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Permit
BACKFLOW PREVENTER REPORT 0 EXISTING ❑I REMOVED KNEW 0 REPAIRED ❑REPLACED OLD S/N PROPERTY NAME ri 11 1 ni Q, V 1 V01 Y SCCir PHONE CONTACT NAME K.(2-U 6 '1 PHONEES-0 L1V I —L1 732_ MAILING ADDRESS CITY �/ �y )�� �� Q STATE ZIP PREVENTER ADDREES7S� 1 I 0( O 5W l,(X Vi 1 i� OJT 4•13OIrd 7 ' r� WATER SUPPLIER 113C1ra4 IAW-1 Pti SERIAL* �IGZ1s6 o Q LOCATION 014 .LA gO'S} Go4.Lrh.ti� MAKE Fc c/ MODEL VCSG SIZE t TYPE El RP ElRPDA 0RPDA-II'DC 1:DCDA ElDCDA-II Ei PVB 1:SVB ElAVB El AG HAZARD PROTECTED ❑PREMISE ISOLATION IWRIGATION❑FIRE SYSTEM❑BOILER❑OTHER APPROVED: ❑ASSEMBLY ❑INSTALLATION ❑ORIENTATION 0 AIRGAP PIPE SIZE in WEAN iD REDUCED PRESSURE ASSEMBLY PVBA/SVBA INITIALTEST CHECK#1 DOUBLE CHECK AIR INLET CHECK VALVE PASSED OPENED AT: PRESS DROP: PRESS DROP: CHECKS! TYPE II El FAILED El MIN 5 PSID TIGHT f INITIAL I' RELIEF VALVE T t MIN I PSID MIN IPSID DATE ��/�,;J2Z RESULTS LEAKED MN I PSID ! OPENED AT: OPEN ❑ MIN PSID CHECK#2 FULLY FAILED SYSTEM PSI RELIEF VALVE DETECTOR METER TIGHT 2 /' _ DID NOT❑ El LEAKED El MIN PASSED El FAILEDEl OPENOPEN MINI PSID NOTES REPAIRS PARTS TEST REDUCED PRESSURE ASSEMBLY PVBA/SVBA AFTER REPAIRS CHECK#1 DOUBLE CHECK AIR INLET CHECK VALVE PRESS DROP: CHECK#1 TYPE IIID OPENED AT: PRESS DROP: MIN s PSID DATE REPAIR RELIEF VALVE TIGHT 0 MIN I PSID MIN I PSI° RESULTS MINI PSID PASSED ❑ OPENED AT: CHECK#2 OPEN MIN 2MD FULLY 0 FAILED RELIEF VALVE TIGHT El MINI PSID 0 PASSED❑ FAILED❑ GAUGE S/N(21 ZI ZO l MAKE/MODEL f}'I IG We5F irqs--.S--CALIBRATION DATE I/S/202 2> In completing and submitting this test report,the tester certifies that the assembly was tested and maintained in accordance with all applicable rules,laws codes and regulations of the state and water system using approved testing equipment and approved testing procedures. INTIAL TEST TEST AFTER REPAIRS TES 3[� TURE TESTER SIGNATURE SI1`iTESTERS CERT## TESTER NAME(PRINTED) TESTER NAME(PRINTED) '1/I--tO I/s b KTE-e,UI,'V regwLASSCI C7cRTHONE# /1 TESTER ADDRESS n c}�,..TESTER ADDRESS @ Ct 4 ilex le Oe IOLAi•(-per R i13 , G/V WI15006 tiQ 1rIO `JEMAIL COMPANY NAME ��� COMPANY NAME WATER RESTORED? DYlrfrrel• �Gt ! HT RECEIVED BY(REPRESENTATION OF OWNER) REPORT RECEIVED BY(REPRESENTATION OF OWNER) WHITE-UTILITY COPY • YELLOW-CUSTOMER COPY • PINK-TESTER COPY 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. 11111 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter r i G A It D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Allyson Armstrong DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Allison May APR 1 2 2022 COMPANY: Westwood Homes LLC. LI I Y OF T IUARU PHONE: 503-713-6294 lUILDIt'G DIVISION By: EMAIL: allison@westwoodhomesllc.com u RE: SW Walnut Street MST2022-00024 (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 5 Additional set(s) of plans. S'4-c r'a� Revisions: _ Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: We moved the LIDA box location due to neighboring trees. FOR OFFICE USE ONLY Routed to Permit Technician: Date: Initials: Fees Due: ❑ Yes ❑ No Fee Description: Amount Due: $ $ $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes ❑No ❑ Done Applicant Notified: Date: Initials: 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 . ' Transmittal Letter 1 i t;,.i n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Allyson Armstrong&Planning Dept DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Allison May JUN 2 3 2022 COMPANY: Westwood Homes LLC. CITY OF TIGARLI BUILDING DIVISCI'n' PHONE: 503-713-6294 By: EMAIL: allison@westwoodhomesllc.com RE: 11850 SW Walnut Street MST2022-00024 (Site Address) (Permit Number) 11850 SW Walnut Street (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 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. 2 Other(explain):two sets of truss engineering and layout. REMARKS: Original truss engineering did not show raised heals.New truss engineering has been revised to show raised heals. FO OFFICE USE ONLY Routed to Pe ItTec ian: Date: (p Z�/�'a-- Initials: a Fees Due: 0 No Fee Desc a-- FeesY' iption: Amount Due: $ I/l'�k` A1/2 LOVA i z"i 64") $ CI SDI/ p $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes No ❑ Done Applicant Notified: Date: / ,/) ). — Initials: 1:\Building\Forms\TransmittalLetter-Revisions_073120.doc City of Tigard 111111 r COMMUNITY DEVELOPMENT DEPARTMENT C : ' T 1 c R D' Building Permit Review — Residential _fitffiT14 616B?g3M1Y3#7t#f'd>. qutimatinvi s 3 .:,.,t. ,.'$'ii6tion6�amlypili€Aiii lT naHo':1 nitatimulo°it Building Permit #: /7ccr77-021 c- OO2# - Site Address: / I Iva() SW K A LA)(.4- Sr. Project Name: (J)fiVDv0 thTht3 Lot #: Planning Review rgr'd•, - 'ATE,�'q4 S rivaC I sec OFplan)+ S lid•2-- 51cb PiAN MOKO ti bq tape loc21,10 Proposal: NEW perAcm-to OM rztv:3-ftaprtit44scsompenc stows cobs 2 �/` � %masses'PiP•Jna*S WPM cug. (d Verify address/suite #active in Accela. ❑ In River Terrace:'' No ❑ Yes, River Terrace Review Addendum Site 1an Elements: Ilf) rosion Control (3 copies of site plan on 8-1/2"x 11" or 11 x 17"paper 14 •11 Rpined trees with drip line and tree protection measures I wn to scale(standard architect or engineer scale) I2 otprint of new structure(including decks) and FFE rth arrow 10t}ility locations&easements(required for new and additions) Si ,.address,project or subdivision name and lot number S�J idewalk/driveway approach LdA plicant information(name and phone number) Location of wells/septic systems I161Lot dimensions and building setback dimensions et tree size,type and location Square footage of buildings to be demolished L��JSet names t E sting structures on site LJCorner elevations (2'contours if more than 4'differ tial) of area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Yes ❑No 21/Clean Water .ces—Service Provider Letter(lot platted prior to 9/10/1995): Wquired: Yes,applicant was notified ❑ N9 Received: ❑ Yes ❑ No ater Meter Fixture Unit Worksheet—Ad ' 'ons,Remodels and ADUs quired: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No C Exemption for ADU applied for: ❑ Yes No Received: ❑ Yes ❑ No Public Facilities Improvement(PFI) Permit/ Required: ❑ Yes,applicant was notified L1 No Applied For: ❑ Yes ❑ No,stop intake nd Use Case #: " Zoning: Q' y' -r e L� quired Setbacks: Front: 2-0 Rear: /S� Side: Street Side: /3 Garage: 2O VJ Building Height: Max. Height: Actual Height: X Landscape ea: MA- % 71 Lot Coverage Max, /VA 0/0 - Entrance �t back no more than 8'from street-facing wall Parallel to street or offset 45 degrees or less Windows �� Minimum 12%of area of all street-facing facades Garage Id Garage door is behind widest street-facing wall EITes ❑ 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. ,ZJ Garage door width is ❑ 12'or less lQ 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 ❑ Balc ny '-sual Clearance ❑ Urban Forestry Plan- , Sensitive Lands: ❑ Yes L2" No Type: NtirConclitions met prior to issuance of building permit Notfsf �Approved By Planning: Date: S`zZ Revisions (after Building Submittal only) Reviewer Date Revision 1: ,Approved ❑ Not Approved _ 2f 2Z Revision 2: e A roved ❑ Not Approved _____424 - _ Li 2 /tow$R. APpMkD 0 MX AFRO r --�_. Z I:\Building\Fonns\Bldg1'ernfit vw RES 122419.docx Building Permit Submittal Original Submittal Date: Ol/$/LO22 Site Plans: # Building Plans: # 3 Building Permit#: [1"—Enter building permit#above. Workflow Routing: [Planning [DEngineering [Permit Coordinator [uilding Workflow Sign-off: [a-Sign-off for Planning(include notes from planning review) Route Application Documents: Q.-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and • original plan review routing form. zit,. a . `[ Building: original permit application,site plans,building plans, engineer and � ' _ beam calculations and trust details,if applicable,etc. .. ►,looNdtes#47.'i<:4t"AOk ? FT ='a:.yi:T7.. By Permit Technician: Date: a4.6�2022_ Engineering Review Slope at building pad: 3 [2'Conditions "Met"prior to issuance of building permit ['Easements (encroachments)per engineering conditions of approval and plat Hr.-Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes C'/No Assess Water Quantity Fee in-lieu: ❑ Yes Er-No �/ �/ LIDA Facility on lot: 'Yes ❑ No Add Fee: L/f Yes ❑ No l� Final Plat Recorded: Cam'NOT Approved by Engineering: TYr rrn+ Date: 2I 31 Ztn-2- 1 Notes: "et"~P'efable ode,,14./7bb.j ok7 G111,1 d,v11 ni - incl./die gads need 1 pkyv4-411 plti.I.$ 12" drevin rocu. should be. 9" t 3" etokP - Coarse ElApproved by Engineering: Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: G°Approved ❑ Not Approved 7.7 ighZkg-t 41712 22 Revision 2: ❑ Agproved 'El Not Ap droved _ cZ6vis+a t:• PfAPP2DvkC) Q pi,tri kr Z-r 1 (c,n/01. 3e01-0 Oh Permit Coordinator Review rev, iofroi Conditions "Met"prior to issuance of building permit r Approved, NOT Released: Date: /Notes: alO realms C‘,rvS — \1._ 2-k (, I2)ZZ Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: 2 t„QCy,s •. 4.21`202Z Al— p'SDC Exemption: ❑ Received yi Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: ffri Yes ❑ N/A Tigard Trans SDC: 7 Yes ❑ N/A Parks SDC: 0 Yes ❑ N/A LIDA � Yes ❑ N/A 4 OK to Issue Permit Approved by Permit Coordinator: Date: 2-! 22.'l2V1 Plyti— — 1I21202Z I:\Building\Forms\BldgPermitRvw RES_1208021.docx Agnes Lindor From: Agnes Lindor Sent: Thursday, April 21, 2022 9:10 AM To: Allison May Cc: Trent Brickey; #Building Permit Technicians Subject: MST2022-00024 Hi Allison- Revisions are required for your permit. Please submit a revised site plan showing LIDA dimensions, type, material, and plantings. Please be sure to submit a transmittal sheet with your revisions. Thanks, Agnes Lindor Associate Planner City of Tigard Community Development 13125 SW Hall Boulevard Tigard, Oregon 97223 Phone: 503.718.2429 Email:AgnesL@tigard-or.gov 1 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 Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Agnes Lindor DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Allison May APR 2 5 2022 COMPANY: Westwood Homes LLC a1 Y OF TIGAtil1 PHONE: 503-713-6294 3t 1ILDING DIVI$IQhy: EMAIL: allison@westwoodhomesllc.com RE: 11$6'0 SW Walnut Street MST2022-00024 (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 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. Other(explain): REMARKS: See attached planting schematic that shows quantity and species of plantings that follow CWS requirements. F R O FI USE ONLY Routed to Permit Technici ,: ate: `�fa7 Initials: API/ Fees Due: Yes Nc' Fee Descri ti n: Amount Due: ❑ P ss Special Instructions: Reprint Permit(per PE): ❑ Yes No Done Applicant Notified: ���/f„�--Date: v/ Initials: 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 -7! , ` Transmittal Letter r l(u,A RI) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Allyson Armstrong DATE RECEIVED: DEPT: BUILDING DIVISION 4.4EGEIVED FROM: Allison May MAR 91021 COMPANY: Westwood Homes LLC. 1;11 Y OF TIGAHL 3UILDING DIVISIOI\ By: PHONE: 503-713-6294 EMAIL: allison@westwoodhomeslIc.com RE: 11860 SW Walnut Street MST2022-00024 (Site Address) (Permit Number) Walnut Street (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s)of plans. 3 Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: Response to review letter. FO OFF CE USE ONLY Routed to Permit Technic,i�: Date: . /I Z'_ Initials: L� Fees Due: ❑ Yes tom-/ Fee Descriptio : Amount Due: $ ;2;5, N D $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes Nov ❑ Done Applicant Notified: ` -ei�-Date: ? ��LZ� Initials: 1 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 Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Agnes Lindor DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Allison May FEB 8 2022 COMPANY: Westwood Homes LLC vITY OF TIGARti PHONE: 503-713-6294 3UILDING DIVISIOOIpy EMAIL: allison©westwoodhomesllc.com RE: 11850 SW Walnut Street MST2022-00024 (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 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. Other(explain): REMARKS: See attached planting schematic that shows quantity and species of plantings that follow CWS requirements, FO OFF E USE ONLY Routed to Permit Technici :C..-Tee-Description Date: �� 3�1 Z'Z Initials: ; 4 Fees Due: Yes No C..- ee Descri tion Amount iue: ❑ � P $ Special Instructions: Reprint Permit(per PE): ❑ Yes No ❑ Done Applicant Notified: Date: 372-2--/2--L Initials: r" �` CITY OF TIGARD MASTER PERMIT i o COMMUNITY DEVELOPMENT Permit#: MST2022-00024 Date Issued: 04/94/2022 T I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S103BD00400 • Jurisdiction: Tigard Site address: 11860 SW WALNUT ST Subdivision: None Lot: None Project: Westwood Homes Project Description: New detached dwelling. Demo credits applied from BUP2019-00094. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 2400 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: Bathrooms: 2 Second: 0 sf Garage: 698 sf Front: 20 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 2400 st Value: $349,185.44 Rear: 15 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 ❑rywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 vp g ry Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5 • 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 Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2400 Owner: Contractor: TUCKER NORTHWEST LLC WESTWOOD HOMES LLC Required Items and Reports(Conditions) BY SPRINGER CONSTRUCTION LLC 12700 NW CORNELL RD 1 Ersn Cntrl 503-639-4175 14845 SW MURRAY SCHOLLS DR PORTLAND,OR 97229 STE 110 PMB 105 PHONE: PHONE: 503-330-2215 FAX: 503-342-2403 Total Fees: $13,053.58 This permit is issued subject to the regulations co tained 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 his per . will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTIO . Or gon law uire y o low the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR O9_nM_nMn rhmiinh n P O _nM_n Vn, nnw nr}he mice_r____ aiincrinoc rn ni wC n.,rvalnn Sn 9 1gA7 nr 1 Ann 2'i9 I/'�"' ,r Issued By: Permittee Signature: 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 lob site at the time of each inspection. , , B'aildina Permit Application / i Residential `` " " ' - i n1F tVFO FOR OFFICE USE ONE 1 City of Tigard 9 Receives O Z ���� PermitNo.:/ydrWz2'�0�2 s 'i --� DaleBy: 2z •lI 1111 • 13125 SW Hall Blvd.,Tigard,OR 97223 a�'o,i`l L g -.-:. Plan Review 2 0 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 3 (S 22„, other Permt:a(f2Z,0OQb06, l f G n is D Inspection Line: 50 d-or.g4175 ` v• 1 bc�'.1 Date Ready/tho / /` �/, S. gee Pent 2i for Internet: www.[igard-ocgov � it F �'!T. �';^ N . ed/Method: / � , ( Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWEI J ING ®New construction ❑ Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all El Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. t IA ® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $�'3 yC i [q&l S ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: .2..-- JOB SITE INFORMATION) fl AND LOOCATION Total number of floors: d 9 lob site address: / / [y6 0 .c7V t�4/ J7CA �Ks New dwelling area: )4eo square feet D City/State/ZIP: r 7 a r D� -7V-9-3 4( -C 49) Garage/carport area: square feet Suite/bldg./apt.no.: Project name: lAJa//vi f-S 7 . Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet /� �1 REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: n,(/� Lot no.: y c-� Permit fees*are based on the value of the work performed. Tax map/parcel no.: 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 SFR Valuation: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:Same as applicant Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: ® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name:Westwood Homes LLC (Please refer to tee rehedwle) 1 I rcon __ f Structural plan review fee(or deposit): YQ�•3`� Contact name: V1 cJ _�/�,�G(�) Address:12700 NW Cornell Rd FLS plan review fee(if applicable): City/State/ZIP:Portland,OR,97229 Total fees due upon application: Phone:503-7I 3-0 0114 /Fax::( ) Amount received: E-mail: 41 U 59V(GWeS+W OO 01lt1 Crne 3 LL , C O V-1 PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: iA/gS-hWtf-Oa Hayyt..e/S L L.C._ Submit two(2)sets of roof plan with connection details ,. I and fire department access,along with the 2010 Oregon Address: 12,7 00 (/I V/ et/(ram( ( Solar Installation Specialty Code checklist. City/State/ZIP: p0(-,f j Gf yt(( ©� 17 ZZ e7 Permit Fee(includes plan review $180.00 ��) 7!3-o 2 9 J and administrative fees): Phone:`J�JV Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: 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: Al U s Date: I /f q/8o *Fee methodology set by Tri-County Building Industry Y Service Board. I:\Building\Pemuts\BUP-RESPermitApp. 02/24/2011 440-46I3T(11/02/COM/WEB) Mechanical Permit Applisgi E r`:6.- .k! - t FOR OFFICE I. SF oyLv City of Tigard ReceiVedPermit No.: 1k—Isr71)22-Ucz)2f.4 • 13125 SW Hall Blvd.,Tigard,OR 97223 ' Plate ReviewIN Other Permit: • Phone: 503.718.2439 Fax 503.598.1960 Date/By: T I G A R O Inspection Line: 503.639.4175 Date Ready/By; Ions VI See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE.OF WORK COMMERCIAL.FEE* $CLLEDI)L,E VSE Ui/EckakSI Mechanical permit fees*are based on the value of the work 0 New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ID Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit Value:$ CATEGORY OF CONSTRUCTION REsintli AI EQUIPMENT rsvgi RMS ItEES" ® I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building F'or special information use checklist ❑Multi-family 0 Master builder ❑Other: Description Qty. ha Total JOB SITE LNFORMATION AND LOCATION Hestiny/eoolhrg: J / Air conditioning I 46.75 Job site address: /) to sW Ilya 1 V I i Li.]- . Furnace 100,000 BTU(ducts/vents) j 46.75 City/State/ZIP: ri.to ea.. q-2 a 3 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Ductwork 2332 Cross sheet/directions to job site: 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 / w v Other: 23.32 Subdivision Lot no.: ��� Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DEEM:1 i'17ON OF WORK Gas flreplace!msert 3339 Flue vent for water heater or gas HVAC for new construction home fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fueplacclinsert 23.32 Chimney/liner/flue/vent 2332 2332 9,PROPERTV OWNt�E((R��,,//yy ''r. C Environmental exhaust and ventilation: Name: WJ[S+k,Uoc( /'f171,l'�S // Range hood/other kitchen equipment I . 33.39 Address: r —7OO Y/v�IiN' CO Y"-I I I/�� ' Clothes dryer exhaust I 33.39 City/State/ZIP: �I�"er " v/'�' 1 Siagle-duct exhaust(bathrooms, /� toilet compartments,utility rooms) 5 2332 Phone:' D9) /-(Q2/ Fax:( ) Attic/erawlspace fans 23.32 i6 APPLTCA1trT - Other: 23.32 Business ,.r e: .e=Li-wo/ d 'PS //6, Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: /�/ (/I ccO I m/ 0.4) / Furnace, ,etc. i Address: t l up N(IvLl/fie/� id,/ Gas ace Pump /for-'/!in el � .17w_ I Wat ended/tmitheater City/State/ZIP: u. Waterer heater I Phone:W..) `1/3--1O2e1 q Fax:( ) Fireplace f E-mail, A t lii.0w1P wa©dhom easll GCS Range Barbente I _ , 1CrOR Clothes dryer(gas) Business name: Lakeside Heating&Cooling Other. MECIIANICAL PERMIT FEES* Address: 7021 SW McEwan Subtotal City/State/ZIP: Minimum permit fee($90.00)Lake Oswego, OR 97035 Plan review(25%of permit fee) Phone:(503 ) 635-5253 Fax:( ) — State surcharge(12%of permit fee) CCB lie.: 227694 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-Couaty Building Industry Service Board ' Print name: Jason Chariton DLit_c_I /y - I:tBuildinglPermioWffC PermitApp_000113.doc 440.4617r(11/02/COWWEB) Electrical Permit Application FIE - 9 t t 3 T' FOR OFFICE USE ONLY '� Oe` , Re -71 City of Tigard ceived Date/By: Permit#: I(&T�,2-C Cfl2y r 13125 SW Hall Blvd.,Tigard,OR 97223 3), ' Plan Review Phone: 503.7182439 Fax: 503.598.1960 Date/By, Related Permit#: Inspection Line: 503.639.4175 Ready Date/By: ian,: H See Page 2 for T 1 G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK 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 mom 0 Building over three stories. 0 Demolition 0 Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION - exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-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. D Multi-family 0 Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION A AND LOCATIONLOCATION 0 Emergency system. larger separately derived ( V �,y� S� 0 Addition of new motor load of system. Job#: Job site address: Swl(� I00HP or more. ❑"A",'B","1-2","1.3", City/State/ZIP: 7114r' is -J��-9-3 ❑Six or more residential units. occupancy. / 9 / (/ /v ' ' ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: / Ir Project name: ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description l Qty. I Each I Total /J New residential single-or multi-family dwelling unit. Subdivision: nil— Lot#:h�/ / Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential New SFR (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) ® PROPERTY OWNER ❑ TENANT Renewable Energy ID See Page 2 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 amps to 1,000 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 EA APPLICANT 0 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, ��qq each branch circuit 7.42 2 Contact name: /l Ditr6y7 /M/,{4A B.Fee for branch circuits without Address: "'J-/ 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:Ross Electric Inc Sign or outline lighting 67.84 2 Address: 2870 SE 75th Ave#203 Signal lte ation(s)or extension. 0 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 inspection(1 hr min) 66.25/hr Phone:(503)642-2800 Fax: ( ) Investigation(I hr min) 90.00/hr Email:RossElectric@comcast.net Industrial plant(lhrmin) 78.18/hr S Inspections for which no fee is 90.00/hr CCB Lic.: 157891 Electrical Lic.: 34-436C Suprv.Lic.: 4232Ji specifically listed(/a hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Stephen Ross Date: ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature:j. A-4�ypy� TOTAL PERMIT FEE: e / This permit application expires If a permit is not obtained within 180 Print name: Date: I htii/et0QA- days after it hm been accepted as complete. • Number of inspections allowed per permit. I:1 Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEn Plumbing Permit Application Building Fixtures pECC:VPD FOR OF!It t: I sr. O\L1 City of Tigard Received • 13125 SW Ha11 Blvd.,Tigard,OR 97223 ' - -I AateBY: Permit No.:e{ST2022-fib 24 : Phone: SD3.718.2439 Fax: 503.598.1960 Plan Review 1 Inspection Line: 503.639.4175 trorZ") Datt/By: Other Perna No.: T i G n F D Internet: www.tigerd-or.gov r i'0! Wo RUBY ++: RI See Page 2 for otiSedlMetlad: Supplemental lemma TYPE OF WORK • FEE* SCUEDULE ®New construction 0 Demolition For special yformmion uSe checklist ❑Addition/alteration/replacement ©Other Description I Q.f I En I Total New I-2-family dwellings(includes 100IL for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 I ®I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath ' 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 50032 ❑Master builder _ Fach additional birchen 25.02 Other: Fire sprinkler(_ s9.ft) Pa 2 !e JOB SITE pIhTOR1tAT10N AM) LOCATION • Site utilities: Job site address: j-.Art/ Catch basin Warta drain 18.76 City/State/ZIP:Tigard OR ell a 83 Drywell leach line or wench drain . Footing dram(no.linear ft.: ) Page age 2 2 Suite/bidgJapt.no.: I Project name: Manufactured home Utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ti:_) Page 2 Storm sewer(no.linear ft.: ) Page 2 Subdivision: �' � Lot noU,&. Water service(no.linear ft.: ) Page 2 .: Fixture or Item: Tax map/parcel no.: Backnow preventer ! 31.27 . .DESCRIPTION OF WORK Backwater valve i2.51 r /'' . - Clothes washer I I 25.02 Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25,02 ® PROPERTY OWNER ❑TENANT:, Expansion tank 12.51 Name:Westwood Homes LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub Address:12700 NW Cornell Road 25.02 Garbage disposal City/State/Z1P:Portland OR 97229 25.02 Hose bib 25.02 Phone: Fax:(503)342-2403 Ice maker i 12.51 0 APPLICA... . 0:CONTACT PERSON interceptor/grease trap 25.02 Business name: VV[ - wOod 1J19r11,P3' L L C Medical gas(value:$ ) Page 2 l rfV7S(/' 1 �m Primer 12.51 Contact name: Roof drain(commercial) I2.51 Address: / -"7 O /�/kJ Co-r // &_p(/ Sink/basin/lavatory 3 25.02 City/State/ZIP: ottl h 0,� 1-7dg-/ Solar units(potable water) 62.54 Phone: 6/2,j[ -1/' a'2 Fax::( ) Tub/shower/shower pan 3 12.51 E-mail ALPS'elieV(N,os+w /wires✓k,6o9r7 Urinal 25.02 CONTRACTOR. Water closet �- 25.02 • Business name:H&H Mechanical ate heater I 37.52 Water piping/DWY 56.29 Address:5757 SE Willow Lane r Other: 25,02 i City/State/ZIP:Milwaukee OR 97267 Subtotal Phone:(503)975-9787 Fax:(503)659-2979 Minimum permit fee: S72.50 126 /'f.1 Plan review (25%of permit fee CCB Lic.: 178122 Plumbing Lic.no: `T ( ) Authorized signature: ,� // ' State surcharge(12%of permit the) l/ r�v�/ i� 4 TOTAL PERMIT 1 Eh Print name:Dus ' ague Datel,G 'i .0 I his Pvmlt aPPtivaon expires if a permit is not obtained withlo ISO drys -A j'�' after it has been accepted as complete. 'Fee methodology set by Tri-County Building Industry Service Board. 1_Building\PermGslP1.MU-PnmitAppdoc 10,01/09 440-4616T00/02/COM/WEB) Plan # aa 1� Floors Large V 2/ -2) Bed rooms Small 9 t6 L/ Tub 3 Basement Vent t--f 1st Floor 2gb0 Water Heater I 2nd Floor AC \/.L-5 3rd Floor School -. o R-3 Total Z9 OO �j Garage (Qct LjaS •.C-c-1:61pA,c-e— Total 3 09 6 j.iQ- d J� #for Elec S U �' <riss. ! ` < 0•� Y'w a U) .t n of c 1.-- ?( - rbo m 1 aimovce_ ,ro P i. V- rr. n ryl,.)m ,e "- Ni 2D C.Yx.A l S pc c.)2. J._.,.. _Aa:tp`rtv‘ ( ,(.00 )ric,et ; S u< ;: '-, i.l ca rrx--- rejt-1-- • t�.¢. -• Loh, \ 5 L A 104, a,,--\\-- l s l s--0 . 3 y `-,- , (`-7) J-- (14)f ti---V;�J v --C-�v \ \I-L IC‘ , 65 L{) y.,:•\-6,,,,_,A cc...4,-st_ Q,c1A.,,,,A4 4-- (Al, onr e_d r \ SO�j 4 ll\,,J2-F oS,-- � aovv2-5j hi\1 So S• 5 ). 2 I City of Tigard IIICOMMUNITY DEVELOPMENT DEPARTMENT TICARD Building Permit Review — Residential Building Permit #: 070Z2-0OO24- Site Address: j I S 60 ,SG„J iv ALAI ,r sr Project Name: (J)rfrON2 thmt3 Lot #: Planning Review bV•t - SVCS et AP1 S1'w�K i#y s R SPBaES larfhrst. Proposal: NE7Ai 1)01G1I-el) filY1S. jd Verify address/suite#active in Accela. ❑ In River Terrac • IQ No ❑ Yes, River Terrace Review Addendum Site lan Elements: rosion Control �3 opies of site plan on 8-1/2"x 11"or 11 x 17"paper yJ(a Re�t fined trees with drip line and tree protection measures Ai D awn to scale(standard architect or engineer scale) h�^d'F���ntprint of new structure(including decks)and FFE rth arrow locations&easements(required for new and additions) Si".-address,project or subdivision name and lot number Sidewalk/driveway approach Ld'r1 licant information(name and phone number) Location of wells/septic systems ZLot dimensions and building setback dimensions Set tree size,type and location Square footage of buildings to be demolished 'AS et names IE sang structures on site Comer elevations (2'contours if more than 4'differ tial) of area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Yes ❑No Clean Water ces—Service Provider Letter(lot platted prior to 9/10/1995): Wquired: Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No ater Meter Fixture Unit Worksheet—Addis,Remodels and ADUs quired: ❑ Yes,applicant was notified LI No Received: ❑ Yes ❑ No C Exemption for ADU applied for: ❑ Yes No Received: ❑ Yes ❑ No epri Public Facilities Improvement (PH) Permit/ Required: ❑ Yes,applicant was notified L1 No Applied For: ❑ Yes ❑ No,stop intake - nd Use Case #: CoApning: e— y• .f" equired Setbacks: Front: 20 Rear: /S' Side: Street Side: /3 Garage: 2O VJ Building Height: Max. Height: Actual Height: /`J Landscape)Area: N,4 % A %Lot Coverage Max),Ma /1 1 Entrance 0 S t back no more than 8'from street-facing wall Parallel to street or offset 45 degrees or less Windows um 12%of area of all street-facing facades • Garage Garage door is behind widest street-facing wall L "Yes ❑ No,one of the following is met: I ❑ 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. 7 ,,IJ Garage door width is ❑ 12'or less lQ 50%or less of facade ❑ 60%or less and includes 7 of following: i ❑ 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 ❑ Balcgmy o `� ual Clearance 0 Urban ForestryP Sensitive Lands: 0 Yes IV-No Type: Conditions met prior to issuance of building permit / Not vApproved By Planning: -.__.___.. Date: tr/ZZ Revisions (after Building Submittal only) Reviewer Date Revision 1: Approved ❑ Not Approved Z 42122-' Revision 2: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPernutRvw_RES 122419.docx Building Permit Submittal Original Submittal Date: 0//€/ZC22 Site Plans: # Building Plans: # 3 Building Permit#: [ "Enter building permit#above. Workflow Routing: P-Planning 111--Engineering IlePermit Coordinator Building Workflow Sign-off: Elk 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. '•• 'L -Buildiing original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: 00620 Engineering Review Slope at building pad: 3.414 Conditions "Met"prior to issuance of building permit [W Easements (encroachments)per engineering conditions of approval and plat ['Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Ci'No Assess Water Quantity Fee in-lieu: ❑ Yes eNo �/ LIDA Facility on lot: C+ 'Yes ❑ No Add Fee: Wes ❑ N o L1G Final Plat Recorded: CYNOT Approved by Engineering: TYGv't+ Date: 2-(3 2.022 - Notes: ` ,1t ^ frokle 0.Ic.r1444bl ail 4.11711 SiiVTI iYa vd< Willis; need plain.; l2" d&arih niue, should be. 9" f 3" choker r trs-e ❑ Approved by Engineering: Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: R Approved ❑ Not Approved %y e5^Z,/t..t1, 2.11711otl2 Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review Conditions "Met"prior to issuance of building permit 71 Approved,NOT Released: Date: Notes: j f Y-MUM o cvr A —At 21 nj (Z)Zz Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Or\\SDC Exemption: ❑ Received A Does not apply •SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: 7(Yes ❑ N/A Parks SDC: Jzr, Yes ❑ N/A LIDA Yes ❑ N/A 7-4 OK to Issue Permit Approved by Permit Coordinator: Date: 2- 1,22. 12)Z . 1:\Building\Forms\BldgPermitRvw_RES_1208021.docx RECEIVED MAR242022 CITY OF TIGARD C1eanWater Services SENSITIVE AREA PRE-SCREENING SITE ASSESWIE IO Clean Water Services File Number 22-000908 1. Jurisdiction: CityorTlgard 2. Property Information(example: 1 S234AB01400) 3. Owner Information Tax lot ID(s): Name: Richard Todd Boyce Tax Map 2S.1.03BD Tax Lot 400 Company: Westwood Homes LLc. Address: 12700 NW Cornell Road OR Site Address: 1186°SW Walnut Street City, State,Zip: Portland,Oregon 97229 City,State,Zip:Tigard,or97223 Phone/fax: M3413'6294 Nearest cross street: 121st Email: altson@wesMroodnomesltc.com 4. Development Activity(check all that apply) 4. Applicant Information ❑ Addition to single family residence(rooms,deck,garage) Name: Richard Todd Boyce ❑ Lot line adjustment ❑ Minor land partition Company: Westwood Homes LLC. ❑ Residential condominium ❑ Commercial condominium Address: 127m0 Nw come!!Road 0 Residential subdivision ❑ Commeraal subdivision City,State,Zip: Portland,Oregon 97229 ❑ Single lot commercial CI Multi lot commercial Phone/fax: 563-713-6294 Other Single Family Residential Email: allison©wesMroodhomealic.com 6. Will the project involve any off-site work? ❑Yes • No ❑Unknown Location and description of off-site work: 7. Additional comments or information that may be needed to understand your project: 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 Rica CEoyoe— Print/type title Managing Partner Signatur Date 3/23/2022 FOR DISTRICT USE ONLY 0 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.Ail 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 P Po YORS 92.040(2).PITE NOS ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed by Date 3/23/2022 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 Main Office , 2550 SW Hillsboro Highway ° Hillsboro Oregon 97123 ° p' 503.681.3600 f 50 681.3603 • cle.-iwaterservices.org f — — — W. —Rot y_ —.4— 1 —y„— — — sw— 1` �sw� ` ..-- _ _ ' --I—' a—sw _ tit, _ ' �11T$? __ - EG 234.15 -- EG:237.97 _83.55 , _� —� /i 20'MIN.FRONT ._ i i211"1 - ,M 0204 _ 1 ,,I, YARD SETBACK 1 #+ I 1 ' 0241 — 3,! r0201 I" DE 10 I DRIVEWAY 1' ' 1 10 , PROPOSED �...,1 5.0'MIN. SIDE YARD SETBACK 103 DRIVEWAY 4-1334 1 1 , 9.9' SIDE YARD SETB P - ' 1. v 114 y , 13.0' SIDE YARD SETBACK 10f:, 17GARAGE I ADJUSTED PLANTER SIZE TO I.' 1i i 035 MEET CWS SPECIFICATIONS 'Y I, , 1033E 3.9'IIDA PLANTER SETBACK MAIN FLOOR 1 U U x 1 FFEIBD 1 1 160SF LIDA Planter 1I''i►I 1;�,0365 '' 10344 I 01 T. , I 45 12"drain rock to be 9"+3„i' jl ' �_ -C*0346 choker coarse. sw 0 0388 _ __ 10393 10392 ' c o411 5 104 -' 018, 1040I)10453 !1— wyi S D454 ,; 4�.wl O1D468 10 4a C,'#.54 '1,,�31 0457 ' 1040 1 ;{T0426 10 '` 5.0' MIN. SIDE YARD SETBACK t� ' ' i1 0460 11 0427 ' 4.0461 , I 114;0428 010467 ' *0463 104 010429 h 4%, A57130 00466 �A..UW7. :.i" I O4Q \041 V�e�91 ‘It: oa6a LEGEND 10 ',{zA/' EXISTING GROUND CONTOUR (2 FT) 0"-'19 1 AC PAVEMENT a4'.,'-p*3 s _ - - EXISTING CONCRETE SIDEWALK VGA , - 0596 15'MIN. REAR EXISTING GROUND ELEVATION EG:100 YARD SETBACK EG:233.65 g3j7 _ FINISHED FLOOR ELEVATION FFE:238 „�,I TREE TO BE REMOVED EG 235.91 AREA CALCULATIONS LOT AREA 25,348 SF N BUILDING COVERAGE AREA 3,025 SF PERCENTAGE OF COVERAGE 12% IMPERVIOUS AREA TBD M. SHE TT 1 PRELIMINARY RESIDENTIAL SITE PLAN DATE 11 SHEET SCALE: 1"=30 FEET 11850 SW WALNUT ST A MS ENGIEERING&FORESTRY, tie DRNN: CRH •� 12965 SW HERMAN RD, STE 100 �� CHKD PAS 30 0 6 15 30TUALAIIN, OR 97062 AKS Joe. WW 503.563.6151 W .AKS-ENG.COM 9137 4C 9137 Sir I LM11711 BuP2.31o) - Hydro Geo&Environmental,Inc 8525 SW 67°Ave.. Portland,OR 97223 none:503.892.2000 Fax'503.246.602I e-mail:hydrogeo( ast.net Hydro Geo & Environmental, Inc. October 19,2021 Project 3085.21 Westwood Homes Attn:Bill Wagoner Re: Site reconnaissance for suspected septic tank @ 11850 SW Walnut Street,Tigard,OR At your request 1 have visited the site @1 1850 SW Walnut Street Tigard. Westwood Homes has been told by prior owner and general contractor for Demo Permit BUP-2019-00094 that there was a septic tank on the property that was pumped out and removed. Since that phone call, that prior general contractor has been unwilling to provide any receipt for that work or documentation and it is ow opinion that the tank has been removed. During our site visit we observed not any sign that the tank is still onsite. Also, systematic probing to a depth of about 5 feet using a steel soil probe failed to locate the septic tank. Based upon our reconnaissance and visual inspection for surface indicators of an septic tank it does not appear to be on the site. If any tank is discovered in the future, Westwood has retained our company and they will immediately decommission it in accordance with all state,city and DEQ standards. We appreciate the opportunity to assist you on this project. If you have any questions or would like additional i i •r ation,please feel free to contact the undersigned at 503-892-2000. Hyd I ' • &En 'ronmental,Inc. itw` fe". DREG td Mike Gol•= • arra►ram_a a. ill Principal Enginee - • -ologist t FFR/NGEJ' -E lift /AZ