Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT
Permit#: MST2020-00200
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/19/2020
t�' Parcel: 1S125DC10500
Jurisdiction: Tigard
Site address: 7533 SW RED CEDAR WAY
Subdivision: RED CEDAR ESTATES Lot: 3
Project: Red Cedar Estates, Lot 3
Project Description: New detached dwelling.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1421 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1464 sf Garage: 507 sf Front: 10 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2885 sf Value: $385,314.21 Rear: 7.5
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 0 Storm Sewer: 100
Tubs!Showers: 5 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
Drywall-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N 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
Furn>=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!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 2885
Owner: Contractor:
JTSC LLC Required Items and Reports(Conditions)
5285 MEADOWS RD,SUITE 171 1 Ersn Cntrl 503-639-4175
LAKE OSWEGO,OR 97035 2 Geo Tech Required Prior To
Pour
PHONE: PHONE: 503-308-7324
FAX: 503-684-0102
Total Fees: $39,002.90
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 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
952-001-0010 through OAR 952-001-0090.-0 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987� po
or 1.800.332.2344.-�-
Issued By: W�QkrQ v0"Permittee Signature: i (' \ 1,5.n
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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 job site at the time of each inspection.
r Building Permit Application A"(
_
,, I ' i. r
Residential RECEIVED FOR OFFICE USE ONLY
Received /�
City of Tigard �UN 2020 11 Rnee/By: 41 I ,QO PemntNo�l1S.rzezoi-_QQtoo
II • 13125 SW Hall Blvd.,Tigard,OR 97223 NPlan Review 1 1
■ Phone: 503.718.2439 Fax: 503.598.19 41 _ Date/By: �/J i Other Petty i�1 2a2��0D127
T I ti n Ft U Inspection Line: 503.639.4175 i I'' t i(" 1i�,3t�+R D Date Ready/By. tuns: El See Page 2 for
Internet: www.tigard-or.gov /ZS Supplemental Information
TYPE OF WORK / RE RED 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. 3Q' 21 1
El1-and 2-family dwelling ❑Commercial/industrial Valuation: v J
ElAccessory building El Multi-family Number of bedrooms: S
❑Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2 339 .
Job site address:7533 SW Red Cedar Way New dwelling area: 2885 square feet 1L k.09
City/State/ZIP:Tigard,OR 97223 Garage/carport area: 507 square feet 11-121
Suite/bldg./apt.no.: Project name:Red Cedar-Lot 3 Covered porch area: square feet
Cross street/directions to job site:SW 74's Ave&SW Red Cedar Way Deck area: 150 square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Red Cedar Estates 1 Lot no.: 3 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:TBD 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.
New home construction Valuation: $
Existing building area: square feet
New building area: square feet
tEl PROPERTY OWNER El TENANT Number of stories:
Name:LFII 74,LLC Type of construction:
Address:5285 Meadows Rd Ste.171 Occupancy groups:
City/State/ZIP:Lake Oswego,OR 97035 Existing:
Phone:(503)657-3402 Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:JTSC,LLC (Please refer to fee schedule)
Structural plan review fee(or deposit): 76 4.S el
Contact name:John Wyland 1
Address:5285 Meadows Rd Ste.171 FLS plan review fee(if applicable):
City/State/ZIP:Lake Oswego,OR 97035 Total fees due upon application:
Phone:(503)209-7555 Fax::( ) Amount received:
E-mail:jwyland@jtsmi[hco.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:JTSC,LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:5285 Meadows Rd Ste.171 Solar Installation Specialty Code checklist.
City/State/ZIP:Lake Oswego,OR 9 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)209-7555 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:200237 Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:John Wyland Date: ql I 'jam *Fee methodology set by Tri-County Building Industry
Service Board.
1:1Building\Permits1BUP-RESPe itApp.doc 02/24/2011 440-4613T(l1/02/COM/WEB)
Mechanical Permit Applicatiai -1 1 FOR OFFICE USE ONLY
4 Received
City of Tigard I 7 y Permit NoI 1.c7'j�--rin Zo7}
13125 SW Hall Blvd.,Tigard,OR 97223 .lU�! 1 2020 Dam Review l/v w e+
= Phone: 503.718.2439 Fax: 503.598.1960 yy 11 Yt[f Oate/By Other Permit:
TIGARD Inspection Line: 503.639 4175 �� Y OF I 1 rti�';_ rate Ready/By: tuns: I RI See Page 2 for
Internet: www.tigard-or.gov 131,1ig )mill yi/"_!
'f't i�t' 9 :Nottfied/Method: Supplemental Information
TYPE OF WORK 1 \l 1.7 J COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
El Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value.$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
El Multi-family ❑Master builder ❑Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:753$ SW Red Cedar Way Furnace 100,000 BTU(ductabents) 1 46.75
City/State/ZIP:Tigard,OR 97321 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Red Cedar Estates Duct work I 23.32
Cross street/directions to job site:SW 74'"Ave&SW Red Cedar Way Hydronic hot water system 23.32
Residential boiler(radiator or
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
Subdivision:Red Cedar Estates Lot no.:3 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater I 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
ElPROPERTY OWNER 0 TENANT Other: 23 32
Environmental exhaust and ventilation:
Name: LFII 74,LLC Range hood/other kitchen
equipment 1 33.39
Address:5285 Meadows Rd Ste 171 Clothes dryer exhaust 1 33.39
City/State/ZIP:Lake Oswego,OR 97035 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 5 23.32
Phone:(503)657-3402 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:JTSC,LLC Fuel piping:
S14.15 for first four;$4.03 for each additional
Contact name:John Wyland Fumace,etc. 1
Address:5285 Meadows Rd Ste 171 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Lake Oswego,OR 97035 Water heater 1
Phone:(503)209-7555 Fax::( ) Fireplace
Range 1
E-mail:jwyland@jtsmithco.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Integrity Air,LLC Other:
MECHANICAL PERMIT FEES*
Address: 16756 SW 72"a Ave Subtotal
City/State/ZIP:Portland,OR 97224 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)572-3594 Fax:( )
State surcharge(12%of permit fee)
CCB lic.:203869 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: ` Fee methodology set by Tri-County Building Industry Service Boned
Print name: Kyle Birman Date: ff w
1 tBuddingtPermits\MEC_PemtitApp_040113.doc 440-4 17T I1/02/COM/WEB)
Electrical Permit A licatio ..' -- I ' FOR OFFICE USE°NI.A
m. a,9,7, Received
City of Tigard Permit It Ai_c( 20 , •
• 13125 SW Hall Blvd.,Tigard,OR 97223 '�(��G DanR .
IIIIIIPlan Review
i Phone: 503.718.2439 Fax: 503.598.1960 DateB : Related Permit x: _
Inspection Line: 503.639.4175 Ready Date/By: Juris: ® See Page 2 for
I IC,ARU Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPED ' — PLAN REVIEW
1�4 New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wiitems checked):
ElService or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑Other:
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
• ofJob#: Job site address:7533 SW Red Cedar Way' ❑Addition 100HP or moew motor load of system
more. ❑"A" "E" "1-2" '"1-3"
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
0 Health-care facilities. ['Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Red Cedar 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:SW 74'h Ave&SW Red Cedar Way FEE SCHEDULE
Description I Qty. 1 Each 1 Total 1 •
New residential single-or multi-family dwelling unit.
Subdivision:Red Cedar Estates Lot#:3 Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 1 168.54 168.54 4
Ea.add'l 500 sq.It or portion 4 33.92 135.68 1
DESCRIPTION OF WORK Limited energy,residential
New home construction (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
ElPROPERTY OWNER ❑ _TENANT . Services or feeders installation,alteration,and/or relocation
Name:LFII 74,LLC 200 amps or less 100.70 2
Address:5285 Meadows Rd Ste 171 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Lake Oswego,OR 97035 601 amps to 1,000 amps 301.04 2
Phone:(503)657-3402 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
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 12508 _ 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
El APPLICANT El CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:JTSC,LLC above service or feeder fee,
• each branch circuit 7.42 2
Contact name:John Wyland B.Fee for branch circuits without
Address:5285 Meadows Rd Ste 171 branchce ciorcuit
feederitfee,first 56.18 2
•
branch circuit
City/State/ZIP:Lake Oswego,OR 97035 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)209-7555 Fax::( ) Each manufactured or modular 67.84 2
Email:jwyland@jtsmithco.com dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Garner Electric Sign or outline lighting 67.84 2
2890 SE Brookwood Ave. Signal circuit(s)or limited-energy
Address: panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP:Hillsboro,OR 97123 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)648-4552 Fax:( ) Investigation(l hr min) 90.00/hr
itS lectri Industrial plant(1 hr min) 78.18/hr
Email:Per n �9arnere c.com •
Inspections for which no fee is
CCB Lie.: 121159 Electrical Lic.: 3 -305C Suprv.Lie.: 3707-S specifically listed(v:hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Charles Garner Date: !Dylan Review Required(25%of permit fee):
rr�� ���''' ,•••e_����''''''"""""" ������������ r� State surcharge(12%of permit fee):
Authorized signature: !/4 g .1..Jfi TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Brittany Burian Date: 4,1(( days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:1Building\Pemdts\ELC PormiiApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I I/05/COM/WEB
e ,
•
Plumbing Permit Application
Building Fixtures VAFrFIVED
FOR OFFICE USE ONLY
City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223 'NI 1 1 2020 Date/By: Permit No-i Wd7 7 7.4..00 200
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:
r-t r°m 9';9 4.q DateBy:
T I G A R D Inspection Line: 503.639.4175 . _ Date Ready/By: Juris. El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
g New construction ❑Demolition For special information use checklist
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(I)bath '. 312.70 _ _
® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 1 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
O Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address7533 SW Red Cedar Way Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223
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:SW 74t6 Ave&SW Red Cedar Way Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) 1 Page 2
Storm sewer(no.linear ft.:_) 1 Page 2
Water service(no.linear ft.:_) 1 Page 2 _
Subdivision:Red Cedar Estates I Lot no.:3 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 1 25.02
New home construction
Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
LLC
Fixture/sewer cap 25.02
Name:LFII 74,
Floor drain/floor sink/hub 25.02
Address:5285 Meadows Rd Ste 171
Garbage disposal 1 25.02
City/State/ZIP:Lake Oswego,OR 97035 Hose bib 2 25.02
Phone:(503)657-3402 Fax:( ) Ice maker 1 12.51
g APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:JTSC,LLC Medical gas(value:$_) Page 2
Primer 12.51
Contact name:John Wyland
Roof drain(commercial) 12.51
Address:5285 Meadows Rd Ste 171 Sink/basin/lavatory 5 25.02
City/State/ZIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54
Phone:(503)209-7555 Fax: :( ) Tub/shower/shower pan 3 12.51
E-mail:jwyland@jtsmithco.com Urinal 25.02
Water closet 3 25.02
CONTRACTOR
Water heater 1 37.52
Business name:Mullen Company Water pipinglDWV 56.29
Address:1601 A SE River Road Other: 25.02
City/State/ZIP:Hillsboro,OR 97123 Subtotal
Phone:(503)640-0113 ax:( )
Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:92689 PI bing Lic.no.:34-260PB State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Jeremy Crace Date: I This permit application expires if a permit is not obtained within 180 days
(! �.0 after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Pennita\PLM11-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
IN41
T 1 G A R D Building Permit Review — Residential
Building Permit #: fri S T Zp 24 00 Zp d
Site Address: —1533 SVJ Red Cesar RAJ j
Project Name: Red CiNaar s-}ot-k-eS 1 Lot #: 3
Planning Review
Proposal: New }N(7JS'
Verify address/suite# active in Accela. 1:1--In River Terrace: 5. No ❑ Yes,River Terrace Review Addendum
Site Plan Elements: XErosion Control
g3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper ( tetained trees with drip line and tree protection measures
,Drawn to scale (standard architect or engineer scale) , Footprint of new structure(including decks)and FFE
Ig`North arrow %Utility locations&easements(required for new and additions)
.Site address,project or subdivision name and lot number idewalk/driveway approach
N'Applicant information(name and phone number) ocation of wells/septic systems
.�
`` L,ot dimensions and building setback dimensions Street tree size,type and location
rv.9pquare footage of buildings to be demolished Street names
xisting structures on site g'Corner elevations(2'contours if more than 4'differential)
t�/�
I�Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? gYes ❑No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Ryes ❑No
Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified , ,No Received: ❑ Yes ❑ No
iNtr Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified .& No Received: El Yes ❑ No
6 SDC Exemption for ADU applied for: ❑ Yes No Received: ❑ Yes ❑ No
'Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified No Applied For. ❑ Yes ❑ No,stop intake
lid Land Use Case#: 50 BiD» —( 1 Zoning: R. " 'C
Vr Required Setbacks: Front: i01 Rear: —VS' Side:3 Street Side:N Pr Garage:
0 tBu lding Height: Max. Height: Actual Height:
l Landscape Area: % 0-Lot Coverage Max:
Entrance Set back no more than 8'from street-facing wall X Parallel to street or offset 45 degrees or less
Windows Minimum 12%of area of all street-facing facades 15°/0
Garage sr..Garage door is behind widest street-facing wall X Yes ❑ No,one of the following is met:
❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
Garage door width is ❑ 12'or less .-k50%or less of facade ❑ 60%or less and includes 7 of following: 1
❑ Covered porch ❑ Recessed entrance ❑ Wall offset 0 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window ttim ❑ Window recess ❑ Window projection ❑ Balcony
1Visual Clearance ❑ Urban Forestry Plan
Iiir Sensitive Lands: -8"Yes ❑ No Type: MOUL I o-k VA\u-e `(viotivrt"
Conditions met prior to issuance of building permit
otes:
t-Approved By Planning: s j Date: (p «J To
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Fonns\BldgPennitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: / I/'-
Site Plans: # 3
Building Plans: # `j
Building Permit#: Q.Enter building permit#above.
Workflow Routing: Planning /Engineering `"B-Permit Coordinator —a-Building
Building
Workflow Sign-off: E 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.
12r-building. original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: •<015 Q44, e Date: (12.,Cr/7-0
Enxineering Review
Slope at building pad: 2,4
/
[ 1 Conditions "Met"prior to issuance of building permit
V2 Easements (encroachments) per engineering conditions of approval and plat
[ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 0 No
Assess Water Quantity Fee in-lieu: 0 Yes ❑ No
LIDA Facility on lot [WYes 0 No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:��
Y Approved by Engineering: Date: 407,,/8U
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Permit Coordinator Review
O Conditions "Met"prior to issuance of building permit
O Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
'4l SDC Exemption: 0 Received Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: 141 yes 0 N/A
Tigard Trans SDC: Vf Yes 0 N/A
Parks SDC: Yes 0 N/A
LIDA Yes 0 N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_RES_122419.docx