Permit n CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2015-00267
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/04/2016
Parcel: 1 S 136AA 12400
Jurisdiction: TIGARD
Site address: 10206 SW 67TH AVE
Subdivision: OAK STREET ESTATES Lot: 19
Project: Oak Street Estates, Lot 19
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1384 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 1508 sf Garage: 494 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2892 sf Value: $354,188.23 Rear: 15
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 Storm Sewer: 100
0
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
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Fum-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: 5 201-400 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
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2892
Owner: Contractor:
LENNAR NORTHWEST INC LENNAR NORTHWEST INC Required Items and Reports(Conditions)
11870 NE 99TH ST,STE 1170 11807 NE 99TH STREET SUITE 1170 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98682 VANCOUVER,WA 98682
PHONE: 360-258-7900 PHONE: 360-216-6423
FAX 360-258-7901
Total Fees: $24,328.90
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 wor suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. T se r es are set forth in OAR
952-001-0010 t OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 o 1.8 . 32.2 4.
Issued By: A Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection da
This permit card shall be kept in a conspicuous place on the job site until comp tion of th project.
Approved plans are required on the job site at the time of each ins ection.
Building Permit Applic �
4 Residential FOR OFFICE USE ONLY
� n1
t_. Received
Ci of Tigard Permit No.: s cO
�J g DateB 22 �S � !
2
't 13125 SW Hall Blvd.,Tigard,OR 97223 a Plan Review
Phone: 503.718.2439 Fax: 503.SQSz " Other Permit:
`ygb 14 i� DateB : i� o �v�0[S'DOl4
Inspection Line: 503.639.4175 1, 3 1, Y �' Date Read B Juris: H See Page 2 for
P >• Y Y
Internet: www.tlgard-Or.gov �?5', az,ryKq No tified/Method:�ow (a Supplemental Information
3a /L L� S Ls
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
®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 profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling ❑Commercial/industrial Valuation.,3
$
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: Z
Job site address: 10206S bl 7721 XJA= New dwelling area: 2 8 Z square feet3
City/State/ZIP: /D jQ 97222 Garage/carport area: 4f
square feet
Suite/bldg./apt.no.: Project name: Covered porch area: 2 3Z square feet /,E-4:3
Cross street/directions to job site: Deck area: square feet IZ9
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: T = /�T 5_-Tot no.: j 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
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:LENNAR NW,Inc. Type of construction:
Address:11807 NE 991h 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 PERMIT FEES*
Please refer to fee schedule
Business name:Lennar NW,Inc.
Structural plan review fee(or deposit):
Contact name:Charles Webb
FLS plan review fee(if applicable):
Address:11807 NE 99`h Street,Suite 1170
Total fees due upon application:
City/State/ZIP:Vancouver,WA 98672
Amount received:
Phone:(360)258-7900 Fax::(360)258-7901
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
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 7 9 `, 3 b 7 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: Date: *Fee methodology set by Tri-County Building Industry
L/ Z' 2 �S Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
r
LA,
Electrical Permit Application
City of Tigard Received /S Permit No: STYS-CY�a(o
13125 SW Hall Blvd..Tigard,OR 9 Plan Review tk3a a Other Permit:
Phone: 503.718.2439 Fax: 503.59 6l Date/By:
Inspection Line: 503.639.4173 (1T � �ly (';i� DateReadytBy: See Page 2for
Internet: Nww^.tigard-oc.gov NotifiedMethod: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑Ncx4'construction Please check all that apply(submit 2 sets of plans w/items checked below):
Addition/alteration/replacement pp y
❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 101000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14.000 ❑Commercial-use agriculnnral
❑ I-and 2-family duelling ❑Commercial/industrial ❑Accesson'building amps for all other installations. buildings
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
❑Emergency system. larger separately derived system
JOB SITE.LVFORMATION AND LOCATION ❑Addition of new motor load of ❑W,-E-,-1-2 .-I-3',
Job no.: Job site address: 10 206, SW 6�N �✓G I OOHP or more. occupancy.
_ ❑Six or more residential units. ❑Recreational vehicle parks.
CityiState/Zl e: �'� OR ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: ❑Service or feeder 600 amps or more.
FEE SCHEDULE -
Cross street/directions to job site: Dw fian I I Fee rural
New residential single-or multi-family dwelling unit
Includes attached gauge.
Subdivision: 04 ' �� __— "7,- Lot no.: 9 1.000 sq,k.or less 168.54 4
Ea.add'I 500 sq.ft.or portion S 33.92 1
Tax map/parcel no.: Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.tt) -
Limited energy,multi-family
75.00
residential with above sq.ft.)
Renewable Energy ❑ See Pace 2
Services or feeders installation,alteration,and/or relocation
PROPERTYOVY?VER ❑ TE 200 amps or less 100.70a X'1P," - _
201 amps to 400 amps 133.56 2
Name: Y 401 amps to 600 amps 200.34 2
Address: I 601 amps to 1,000 amps 301.04
A Over 1,000 amps or volts 552.26 2
Cin Sta[e,'ZIP: ac 1AAv �rlTemporary services or feeders installation,alteration,and/or
Phone: �o jt5�— _11WO Fax:(FJW) 52) 1-101 relocation
200 amps or less 59.36 1
Owner installation:This installation is brine made on property that l own which is not 201 amps to 400 amps 125.08 2
intended for sale.lease.rent or exchange,according to ORS 447.449.670,and 701. ant amps to 599 amps 168.54 ! 2
Owner signature: Date: Branch circuits-new,alteration,or extension,per ane]
APPLICANT ❑:CONTACT PERSON A.Fee for branch circuits wish
_; above service or feeder fee. 7.42 2
Business name: r each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first 56.18 2
branch circuit
Address: z i I Each add]branch circuit 7A2 2
Cih"Sta[er7_1P: I I liscellaoeous service or feeder not ineluded
ry C Each manufactured or modular
Phone: Fay: : ��
dwellin ,service and or feeder 67'84 2
Py Reconnect only 67.84 2
E-mail- ann Pump or irrigation circle 67.84 2
CONTRACTOR Signor outline lighting 67.84 ,
Business name:
�\�, y tiTIC GL+C Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: %L\075 VC _ Each additional inspection over allowable in anv of the above
Additional inspection(1 hr min) 66.25'hr
Cilt:'Stale/ZIP: �� Investigation(I hr min) 66.25 hr
Phone:( } ,� Fax:( ) Industrial plant(I hr min) 78.18'hr
Inspections for which no fee is 90 00'hr
CCB 1.ie.: Electrical Lie.: (_ \Q Suprv. Lic.: �� s ecifically listed( i hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature.required: Subtotal:
Print name: ' - � ate: Plan review(25%of permit fee):
State surcharge(12%of permit fee):
t Authorized signatur . ��Owy t TOTAL PERtvfIT FEE:
This permit application expires if a permit is not obtained hithin 180
Print name: e�� �`��t✓J C Date: days after it has been accepted as complete.
Number of inspections allowed per permit.
I Awldinc�Pemits'ELC_PenniLXpp_ELR_EREdm Re,05,71!7013 430-16151"II IrC,5 Co.%t,WEB
Mechanical Permit Apel �t,> ' ,I Ei FOR • ONLY
Received
City of Tigard Date/By: Permit No.:��%�y���
V 13125 SW Hall Blvd.,Tigard,OR 323 qq Plan Review v�
Phone: 503.718.2439 Fax: 503. 98.196 g 2 ?0�5 Other Permit:
Date/By:
6 Inspection Line: 503.639.4175 Date Ready/By: runs: ® See Page 2 for
Internet: www.tigard-or.gov 0 d IURD Notified/Method: Supplemental Information
0
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 information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
n Air conditioning i 46.75
Job site address: 1-0266 S W 'rr4lly &- Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP: / 4�91? Q l? 972,0-.3 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: H dronic hot water system 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 any of above 23.32
Other: 23.32
Subdivision: Op�� LS�'f�TC Lot no.: ��
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(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:LENNAR NW,INC Range hood/other kitchen
equipment 1 33.39
Address:11807 NW 99`h Street,Suite 1170 Clothes dryer exhaust 1 33.39
City/State/ZIP:Vancouver,WA 98682 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32
Phone:(360)258-7900 Fax:(360)258-7901 Attic/crawls ace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name:LENNAR NW,Inc Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Charles Webb Furnace,etc.
Address:11807 NW 99`h 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(gas)
Other:
Business name: G L r-0,9-1 / �L U!N l 1 MECHANICAL PERMIT FEES*
Address: IS 60 L YN9/ T/ 4 2 w Subtotal
City/State/ZIP: ___..Q(4 77D AL b C1 fiB Q Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(501 667-1 Fax:W,>3 ) (O 7_ �! / State surcharge(12%of permit fee)
CCB lic.: J / 222 06 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: l ��� * Fee methodology set by Tri-County Building Industry Service Board
Print name: &k/2444 1U Date: 6 , 5
IABuilding\Permits\WC_PermitApp.040113.doc 440-4617T(I1/02/CONVWEB)
• Plumbing Permit Applicatimr
Building Fixtures `" ' ' VEJ
) FOR OFFICE USE ONLY
Received /
City of Tigard , ,� DateBy: �� Permit No.: 7
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Other Permit No.:
Date/By:
a Inspection Line: 503.639.4175 k j[ V ()p I I(,,A I(t) Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov R1111 WATO Notified/Method: I Supplemental Information
TYPE OF WOR >r FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist
Description IQty. Ea. 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
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 1 500.32
❑Accessory building [jMulti-family
Each additional bath/kitchen 25.02
El Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: f U ZOC9 Sw �/ /��L Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: 9 M� Of fj A?
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
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: jAyLot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
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 99t1i 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 99t'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
Water heater 1 37.52
Business name: WJ t C n 7'j PL U Al 13 A,1_0? Water piping/DWV 56.29
Address: /075- W. 15 7D ev 4 a 1h l3/1 r: 25.02
City/State/ZIP: �ZoW 7�i4G^ �2 y70 4�0 Subtotal
Phone:(5a3)66 7•.l79X7 Fax: 03) to T' 8�� Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.: 22200 Plumbing Lic.no.:� _ ��
'
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Pnnt name: C� Date: This permit application expires if a permit is not obtained within 180 days
�'/� `, after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLW-PermitApp.doc 10/01/09 4404616T(10/02/COM/WEB)
City of Tigard
~ COMMUNITY DEVELOPMENT DEPARTMENT
■
Building Permit Review — Residential
Building Permit #:
Site Address:
Project Name: �4,� � - S Lot #:
(New dwelling=subdivision name;.Addition or_alteration=last name of owner)
Planning Review
Proposal: Ale4o S�'�
Verify site address/suite# exists and active in permit syste
a[�I iver'Ferrace Neighborhood: ❑ Yes VNo
Si Plan Elements:
Xteree(3)copies of site plan 4 sting structures on site
plan must be on 8 1/2"x 11"or 11 x 17"paper Footprint of new structure (including decks)with finished
Site
to scale(standard architect or engineer scale) �or elevations
Vrth arrow 14utility locations (required for new,may apply for additions)
sitc address,project or subdivision name and lot number cation of wells/septic systems
plicant information(name and phone number) Erosion control(including drainage-wap protection,silt fence
;: of dimensions and building setback dimensions sign,location of catch basin,etc.)
t area,building coverage area,percentage of coverage and eet names
pervious area (applicable if R 7,R 12,R-25&R-40) Street tree size,type and location
VI
Property corner elevations (2 foot contour lines if more than 1W_ trees to be retained with drip line,and tree
4 foot differential `` rotection measures
tj 1 lean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
U Public Faciliti Improvement (PFI) Permit:
equired: es,applicant was notified ❑ No Applied For: /Yes ❑ No, stop intake
Vand Use Case#:
Voning:
Setbacks: Front a(J Rear s Side S Street Side
., Garage ,
kandscape Requirement: °o
kilding
f Coverage Maximum: %
Height: Maximum Height Actual Height //
!�
isual Clearance
Easements
ensitive Lands: ❑ Yes No Type
VCrban Forestry Plan
onditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: --` Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Ruiifiino\Fnrmc\RIAvP�iniiRvw RFC mnoicA
Building Permit Submittal
Original Submittal Date: /it
Site Plans: #
Building Plans: #
Building Permit #: 2r Enter building permit#above.
Workflow Routing: Planning Engineering 9'1'ermit Coordinator -Building
Workflow Sign-off: [7 Sign-off for Planning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
d Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Date:
Engineering Review
Slope at building pad: 9�
Conditions "Met"prior to issuance of building permit
I�Easements (encroachments) per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes X No
Assess Water Quantity Fee in-lieu: ❑ Yeso
LIDA Facility on lot: ElYes No
O 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:
,gDSDC Fees Entered: Wash Co Trans Dev Tax: es ❑ N/A
( Tigard Trans SDC: /❑ Yes N/A
Parks SDC: g'Yes ❑ N/A
OK to Issue Permit
Approved by Permit Coordinator: I*k Date: 1/117-
1-\Ruildinv\Fonns\B1dePennitRvw RES 070915.docx
At c 7`J- i7l S - 72-C- ?
ce77,1
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: ® 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.
n 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,
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. t Tigard, Oregon 97223 • 503.639.4171
111
•
City of Tigard
TIGARD Accela Refund Reques t
c•
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts, documentation and the Request for Permit Actio. form (if applicable)must
be attached to this request form. Refund requests are due to Accela S-ystem 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 BY: 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 can be applied and all SDC
fees paid by developer shall be refunded.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No.
Exam.1e: Buildin: Permit Fee Exam.1e: 2300000-43104 Rmoui
Washin•ton Coun Transportation Development Tax 405-0000-43320 $Aount
Parks SDC-Improvement 425-0000-43300 $237,723.00
Parks SDC-Reimbursement 425-0000-43301 20,203.00
Sewer Connection
500-0000-25500 3,633.00
_21,896:130 .
6 Scud,v;T
TOTAL REFUND: ,$333;449701
APPROVALS: SIGNAT _; S DATE: 0-C?,O"D
If under$5,000 Professional Staff ..7r
_ q41-/—
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 21:.4ESiVt r--
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: Date: WAW .:aa.
B :