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Permit CITY OF TIGARD MASTER PERMIT $ COMMUNITY DEVELOPMENT Permit#: MST2022 00104 Date Issued: 05/16/2022 T 16 ,1 R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111 DC03600 Jurisdiction: Tigard Site address: 15640 SW ALDERBROOK DR Subdivision: SUMMERFIELD NO.7 Lot: 383 Project: Smith Project Description: Adding 252 sq ft patio cover,front window bump out, and rearrangement master bedroom and bathroom. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 15 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Total: 0 sf Value: $200,000.00 Rear: 8 PLUMBING Sinks: 0 Water Closets: 2 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 3 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains: 0 Storm Sewer: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 1 Water Lines: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 3 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 1 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvcfFeeders 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: 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 N Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 0 Owner: Contractor: SMITH,ROBERT K LORANGER BUILDERS Required Items and Reports(Conditions) 15640 SW ALDERBROOK DR PO BOX 326 TIGARD,OR 97224 HILLSBORO,OR 97123 PHONE: PHONE: 648-1911 FAX: Total Fees: $3,768.21 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: Or n law equir you to w the rules adopted by the Oregon Utility Notification Center. Those rules are stt forth in OAR oc9-nn1_nnln rhrniinh rlAR Q -nni-n ehn a,,nhta. rnmi of tho rnioc nr rlirort ill ioctinnc fn rli NC by roilinn 9n1 9 1oit7 nr 1 Rnn'119 914.4 Issued By: Permittee Signature: /2/(C4t) -,Z__, 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 13„ 1! 22 Residential RECEI'/E l OI OI:I:I('L: LSE O\I.) City of Tigard Received pp Date/By: 1/,Z� 4+ ,Sr�� -0otQ II 13125 SW Hall Blvd.,Tigard,OR 97223 bWfl 1 ZOZZ 1 1 4 Plan Review/f Phone: 503.718.2439 Fax: 503.598.1960 Date/By: �11 / Other Permit: T lc-,A R 1, Inspection Line: 503.639.4175 CITY OF TIGARLi Date Ready/By: / i 10 See Page 2 for Internet: www.tigard-or.gov e111 ed/Method. L Supplemental Information BUILDING DIVISION "` OF oit k REQUIREDRATA:I-ANC 2-FAMILY LITYELDWELLING ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the rofit for e ' , work indicated on this applicatio . CA`11EC0R'If O CONSTRUCTION C 1-and 2-family dwellingValuation: $ ©� O� /" ❑Commercial/industrial 0 Accessory building ❑Multi-family Number of bedrooms: 0 Master builder 0 Other: Number of bathrooms:g p-a,�'fet- o_ . OB SITE.INFO INFORMATION AND; LOCATION Total number of floors: Job site address: (C(p 1.,1 Q 5 y) C�1 4Q it 19 rcc k ])r, New dwelling area: square feet City/State/ZIP: (1 ta v�I kr , ci 1 2, Garage/carno t area: square feet Suite/bldg./apt.no.: Project name: 5`Af l Covered Owen area:(j7 square feet Cross street/directions to job site: .,? [ c�V1'l yy1�r Ti t e.{/ .4( J--.f)')')e— Deck area: square feet V✓e Sh_' !S p cr Afi,ri Other structure area: square feet -. 14 Vklaidy-- is riii‘reNfe ` ,06J tifi . 'T AICO T i � T ubdivision: Via& I Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no 6104.1A Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the ` 4;� >, � ION OF r work indicated on this application. to I ( it A a 9 ' PA b eio ver Prr%D Valuation: $ "1-CO vvi- ' Existing building area: square feet rear fez--et , V�.S [ J (A)o C Ye_.. ).0 q---b f New building area: square feet t' ER ,,. 4tt TI • Number of stories: I Name: :11). b r e &re,Ss.1r1 Zgy- S / Type of construction: Address: j 5 L4 ,Q S k) rf-1 j4e, (;)rejc -✓r . Occupancy groups: City/State/ZIP:---iTaketrift. Or- cm 2 2 Li Existing: G. aiy Phone:(GO 5) ei i • _ ai 4-f—'(„ Fax ( ) New: TC`AN APPL .`�' o •'ACT ON 1 _ :Ittserefertof'ee t. Business name: 1--T0 ro�Vt. Q-( j I. D t"S 1-LC. �Q, / ,„ I Structural plan review fee(or deposit): Contact name: F-4�Q, r (--6t f- �q e r Address: 9'10 e t i/p. � i-, FLS plan review fee(if applicable): Total fees due upon application: City/State/ZIP: 0_,,r),,-✓L ej i a.„S Cr . of i t I 3 le Li �-� ! i / Amount received Phone:(� � Fax: :( �'�� p�G 5I �(D L�Y-z-4,q Co 4i-- y - . C dyvt 0V A1C AR' 1Y 1 ST 1► � E-mail: !s) d Fr. x Commercial an residential prescriptive installation of ;...,. qW� A ' . „w -A ,_. roof-top mounted Photo Voltaic Solar Panel System. Business name: Ca It i er 6 D r g L h.G Submit two(2)sets of roof plan with connection details ( and fire department access,along with the 2010 Oregon Address: q t p 66.,.se b i n 62 .f , Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review C1Q( l/wA 1,L,A . 4,Z i t 3 $180.00 q and administrative fees): Phone:(cp3) (0 4 V- t { i( Fax:(S' 3 6, g 3 '' 6 9 State surcharge(12%of permit fee): $21.60 CCB lic.: 10 g 11 S--- II 7/a.2 Total fee due upon application: $201.60 q Authorized signature: This permit application expires if a permit is not obtained ,,,,./.."1/6within 180 days after it has been accepted as complete. a ) *Fee methodology set by Tri-County Building Industry Print name &,) re_ 1 Date:/', -7- O Service Board. l:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) i Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONIv City of Tigard Received Date/By: Permit No.: +1 13125 SW Hall Blvd.,Tigatd,OR 97223 Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 T 1 CiA RD 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing ElMechanical Internet: www.tigard-or.gov 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 'es No "/." 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ■ ig 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 ■ 3 Verification of approved plat/lot. 0 0 ti 4 Fire district approval required. Name of district: 0 0 I. 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ■ 6 Sewer permit. 0 0 7 Water district approval. 0 0 Ni 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 ■ 69 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 ■ PA',.sin protection,etc. 10 . 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 beet attached to the plans with cross references between plan location and details. Plan review cannot be completed if Tpyright violations exist. I 1 Aite/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ El ■ 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 -urface urface drainage. 4 1 oundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ■ ■ d location. ,�loor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 ■ ■ mace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. .• 14 ross 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 •. d foundation,stairs,fireplace construction,thermal insulation,etc. di15 'levation 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. ` 11-size sheet addendums showing foundation elevations with cross references are acceptable. 16 all bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ■ ■ _ .escriptive path analysis provide specifications and calculations to engineering standards. door/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 ❑ ■ ■ ,.syystems,see item 22,"Engineer's calculations." 4 19 1 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. ❑ ■ a 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 ■ 21 for four or more appliances. ngineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 ■ ■ .rchitect licensed in Ore Ion 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 tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑ 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 ❑ ❑ ❑ 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 the project 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. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) a , . Mechanical Permit Applic FCEI V E Folz(0FFI( i, I sr:()NI.) City of Tigard Received Permit No.: 2022 "1 13125 SW Hall Blvd.,Tigard,OR 97223 APR 1 4 Date/By: Plan Review Phone: 503.718.2439 Fax: 503.598.1960 y Other Permit: T I G A R l3 Inspection Line: 503.639.4175 CITY OF TIGARL) Date Ready/By: tuns: Internet: www.tigard-or.gov Notified/Method: tSee Supplemental Information BUILDING DIVISION! xi .. li '-f' 'a2. 1 . . ..,. l'` , COmmtR.„ AL 1 +;1• r�bULE-USE-CHECKLIS ''_' Mechanical permit fees*are based on the value of the work ❑ ew 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:$ XFOATl GC1IIX; `C41NS RUCTIOI"T -- RESIDENTIAL EQUIPMENT/ YST" FEES* 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building or special information use checklist ❑Multi-family 0 Master builder Li Other: Description Qty. Ea. Total iiiiiir„i,,i1,7,04,1fe?,,,Ttl'463, SITE' ORMA'I E Ai4v, T Y,,,;. Heating/cooling: Air conditioning 46.75 Job site address: )v 613 C Gj a,I a,,Gr 9('Dc/ 3)r Furnace 100,000 BTU(ducts/vents) I 46.75 City/State/ZIP: f l lJC ict c1-7•�2 4 qa Furnace 100,000+BTU(ducts/vents) 54.91 "'� I Heat pump 61.06 Suite/bldg./apt.no.: 0 Project name: Duct work 23.32 Cross street/directions to job site: S(.(wv1 Y1'1er T 1 e___Ick h l 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 Other: 23.32 Subdivision: Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater I 23.32 23,3z ; 1 ,• Gas fireplace/insert 33.39 `" i ' `' Flue vent for water heater or gas y / (.L �,� fireplace ! 23.32 2.3 y l, )-M Ct1 Log lighter(gas) 23.32 1 Wood/pellet stove 33.39 /':��l �!W' a y1. • 1 . Wood fireplace/insert 23.32 / _ Chimney/liner/flue/vent 23.32 Other: 23.32 E � k 9I3j ,,,. `"I'1✓NA'1�F :_°� � _�� ^°__ F , '' � _ , Environmental exhaust and ventilation• Name: j-e-,✓ t e re) Range hood/other kitchen j equipment _ 33.39 Address: ( S q-(a() 5 t,(}, O-1 t -e.r brczfyk- � D - Clothes dryer exhaust 33.39 City/State/ZIP: 1 t .rdi r c2 1 7-2-t4 Single-duct exhaust(bathrooms, / (lilt' toilet compartments,utility rooms) 3 23.32 • '---' Phone: `L(C-a � �`S � !, Fax ( ) Attic/crawlspace fans 23.32 r 5� al'? s -£', ("i`,PEI# s 1 Other: 23.32 Business name: (d QI� LA.-C-_ Fuel piping: ��'� e'1r ft'� $14.15 for f rst four;$4.03 for ea additional Contact name: �n,A„`�'J r��k .Q ?' Furnace,etc. 1 1•{. ISM Address: Zo � ,� Gas heat pump r " Wall/suspended/unit heater ''''.3t City/State/ZIP: 0_0 p_N e•1 v( r. (-71. it 3 Water heater ' Phone:( .5) 6,, ti d _ (-L (l Fax::(SO;) (C.3__( 3{„ Fireplace / Range E-mail: L d r -P�C® l C( 0 Qm Barbecue i' to Clothes dryer as,. '�� g x t aA ''� Il��l� , • rY (gas) Business name: 1 �p Other ii-e_, ' i I A it*t° E SubtoFIER* Address: 9t r� ,( g 5 ` Subtotal i.© Is I! cj'City/State/ZIP: hire �.1 5 6 p & 1 ( z Minimumermit fee permit ($90.00) Plan review(25%of permit fee) 3 ) ,6,1 Phone:(03) fi''3 i ( Fax:6V 5) 35?- 91/_35 State surcharge(12%of permit fee) f ',(jocz CCB lit.: '7 ) OI -i 2,. TOTAL PERMIT FEE 119, / 3 -- ---- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: z ate:/��. � * Fee methodology set by Tri-County Building Industry Service Board e 1 (��. Lys ti�zt Print nam F �� 7-- �e12- I:\Building\Permits\MEC PermitApp_040113.doc 440-4617r(1 I/02/COM/WEB) . . '. 'Plumbing Permit ApplicationRECEIVED Building Fixtures • APR I 4 2022 11111111111E1=11111111111111111 City of Tigard CITY Received OF II TIGARb DatelBy Permit,..„ 41 13125SW Ilan Blvd,Tigard,OR 9724?,,, Plan Revee: * ' Phone 503.718 2439 Fax: 503 59401WILDING DIVISION Dat'''''' Other Purina No.' i 1(;,,;I,I..) Inspection Line: 503.639 4175 Date Ready/By. lusts Pi Ste Page 2 for Internet: www.tigard-orgov Nati fiediMethod. Supplemental Information r - ,-. ',,-A- TYPE or :',*f,. ',--,,i,e,ilvz..Abwz,-, - - ,: -,, ,','„,.,,,,, , iiiiw;:sc Hiivtif,., ,,,,' ., :,..•''', . . -' ti Om construction 0 Demolition . For special information use checklist Description I QtY I I-a. j -Intel Addition/alteration/replacement E1 Other: New I-2-family dwellings(includes 100 it.for each utility connection) S#ifir,.,,,,-„-,:, ,,..,bi,i., ,.. ,;::,1. . ..;,,,I,s ,;,,e,:r4 ,,,i :. ,-,,, SFR(1)bath 312.70 J-and 2-family dwelling 0 Commercial/industrial SFR(2)bath " 437.78 SFR(3)bath 500.32 0 Accessory building p Multi fan Each additional bath/kitchen 25.02 CI Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 ,IW'o, ' ' - -' LOCAflON '. ,,,741:7'.-',, .::':g Site utilities: .„„ :'!,.•- ..-r r.v.-.,.-: ..,',. ... '-'•..,....,e" ' -- , .i, Job site address: 1;(75.-- q -c) -,3,0.) CI/ -e r 3/Tel- -3)f . Catch basin or area drain • 18.76 Drywell leach line,or trench drain 18.76 CityeI : c 6 ) i7 ay ;. eLf Footing drain(no.linear ft. ) Page 2 Suite/bldg./apt.no.: f,) I Project name: Manufactured home utilities 50.03 ,„..,.. • ,.. ,/, l , Cross street/directions to job site: - -AA/yyt yn.e:r--....c,,, e,.....icy ;,.„1-m-e- Manholes 18 76 Ram drain connector 18,76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.. ) Page 2 Water service(no,linear it. ) Page 2 Subdivision: I Lot no.: Fixture or hem: Tax map/parcel no.: Backtlow presenter - 3).27 er.iiik./,' ,",:'V:.1,, rrlitfiVIT,O,:- ‘,14;- - ,'I--,-,', ,-7, Backwater valve 12.5 I ,,„i-,. .q...', ..,INeW•:c,•,?,:1„.W.f.-2,-,,,,,„ -, ,-,:',,,,-,,-, ',,',, -.1,-.-';„:., ,-.,,4-,,,,, ,-&;,•,-;, -,- ::,---,-,t,:,-;t4+--, „ . Clothes washer 25.02 I (,..i,r' 4.1 rri 5-r Li12-xt-f-k i?-1/1.D IC 1,,06 -e 4 ,r Dishwasher 25.026---ek cte-ma,,,,,,A,„ 440,a,feir Drinking fountain 25 02 _ 1/7•62t-C-A" Ejectors/sump 25 02 .,,rialt.w.,, , ,...,2er..,;.„...,mi, ziit..Ttlys.:' ";:'%-.',,u , Expansion tank 12.51 •.,;;(41.te,"4,,P..°",..,‘',. ." '..Nn.i-. -i,,,, , • Fixture/sewer cap 25.02 Narne: -1-)2 IC,,-7b I e L.-,T-C-'7'..-; !--il Floor drain"hour sink huh 25.02 , I Address: )4.,...:). 1.4 Co C) .._...,t..C...) 6,L.1,ote f,'"k2rCZ). -..' IT)r, , Garbage disposal 25.02 Cit )y/State/ZIP:-1-,, - ,,CL,(410.. C.,\(;r. Ci--2 '').-2----L-1 [lose bib 25 02 Phone:( " ci pt-s3. Fax:( ) . Ice maker 12 51 ' ''''''''''' '' '''' " - ' '''-•''-'44-'"''''' , cONThcTT,'.4',,,-v, t'-,-*, Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business1-C name. lCI tirt 40,e.r j4). I 0 r.0 i- t ' i Primer 12 51 Contact name: Rt (*.... 1 .04,&-ylci e,r Roof drain(commercial) 12.51 Address: c.'i Li 0 L . . r.3 a s e,I i, yle, '4:1-3 k- . saiktbasinitavatory "3 25.02 r75-e)Co City/State/ZIP: 0_010.el 1 t„c. 41-2 i i "7", Solar units(potable water) 62.54 Phone:( T.,.7e 3 6 ti is,.-..... 1 01 I Fax::(50:3 6,c1 3, . 6,9 Tub/shower/shower pan 1 12 51 it ., .5-I Urinal 25.02 E-mail:LQ.1ZL iiiA€1,--- cr....0 -....e/ V-1c,i ‘<,26))41_, Tr ',,,,,, ;4.'',';','';,',. i'''==%'..:',,,''•,•;,,,ka, 'i;F4, 'og.Ilt ,r,v-- ,ale.!-,„ Water closet iq,it''', ..1-i..: ',.',44 .. Iii`':'.'!:, :Ma' -•:. , .f.",:-. .,., ''"'Ir,'. f'-• .7..,•''' < ':''''''''' ''...',7''';'s,', wat„heater i- I 37.52 Business name: '.30e, t 36_lc -t- I („/..4-1,1.tot ,(10.--- Water piping/DWV 56.29 Address: SO2. j'' ,„4 ,-.140,-- As,r ef,„ (j Other: 25.02 ,4- -- , City/State/ZIP: ('C,,x.' 0 e(1 t,,ii c.„. l''' Subtotal 175 f Phone:(5C3) ,..-.7 t4,...1- - el 0 4„ e Fax ( ) i/i/2-3 Minimum permit fee $72.50 Plan review (25%of permit fee) V -7 5 CCti Lie.: ,:;;`, i Cs c;2 r'2 5.--7kii.z.. plumbing .110.:V 6. t 9 State surcharge(12%of permit fee)It , Authorized signature: TOTAL PERMIT FEE ;;,4,31, q,,,3 Print name. Date:3/22/22 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. .Fee methodology set by Tri-County Building Industry Service Board. r'..13tulding',Nrmg$TIMU-PertnitApp Cos. l0101,0q 440-4611/T(10/02/COMAVEB) City of Tigard r COMMUNITY DEVELOPMENT DEPARTMENT illh g l c Building Permit Review — Residential Tf Building Permit #: ,S JaZ-1- Site Address: I 6�Q SW d u �k Pr, Project Name: Se 5 /7 Lot #: 'je3 Planning Review Proposal: Pa T1 o (,Ov,ev- 9' fat* RUNtak Verify address/suite #active in Accela. ❑ In River Terrace: Ap No ❑ Yes,River Terrace Review Addendum Site Plan Elements: sion control P.1 3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper '4 k Prawn to scale(standard architect or engineer scale) Footprint of new structure(including decks) T rr North arrow � ~ ditions )4ISite address,project or subdivision name and lot number ASidewalk/driveway approach ❑Applicant information(name and phone number) Lot dimensions and building setback dimensions [ l€tr8c++ y r a ❑C ar=F:Q a e of buildin +n hP to uli + a kt6treet names Existing structures on site for lt.uitinnc ( 'contnurc;f than L ental) pLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes itiNo impervious area (applicable if R-7,R-12,R-25&R-40) If yye,. to•ris-&-.•,,^- 443ter ,ali4 f iiit hQwn? rev o ("Clean WateiServices—Servi natide better-(1 rphTre prime or 9/10/1995): ems. guiirs ---ff-Tes he t�vas t• ed 0 No Received: ❑ Yes ❑ No ter Meter Fixture Unit Workshtettlittvrl , dels and ADUs Required es, p can d ❑ No Received: ❑ Yes ❑ No ❑ _ ! -Exemption for ADU applied fair -- Yes LI No Received: ❑ Yes ❑ No ❑ acilit• s Improvsbnet FI e • P 'es,applicant was no No Applied For: ❑ Yes ❑ No,stop intake -Land Use Case#:- 5 Zoning: (Z -7- • Required Setbacks: Front: t'5 t Rear: t 1 Side: �j t Street Side: l 51 Garage: _201 eig ax. e. . . E1 Landscape Area: 2O % KI Lot Coverage Max: R�) 0 % et ac ' frnm +r + f «,all ❑ Parallel to ctreer nr offse 4��1�ees can less mum o a s reet- acing aca es Garage_ 0 Garage door is behind widest street-facing wall ❑ Yes ❑ No,one of the foll wing is met: "-=-__b`IIaor axt ds no more than 5'from wall and there is a covered porch exte • and garage. ❑ Door extends no more ,' rem wall and there_ is a dow above garage on 2nd floor. ❑ Garage door width is ❑ 12'or less ❑ 11 s of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ Re entrance ❑ Wall o se 1'Roof eave ❑ Roof offset ❑ Fire shingle Lap Siding ❑ Roof pitch ❑ Gable,hip,or g oof ❑ Dormer ❑ t siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony r3 Clearance 4;;;--14r6t43-Fexest Plan ❑ Ycs El No Type: -prioro issuance of building perrru-t Notes: Approved By Planning: uAlitli-( Date: ( Zt% 2 Z Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved Li Not Approved I:\BuildingWonns\BldgPennitRvw REs 122419.docx Building Permit Submittal Original Submittal Date: g7/GI4.L.Z Site Plans: # Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: Planninggineeringrmit Coordinator --Building Workflow Sign-off: E"—Sign-off for Planning(include notes from planning review) Route Application Documents: 2---Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. .Boding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: Gl Engineering Review Slope at building pad: aZZ I Tonditions "Met"prior to issuance of building permit Et-Easements (encroachments)per engineering conditions of approval and plat ( 'ater Quality/Quantity Facility: ��,, ` Assess Water Quality Fee in-lieu: El Yes I;No Assess Water Quantity Fee in-lieu: ❑ Yes 2-rl, LIDA Facility on lot: ❑ Yes 2'No Add Fee: ❑ Yes El No Final Plat Recorded: El NOT Approved by Engineering: Date: Notes: C pproved by Engineering: , (sA Ga2 Date: 4 - -zv22 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: SDC Exemption: ❑ Received .r Does not apply rd SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes )71 N/A Tigard Trans SDC: El Yes /N/A Parks SDC: ❑ Yes N/A LIDA CIYes C N/A k( OK to Issue Permit C� Approved by Permit Coordinator: Ago Date: 4 ji S f2oz1 I:\Building\Forms\BldgPemvtRvw_RES_1208021.docx RECEIVED CITY OF TIGARD APR 1 4 2012 Approvd by Planning 1 CITY OF TiCiAfiL Date: 14/(14/249 2 2- , BUILDING DIVISr , --coilit- - F----_ -- ,_ ,, ors 1' p119 , - 60 yzyc, — . .ylvit--16- . KE5r,-,AvEllc,-ET cs.:1 ,(Hoioxty-zr wIticovi . , -4 - .i- 1 .,._ v1 ts.4-br-- 22K,. r.TAz.( --- .1111__, .,l Pr lot coverage 4160 sq ft esisting house 2012 sq ft, 48.4% driveway & patio slab 652 sq ft. ':7-3ITE LA ---4 proposed patio cover 252 sq ft. 171)1;9--- ---- tlke '2,. 1 11 Dco cirri' or: TVAARD 1-Or SoitiEr,-Igt,z)