Permit CITY OF TIGARD MASTER PERMIT
4
COMMUNITY DEVELOPMENT Permit#: MST2015-00266
a 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/06/2016
Parcel: 1 S136AA12100
Jurisdiction: TIGARD
Site address: 10128 SW 67TH AVE
Subdivision: OAK STREET ESTATES Lot: 16
Project: Oak Street Estates, Lot 16
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Reoulred
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: i Third. 0 sf Right: 5 Detectors: Yes
Total: 2892 sf Value'. $351,999.56 Rear: 15
PLUMBING
Sinks: 1 WaterClosets: 3 Washing Mach: 1 Laundry Trays: 0 Rain rain: 1nna s: 0
Lavatories. 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain 0 Storm Sewer: 100
TubsrShowers. 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckf w 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
FuelTypes Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<100K'. 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furry=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Swc/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 201400 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 8 Stereo: N HVAC N SecuntyAlarm: 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: PHONE: 360-216-6423
FAX 360-258-7901
Total Fees: $24,313.80
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/ar-su-irpqrided for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. rules re set forth in OAR
952-001-0010 through OA 52-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1,W or 8 .3 .2344.
Issued By: Permittee Signature:
Call 503.639.4176 by 7:00 a.m.for the next available inspectln date.
This permit card shall be kept in a conspicuous place on the job sae until co lotion of project
Approved plans are required on the job site at the time of each Ins tion.
Buildin Permit Applicatio ECEIVED
Residential FOR OFFICE USE ONIA
City of Tigard DEC 2 2 2015 Deceivffie s perm
13125 SW Hall Blvd.,Tigard,OR 97 n, Plan Review
Phone: 503.718.2439 Fax: 503.59 . Y O� ( �(7 rt!�7 Date/By: 5 Other Per>�i (�f�[�����
a Inspection Line: 503.639.4175 BUILDING 'l!v�.C."'.)N Date Ready/By: mr�m 0 See Page 2 for
Internet: www.tlgard-orgov, Notified/btethod: Supplemental fafarmafioo
TYPE OF WORK REQUIRED DATA:1-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 applica' n. It
Z I-and 2-family dwelling ❑Commercial/industrial Valuation: ' 00 6 3
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms: 3
JOB SITE INFORMATION AND L2
LOCATION Total number of floors:
Job site address: ) U Z 8 j h/ (fl 77lie /'IV,!L- New dwelling area: 2 5792 square fee
City/State/ZIP: w Q 722 3 Garage/carport area: !{-Q square feet
Suite/bldg./apt.no.: Project name: Covered porch area: Z Z 2 square feet f O
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 9 S- — -T 's AT=GS 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 99'"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 PERMfr FEES*
Business name:Lennar NW,Inc. Please refu to fee schedule
Structural plan review fee(or deposit):
Contact name:Charles Webb
FLS plan review fee(if applicable):
Address:11807 NE 99'"Street,Suite 1170
City/State/ZIP:Vancouver,WA 98672 Total fees due upon application:
Amount received:
Phone:(360)258-7900 Fax: :(360)258-7901
E-mail:PORPermits@lennar.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PbotoVoltaic Solar Panel System.
Business time: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
Total fee due upon application: $201.60
Authorized signature: / This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: *Fee methodology set by Tri-County Building Industry
/L'-! L13 �2'ZZ' �5 Service Board.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-0613T(I1/02/COM/WBB)
Electrical Permit Application
tip..
City of Tigard q ' Daee� Permit No:/7s'�'nS �6
13125 Sun Hall Blvd_Tigard-OR 97223 C'7C C 2 2 2M i5 plan Rn•iew /`(7
Phone: 503.718.2439 Fax 303 598.1960 _ WteIB Other Pennic
Inspection Linc 503.6394175 ('�; 'y' '. },� Dat<ReadylBy luny 0 See Paget for
Internet: www.tigard-ocgi v s 1; ••,` p ohfied•Mnhod: Soppkmeohl information
77
TYPE OF WORK PLAN REVIEW -
Now construction t Please check all that apply isubmit 2 sets of plan W items checked below):
❑ ❑Addition alteration/rzplacemznt _
❑Service or(ceder 400 amps or more ❑Building over three stones.
❑ Demolition ❑Other. where the available fault cvtu ❑Mannas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14.000 ❑Commercial-use agricuknml
❑ 1-and 2-family dwelling ❑CommerclatlindusMal ❑Accesson'building amps for all other installations. buildings.
❑ Multi-family ❑Master builder ❑Other: ❑Fire Pump. O lostallation of 150 KVA or
❑Emergency system. larger separately denved s,nom
JOB SITE ]INFORMATION AND LOCATION [I Addition of c.,motor load cf ❑-A-,-E-,-1-2'-.^13'.
Job no.: Job site address: 7771 ,(J`/L 100HP or more. occupancy.
❑Si,or more residential units. ❑Recreenunal vehicle parks.
CIR'i$[ale/Zl�: r Q / ❑Heahh-cue Facilities. ❑Supply'voltage fm more then
❑Harzrdous lacxnons. 600 volts nominal.
Suitabldglapt.no.: Project name: ❑Service or feeder 600 amps or more.
FEE SCHEDULE -
Cross streeVdirections to job site: oe.r dm F. Taal
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Ux� '< s�� — — — "� - Lot no.: t� 1000 sq.ft.or less IcB.ii 3
Ea.add]500 sq.fi.or Ponion 33 92 1
Tax map!parcel no.:
Limited energy,residential 75.00 ?
DESCRIPTION OF WORK - (with above sq.@.Y
Limited energy,multi-(amity 7500
Renewable
residential With above sq.ft.) -
Renewable Eae 0 See Pier 2
Service,or feeders Installation.alteration,and/or relocation
PROPERTY OWNER ❑ TENA.NT 200 amps or less 100.70 1 1 _
t� j 201 amps to 400 amps 133.56
Name' f Ir 401 strips to 600 amps 200.34
Address: , 601 amps to 1000 amps 301.04 2
,/ v Over 1.000 amps or volts 552.26 2
City'State.'ZIP: qIAA "p Temporary services or feeders installation,alteration.and/or
Phone: k)o 1 ❑, (�(', relocation
200 amps or less 59.36 I
Owner installation: This installazion is being made on prop" that I own which is not 201 amps to 40o amps [35.08
intended for sale. lease,rent.or exchange.according to ORS 447.449.670.and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Brancheitcuits-new,alteration,or extension,mr eninel
APPLICANT - - ❑ CONTACT PERSON. A_Fee for branch circuits with
above service or feeder vee. 712 2
Business name: each branch circuit
8.Fee for branch circuits uifhouf
Contact name: service or feeder fee,first S6.18 l
branch circuit -
Address: r 4�,, ' i I-In Each add'I branch circuit 7.42 2
Cih"State 7"IP: I .Miscellaneous serviceorfeeder notiaeluded
Each manufactured or modular
Phone:( U ) — Fax: : ` �—I dwelling,senice and:ur feeder 6T8-{
J 66 Reconnect only 67.84 2
E-mail: 'r' C Pump or imeation circle 67.84 _
.CONTRACTOR Signor ouOine lieMing 67,84
Business name: wP-<L ;GYG Gk.•�' Signal circuits l or limited-enem See ,
G` ane),alteration.or extension. Pauc 2
:\ddress: �� 7�- Each additional inspection over allowable in any of the above
Additional inspection(I hr mm) 66.25hr
Cilystale'ZIP: pC - Investigation[l hrmin) 66.25 hr
Phone:iql ) S-3 Fax:( I Indusnial plant I I ht min) 78.18'hr
Inspections for Which no fee is 90.00'hr
CCB Lie.: TT Electrical Lic.: C �Q Suprv. Lic.: 05rj s eci0calle listed(5e hr min)
ELECTRIC 4L PERMIT FEES
Satin.Electrician signature,required: _ Subtotal:
Print name: r -�� ate:
Plan review(25%of permit fee):
State surchargc(12%ofpennit fee)'.
Authorized signator. �E TOTA1.PERMIT FEE:
` I This permit applicafion spires if a permit u not obtained within 180
Print name: �JJ. �,(\Q �1�\��eJ C, Dale. dao after it has heen acttpled as complete.
Number of msNoions xlloaed per Permit.
t PuildlnPP<rmiu LLC Ne riiLapp ELR ERE dm Re,011'611 "- 4615TI 11.95CO14WE6
Mechanical Permit Apph ti F OR
City of Tigard t'- DaeByd Permit l,�J2'Op/<' Oa&
13125 SW Hall Blvd.,Tigard,OR 97223 r I`r/ J
9 Z�'iJ Plan Review Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 UEC � Date/By:
a Inspection Line: 503.639.4175 _ _ Date Ready/By: and:: ® See Page 2 for
Internet www.ligard-or.gov (�; ' Y 1 - Notified/Me[hod: 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 information use checklist.
❑Multi-family ❑ Master builder ❑Other: Description Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
.ry Air conditioning ( 46.75
Job site address: A918 Sw ( N Furnace 100,000 BTU(ductsNams) 1 46.75
City/State/ZIP: l q 72 Furnace 100,000+BTU(ducts/vents) 54.91
116117 , Heat pump 61.06
Suite bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job site: Hydronic 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 my of above 23.32
Subdivision: Lot no: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32
DESCRH'TION 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
pOther
lace/insert 23.32
lliner/flue/vent 23.32
® PROPERTY OWNER ❑ TENANT 23.32
ental exhaust and ventilation:
Name:LEN'NAR NW,INC od/other kitchent 1 33.39
Address:11807 NW 99i6 Street,Suite 1170 ryer exhaust 1t23,32
39
CiTy/StateJZIP:Vancouver,WA 98682 ct exhaust(bathrooms,
toilet compartments,utili rooms) 532
Phone:(360)258-7900 Fax:(360)258-7901 Attic/crawls ace fans 32
® APPLICANT ❑ CONTACT PERSON Other:
Fuel piping:
Business name:LENNAR NW,Inc
$14.15 for first four;54.03 for each additional
Contact name:Charles Webb Furnace,etc.
Address: 11807 NW 991"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 Fire lace
Ran e
E-mail:PORPermits@Lennar.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: G L O 0'__r 1 (IS
Other
MECHANICAL PERMIT FEE `
Address: /J' V Y1_S7_01?1C e6tiWAY91,14TIV&52 W Subtotal
City/State/ZIP: —'V C ci 76 a Minimum permit fee($90.00)
/ y Plan review(25%of permit fee)
Phone:(30.3 6 G 7-�7 � . Fax.C .) 6 /O !G l State surcharge(12%of permit fee)
CCB lic.: 222U D TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
� ��f�, days after it has been accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board
Print name: L/�_ Ol7/M U Date:
I auddingTermilsU C PermitAOV 040113doc 440461II(11102100 / m
Plumbing PermitApplicatipri�: ;" ;';" 1;
Building Fixtures FOR OFFICE USE ON[N
�
City of 2 of Tigard 2 Z015
Date/By: Pemut
v hone S50}Tall Blvd.,Tigard,OR 977.11. - �-�r.,
� E y - , �f� Plan Review
Phone: 503.718.2439 Faz: 5035Y8!l Jpu -' ! Other Permit No.:
- ���is Y Date/By:
Inspection Line: 503.639.4175 _!,�. Date Ready/By lues. ® See Page 2 for
Internee www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
®New construction ❑Demolition For special information use checBlist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling ❑Commerciallindustrial SFR(2)bath 437.78
ElAccessory building El Multi-family SFA(3)bath 1 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: Sb✓ 77-1-4Kv= Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: 1
Footing drain(no.linear ft.: Page 2
Suite/bldg./apt.no.: 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: , sem/ - '.S�� ES Lot no.: 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
Address: 11807 NW 991"Street,Suite 1170 Floor drain/floor sink/hub 25.02
Garbage disposal I 25.02
City/State/ZLP: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 99"Street,Suite 1170 Sink/basin/lavatory 5 j 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
n Water heater 1 3252
Business name: Wo L Col- /-LUA, 13 Al(, Waterf/D 1 in WV 56.29
r P P
Address: Il] 75 7aglc Ce' 4am,,-4m /r!f r: 25.02
City/Statc/ZIP: ,po 7�,4 L-"I D/? `774 4�O Subtotal
Phone:( 63) Fax:(jp ) Minimum permit fee: $72.50
5 667-/76' cx� P. 3 G67- 891
CCB Lic.: Z Plumbing Lie.no.: Plan review (25%of permit fee)
Stale surcharge(12%of permit fee)
Authorized signature: 2 TOTAL PERMIT FEE
Prim[Mame: C` ��` /�d� Date: 2,14. 15- This permit application expires if a permit is not obtained within 130 days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
I9 uildingTermi[sNLW-PermilApP.doc 10/01/09 440-0616T(10/0VC0M/WHm
City of Tigard
COMIviUNIIA'DEVEI,OPbIEN"1'DI�PAR'I'NIENT
■
Building Permit Review — Residential
Building Permit #: NfSja0�s�0O�Ce�o
Site Address: 012-$ SW 6144 Ave,
Project Name: Oak �ii(P)e,4 Esta-ies Lot #:
(New dwelling=subdivision manic;Addition or Alteration=lust name of owner)
Planning Review
Proposal: new SF
Q Verify site address/suite #exists and active in permit system.
0 River Terrace Neighborhood: ❑ Yes No
Sits Plan Elements:
12"Wee (3) copies of site plan -ttlEmsting structures on site
e plan Must be on 8-1/2"s 11"or 11 x 1S"paper S/Footprint of new structure (including decks)with finished
9rawn to scale (standard architect or engineer scale) Qoor elevations
orth arrow t'1JUtihtg locations (regwred for ncw,mag apph for additions)
Exile address,project or subdivision name and lot number - ,,,,,Cation of wells/septc systems
�pphcant information (name and phone number) ( sion control(including drainage-way protection, silt fence
D(ot dimensions and building setback dimensions sign,location of catch basin,etc.)
-}.ot arca,building coverage area,percentage of coverage and 14 ect names
pervious area (applicable if K--,R-12,R-25&R-40) Veet tree size,type and location
Propern corner elevations (2 foot contour lines if more than -E�}?xisting trees to be retained with drip line,and tree
4 out differentia] protection measures
Clean A$'ater Services—Service Provider Lettc (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified rg No Received: ❑ Yes ❑ No
(Public Facilities Improvement(PH) Pennit-. /
Required: ❑ les,applicant was notified ElNo applied For: ® -,-CS ❑ No, stop intake
and Use Case #: JU'1�I 20 1� — 0000
,��onhng: 7— `1 ,S
I Setbacks: Front ' (D Rear j Side Street Side — Garage
$Landscape Requirement-.
Lot Coverage ;Maximum: °a
uilding I leight: Maximum h �J
eight 3 C7 Actual Height 7-
'Visual Clearance
C Casements
L Sensitive Lands: 1:1 Yes �, No '1'tpe
LJ 'rban Forestry Plan
Conditions "Met" prior to issuance of building permit
Notes:
Approved By Planning: l G Date: I Z ILL 11
Revisions (after Building Submittal onlv) Reviewer Date
Revision l: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approx-ed
Revision 3: ❑ Approved ❑ Not Approved
I:�Building\Forms%BldgPermitRvw_RES_070915.dacx
Building Permit Submittal
Original Submittal Date: 42��2
Site Plans: # '3
Building Plans: # 3
Building Permit#: C�Enter buddingpermit# above.
iWorkflow Routing: P-Planning Engineering Permit Coordinator fes—Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: L;,I_ ngineering: (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.
Notes:
By Permit Technician: Date:
Engineering Review
Slope at building pad:
}J Conditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat
Water Quahty/Quantity Facility-:
Assess Water Quality-Fee in-lieu: ❑ Yes P"No
Assess Water Quantity- Pee in-lieu: ❑ Yes 12���'���(((N...o
LIDA Paulin- on lot: ElYcs 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:
SDC Pees Entered: Wash Co Trans Dev Tax: Yes [IN/A
Tigard Trans SDC: ❑ Yes N/A IF
Parks SDC: �] Yes ❑ N/A
K to Issue Permit
Approved by Permit Coordinator: Gate:
I:\Bu i Idi ng\Forms\B IdgPcnmit Rvw_RES_070915.docx
zfrtS
tot)-ei
• X
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. F Tigard, Oregon 97223 • 503.639.4171
_---
lbY` City of Tigard
TIGARD Accela Refund Reques t
This form is used for refund requests of land use, development engineeriii=ag 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
Address/Parcel: Va
Pay Method: CreditCard rious
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 cari be applied and all SDC
fees paid by developer shall be refunded.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No.
Example: Building Permit Fee Refund
Example: 2300000-43104 $Amount
Washin•ton County Transportation Development Tax 405-0000-43320
Parks SDC-Improvement 425-0000-43300 $237,723.00
Parks SDC-Reimbursement 20,203.00
425-0000-43301
Sewer Connection
500-0000-25500 3,633.00
_7-1,896{00 •
TOTAL REFUND: -$333;44970i
APPROVALS: SIGNAT L S DATE: � �i OS��.Iry
If under$5,000 Professional Staff Agar
. _
If under $12,500 Division Manager 3 j9,1/62
/1
If under $25,500 Department Manager
If under $50,000 City Manager i-
/4t/'
If over$50,000 Local Contract Review Board .�oES w07— i1�f'e c.,.t3y/
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY '�b' S/
Case Refund Processed: Date:
3/„a //6.„) I By: [ ., -