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Permit 111 CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2021-00213 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/16/2021 Parcel: 2S 112BB03200 Jurisdiction: Tigard Site address: 8550 SW COLONY CREEK CT Subdivision: COLONY CREEK ESTATES Lot: 28 Project: Donaldson Project Description: Removing&replacing 381 sqft storage structure BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 0 sf Basement 0 sf Left: 5 Parking Spaces: 0 Height: 13 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 15 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: No Total: 0 sf Value: $7,620.00 Rear: 15 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains. 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 2 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: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 0 Owner: Contractor: DONALDSON,JEFFREY D&KARI LEE OWNER Required Items and Reports(Conditions) 8550 SW COLONY CREEK CT JEFF DONALDSON TIGARD,OR 97224 8550 SW COLONY CREEK CT TIGARD,OR 97224 PHONE: PHONE: 971-404-7220 FAX: Total Fees: $552.57 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: Holly Van, Permittee Signature: OvvAppi.. CCAVA -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. Building Permit Application : 5/24/21 Residential RECEIVED FOR OFFICE USE ONLY City of Tigard �aSe�nyd Q5f 27�zo2 �� Permit No.: M� QZ� ���13 -° 13125 SW Hall Blvd.,Tigard,OR 97223 AY 42027 'rl Plan Review (I 1/i'/ Other Permit: ll Phone: 503.718.2439 Fax: 503.598.1960 Date/By: f/ TIGARD Inspection Line: 503.639.4175 CITY Date Ready/By: �/` J / l�u�c►/- P1 See Page 2 for Internet: www.tigard-or.gov OF TIGARD Notiti- etho : L 41Qti`0 & Supplemental Information BUlLDIN . •►+ d.. Al/% TYPE OF WORK REQ RE 0 f TA:1-AND 2-FAMILY DWELLING ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. jIndicate 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. Valuation: $ O� ❑ 1-and 2-family dwelling ❑Commercial/industrial .LQ ❑ Accessory building ❑Multi-family Number of bedrooms: ❑Master builder it Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: Lr cr, New dwelling area: square feet 8/�5O �� j,� it City/State/Z1P: 6,6 t,D o&. 9;7 2 4 Garage/carport area: square feet Suite/bldg.!apt.no.: Project name: I\Eiekd)L.1) Covered poich area: square feet Cross street/directions to job site: Deck area: square feet —p 411 13L v D - 3 ,J -FA Al1V0 C. FIE R.- De, Other structure area: `sal square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Cd Jo - y C efik- -SrA7.4-S Lot no.:3Zcl z8 Permit fees*are based on the value of the work performed. 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. Valuation: $ 12E P1Acc E Jet sT-.•b S-r-o2nc. ( 4tgoc7,0e: Existing building area: square feet New building area: square feet "I..PROPERTY OWNER ❑ TENANT Number of stories: Name: ...1C Fj tEAt,i4 L PS oar-1D 0 14.At la Son Type of construction: Address: (.5;)SsU } On 10 i.J y (zee 0I Occupancy groups: City/State/ZIP: 1 ' L.4e, ) r O g 9 9-072 4 Existing: Phone:(1'7� 4104 7,2,20 Fax:( ) New: ❑ APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refertafeeschedui _ Business name: .. _.___._______._-___- Structural plan review fee(or deposit): i27 Contact name: ----- FLS plan review fee(if applicable): Address: - -- — — Total fees due upon application: City/State/ZIP: -- Amount received: Phone:( ) Fax: :( ) E-mail ( 1o' PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* 'I `� Commercial and residential prescriptive installation of CONTRACTOR noon t 0 k.1 n,f it roof-top mounted PhotoVoltaic Solar Panel System. Business name: -'E r F' r0® >0 4- U,,,LA S f Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address_ city/state./Z1P: 1 85.n S.i Coto --.y CPFED -r • Solar Installation Specialty Code checklist. _.-�--+ Permit Fee(includli __ Q jZ es pan review and administrative fees): $180.00 Phone:(� Lf uq 2 Zc Fax:( ) - State surcharge(12%of permit fee): $21.60 CCB lic.: Total fee due upon application: $201.60 Autht e r :• This permit application expires if a permit is not obtained \ 3L--4 - >t i tiCi:_ , within 180 days after it has been accepted as complete. Print name: Date: *Fee methodology set by Tri-County Building Industry _____ Service Board. I:`Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1I/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY Cityof Tiand Received g Permit No.: INw 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: _ Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: TIGARD 24-Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing 0 Mechanical Internet: www.tigard-or.gov 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: • ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity CICI CI 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ ❑ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore_on and shall be shown to be applicable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tame-ons. "Mirrored"building plans will not be accepted. ❑ ❑ Cl 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ Cl Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include theproject arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. l:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) • Electrical Permit ApplicatioI RECEIVE I FOR OFFICE LSE ONLY City of Tigard Received Permit#. 14Si2021-c02l3 II "" 13125 SW Hall Blvd.,Tigard,OR 97223 'MY 2 . 2O2 Date/BPlan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: Juris: ® See Page 2 for .. Internet: www.tigard-or.gov ��((���� Af�± �/�+ It Notified/Method: Supplemental Information TYPE OF WORKLDING DIVISION PLAN'ItEVIEVi'' ❑ New construction di Addition/alteration/replacement 0Pleas Service eckr all that apply(submit 2 e is ofplla /it over checked): P 0 Buildingthree❑ Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family ❑ Master builder 6 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived CC �- ❑Addition of new motor load of system. Job#: Job site address: 8 sae -xs� a i AI Oftrc 4-- car 100HP or more. ❑"A","E","1-2","1-3", City/State/ZIP: 1 ' &/q IL© 0 f 9 72r 1 ❑Six or more residential units. occupancy. 0 0 Health-care facilities. Recreational vehicle parks. Suite/bldg./apt.#: Project name: R l go i(,. 0 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: '^l" 't.i �ti x1�„ .. . ''PEt °° .114°°''''ir•t,, '!.-,„:',11 .h,r �, k ii- I 1 [Sty p — Sw r-P��.� e K- � P � Description Qty. I Each Total -�1 "�� / t l {� }� New residential single-or multi-family dwelling unit. Subdivision: Colo,",Y a Rtck F sr Are c I Lot#:3z“d2,5 Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 I L-/ -r 4 i v,i Lr T` C t KCU t 7 (/5 Limited energ y,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 E PROPERTY OWNER I 0 TENANT Services or feeders installation,alteration,and/or relocation Name: J E F F" bp, 1_p 0,,,,0 200 amps or less 100.70 2 /'� 201 amps to 400 amps 133.56 2 Address: 6550 W 6.--y C'g Ef k J • 401 amps to 600 amps 200.34 2 City/State/ZIP: "T j 1,4 2 ©i2 q 4.92 4 601 amps to 1,000 amps 301.04 2 Phone:(9 31) 404 _7-2 2 0 i 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 r sale,lease,T, or e2�chang cep cording to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: ��((Jf �(��"..�'L�J�r!/''�"`- Date:5h0/ZOZ J 401 amps to 599 amps 168.54 2 Branch circuits—new,alteration,or extension,per panel 0 APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with Business name: above service or feeder fee, each branch circuit 7.42 2 Contact name: ee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'l 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: Sign or outline lighting 67.84 2 Address: Signal circuit(s)or limited-energy 0 See Page 2 2 panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email: Inspections for which no fee is specifically listed '/z hr min 90.00/hr CCB Lie.: Electrical Lie.: Suprv.Lie.: p y ( ) ELECTRICAL PERMIT'PEES` Suprv.Electrician signature,required: Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. ' Number of inspections allowed per permit. I.\Building\Permits 1ELC1yermi\App_ELR_ERE.doe Rev 06/17/2015 440-4615T(1 1/05/COM/WEB • Plumbing Permit Application Building Fixtures RECEIVED FOR OFFICE USE ONLY City of Tigard G V Received 114 • 13125 SW Hall Blvd.,Tigard,OR 97223 ,L,' w� q q Date By: Permit No.: a Phone: 503.718.2439 Fax: 503.598.19�tpN t LUL1 Plan Review Date/By: Other Permit No.: TIGARD Inspection Line: 503.639.4175 Date Ready/By: uris I gi See Page 2 for Internet www.tigard-or.gov li • AHLI Notified/Met ed• 1 `+upplementat Information ' ....;. .` A i , a .fir FEE* r a xw . a ❑New construction Demolition For special information use checklisL Description 1 Qty. j Ea. I Total Addition/alterationreplacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)_ CATEGORY OF CON,STRUC TV � , SFR(1)bath 312.70 �„"e!ram ❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ❑Multi-family - SFR(3)bath 500.32 ❑Master builder Each additional bath/kitchen 25.02 ['Other: Fire sprinkler( ,sq.ft.) Page 2 s, a ,�JOR, ITE 5 r. Nc g r '�.,, ,.`�'����� - Site utilities: Job site address: &155C7 *Sc_.,,,,) Cz low C R. (�.- CT-, DryweCatch basin or area drain 18.76 City/State/ZIP: `T7 A.ALD r 0 t. e C+/72Z'ei Footing 1,leach line,or trench drain 1ge2 7 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: RE 13g. 7 L FJ Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 t-(Al! 13C-VD „e., FA0,,,y--V ORlelc ) r Rain drain connector r 18.76 ,P;(F 7ct. Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: )Onr �t.zi{‘.4 f S7,F4T 4 Lot no.: a /Z y Fixture or item: Tax map/parcel no.: - O Backflow preventer 31.27 DESCRIPTION OF..WORK S ti ,'''.`:1:... e: Backwater valve 12.51 Clothes washer 25.02 R e etACe EX- 57--4-43 5''GsL4 42 579,,anal Dishwasher 25.02 Drinking fountain 25.02 J Ejectors/sump 25.02 (:,.PROPERTY OWNE$W, 7 1 7' s� i. : . p1t' 4 Expansion tank 12.51 Name: ✓e,,�..t 41�TA L DS 0 IvFixture/sewer cap 25.02 v r, Floor drain/floor sink/hub 25.02 Address: 8 J U 53Ce,, co I©ti PE CZ--(k Cr:RGarbage disposal 25.02 City/State/ZIP: e,/p 17 R redo 2'z'' 4 Hose bib 25.02 Phone:(9'qi) 40+ 7.q2 v Fax:( ) Ice maker 12.51 0 APPLICANT CQNTACT IT,RSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 )+ Water closet 25.02 cQ / Om.r c4","..&"l r.,'.r I,..' Water heater 37.52 Business namee_44 IDe:),,,,)4 4,p SIN Water piping/DWV 56.29 Address: 85 a0 C.��� Co/oy"y 0J far( C7 Other: 25.02 7'City/State/ZIP: 4,4 a s/ a K+ 9 7 22 ell Subtotal ii- -' Phone:( c 4p 4 7-2 -a Fax:( ) Minimum permit fee: Plan review (25%of permit fee)tfee) 7�.so CCB Lic.: Plumbing Lic.no.: State surcharge(12%of permit fee) , 70 Authorized signature: TOTAL PERMIT FE17(s 1 ,3-0 LPrint name:_`a '�� 1:),-„,HL p So"..../ .Date: 6/ / Z/ This permit application expires if a permit is not obtained wi In1180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:10uilding\Permils,PLMt)-PermilApp.due IN01,09 44046 I6T(10/02/COM/WEa) City of Tigard 114 COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Building Permit Review — Residential Building Permit #: MSTZOZ(- DOZI 3 Site Address: 8550 SW Colony Ct Project Name: Donaldson Lot #: Planning Review oposal: Remove/replace attached acces .ry structure Sr e Verify address/suite#active in Accela. 1i n River Terrace: liNo ❑ Yes, River Terrace Review Addendum Si- Plan Elements: ,erosion Control rt copies of site plan on 8-1/2"x 11"or 11 x 17"paper ..Retained trees with drip line and tree protection measures ri oirawn to scale(standard architect or engineer scale) footprint of new structure(including decks)and FFh ► .rth arrow _ tility locations&easements(required for new and additions) F. t- address,project or subdivision name and lot number sidewalk/driveway approach FA.. .plicant information(name and phone number) Location of wells/septic systems FA .t dimensions and building setback dimensions street tree size,type and location quare footage of buildings to be demolished ...Street names FA sting structures on site _Zorner elevations(2'contours if more than 4'differential- ��,it area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? LJYes %,o impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es u 'o ❑ Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: ❑Yes,applicant was notified ❑No Received: ❑Yes ❑No Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs 4E1 Required: ❑Yes,applicant was notified ❑No Received: ❑Yes El No ElSDC Exemption for ADU applied for: El Yes ❑No Received: ❑ Yes ❑No 0 Public Facilities Improvement(PFI)Permit: Required: ❑Yes,applicant was notified ❑ No A.,lied For:pp❑ Yes El No,stop intake nd Use Case#: Zoning: fL' / uired Setbacks: Front: Fa F5 Rear: 15 Side: 5 Street Side: N/A g Gara e: 20 Building Height: Max. Height: 30 Actual Height: 13 1 Landscape Area: % ❑ Lot Cov rage ax: Entran Set back no more than 8'from street-facing wall II arallelto street or offset 45 degrees or less Windows .,. um 12%of area of all street-facing facades I Garage Gara e ..• is behind widest street-facing wa ❑Yes ❑ No,one of the following is met: Door exten.. •o more than 5' fr. all and there is a covered porch extending beyond garage. Door extends no me - from wall and there is a 12 sq ft.window above garage on 2nd floor. ❑ Gara:. El door width is 'or . 50%or less of facade 60%or less and includes 7 of following: Covered po — Recessed entr. ElWall offset ❑ 1'Roof eave Roof offset Fire gles _ Lap Siding II Roo -' ch ❑ Gable,hi ,or gambrel roof ❑ Dormer ccent siding _ Window trim C Win.. ecess LI Window projection ❑ Balcony ❑ Visual C -:.ance ❑ Urban ForestryPlan ElS-• tive Lands: ❑ Yes No Type: L Con 'bons met prior to issuance of building permit Not . ._//:_i__ Approved By Planning: --r ... --= Date: -2 -2- Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: /2 /2e'2f Site Plans: # �3 Building Plans: # 3 Building Permit#: Inter building ermit# above. � Workflow Routing: U Planning Engineering Permit Coordinator B tuilding Workflow Sign-off: I Sign-off for Planning(include notes from planning review) Route Application Documents: tngineenng: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. a3uilding: original permit application, site plans,building plans,engineer and beam calculations . • trust details,if applicable,etc. Notes: By Permit Technician: %i//? Date: 6/AD21 17= 7 Engineering Review Q Slope at building pad: 2,`2 Conditions "Met"prior to issuance of building permit P1/'- Easements (encroachments) per engineering conditions of approval and plat P f" Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes BNo Assess Water Quantity Fee in-lieu: ❑ Yes I No LIDA Facility on lot: ❑ Yes QFinal Plat Recorded: n I"- ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: T�,,�, f f,P„* ,� Date: Si' Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review •a 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: JLJ SDC Exemption: ❑ Received Z Does not a 1 mSDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes /A Tigard Trans SDC: ❑ Yes N/A Parks SDC: ❑ Yes N/A LIDA ❑ Yes N/A OK to Issue Permit Approved by Permit Coordinator: Date: 5 J 21 1 24)24 I:\Building\Forms\BldgPermitRvw_RES_122419.docx 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 1711 Transmittal Letter TIGARD 13125 SW Hall Blvd. •Tigard, Oregon 97223 •503.718.2439 •www.tigard-or.gov TO: f}')'j y $p,U f(Z DATE CEIVED: DEPT: BUILDING DIVISION DECEIVE D FROM: S e tf-f Wi n)e.-i_ D So iv JUN 7 2021 COMPANY: CITY OF TIGARD PHONE: 7 /,- 464_7-22 O BUILDING DIVISION EMAIL: e @ 81 4 D Bta L I-i g S' e C'Qj r1" RE: 5 C) SCR-) Co IOru (-R e-g ic CO°tL " / 57O�o11'(�Or�( 3 �(Site ddress) r� Q� (Permit Number) ! 1 � D, Q R, / 7 1 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: I Description �si( P400s i 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. 1:4_ Other(explain): f A I A' 'pier+) e eiN REMARKS: " . X r 'X,4�,,. 5' F1A.vL/3 ✓✓ ,k 1 1 s i _ Routed to Permit Technician. 21 Initials Fees Due: 0 Yes o Dee Des ri tion: Arn- �/ Amount Due: i a $ Special $ A6lt.r�ffZL,Sal f!P/?f a ( l�.j Instructions: l/ Reprint Permit(per PE): Yes I L-SO > ❑Done Applicant Notified: �__ Date: p c-A4 Initials: Property Owner Statement RECEIVED Regarding Construction Responsibilities MY 2zoz Oregon Law requires residential construction permit applicants who are not licensed witld FTIGARD Construction Contractors Board to sign the following statement before a building perm issued. (ORS 701.325 (2)) @krb G DIVISION 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. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: 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 10 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. �I E rF *DO r1 A Lb So /✓ Print Name of Permit Applicant 2/ J Co2.l Sig toe of P Applicant Date Permit#: Address: �NI;• ::41 a \ i'_ Issued by: Date: This Copy for Permit Offices