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Permit Support Document (5) 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 III _ II Transmittal Letter T I G A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tieard-or.eov TO: Allyson Armstrong DATE RECEIVED: DEPT: BUILDING DIVISION FROM: Allison May RECEIVED COMPANY: Westwood Homes LLC SEF u U 21711 CITY OF TIGAR PHONE: 503-713-6294 3IIII_DING DIVISI ICY'— - EMAIL: allison@westwoodhomesllc.com RE: 12050 SW VIEWCREST CT MST2020-00219 (Site Address) (Permit Number) Estates at Aspen Ridge Lot 2 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: 8� 711-:':: �.-a '' i'l t‘-',4-' ',h 0.i'''" S5 ^t'i !^s°.., +5 '''''..*„.1, 'A' r{ :y e - rx + > t �" Re=p! !l l w a� k¢9 1 1 E r� @ i,� i i C .. ..5:a�>�. x d�¢' <�..�w;. .,,4. ! '.'..-: '44'4.,' x 4'€>�i✓� � v.,`I f gz'sl«„'Z ` � �i�C"-+r't�J.:: '1 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. 3 Other(explain):TSI Revision REMARKS: We had to change a few floor joists and head them off to drop the floor in the two showers upstairs. FOR • OF CE USE ONLY Date: 9 21 f -j Initials: Routed to Permit Technici 44-#1- Fees Due: [I Yes w No L---Fie Descriptio/i: Amount Due: $ Q h 1! v I $ Special Instructions: Reprint Permit (per PE): I❑ Yes _ , I ❑ No ❑ Done 2A,\,_ Applicant Notified: ----7 �7 ate: 7 5/,,i( Initials: (1 • • CITY OF TIGARD MASTER PERMIT 0• COMMUNITY DEVELOPMENT Permits: MST2020-00219 • T[GAR I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04122/2021 Parcel: 2S110BC12700 Jurisdiction: Tigard Site address: 12050 SW VIEWCREST CT Subdivision: ESTATES AT ASPEN RIDGE Lot: 2 Project: Estates at Aspen Ridge, Lot 2 Project Description: New detached dwelling. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 1289 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 1510 sf Garage: 773 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2799 sf Value: $396,079.37 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines. 100 SF Rain Storm Sewer: 100 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines. 100 Drains: Catch Basins: 0 Bckflw Prevntr: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Typos Air Conditioning: Y Vent Fans. 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods. 1 Other Units: 0 Fum<100K: 1 Vents: 0 Wocdstoves: 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'l 500 sf: 6 201-400 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. BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VC R-3 2799 Owner: Contractor: ANASTASIOU,ANASTIS WESTWOOD HOMES LLC Required Items and Reports(Conditions) ANASTASIOU,HARRY 12700 NW CORNELL RD 1 Ersn Cntrl 503-639-4175 17 PARTRIDGE LN PORTLAND,OR 97229 LAKE OSWEGO,OR 97035 PHONE: PHONE: 503-330-2215 FAX: 503-342-2403 Total Fees: $39,532.89 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 By: 1-1aLby VAMi'De111eoe Permittee Signature: 0 Ili sr4PPUC.titrt,01't 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 . 3 j; Residential RECEIVED FOR OFFICE I SI.0\1.1' City of Tigard 0 2020 Date/By:eived Re` 7/j,C/ xVio Permit No,,(ZT 2�—eV Z., 9 NI C • 13125 SW Hall Blvd.,Tigard,OR 97223'JUr PlanResiew / /� Phone: 503.718.2439 Fax: 503.598.1 y o TIGARD Date/By: 7(a7 Z� /'A otherpermit tvg.20 0—,90135 TIGARD Inspection Line: 503.639.4175 Date Ready/By: Julia: See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: 7 (e/ t .. 9 Supplemental Information /�"14/t_. /t7tr.ID.� TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction ❑Demolition Permit fees*are based on the value of the work performed. ❑Addition/alteration/replacement ❑Other: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El 1-and 2-family dwelling ❑ Commercial/industrial Valuation: $ 39�J b7 1 ElAccessory building El Multi-familyNumber of bedrooms: ❑Master builder ❑Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 2, 3 `/ 57 0`� Job site address: 120W 5 N vi G(es-/ G-/. New dwelling area: 21 Gj7 square feet l 5I 0 City/State/ZIP: Garage/carport area: Q 'f� square feet Suite/bldg./apt.no.: Project name:�.Q, eq./48. y, Covered porch area: ` , square feet Cross street/directions to job site: (if q% Deck tar. 5'�� square feet vmer strucFai square feet ,[,� s '/ REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:•eS 5 "�7L 095p in �j(/� Lot no.: 2-- Permit fees*are based on the value of the work performed. 9 Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK ,/ work indicated on this application. w S;111/. -{ �wi1_ 1-as7f(l-n)44/ Valuation: $ ✓✓ Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: i Name: Same as applicant Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: ® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule Business name:Westwood Homes LLC Structural plan review fee(or deposit): "j 5(, S I Contact name::4l uSaYt Mail tj J FLS plan review fee(if applicable): Address:12700 NW Cornell Rd Total fees due upon application: City/State/ZIP:Portland,OR,97229 Phone:5O3—•13—lp Z s7Gl Fax::( ) Amount received: E-mail: 4.1 L%5(f►' QttieShi f oD ch 0M's L�a C J PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: W QS trOa rkitS L../.—C.- Submit two(2)sets of roof plan with connection details / and fire department access,along with the 2010 Oregon Address: 12,7 0 O (V I1/ Cv r�I ( ed. Solar Installation Specialty Code checklist. City/State/ZIP: por'Fl GLl. ©a- ' 7 ZZ 7 Permit Fee(includes plan review $180.00 and administrative fees): Phone: 7/�j (P Z (./ Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:195597 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after It has been accepted as complete. Print name: �-1 idb MtVl lt.t/ Date: (//50/�� *Fee methodology set by Tri-County Building Industry J Service Board. 1:1Building\Pennits\BUP-RESPennitApp.doE 02/24/201 I 440-4613T(11/02/COM/WEB) Mechanical Permit Application ,/C FOR OFFICE USE ONLY • Cityof Tigard RECEIVED E.D Received _ ` - g Permit No.: -0 • 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: I z S 12U2p Q J Phone: 503.718.2439 Fax: 503.598.1960 JUN 30 2020 Plan Review Date/By: Other Permit: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: hurts: H See Page 2 for Internet: www.ti and-or. ov g g CITY OF TIGARD Notified/Method: Supplemental Information BUILDING DIVISION TYPE OF WORK • COMMERCIAL FEE* SCHEDULE -USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: /��yy 5 �� n Air conditioning 1 46.75 46.75 Job site address: I ZVJ t/ .7W V ,{AJt�Y S� l%� Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75 City/State/ZIP: 7j ,5 4.1-at 04- 9�.2 2f..� Furnace 100,000+BTU(ducts/vents) 54.91 HeaJ _/�/ Duct pumpwork 61.06 Suite/bldg./apt.no.: Project name: S Q� /� Duct work 23.32 23.32 Cross street/directions to job site: /e./GiCkCi Hydronic hot water system 23.32 CVJ 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 >i< 23.32 23.32 Other: 23.32 Subdivision: Lot no.: Z Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Oth ElPROPERTY OWNER El TENANT S' 23.32 Environmental exhaust and ventilation: Name:Westwood Homes LLC Range hood/other kitchen equipment 1 33.39 33.39 Address: 12700 NW Cornell Road Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP:Portland Oregon 97229 Single-duet exhaust(bathrooms, \p toilet compartments,utility rooms) scot" 23.32 93.28 Phone:(503)713-6294 Fax:( ) Attic/erawlspace fans 23.32 ® APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name:Westwood Homes LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Allison May Furnace,etc. 1 14.15 Address: 12700 NW Cornell Road Gas heat pump Wall/suspended/unit heater City/State/ZIP:Portland Oregon 97229 Water heater 1 4.03 Phone:(503)713-6294 Fax: :( ) Fireplace 1 4.03 Range 1 4.03 E-mail:allison@westwoodhomesllc.com Barbecue CONTRACTOR Clothes dryer(gas) Business name:Performance Insulation&Energy Services' MECHANICAL PERMIT FEES* Address:12700 sw hall blvd Subtotal 326.44 City/State/ZIP:Tigard Oregon 97223 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)598-8001 Fax:(503)598-8002 State surcharge(12%of permit fee) CCB lic.:199448 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 Board Print name:Allison May Date:4/3Q/2024 I:\Building\Permits\MEC_PamitApp_040113.doc 440-4617T(11/02/COM/WEB) Electrical Permit Application FOR OFFICE USE ONLY + City of Tigard RECEtV EG Received Permit#.�/�t 13125 SW Hall Blvd.,Tigard,OR 97223 DateB t V`�T 2-0 ��o if-2-1 :� I ' Phone: 503.718.2439 Fax: 503.598.1960 J U N 3 0 2020 Plan Review Date/B Related Permit#: Inspection Line: 503.639.4175 Ready Date/By: kris: Fil See Page 2 for r I G A P. Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information TYPE OF woddtll1DING DIVIv10N PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more 0 Building over three stories. El Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. ® I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived Job#: Job site address: / .0 S� V I&'t1C , 'f-£ ❑Additioo new motor load of system. 100HP or more. ❑"A","E","1-2","1-3", City/State/ZIP:nlard OE- 1 7 22-"( ❑Six or more residential units. occupancy. 0 ID Health-care facilities. Recreational vehicle parks. Suite/bldg./apt.#: Project name:.O,sy-a.'5 a 45-pe/f'L ❑Hazardous locations. 0 Supply voltage for more than / ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: �iiv vy� FEE SCHEDULE 9 Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision:.- leS Ay,- 61-5 j�- Lot#: Z Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'l SOD sq.ft.or portion 33.92 1 DESCRIPTION OF ORK Limited energy,residential 75.00 2 New SFR (with above sq.ft.) Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy ❑ See Page 2 ® PROPERTY OWNER El TENANT Services or feeders installation,alteration,and/or relocation Name:Westwood Homes LLC 200 amps or less 100.70 2 Address: 12700 NW Cornell Rd 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State✓ZIP:Portland,OR 97229 601 amps1,000 to amps 301.04 2 Phone:(971)678-5018 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 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 :4 APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name:Same as Owner above service or feeder fee, each branch circuit 7.42 2 Contact name: B.Fee for branch circuits without service or feeder fee,first Address: branch circuit 56.18 2 City/State/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Ross Electric Inc Sign or outline lighting 67.84 2 Address:2870 SE 75a Ave#203 Signal circuit(s)or limited-energy ❑ See Page 2 2 panel,alteration,or extension. City/State/ZIP:Hillsboro,OR 97123 Each additional inspection over allowable in any of the above Additional inspesdon(1 hr min) 6625/hr Phone:(503)642-2800 Fax:( ) Investigation(1 hr min) 90.00/hr Email:RossElectric@comcast.net Industrial plant(1 hr min) 78.18/br Inspections for which no fee is CCB Lic.: 157891 Electrical Lie.: 34-436C Suprv.Lie.: 42325 specifically listed('Vs hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Stephen Ross Date: ❑Plan Review Required(25%of permit fee): J /,t State surcharge(12%of permit fee): Authorized signature:�i l4 . ' 4;1 TOTAL PERMIT FEE: `�rL "/f /F This permit application expires if a permit is not obtained within 180 Print name:Sr�eph eA'1 0 Date:67/// /� 70,0] days after it has been accepted as complete. * Number of inspections allowed per permit. I:muildinglPermhs\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 4404615T(11/05/COM/WEB PIumbing Permit Application Building Fixtures RECEIVE IOR OFt7('f: 1'SL O\1.!' City of Tigard `l)N 3 0 ZOZO Re • 13125 SW Hall Blvd.,Tigard,OR 97223 +�Y: Permit N°M3.j2e;- '-670 Z 1 _ Phone: 503.718.2439 Fax: 503.598.196t,a OF TIGARD Plan Review Inspection Line: 503.639.4175 DudBY: Other Permit No.; l " 1`1� Internet: Line:gerd or.gov 6IIII DING DI.VIS10 Date Rea�By: ,ter 1 iD see Page 2 for Notified/Method: I Supplemental information TYPE OF WORK FEE* SCHEDLJI,E ®New construction ❑Demolition Fors Penal utjorrrtatlph use checklist. ❑Addition/alteration/replacementDescription 1 Qty. 1 Ea. 0 Other; Total New I-2-family dwellings(includes 100 ft for each utility connection) CATEGORY OF CONSTRUCTION . SFR(I)bath 312.70 et I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3) t l 50032 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft) Page 2 JOB SITE INFOR.IATION AND LOCATION Site utilities: Iob site address: i`y 3,-0 s T i Catch basin or area drain 18 76 City/State/ZIP:Tigard OR q 7 f a Dlywell leach line,or trench drain Page18.76 2 �/ ` ,,- n Footing drain(no.linear ft: Suite/bldgJapt.no.: I Project name:,. 57"7 Ar �'YS Manufactured home utilities ) 2 / T 50.03 Cross street/directions to job site: 14'/d/),( _ Manholes 18.76 �� vv Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft:_ J Page 2 Subdivision: Water service(no.linear ft.: ) Page 2 Lot no.: - Fixture or Item: Tax map/parcel no.: • Back low preventer I 31.27 DESCRIPTION OF WORK Backwater valve 12.51 1 r f - Clothes washer ' 25.02 Dishwasher il 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER - 1 . 0 TENANT Expansion tank 12.51 Name:Westwood Homes LLC Fixture/sewercap 25.02 Address:12700 NW Cornell Road Floor gedr disposal/floor sink/hub 25 02 City/State/ZIP:Portland OR 97229 Garbage 25.02 Hose bib 2 25.02 Phone: Fax:(503)342-2403 Ice maker i 12.51 ®APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:S_ ) Page 2 Contact name: Primer 12.51 Roof drain(commercial) 1251 Address: Sink/basianaratory 6- 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone: Fax::( ) Tub/shower/shower pan 3 12.51 E-mail Urinal 25.02 Water closet 25.02 COTS RA(TOR. Business name:H&H Mechanical Water heater 37.52 Water piping/DWV 56,29 Address:5757 SE Willow Lane Other. 'a, s1/44)1 1 \ 25.02 City/State/ZIP:Milwaukee OR 97267 Subtotal Phone:(503)975-9787 Fax:(503)659-2979 Minimum permit fee: 572.50 CCB Lic.: 178122 Plumbing Lic.no.:POL/'I Plan review' (25%of permit fee) i2 � , 1 54 State surcharge(12%of pemlit fee) Authorized signature: TOTAL PERMIT FEE IPrint name:Dus' ague J Date <3 This permit application expires if a permit it not Obtained within ISO days after it has been accepted as complete +Fee methodology set by Tti-County Building Industry Service Board. ):lavildung\Permus1PLMU-Pmnitwppdoc 10/01/09 440.46167(10'02/COMfWE8) Plumbing Permit Application ' Building Fixtures i � ,,),; (,r lit i , tit 0„l,, fik City of Tigard A U G 2 6 Jtmeivrd /� 13125 SW Hall Blvd,Tigard,OR 97223 AaldB: �' L'Gr r( ) Pamir xa.://!a72�Z0"GAG' J B Phone: 503.718.2439 Fax: 503.5981960,ITY rreltevkw Inspection Line 503.639.417$ „ C F rI GH({- ate P.c Other Pewit Na: 7:f(.iaKU 1 n PIS mine,•' Dewgrad By:Internet•. www.ligard-or.gov juw� 0 see Pie i ear 1 /1dQ1pd: trIPPiemeemr:14, ason TYPE OF WORK Et New construction F1SEt []Demolition For special L)formaa'oa use checklist ❑Addition/alteration/replacement 0 Other. Description Qh Be Total New 1-2-family dwellings(includes 100 it.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 21 1-and 2-fantiiy dwelling 0 Commerelabbdustrial 4t7.78 7.78 ❑Accessory building50032 0Hniti-family 500.02 Each additions/bath/kitchen 25.02 0Master builder 0Oder: _ Pire sprinkler(_,,,,sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site stainer: lob site address: r / jl1 Pw l�7�/. Catch basin or area drain ? 18.7b 111 City/State/ZIP:Tigard OR a Drywall,lead[line,or bench drain 18.76 Suiielbldg✓apt.no.: Project name:� �' /1.� i 1 Page 2 `��.e'�TS� �. ll 50.03 Cross street/directions to job site: 1�-"► i' Mmiwks =�_ Rain drain connector I8.76 MIMI Sanitary sewer(no.lines fL:._,_) Pagc 2 Storm sewer(no.lines 8:,_,_,) Page 2 Subdivision: Water service(no.linear 11,: ) Paget 1 Lot no.: 2 Fixture or Item: • Backow premier 31.27 map/parcel no.: BadrwaYvvale 12.51 .11 •DESCRIP ION OF WORK v Clothes was 25.n4 1 .iaiyi -. 4d Dishwasher -_. 25.02 III Drinking fountain 25.02 IIII s PROPERTY OWNERL. 7E}VANT 25.02 ID 1111 12.51 Name:Westwood Homes LLCman 25.ffi MIN Address:12706 NW Cornell Road Floor drain/floor sink/Irab 25.02 1111 Garbage disposal Crt y/stau2lP:Portland OR 972x925.02 Hose bib 11111 25 .02 Eiralliphilitillaila Fax:(503)342 24p3 Ice maker APPLICfrJ 12 51 . ... ..0 CONTACT PBRB(fN._:: Interceptor/grease trap III 25.02 El Business name: Medical gas(vale S ) Pego 2 Contact name: Printer 12.51 Andress: Roof drain(commercial) I2.51 Sinlcibasiallavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone: Far:( ) TuWslrowrrlslwwerpaa NMI � E-mail Urinal 25.02 111.111 CONTRACTOR Water closet 25.02 111 Business name:MN Mechanical 37.52 rm Waterpipinp/DWV 56.29 Address:5757 SE Willow Lane lRAN0/ ✓/ lirill 25.02 111111M' Cit}/State/ZIP:Milwaukee OR 97267r) . ,yea, -%c j Z1 Subtotal aging Phone:(503)975-9787 Fax:(503)659-2979 f t�I2-,'9/ -! Minimum permit foe: $72.50 1111111 CCB Lie.:178122 Plumbing Lie,no.:P6q 1/-j Plan review (25%Ofpermit tee) _ Authorized signature: 11 •": - : f I� S��nF�] TOTAL PERMIT FEEMIME Print Warne:Dun' ague Date ���.!/'� This k perm appikalim expires ie a permit is nor obtained within$5 days " ' alter it has beee accepted as complete. • •Pea muhodeler/so by rri.Coomy Building Industry Service Board islawltiaswerrabskSaiu-PeneitAPP.doc ro/o.vi 440.4616T(I0g2XomMEB) City of Tigard C COMMUNITY DEVELOPMENT DEPARTMENT IPPI T]G A R D Building Permit Review — Residential Building Permit #: /`1ST?-f12O - 00 Z 19 Site Address: Pao if) ,fU e — Project Name: Es' 4 y.� Alzpn. p Lot #: .2 Planning Review D Pro sal: kleh 1 2� Verify address/suite# active in Accela. OP‘River Terr e: No 0 Yes,River Terrace Review Addendum Sit Plan Elements: fr.sion Control copies of site plan on 8-1/2"x 11"or 11 x 17"paper 111t -tained trees with drip line and tree protection measures Oli raven to scale(standard architect or engineer scale) �►I F otprint of new structure(including decks) and FF'h )forth arrowiliDd f.� • ty locations&easements(required for new and additions) 'to address,project or subdivision name and lot number II Sidewalk/driveway approach pplicant information(name and phone number) PA W,cation of wells/septic systems dimensions and building setback dimensions !I Str--t tree size,type and location are footage of buildings to be demolished P1 4,eet names -sting structures on site •Corner elevations(2'contours if more than 4'diffe dal) area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? Yes ❑I*]A an.en7ous area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown Yes�°y'("To 5" Clean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): 'equired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No it Water Meter Fixture Unit Worksheet—Additi s,Remodels and ADUs ' -quired: ❑ Yes,applicant was notified [ No Received: ❑ Yes ❑ No 10;DC Exemption for ADU applied for: ❑ Yes No Received: ❑ Yes ❑ No II Public Facili • s Improvement (PH) Permit: paired: Yes,applicant was notified ❑ No -1 lied For: Yes ❑ No,stop intake IlJ and Use Case#: �� US`00 A= 00070V.-Zoning: y�-z-1 .�� Pi/Required Setbacks: Front: w Rear: /- Side: Street Side: f-i Garage: 2O Building Height: Max. Height: Actual Height:'22« andscape r . % of Coverage Mays/ % l Entrance et back no more than 8'from street-facing wall )] Parallel to street or offset 45 degrees or less Windows 4inimum 12%of area of all street-facing facades �� Garage 0Gara door is behind widest street-facing wall ID ld 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 w and there is a 12 sq ft.window above garage on 2nd floor. Garage door width is ❑ 12'or less 50%or less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding Window trim ❑ Window recess ❑ Window projection ❑ Balcony \ / isual Clearance Urban Forestryylan i 3. 'ensitive Lands: ❑ Yes No Type: FA C nditions met prior to issuance of building permit N es: I .7� Approved By Planning: / . Date: .-hc1.2—(,) Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Fonns\BldgPennitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: /3 d 20 Site Plans: # 3 Building Plans: # .� Building Permit#: tD—Enter building permit#above. Workflow Routing: E�Planning C ugineering -e'Isermit Coordinator t D- uilding Workflow Sign-off: [Sign-off for Planning(include notes from planning review) Route Application Documents: [yEngineering: (1) copy of permit application, (1) site plan, (1) building plan and ��original plan review routing form. L"J Building. original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: ((l/ i L OaA— Date: 7A-57 e Engineering Review Slope at building pad: ' Conditions "Met"prior to issuance of building permit Easements (encroachments) per engineering conditions of approval and plat ID/Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 1 No Assess Water Quantity Fee in-lieu: ❑ Yes o LIDA Facility on lot: Ir' Yes ❑ No LI Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: (Approved by Engineering: Date: 21 20 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review )Ri 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: ,tS. SDC Exemption: ❑ Received 14 Does not apply ,KSDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA g Yes ❑ N/A OK to Issue Permit Approved by Permit Coordinator: Date:1 f z `20 I:\Building\Fonns\BldgPermitRvw_RES_122419.docx