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Permit
CITY OF TIGARD MASTER PERMIT ''1 2 ' COMMUNITY DEVELOPMENT Permit#: MST2020-00337 Date Issued: 02/22/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S125D602800 Jurisdiction: Tigard Site address: 9228 SW 74TH AVE Subdivision: BOULEVARD HEIGHTS Lot: 4 Project: Deoca ADU Project Description: New 690 sf detached ADU. NO FINAL INSP UNTIL WATER METER IS UPSIZED. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 1 First: 690 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 14.5 Bathrooms: 2 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 690 sf Value: $92,003.36 Rear: 5 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 2 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 135 SF Rain Storm Sewer: 90 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 2 Water Lines: 135 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 1 Natural Gas Heat Pump: Y Hoods: 1 Other Units: 0 Furn<100K: 0 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: 1 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 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 ADU VB R-3 690 Owner: Contractor: DEOCA,GEORGE&SILKE SOLARIS SOLUTIONS Required Items and Reports(Conditions) 9230 SW 74TH AVE 16869 SW 65TH AVE 7 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 LAKE OSWEGO,OR 97035 PHONE: PHONE: 503-341-4023 FAX: Total Fees: $13,309.27 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. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued B . 7�--/ Permittee Signature: 141 417PL7 C4 %7L7"." 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. w .. Mechanical Permit Annlicatins,CC city of Tigard gl 13125 SW Rail Blvd„Tigard,OR 97223 Phone: 503.718.2419 Inspection Lille: 503.639.4175 Interim. www Imarct-or.gov trtocrixed 7,EC 0 8 /.::t/.'U INII'll!` Nan Room '.;i T1'OF TIGARD Dliwr s„. — ,.! r-,,,.r• -,,,,c,Int, Nottaatlxiettad. Calla Nemo Soo Pagel for Sulttgarotatal leforroxoon TYPE.bti WORK L'OMMERCIAL PEE•SCREDFLE-ESE CIIICIO.LST 1 "7.11Strlietitrl 0 Additilgraluration rc.phicethent , \tewthathal pcnth,rm,.„based on the,31,,c ot too mak performed Indicate the value rrunattol to Mc ocuest&Bari at all i 0 13cmolitton C3 Other: mechanical materials.equipment.labor,overhead,and moth CATEGORY OF CONSTRUCTION Value.S RESIDENTIAL EQUIT*MENT/SYSIENIS FEES* CSi-mid 2.1arnily lin.Ciliag 0 Conunercaa:industnal 0 Acccisor:,blinding For*tall infonstrasor use fatalist 0 Muiti-ramiiy 0 MUSICS boa I der 0 Other: Description I Qty. ha. Total JOB STIII:VEORNEATION AND LOCATION ileating/coolian: Jub Nile address: 922 (3 c,„,,' 7 tit 4 i/ ( .-."--- Air conditioning 46.75 FUttlaCt 100,000 BTU talatta`rtatat 46.75 City/State/71P. 7 / ,,,,41.1e.07, / a ct 4 7 22.7 Furnace 100.000+BTU(ducta'Yentii 54.91 Suiselbldgiapt.no.: Project mune p e.:Ct.4 /4044/ Heat pump 61.06 Duct work 23 32 Cross Orem/directions tondo site: Hydrunic hot water eTatem 23.32 Residential boiler'Radiator or hydronte Y ,., 2332 ....„ Unit heaters(thel-ty pc.uot electric t. to-watt,in-duct.saspenticd,etc. 46.7S Hocken I far any of above 23.32 Subdivision: 1 I At ob.: Watt. 23.32 '"---- Other fuelapplittaces: Tax map,parcel no" , „, 1 %kali:I healer .-, 23 32 ,.. _ DESCRIPTION OE 'WORK Gas fircplacemscrt 33 39. PrVi r / erf Rh,1-,-,1 / /7-;:r .,,*1-/ r Flue vent for water beat=nr gas rue, .et_ 23.32 Tag lighter(Ems) Wood:poi let stove 33.36 1 Wood futplaceinscrt 23.32 Thironeslinerilluereest _ 23.32 0 raorrary OWNER 0 TENANT Other. 23.32 Environmental exhaust and ventilation: Name: Range hoodnither hitcher) Address: couipment i 33.39 Clothes dryer exhaust i City/Stay-LIP' Singtc.duct exhaust(bathrooms, Phone: nada compartments.many room) ID-... 23.32 ( 1 1 Fax : „- Attieictess boxer.loos 23.32 gr, ,,.‘ 0 APPLICANT 0 CONTACT PERSIL% Other: 21.32 Business name: Fad piping; Contact name: 514.15 for nrta fear:$4.03 for each mid Mortal PorttaCt,etc. Addtess: Cat be.et. in City/Stale/ZIP wallisustended,Mat heater water heater ,. Phone:( ) I lax::( ) Lire datv t E-mail Range , -14aa- ... - , . Bar Pscut Bkfiriff name. 5d Zifikie I,r Addres.s. ' al • 4* ,,, 6 ' ' if' Subtotal City"StateffIP: /4..t(e7 40 s,,,..),--.e...e) evr or Minimum permit fee(590.00) n" C*3 4fr/ (f0 L 3 II 1:2 1 I 111 I I I 111 I I I i I I I I I I I I I- Plan review(25%of permit ice) State surcharge 112%ormolu fee) EinligeiTT710 7; ." TOTAL PERMIT FEE This penait ipplicatios expires if a permit 6 Mit obtained within tat) Authorized signature. -. rlays after il ham bets adapted tr.ram phut. , ' 11111Pr 4, Fel!meteodology tel by Tn.('wetly aostditte Industry Servmc WA"! Print name: — ' . 01IMMIll,. IN Date: - - i .. ar 1 ZAdes4ePoma"11,C_PenritAg p_C•12120 der 44Q-I.tTI VI WAYAVYMOf Electrical Permit ApplicatiottlECG I\IE FOR OFFICE.I. I',11 City of Tigard i:. 0 2020 " ° l'�S72o 20 -ot7 33 7 13125 SW Hall Blvd.7igmd,OR 97223 Plan Renew Relaed Permita: anew Phone: 303.718.2439 Fax: 503.598.19601 I y 0i_Ty bam'0r. ' Date*: _.. Inspection Line: 503.639A175 Sealy interact: virww.ti$ardeor gov rtI III 1iItI(' I— Sart,tted!et6vd; - j RI See Page 2 far Supplemental infurmadaa F V1.349;.. - Tt'P. OF WORK I. •.""Ik4 e ^r ddlUnNd)irr-aIlUn.Fc{'1. .iI eit Pkz-e check all d,u.urply asubnats acts ofplanswaremacbcctedi. .ICW construction ❑% DS rv,we,x fecdcr 4).amps or.mace Q nnddmg ova clues Sink: [}Demolition ❑Other .w,.. where the available fault current 0 uxr;tus and boarymd; cai71 R a ' t r'1t.01 a'b EV044 10.000 antes at 130 woks or ❑floating bmhirna, low m Fount or ascends ins rout) ElCoramerr,al-ute agricultural }`f and'--fannly dwelling ❑Conarnerviabindustrial 0,ACCcssorg building amps for a t other bnstaitaua,* Mrldina ❑ tiulti-.uanly ❑Ntasicrbuilder ❑tither: • 1:IFtre moo QinatallalimoI i SoFVAor . _. JO$ INFORMA'TION AND LOCATION Cl Enosswcy synasa beg=separatob do i•ed c. ❑Addition of taro motor load of syv ,a.e 11,1;t r,: Job site address: 1 2. fJ 2 62' 7 Lr A✓e. 100111'01 awes[. Q"A'."E" i-' •I-3 } ❑Sirs or mug 1.ititeMal Gnat. 'u^ y City/State'ZIP: T/ /? .' , L7,-'2 . ,7 ❑Nealth•cars. thin. EJ Amazon!vehicle pairs . y") Al) O Rawtlouv G mars. ❑Supply v.rha.¢for mme II, j,� � Tr Suite/bldg./aft Pmjcct name: G � 600 volts manna. [� ,.0 crrxL,r tk'aiamtx;.a snore Cross street/directions m job site: --vrA,scliEur LE. ` y t twooi raw ) Qtr_,1 . fl Taw I ' New residential single-or multi-fatuity dwelling unit. Subdivision: Lot rt: Includes attached garage. ' LOW sq ft.or Irss f , 16$. 4 I i4t,lf 4 T.a mnP'parccl c; _. .... Fa add-1 500aq.ft orpinion 33.92 I ,D ER'4 Aid . Waned vireo'.residential ' 73.W 2 r�,, �S ) (wilb abgnt aa.R) ..�.-Grf3 J t�l"t )t"r�/ Z C�4�?!?ay y`+tr Limited mew.milli-fan* 75.Ot? (} _ residential(with above sq.0) Gar'` -' RenewableEnerir p Stt Page 2 d PROPERT% OWNER I a TENANT Services or feeders installation.alteration,uadtor relocation \arse: 2W snips oe less I 100 70_zee•-rj 2 ... 20t amps to 400 amps 133.5E 2 Address: 401 amps to600 amps 20314 2 CityIStateiZIP: 601 antra to 1,000 amps 301.04 2 Phone:( ) fax:( 1 Over 1,000 amps or wits s2.26 2 Temporary aenices 6r feeder intallatieta,alteration,and/or kmai.l: _relocation Owner installation:Ibis installation is being made on property that I own which is not 200 arrgaa or twos 3916i. 1 intended for sale,lease,rent,or exchange,according to ORS 447,449.670,and 701. 201 amps to 401 amps 12s.0g 2 Owner signature: Date, 491 amps to 599 amps t0g.54 2 ,v,.' '� [_I CONTACT Pt ft'tiONi- Bra nch circuits-new,alteration or extension,ter panel 0' a . '_._i A Fee for Lionel omottr with isysines name: above strike at Feeder fee, 7.32 2 _... ......,.— each brumes Mutt . ('ontact name: 13.Frye for tumult.eutwits,ei/LOW . -- service or feeder fee,first 56.18 2 Atldress: branch cmust Ciryr'StatcdZlP: tech add')launch cueuit 7.42 2 3tlsctllamoaa(service or feeder nut Included) Phone:( ) I Fax::( ) Farb mamdaatutcd or modular 67.84 2 -... .�. dwwclimy servtee xndkir Cecilia Email- ...,..,. Reconnect only 67.84 2 CONTR ieltiR Pump or lrngauon circle 67&S 2 Business name: i_/ / / 7 /am yt ✓ / Sign or outlaw lighting r 6714 2 ..... +7 (+�6�Ts�l ,: YCJf- lG 4..,�r�d �f 54. Si unait(sl or Bursted-entr96' Address: 9-,[..J 0 5 Led 7i q. U C puree alteration,w extension Q See Page 2 2 C'ityiStatct7_IP: 7/6.A,!Ha• ,r 4„etci, 7 2,2. 3 Each additional inspection over allowable is any of the*bore /'/ f� -ter Additiox,t„k pasion(1 tt run) _66 25t hr Phone: ) . / es L Q Z 3 Fax:( ) Investigation t I Iir mat) 9u.ttp it ... -` `/10 r Industrial plant(I hr mus) 7A i)V he hmail: 5 eode Srr �2 rfl !r ll t tet�/L G f inspections ra which rw fee is y apecifaaitt lobos hr turn) 9ti(XX ill {.�LtS Lief Sp Electrical 1. uprv.tic.:3��j !--j —. - if aet�S xor.a[ 'd, a rut Super.fir i More,required: � . Subtotal: Print name: J - age:/ 8 Ty 2.o 0 Plan Review Required I23%billionth BO: StdiC wrr3irttt(12Ya ofpermit Ica): l'eFr4L PERhii I Ire) Authorized signature: t , e 7// Zo✓3 .,. i 6t•,permit application expires if a arms(is net obtai*M within ISO Print name: - r- / f t/ [ [ITate:/alp ,�Q 1 days afar a less bees aerepied a toe**. ll.-- _ _ • Number„r wo :a-hoar aiWnxd Pa Permit I'Ikttldtrothrwds*LL:Perctisipp_t33t OWdec uM'm9itUDai s+U4013Ti1 MV O5 nix L—G I C,772! e,9'L Li C 6---fri/S c= /t/o T GD74 ND - 6--}c/�/eems '� e Plumbing Permit ApplicationEC I1n Building Fixtures 'DEC 0 8 L., City Ot f'WICd Reeewd > (`�� II .-. 1.1125 SW Hall Hlvd.,'r( d,OR 97223 tune Br Fro 7 r.G` 33 7 pl:a Ha.;�., a Phone: 503.7182439 Fax: 503.598.1960 1 t, Oder Femur ACtit.ItD tnapeeticm Zinc: $Qib39.4i75 ;I� It .;,r tiv ha+, El Ste e.at2tm Intemet aww.ligard-ot_go4' t,:i....d N,:ct,c+ SUpplcsnmtal turoraanma TLTE OFWORK SCHEDULE NrW tunJiruetion ®Ur nolurr,n For cial information u.Ae checklist _.. . t scncbon k Total. ❑Addition'aherationimplaceinent 1 0 Ot r New 1-2-64Lidy d dli ' CATEGORY OF C(3NSI'RUCTION SFR(1}bath 1270 --^� ( SFR(2)bath 1 437.78 c/37} ` A 1-and 2-family duelling ©Co mmerciaVindust Cal SFR(3)bath 500.32 Acceexnly building 0 MULU fatnily Each additional bath/kitchen 25.02 0 Ma.ster Milkier 0 Other: Fite sprinkler( xq.(L) Page 2 JOB SATE INFonswrios AND LOCATION .Site unlinks. , �•. Catch basin of area thsin 18.76 Job eta address; t, a1 B S t-i A 0 Drysioli,leach line.or trench drain 18.76 City/State/ZIP: Ti (y j�,i'1 e)Bt- q 1 AI.3 Footing drain(no,linear ii Pafc 2 g7 5uiL&bIdglap4 no.: Project name: 9 4 4 A.1)c Manufactured home utilities 50.03 Ca txs sviceUdirettioas to job site: 7%/i3 YL-c^rl'.$ t eiry g..P . Manholes Is.76 Rain drain amnector 18,76 Sanitary sewer(no.linear 1 rage 2 Slam senor(no.linear ft CIO Page 2 Water service(no.linear li 1 Page 2 Subdivision: Lot no.: Fixture or Item: Tax andOparcel no.: Bean prevcniec 31.27 a .. , ,''- , C r„ sn ; . Backwater valve 12,51 lt-1 1. L,11)( r ' 3; ,i.lf auk:,weshar 25.02 / G7ftC/ t` r�/ I . ,ve i t i, ie/ f' _n�irwastter I 25.02 ,2 l3 R 7 m' prinking Fountain 25.02 Ejccaorrrsump 25,02 0 .•., 1 -I cy' F sitnr tank 12,51 ..a -liy- , Fixture/seismcap 25.02 Name: 311 /_�C.,r„"z'' Floor drninitioar sinknwb 25.02 Address: gZ-30 j`L.J 7 At 41 e- j -^f Garbage disposal 25.02 City/State/LIP: 726i' 1 r/ y 4 c2 I'!2„2,7 hose bib L., 25.02 - Phtme:1 ) Fax:( ) ice maker 12:51 Al APPLICANT ❑ co♦TAC"t PF.FLSON Intcrcepten/grease trap 25.02 ... ; Ni 0•"al gas(valve'$_) Page 2 Businessnoon: -1 n : --/ -- ---- Pruner 12.51 Contact!tame: Roof drain(commercial! 1151 Address: Sink bnsimAavatory 25.02 CitylState/LIP: _.._ Solar units(potable sisal 62.54 Phone:( ) Fa),: :( i Tub7sh»wrrlslsower pan _..12,51 - E-mail: Urinal _ 25.02 f-0, _a ,,. . a +,a r. a,... - Water closet 25.02 =, .+w-r L+°.:1 42'1u „.} QR WatcriKalar 7752 __. . , Fiusi>acs tttene: \-__.._a _ s '-'_.j. 5es,.iv pira..+-�+ %t 9 L.C.,. WMcrpipingDWV 5629 Address. t2v2 Sv v..St-r-- 0 ig... Other. 25.02 CitytStateYLIP: a. t o 12 t3 Z &twa ` `(93) -, - 13 rax:I 1 .. jl/.Z3 t,. mm permit FCC $72.50 ---an-t- Mini CCA Lie.: 1 e , , Pltsnbing Lie.no.: Z w 1 1 y7 i P1ad review f'�ShG of permit tee) ._., _ State surcharge 02%ofpermit fee) Authorized si store: ,,'- ItY(AL PERMIT FE ..�.+' +y Tata permit apptratiaw eapfa st“a prevail is vet atdtiatd whits 1 as drys Print n i v.{ .. t?= y'�... I F=R'7 after It per Marc sorepted aa umpteae. lt��.. •€of too.b dotogy we ay Tni-Gwntp Uuilkna No-dust)Scrota Ikmd. I dloditurghrmurrt-.MU Permit/km dot l4rolar,+ ru lat8T0 arlyanul:ss /Nd rE 6 4.a d ; 7-97'-y 1 & 7 - ,C v City of Tigard 1Zig1 ,0 ■ COMMUNITY DEVELOPMENT DEPARTMENT C T I G A R D Building Permit Review — Residential Building Permit #: r 12C12-0 00 35 7 Site Address: 9.22 e ,C)10 ?1/71 _ , -e Project Name: pat �t{ Lot #: Planning Review yposal: /Veit) dt ge__ k_ Verify address/suite# active in Accela. Ofrin River Terrr e: No ❑ Yes,River Terrace Review Addendum Siy Plan Elements: 'Erosion Control copies of site plan on 8-1/2"x 11"or 11 x 17"paper U.I!114-tamed trees with drip line and tree protection measures HA rawn to scale(standard architect or engineer scale) �..1 otprint of new structure(including decks)and FFE orth arrow 1� ,tility locations&easements(required for new and additions) ate address,project or subdivision name and lot number L!Sidewalk/driveway approach �/�tpplicant information(name and phone number) ocation of wells/septic systems L. dimensions and building setback dimensions 1111'. eet tree size,type and location 14 •uare footage of buildings to be demolished ! ' reet names 7 ' ling structures on site Comer elevations (2'contours if more than 4'differential) 11 't area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes II.► o )pervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? oyes 7I No NJ Clean Water ices—Service Provider Letter (lot platted prior to 9/10/1995): )14 Required: Yes,applicant was notified ❑ No Received: PJ Yes El No Water Meter$tture Unit Worksheet—Additions,Remodels and ADUs�'71//,V4) equired: D4 Yes,applicant was notified ❑0o Received: 1[�Yes No NJ SDC Exemption for ADU applied for: qd Yes El No Received: ❑ Yes ❑ No O 'ublic Facilities Improvement(PF1) Permit: quired: ElYes,applicant was notified No A ed For. ❑ Yeses ❑ No,stop intake and Use Case#: �•9 tat)— �)t�i/ Zoning: ,a�^ (-r— �equired Setbacks: Front: � Rear: s Side: c Street Side: /U4 Garage: Ol � -- l1Q Building Height: Max. Height: Q Actual Height: /y S a andscape Area: % ❑ Lot Coverage Max: Entran ❑ Set back no more than 8'from street-facing wall -\ Parallel to street or offset 45 degrees or less Windows ■ , urn 12%of area of all street-facing facades Garage ❑ Garage .-.r is behind widest street-facing w. ❑ Yes ❑ No,one of the following is met: ❑ Door ext- • no more than 5'fro.- all and there is a covered porch extending beyond garage. El Door extends no • e tha. rom wall and there is a 12 sq ft.window above garage on 21'd floor. ❑ Garage door width is • • ess El 50%or less of facade ❑ 60%or less and includes 7 of following: ❑ Covered port. • Recessed - ce El Wall offset ❑ 1'Roof eave ❑ Roof offset ❑ Fire s •:es El Lap Siding • '-.of pitch ❑ Gable,hip,or gambrel roof ❑ Dormer El cent siding ❑ Window trim ■ ' '.dow recess El Window projection ❑ Balcony ❑ Visual Cle. : ce ❑ Urban Forestry Plan ❑ Se '. e Lands: ❑ Yes ❑ No Type: II[ onditions met prior to issuance of building permit No Approved By Planning: —C—_- /7 Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms1BldgPermitRvw_RES_122419.docx • Building Permit Submittal Original Submittal Date: /L/ ' Site Plans: # ,�� Building Plans: # Building Permit#: Ca—Enter building permit#above. � Workflow Routing: [Planning Engineering �irermit Coordinator — Building Workflow Sign-off: 0'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. .12rtiuilding. original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: r 1/ L4-1 Date: /2/z 2/20 Engineering Review //`` 'Slope at building pad: 2% Er Conditions "Met"prior to issuance of building permit a UO Easements (encroachments) per engineering conditions of approval and plat nf"- R .Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Q�No Assess Water Quantity Fee in-lieu: 0 Yes LIDA Facility on lot: ❑ Yes [CYNo l Final Plat Recorded: 0l0- 0 NOT Approved by Engineering: Date: Notes: krApproved by Engineering: „f I i Date: f 2/23/242 3 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved 0 Not Approved Revision 2: ❑ Approved 0 Not Approved Permit Coordinator Review X. 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: SDC Exemption: Received ❑ Does not apply ,2a SDC Fees Entered: Wash Co Trans Dev Tax: '' yes ❑ N/A Tigard Trans SDC: Yes 0 N/A Parks SDC: X Yes ❑ N/A LIDA 0 Yes ' N/A $. OK to Issue Permit Approved by Permit Coordinator: AnYvp Date: 0.I2,8I2.02V 1:\Building\Forms\B1dgPennitRvw_RES_122419.docx RECEIVED DEC 0 5 2020 � CITY OF TIGARD CleanWater Services SENSITIVE AREA PRE-SCREENING SITE ASSES f4ffr Clean Water Services File Number 20-003083 1. Jurisdiction: Tigard 2. Property Information(example: 15234AB01400) 3. Owner Information Tax lot ID(s): Name: George Deoca 1S125DB02800 Company: Address: 9230 SW 74th.Ave OR Site Address: 9230, 9228 SW 74th Ave City, State,Zip: Tigard, Or., 97223 City, State,Zip:Tigard, Or., 97223 Phone/fax: 503-341-4023 Nearest cross street: Taylors Ferry Rd. Email: 9eodeosolaris@gmail.com 4. Development Activity(check all that apply) 4. Applicant Information ❑ Addition to single family residence(rooms,deck,garage) Name: George Deoca ❑ Lot line adjustment 0 Minor land partition Company: 0 Residential condominium ❑ Commercial condominium Address: 9230 SW 74th.Ave ❑ Residential subdivision ❑ Commercial subdivision City,State,Zip: Tigard, Or., 97223 ElSingle lot commercial ❑ Multi lot commercial Phone/fax: 503-341-4023 Other ADU Detached Email: geodeosolaris@gmail.com 6. Will the project involve any off-site work? ❑Yes 0 No 0 Unknown Location and description of off-site work: 7. Additional comments or information that may be needed to understand your project: We are building a detached ADU behind our existing home. Please let me know if we need to add anything? Thank you Geo This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality, Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form, the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/type name George Deoca Print/type title Signature ONLINE SUBMITTAL Date 11/19/2020 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200'of the site.THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. Based on review of the submitted materials and best available information sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5,Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and approvals must be obtained and completed under applicable local, State and federal law. ❑ Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5,Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and approvals must be obtained and completed under applicable local,state and federal law. ❑ THIS SERVICE PROVIDER LETTER IS NOT VALID UNLESS CWS APPROVED SITE PLAN(S)ARE ATTACHED. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed by Date 11/25/2020 Once complete,email to:SPLReview@cleanwaterservices.org • Fax: (503)681-4439 OR mail to: SPL Review,Clean Water Services,2550 SW Hillsboro Highway, Hillsboro, Oregon 97123 vlxtd 2/2020 Main Office • 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 • p: 503.681.3600 f: 503.681.3603 • cleanwaterservices.org • GDR( l) Sv3 - I- / -Loa3 Q ? f 9) 3° sw 74( 41-uc >d pr -T/to gR,) , G 2 97' -.3 TMPROPOerY LP* " e-r2Qx 'CAM \\ see UP SMACK Li -al it-7- moo xo ' \ 1 \ \� l 1. l \ ‘I rt7 j ! ' 0 I 1 • \ \ C L 14 .� \I I Tot �`• �� , Lj: I1,sj t -+ . w. LWISPIER.e.1. Bran �,�, \\ I — : — — , _I— \ LOCJT®e MOW bile-1 mr0 v- tl� M I. era PLAN Gent!-a'eD MR II3ASMi6TG44 CaetiT TAIL!LPG AM IbMIPIPIAP. Y LOcA104 a e• X V -V X• % X- - C.I L f Pt 04 ect-t 0 A FtncC h Ct TAx+•P.IMOD 4- SITE PLAN x ` T,p'CPmum J er-A+W.P•20-O' 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. SiCity of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter 13125 SW Hall Blvd. •Tigard,Oregon 97223 • 503.718.2439 • www.tieard-ar.gov TO: A-T-TA, A LL1 y5e1 _ DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Gecc -e., D e...o 'JAN 2 i 2011 COMPANY: CITY OF TI.' PHONE: 603 - 3 N I - t/a 9z 3 BUILDING c `aY''``' IS EMAIL: 9 -et9- tvt r 1S� nar nL ' cOIAA RE: `tga8 5 7 XV e M ST.1a0 • 0033 i' _. (Sitc Address) (Permit Numbcr) 1) COCA if t)C k (Project name or subdivision name and tot number) ATTACHED ARE THE FOLLOWING ITEMS: Co,.es: Description: Co Descri lion: Additional set(s)of plans. Revisions: J Cross section(s)and details. Wall bracing and/or lateral analysis. — Floor/roof framing. Basement and retaining walls. Beam calculations. X Engineer's calculations. Other(explain): — REMARKS: Yy u 55. P4 c ce.+i J -e 5Pa r i5 e 11-0 Pie( Aj Re v.C(} ' FO' 0 ' '+CE USE ONLY Routed to Permit 1'cehnici: i: Date; `3 2� _ Initials: Fees Due: n Yes W® Fee Descri.do : Amount Due: $ T. T7imP $ j5. Special Instructions: - — Reprint Permit(per PE): IDYes i No Done Applicant Notified: Date: Initials: A