Permit City of Tigard
71 COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Residential
TIGARD
Building Permit #: &! . i--( ipse
Site Address: 13615 SW 121st Ave
Project Name: 121st Ave Cottages South/ Rowan Cottages Lot #:
Planning Review
Proposal: Demo existing structures on site/
Verify address/suite#active in Accela. lln River Terr�ce: No ❑ Yes, River Terrace Review Addendum
Sits Plan Elements: -rosion Control
opies of site plan on 8-1/2"x 11"or 11 x 17"paper
cetained trees with drip line and tree protection measures
,//4 awn to scale(standard architect or engineer scale) ootprint of new structure(including decks)and FFE
rth arrow �\ Ttility locations&easements(required for new and additions)
ite address,project or subdivision name and lot number \-� idewalk/driveway approach
1p 'cant information(name and phone number)
atocation of wells/septic systems
dimensions and building setback dimensions t tree size,type and location
4uare footage of buildings to be demolished eet names
'V'xi g structures on site __,.,omex elevations(2'contours if more than 4'differential
t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 'es o j
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? 'es o
0 Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑ No Received: 0 Yes ❑ No
Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
0\160
Required: 0 Yes,applicant was notified ❑No Received: ❑Yes ❑ No
0 SDC Exemption for ADU applied for: ❑Yes ❑ No Received: ❑ Yes ❑ No
i❑ ublic Facilities Improvement (PFI) Permit:
Required: ❑Yes,applicant was notified CI pplied For: ❑ Yes ❑ No,stop intake
Land Use Case #: SDR2020-00001 Zoning: R-4.5
Required Setbacks: Front: Rear: Side: Street Side: arage:
❑ Bu .: _ Height: Max. Height: Actual Height:
❑ Landscape ' -a: % ❑ Lot Coverage Max:
Entrance — Set ba : .o more than 8'from street-facing wall ❑ P. :l el to street or offset 45 degrees or less
Windows Minimum 12' • c area of all street-facing facade
Garage _ Cram e door is behin. :dest street-facing wall ❑ Yes ❑No,one of the following is met:
Door extends no more .i 5' from w.. ,nd there is a covered porch extending beyond garage.
Door extends no more than . 4 wall and there is a 12 sq ft.window above garage on 2°d floor.
❑ Gara e door width is I 1 ' .r less t%or less of facade 60%or less and includes 7 of following:
Covered porch I Recessed entrance I Wall offset 1'Roof eave Roof offset
Fixes ' ; I Lap Siding ❑ Roof itch Gable,hi ,or gambrel roof Dormer
-nt siding I Window trim Window rec Window projection ❑ Balcony
❑ Visual Cie. . ce ❑ Urban Forestry Plan
❑ Sen 'e Lands: ❑ Yes ❑ No Type:
P. .•nditions met prior to issuance of building ermit `
N. es: APPROVED FOR DEMO OILY
!l Approved By Planning: —T - e`� -4? Date: .5"- 9/2l
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
1:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 5'/a!57 I
Site Plans: # a
Building Plans: #
Building Permit#: n�ter building ermit#above.
Workflow Routing: arming Engineering ertnit Coordinator ❑ Building
Workflow Sign-off: i-off for Planning(include notes from planning review)
Route Application Documents: I ngineering: (1) copy of permit application, (1) site plan, (1) building plan and
origins Ian review routing form.
uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: o q 7///Jl . ... 75t u"..( 2c—,rec 79. . off "-I Sy0 2,
By Permit Technician: t/jr.G.,,..„.e, Date: 6/0f
Engineering Review
❑ Slope at building pad:
6 ❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments) per engineering conditions of approval and plat
1, ❑ Water Quality/Quantity Facility: J�
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No L(/ �f
,-i Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
` ❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Mh.
.te Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Z
3 Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
b i111 Conditions "Met"prior to issuance of building permit
a II Approved, NOT Released: Date:
Notes:
,r Revisions (after Building Submittal only)
��l Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
4 SDC Exemption:
p ❑ Received Does not a.; y
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes J N/A
Tigard Trans SDC: ❑ Yes FA" /A
Parks SDC: ❑ Yes MI N/A
LIDA ❑ Yes I/ N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: 7e/9A
I:\Building\Forms\BldgPermilRvw_RFS_I22419.docx