): $21.60
' ',) 3 b 7 Total fee due upon application: $201.60
Authorized signature: This permit application ezpires if a permit is not obtained
` within 180 days after it has been accepted as complete.
T *Fee methodology set by Tri-County Building Industry
'Print name: 2CK v a_ay Date: �Z'3—[ S
Service Board.
'uildinglPermitslBUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
t
Electrical Permit Application Kolmaimmu in
O :Ds1c1By:
ed
City Of Tigard `�� v: Permit No.:
13125 SPI Hall Blvd-Tigard.OR 97123 eview
Phone: 503.718.2439 Fax: 503.598 �Q�h AOtherPeairInspection Line503.6394175 Q qrteadyrBy. hmiv 0 See Paget tar
Internet: www.tigard-ocgov \ Q � ed,Mehod: sappkmmot lnform•tbo
TYPE OF WORK - PLAN REVIEW. ::
❑
New COn5WCl10n
❑Addltion/alteratio Please ched all dot apply(submit just of plam w/hems checked below):
❑Smice or feeder 700 amps or more ❑Building ova three riorim.
❑ Demolition ❑Other: zr where the available fault curter ❑Marinas and baryds
ar
CATEGORY OF CONST R CTIoN exceeds 10,000 amps at ISO volts or ❑Flaring buildings.
less to pound,or exceeds 14,000 ❑Commercial-um agrivolmral !
❑ I-and 2-family dwelling ❑Commerciabindustrial ❑Accessory building amps for an other matanatiom. buildings.
❑ Multi-family ❑Master builder ❑Other: ❑Fire pump ❑Installation of 150 KVA or
❑Emergency system. larger cpmarely derived 53 P=.
JOB SITE INFORMATION AND LOCATION ❑Addison of new,mot"load of ❑`A-,-E-,`I-2-.-1
Job no.: Job site address: 7 �s IOOHPormore. occupancy.
❑Six or more residential units. ❑Recreatioal vehicle parks.
CiryiStatc/Zll�: q�7D D ❑Hplibcare facilities. ❑Supply voltage for more than
Tl—a [I Hazardous locations. 600 volts nominal.
Suite/bldeJapt.no.: Project name: ❑Service or fader 600 amps"must.
ma
... _ ..
FEE SCHEDULE
Cross streeVdirections tojob site: nuerhmn FK -I T.m I !I
New residential single-or multi-family dwelling unit -
/' Includes attached garage
Subdivision: Oq �e-__— — 7 7_ Lot no.: 1.000 sq.R.or less 168.54 4
Tax mainfpareel no.: Fa add]500 sq.h or portion 33921
Limited energy,residemud 75.00 t
- DESCRIPTION OF WORK - (with above .R)
Limited energy,multi-family 7.00
residential with above sq.a.) -
Renewable Energy O See Pa e 2
Service or f«den iastallat oo,•iteration,madfor relocation
PROPERTY OWNER - 1 TENANT - 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: Y. _ 401 amps to 600 amps 200.14
Address: ,� 601 amps to 1.000 amps 301 04 2
Over 1.000 amps or volts 552.26 2
C ity,'S9 late'ZIP: Temporary services or feeders installation,alteration,aad/or
Phone:OkO )-)5 - 00 Fax:(?:;(X) rclontioo
200 amps or less59,36 I
Owner installation:This installation is being made on property that 1 own which is not 101 amps to 400 amps 125.03 2
intended for sale. lease,rent or exchange.according to ORS 447.449.670.and 701. 401 amps to 5"not 168.54 12
Owner signature: Date: Branch circuits-new,altentioe,or extension,per mad
APPLICANT COIyTACT:PERSON'.,. A.Fee for branch cinctins with
above service or feeder fee. 7 4T t
Business name: r NIM. each branch circuit 2
B.Fee for branch circuits srkhour
Contact names -+1 IAJPservice or feeder fee,first 56.18 x
branch circuit
Address: , *- II Each add'I branch circuit 7.42 2
Cit):'State,'ZIP: Miscellaneous service or feeder not included
Fsch,nartufactured or modular 6794 t
Phone:( v) t Fax: : r.-7 dwelling,sen'ice andor feeder -
p Reconnect only 67.84 2
E-mail: 'r Corn Pump or irrigation circle 67.84 _
CONTRACTOR Sign or outline lighting 67.84
Business name: �;,o Sigalcircuit(s)orlimited-energy See
mel,alteration,or extension P c2 t
Address: Q� _ Each additional inspection overallowa6le in any of the above
CiIx:�Statcr Zl P: �f
`, - Additio al imnd;on(I hr min) 66.25'hr
OC�CX1a 1 Invesiigationll hr min) 66.252hr
Phone( rr ) 5-RJ Fax:( 1 Industrial plant(I hr min) 78.18'hr
Inspections for which no fee is 90 U0'hr
CCB Lic.: VT Electrical Lie.: C w Sup- LIC.: 05 5 s d0canr listed(',4 hr mins
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: _ Subtotal:
Print name: r Xr - ere: Plan review(25%of permit fa):
aState surcharge(12%of permit fa).
Authorized signatur . �-� .y C TOTAL PERMIT FEE:
This permit application expires if•permit is not obtained within 190
Print name: Date:
(-, days alter it has been accepted as complete.
' Number of lnspectimo allowed per permit.
I RL'id AgRNmimEl.0 PenniL>py ELR EREdm Rer OL]IP014 4 04613TII I,OSVOMMEB
Mechanical Permit Application
Received
City Tigard O DateBy Permit No.:
� 13125 SW
W Hall Blvd.,Tigard,OR 97223 �/ Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
DaleBy:
Inspection Line: 503.639.4175 + Dale Rea B - rear_
Internet www.ti ard-or. ov y' Sm See Page 2 for
g g _1� ^ �O`� Notified/Method: $upplemenhl lot armatioo
TYPE OF WORK COMMERCIAL FEE' SCHEDULE — USE CHECKLIST
',c.� gp Mechanical permit fees'are based on the value of the work
®New construction ElAddition/alteration/µp ac�fpperformed.Indicate the value(rounded to the nearest dollar)of all
O❑Demolition El Other: v' mechanical materials,equipment,labor,overhead,and rofit.
Value:$
CATEGORY OF CONSTRUCTION RESIDEN'T'IAL EQUIPMENT/SYSTEMS FEES"
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checkfiA
❑Multi-family ❑Muster builder ❑Other: Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning ( 46.75
Job site address: l G o W 6N 7 /Tn vL- Furnace 100,000 BTU ducWvents 1 46.75
City/State/ZIP: TL• D �.e 7-z3 Furnace 100,000+BTU ducts/vents 54.91
Heat pump 61.06
Suite/bldg✓apt.no.: I Project name:
Duct work 23.32
Cross street/directions to job site: H dronic hot waters stem 23.32
Residential boiler(radiator or
h dronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for my of above 23.32
Other
Subdivision: �Ia� S 24 E ST/�rE- Lot no.: / : 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32
DESCRIPTION OF WORK Gas fireplace/insert 1 33.39
Flue vent for water heater or gas
NSFR fireplace 23.32
Log lighter as 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chime /liner/flue/vent 23.32
Other: 23.32
® PROPERTY OWNER LlTENANT
Environmental exhaust and ventilation:
Name:LENNAR NW,INC Range hood/other kitchen
equipment 1 33.39
Address:11807 NW 99`^Street,Suite 1170 Clothes dryer exhaust 1 33.39
City/State/ZIP:Vancouver,WA 98682 Single-duct exhaust(bathrooms,
toilet compartments,utilityrooms 5 23.32
Phone:(360)258-7900 Fax:(360)258-7901 Attic/crawls ace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business time:LENNAR NW,Inc
$14.15 for first four;$4.03 for each additional
Contact name:Charles Webb Furnace,etc.
Address: 11807 NW 99ih Street,Suite 1170 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98682 Water heater
Phone:(360)258-7900 Fax::(360)258-7901 Fireplace
Range
E-mail:PORPermits@Lennar.com Barbecue
CONTRACTOR Clothes dryer as
Business name: G LCO%T J 0 Other:
MECHANICAL PERMIT FEES"
Address: 5 YI.S7_4RIC
CL / I G IV Subtotal
City/State/ZIP: � ALE 7 7,5 Q Minimum permit fee($90.00)
//�� y c Plan review(25%of permit fee)
Phone:(,TO� ( �7- ]8 3B Fes'X03 ) (O / _ 7 State surcharge(12%of permit fee)
CCB tic.: 2 (J G 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: 1xu(,054101 • Fee methodology set by Tri-County Building Industry Service Board
Print name: W 41 I Date: 6 5
I\BuildingTermits\WC_PemiltApp_040111doc 440-46191'(11/0]/COMAVEB)
plumbing Permit Application
' Building Fixtures
Received
City of Tigard �G Pelmit No.:
`j DA./By:
13125 SW Hall Blvd.,Tigard,OR 972
Plan Review
Phone: 503.718.2439 Fax: 501j C, DaldBy. Other Permit No.:
Inspection Line: 503.639.41 VV 1"d
p Date Ready/By ]uris. S See Paget for
Internet www.tigard-OLgOv� 3r Notified/Method: Supplemental Information
TYPE OF WO FEE* SCHEDULE
®New construction For special in ormadon use checklist
Descri tion I Qty. I Ea. Total
❑Addition/alteration/replacement New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONNRUMON SFR(1)bath 312.70
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 1 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler C_sq.fL) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: /O/� S �/ A✓G Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: �� l �j 2 3 Footing drain(no.linear ft.: Page 2
Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03
Cross street/directions tojob site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.uw Paget
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: Page 2
Subdivision: S 'S>gTES Lot no.: /5 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 1 25.02
NSFR Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:LENNAR NW,Inc Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 11807 NW 99'h Street,Suite 1170
Garbage disposal 1 25.02
City/State/ZIP:Vancouver,WA 98682 Hose bib 2 25.02
Phone:(360)258-7900 Fax:(360)258-7901 Ice maker 1 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:LENNAR NW,Inc Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Charles Webb
Roof drain(commercial) 12.51
Address: 11807 NW 9918 Street,Suite 1170 Sink(basin/lavatory 5 25.02
City/State/ZIP:Vancouver,WA 98682 Solar units(potable water) 62.54
Phone:(360)258-7900 Fax: (360)258=7901 Tub/shower/shower pan 3 12.51
E-mail:PROPermits$Lennar.com Urinal 25.02
Water closet 3 25.02
CONTRACTOR
AL
Water heater 1 37.52
Business name: L CD7/ /-LGf /,3 � Water piping(DWV 56.29
Address: /U7 ISTO CJ4aM/3/,4 it r: 25.02
City/State/ZIP: _Te_og7V,41_&rj O rf 70 60 Subtotal
Phone:(5d3) Fax:(jp ) Minimum permit fee: $72.50
5 X67 /78 tx� 3 G6T- �'9!
CCB Lic.: 22,7()o Plumbing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Prim[name' CN /tZi��� Date: �' ./�;.. �5 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
'Fee methodology set by Tn-County Building Industry Service Board.
IdBuildingNUmits\PLMU-Penni1App.doc 10/01/09 440-4616T(10/0VC0 WEB)
City of Tigard
COMINFUNITY DFVELOPMBNT DEPARTMENT
Building Permit Review — Residential
Building Permit #:
Site Address: I Ol a6 SSW 6-7-41 Pue-
Project Name: C)ak S}ree-4' Eis 4P,5 Lot #:
(New dwelling=ubdivision nam e;.\ddition or.\Iteration=last name of owner)
Planning Review
Proposal: rpW SV-
Verify site address/suite # exists and active in permit system.
�K River Terrace Neighborhood: ❑ Yes -5< No
Sit Plan Elements:
'tree (3) copies of site plan 4, xxisting structures on site
Ze plan>�bc on 8-1/2"x 11"or 1 l x I—paper LCJFootprint of new structure(including decks)with finished
;1j�i yawn to scale (standard architect or engineer scale) door elevafions
IP, rt h arrow Utili . locafion5 (required for new,mac apply for additions)
S c address,project or subdivision name and lot number cation of wells/septic systems
\A
phcaut information (name and phone number) Erosion control (including drainage-svav protection,silt fence
,tit dimensions and building setback dimensions "esign,location of catch basin,etc.)
a)t area,building coverage area,percentage of coverage and 16S r et names
pervious area (applicable if R-7,R-12,R-25&R-40) reet tree size, tvpe and location
Property corner elevations (2 foot contour lines if more than Existing trees to be retained with drip line,and tree
4 foot differential protecton measures
Clean\Fater Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,apphcant was notified X No Received: ❑ Yes ❑ No
❑ Public Facilities Improvement (PI'l) Permit:
Required: E] ]'es,applicant was notified 11 No applied For: El Yes El No,stop intake
,/Land use Case #: SUB201� —OCc�c� �
Ifs l oning:
Setbacks: Front 20' Rear �_ Side 5 Street — Garage 2-0
$'1, adscapc Requirement °
4 .ot Coverage Maximum: n.z l
VBuilding I leight. Maximum I leight 3� actual Height .v 2 S
isual Clearance
I?asements
,,_,/�cnsitive I ands: 11 Yes No Type
lLrban Forestry Plan
❑0 Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: r Date: 12
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ approved ❑ Not Approved
Revision 2: ❑ approved ❑ Not approved
Revision 3: ❑ approved ❑ Not approved
is Building Fonts BldgPennitRaw_RES_070915.doxz
Building Permit Submittal
Original Submittal Date
Site Plans: #
Building Plans: #
nter
Building Permit#: building�penmt## bove.
Worktloxv Routing: anning ;✓ nglneering ermit Coordinator mut ding
Workflow Sign-off: �--off for Planning(include notes from planning review)
Route Application Documents: &—ngineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
wilding: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Date: /3 Id �S"
Engineering Review
Xe Slope at building pad:
Conditions "Met"prior to issuance of building permit
®Fasements (encroachments) per engineering conditions of approval and plat
Water Quahtc/Quantity Facility:
Assess Water Qualm Fee in-lieu: ❑ Yes ❑ No
:Assess Water Quantin Ice in-lieu: ❑ Yes ❑ No
LID_A Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ :Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not:Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to ,Applicant
Revision Notice 2: Date Sent to :Applicant:
Revision Notice 3: Date Sent to Applicant:
C Fees Entered: Wash Co Trans Dev 1'a1: �es ❑ N/A
Tigard'rrans SDC: ❑ yes )S.�PQ/A
Parks SDC: >_'Yes ❑ N/A
Kto Issue Permit
Approved by Permit Coordinator: / ' L Date: ��• i S ��'
1: BuildingFonns,BldgPenwtRvw_RES 070915-docx
44 s) c)t g---* (26)'2-1>f/L
(0(0(a SA) (e7
Ar
TIGARD
City of Tigard
March 9, 2016
Lennar Northwest Inc.
Attn: Juls Call
11807 NE 99th St., Suite 1170
Vancouver,WA 98682
Re: Permit No. Various New SF Residential Permits - See Attached List
Dear Applicant: •
The City of Tigard has processed a refund for fees on the above referenced permit(s) as
follows:
Site Address: Various
Project Name: Oak Street Estates - Lots 1-23 and 25-31
Job No.:
Refund: ►1 Check #220393 in the amount of$338,059.00.
n Credit card "return" receipt in the amount of$
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account "deposit"receipt in the amount of$
Comments: Refund for SDC fees paid prior to available credits applied from demolition
permit BUP2015-00091 for armory building and SF residential building. See attached
spreadsheet for SDC credit balance and list of permits that credits were applied to.
If you have any questions please contact me at 503.718.2430.
Sincerely,
.#1,9
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
City of Tigard
TIGARD; Accela Refund Reques t
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts, documentation and the Request for Permit Action form (if applicable)must
be attached to this request form. Refund requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: Lennar Northwest Inc. DATE:
Attn: Juls Call 3/7/2016
11807 NE 99th St., Suite 1170 REQUESTED 13Y: Dianna Howse
Vancouver,WA 98682
TRANSACTION INFORMATION:
Receipt#: Various Case #:
Date: Various Various
Pay Method: CreditCard Address/Parcel: Various
Project Name: Oak Street Estates
EXPLANATION: Refund for transportation development and parks system development fees paid prior
to demolition credits for armory structures and (1)residential structure. Received final
inspection for BUP2015-00091 on 2/10/2016 so credits care be applied and all SDC
fees paid by developer shall be refunded.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No,
Exam.1e: Building Permit Fee Example: 2300000-43104 Refund
Washington County Transportation Development Tax 405-0000-43320 Amount
$
Parks SDC-Improvement 425-0000-43300 $237,723.00
Parks SDC Reimbursement425-0000-43301
20,203.00
425 0000 43301
3633.00
Sewer Connection
500-0000-25500 '
._21,8949:00
TOTAL REFUND: ,.$83374491)1
APPROVALS: SIGNAT S/DATE: -33,fi -- trp
If under $5,000 Professional Staffmag
If under$12,500 Division Manager j9//&
If under $25,500 Department Manager ,
If under$50,000 City Manager ,��
If over$50,000 Local Contract Review Board .DOES Ivt?7- /�J��L , ���--
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLYCase Refund Processed: Date: ' 6.?
By:
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10106 SW 67TH AVE, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - C of O
MST2015-00243
Jeff Grove
Street tree
Moisture content
Lighting efficiency
Forms received
Violation Summary:
Inspector Contractor