Permit FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
1111 Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: 46 DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
JUL 3 2019
FROM: \1A‘Zn a_ Cat""( CITY OF TIGARD
BUILDING DIVISION
COMPANY:
PHONE: � 3c1 S— TCb3b
By:
RE: I 3 C I (3 S(e) (-i (15.14I ("¢ r)r 57 01,-Ge J'/7
(Site Address) (Permit Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s)of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
•
REMARKS: feu) 15 i fig", {tf � C71 1 nc V�r�� 1.�� ,
FO OFF CE USE ONLY
Routed to Permit Technician: Date: i3D `j Initials:
Fees Due: ❑ Yes 3No1Fee Desc ptio Amount Due:
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes ): No ❑ Donen
Applicant Notified: Date: I �,( ?,/ / ': Initials: �/
L•\Building\Forms\TransmittalLetter-Revisions_061316.doc
FOR OFFICE USE ONLY- SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
MCity of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
. Transmittal Letter
TIGARI) 13125SSW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.aov
TO: 79(f-fir�/� DATE RECEIVED:
DEPT: BUILDIVISION RECEIVED
MAY 9 2019
FROM: - r _ S CITY OF TIGARD
BUILDING DIVISION
COMPANY:
PHONE: S(cD - By:
RE:
(Site Ad ress) (Permit umber)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: I Description: I Copies: I Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. ✓ Engineer's calculations.
Other(explain): t t l
REMARKS: �c , M \�. 1 .u,r ici�el�:cs L clot- Cc M p 1/F^ l Lt.n14.
rov "51
FOR 9FFICIE USE ONLY
Routed to P ician: Date: 5/ t3 / t `7 Initials: r
Fees Due: _ Yd"s [J No Fee Descrip'tion: / Amount Due:
$ _
�/Z 7 ) rLU $ 4.5 v—
$
Special
Instructions:
Reprint Permit(per PE): LI Yes - 0-No Q Done /��
Applicant Notified: Date: d. / ;/ //y Initials: J:.
I:\Building\Fonns\TransmittalLetter-Revisions_061316.doc
City of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT
1111111
T l G ARD Building Permit Review — Residential
Building Permit #: /tCC-7-da,/ -Cel/4/7
Site Address: 13518 s J l l l5h 112e Dv--
Project Name: eraIP�AG Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: 'Pjqfs-clYi 4 ' hPrnoct?.j,c2ecAL -expsinsw1.. ZE. S"tAtics
Verify address/suite# active in Accela. I(In River Terrace: XNo ❑ Yes,River Terrace Review Addendum
Site Plan Elements: Parsosion Control
copies of site plan on 8-1/2"x 11"or 11 x 17"paper Retained trees with drip line and tree protection measures
Srawn to scale(standard architect or engineer scale)
ootprint of new structure(including decks)and FFE
orth arrowNifitility locations&easements(required for new and additions)
Wire address,project or subdivision name and lot number .- .ewalk/driveway approach
Applicant information(name and phone number) r''' .cation of wells/septic systems
of dimensions and building setback dimensions 14.treet tree size,type and location
VI •uare footage of buildings to be demolished a treet names
S xisting structures on site 'corner elevations (2'contours if more than 4'differen )
P. •t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? e$/ 1No
impervious area(applicable if R-7,R-12,R-25&R-•t ,. If es,is a storm water •uali facili • shown? No
X Clean Water ServiService Provider - ' ot)platted ptjifo 9/10/1995):
Required: ecus/-
0 licant was notified ` Received: Yes $,No
i 1� '
'�Public Fas Improvement(PFI)P•P . 't: i l� ,v N ,k),
Required: ❑ Yes,applicant was notified X No V C r�j i't'plied For: ❑ Yes ❑ No,stop intake
I l°� 12_7 C'P Di
and Use Case#: 9 �-Zoning:
Required Setbacks: Front: t4 f4 Rear: iS Side: Street Side: N/A- Garage: IV ill-
D Building Height: Max. Height: 1 Actual Height: '• 15
Landscape Area: 2D % ❑ Lot Coverage Max: ��
nuance 0 Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows El 12%of area of all street-facing facades
Garage 1\1 ❑ araq—oor is behind widest street-facing wall CI Yes ❑ No,one of the following is met:
❑ I• . extends no more than 5'from wall and there is a covered porch extending beyond garage.
r I oo,extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2"a floor.
❑ Garage door width is 0 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following:
El Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave CI Roof offset
❑ Fire shingles 0 Lap Siding ❑ Roof pitch El Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim El Window recess ❑ Window projection 0 Balcony
!FA isual Clearance 0 Urban Forestry Plan
14 Sensitive Lands: 'Yes ❑ No Type: 4-ep S lO peS
onditions met prior to issuance of building permit
tes: If6g 119V h WG.tjplt.,`-faiebt— no SLR- re/0
j--Approved By Planning: v Ce4A-- Date: Lk1�1 119
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Fonns\BldgPemiitRvw_RES_022819.docx
Building Permit Submittal /
Original Submittal Date: 4` 7.7 e //?
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing Planning Engineeringermit Coordinatoruilding
Workflow Sign-off Ign-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.
,uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By �� ffi / i
Permit Technician: / i Date:
AEI
Engineering Review
E. Slope at building pad: 15 7,
Conditions "Met"prior to issuance of building permit N/A
Z- Easements (encroachments) per engineering conditions of approval and plat
54 Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
El Final Plat Recorded:
O NOT Approved by Engineering: Date:
Notes:
❑ Approved by Engineering: Date: L/- z Z - Z of 9
Revisions (after Building Submittal only) <`' Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 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
tX-SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes Mi N/A
Tigard Trans SDC: 0 Yes ` +� N/A
Parks SDC: ❑ Yes N/A
LIDA 0 Yes N/A
Itt-OK to Issue Permit
Approved by Permit Coordinator: Q ec_ Date: 41 Z1 lq
I:\BuildingWorms\B1dgPermi[Rvw REs 0228I9.docx
D
RECEI►lEDIVISION
SEP 1 0 2020
ti
Water Meter Fixture Unit Worksheet for Additions/Remodels/ADU CITY OF TIGARD
UILDING
Please complete the following information:
Customer Name: J 1 t C�i 1 c_—r-. I .C7 t
\ -' S HIsC _s i,) I '-.
Service Address: Street/Suite#: �.( ''
Cam: 1 l 4 d State: L. - Zip: C/7-7 . 3
Phone Number: ..) /I `- - E"� L.. C'
1,R � ��..�EmaiL• � 3 IN,ct,..%lc5_1/4:i14-E-1 (IC<:, -:.2..<c1 tv�4. ( (- ��,
Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add.
Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at
total. the proposed total.
Fixture Unit Current Point Current Proposed Point Proposed
Quantity Value Total Addition Value Total
Bar sink x I =
= x I =
Bidet
x I x 1 =
Clothes washer / x 4 = y '. x 4 =
Dishwasher / x 1.5 = J/
=
Hose bib 1 x 2.5 '� �'c x 2.5/ x 1.5 = � ,
Hose bib,each x 1 =
= x 1
Kitchen sink
/ x 1.5 j, � i x 1.5 —
/ f
Laundry sink x 1.5 — x 1.5 =
Lavatory x 1 _ I .) x 1 �)
Water closet, 1.6 GPF M x 2.5 ter, } x 2.5 = 1
Bathtub/whirlpool x 4 = 1 x 4 = 5/
Shower stall x 2 = / x 2 = >
Bath/shower combo / x 4 = 1,.f— x 4 =
Current Points: 1 `=• Proposed Increase: /f3: .,'
Current Points-I-Proposed Increase= Li =New Total Points =Required Meter Size '/ y
Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points=3" 37.5 and over points= 1"
New Meter Size Needed far New Total Points: 3f Cost: $ 13 /Y2 (see page 1)
Current Meter Size per Utility Billing: ` 1 Cost: $ 7 LJG(' (see page I)
New Meter Size Cost minus Current Meter Size Cost= $ / / LJ
(This is Your Cost to Increase Meter Size Due to Additional Fixture Units) /
FOR OFFICE USE ONLY
Current Meter Size Confirmed with UB
Signature of UB Representative Date
._
I:/Building/Forms/WaterMetcrs 070119 Add.dOCX Page 2
r
Property Owner Statement ECF1VE®
Regarding Construction Responsibilities SEP 08 2020
Oregon Law requires residential construction permit applicants who are not licensed with the , OF i�G��p
Construction Contractors Board to sign the following statement before a building permit can be_TINO DIVISION
issued. (ORS 701.325(2))
This statement is required for residential building, electrical, mechanical, and plumbing permits.
Licensed architect and engineer applicants,exempt from licensing under ORS 701.010(7), need not
submit this statement.This statement will be filed with the permit.
asPlease check the appropriate box:
l/ I own, reside in, or will reside in the completed structure and my general contractor is:
&a-4 A4IO S)SiN! . A'-- __
Name CCB# Expiration Date/�/
I will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
1 I will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
S�� 11� cr / S
Print Name of Permit Applicant
-�-2�-� C) /7/k
S' nature of ermit Applicant Date
Permit#: /1-f7-2-0/ 9 —GIQ/`/7 ,
Address: /35 /e. S� L /f//1 be � �`�- ,
jii Ytufa'{:' ,
Issued by: O Date: 1-
Y � �/ /20
This Copy for Permit Offices