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Permit
CITY OF TIGARD MASTER PERMIT i ' COMMUNITY DEVELOPMENT Permit#: MST2022-00094 T i G A It.I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/14/2022 Parcel: 2S110BA01000 Jurisdiction: Tigard Site address: 14185 SW 117TH AVE Subdivision: None Lot: None Project: Hickok Project Description: Adding 528 sq ft Accessory Structure. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 11 Bathrooms: 0 Second: 0 sf Garage: 528 sf Front: 20 Smoke No Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 0 sf Value: $27,075.84 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 Drains: 0 Storm Sewer: 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 Fum>=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'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O SvclFdr: 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: NEW ACS VE R-3 0 Owner: Contractor: HICKOK,SHARON KAY LIVING TRUST TUFF SHED Required Items and Reports(Conditions) 14185 SW 117TH AVE 6500 NE HASEY 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97224 PORTLAND,OR 97213 PHONE: PHONE: 503-8486090 FAX: Total Fees: $1,175.31 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,i if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility N ificati n enter. T ules are set forth in OAR :::::::: +hrni inh A o59-nn1-nnovnu maa nhfsln Ta rnnvoffho n'lac nr',fired nnoatinnfnnlINrhw 1' �a 1+� C/'�/V 1 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. /r h y RECE V C_l Building Permit Application Residential APR 5 2022 l oR of n i l: I. sf:()NI.1 City of Tigard Received c 1111 13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGHBL DeleBy L/ �� V. 1/ (J� � Plan Review y477 �y Att S Phone: 503.718.2439 Fax: 503.598.1960�UIL DI(�I�� pIVISIOh Daze By: Other Permit: T i G A R D Inspection Line: 503.639.4175 ate Ready/By: tern_ ra See Page 2 for Internet: www.tigard-or.gov citified/Method: Supplemennd Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction 0 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 profit for the CATEGORY OF CONSTRUCTION work indicated on this application. et/ Valuation: $ a7, O7s / ❑ 1-and 2-family dwelling 0 Commercial/industrial ❑x Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: '1 Job site address: 14185 SW 117th Ave New dwelling area: square feet / City/State/ZIP: Tigard, OR 97224 Garage/carport area: 5z� square feet 1' Suite/bldg./apt.no.: Project name: Covered porch area: square feet 1 Cross street/directions to job site: Deck area: - square feet SW Grande St, SW Cole Ln Other structure area: , • square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: R491220 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.:2S 11 OBA01000 equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. DETACHED ACCESSORY BUILDING 22'-0"x 24'-0" Valuation: $ 21,983.00 - 13'-11" HIGH, (TUFF SHED)ON A FOUNDATION. Existing building area: square feet A,C' e #6 f p/, V/k/- ie9 r i)'r New building area: 528 square feet •1 ® PROPERTY DOWNER f/ TENANT Number of stories: 1 Name: Sharon Hickok Type of construction: Pre Fabricated Address: 14185 SW 117th Ave Occupancy groups: Detatched Accesory City/State/ZIP: Tigard, OR 97224 Existing: Phone:(503 )539-4967 Fax: ( ) New: ® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Permit Services Structural plan review fee(or deposit): Contact name: Dani Romero FLS plan review fee(if applicable): Address: 980 Hopper Ave Total fees due upon application: City/State/ZIP: Santa Rosa, CA 95403 Amount received: Phone:( 707)-527-7727 Fax: :( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: dani@permitservices.com Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: TUFF SHED Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 6500 NE Halsey St Solar Installation Specialty Code checklist. City/State/ZIP: Portland, OR 97213 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503 )8486090 Fax:( ) State surcharge(12%ofpetmit fee): $21.60 CCB lie.: 1059 Total fee due upon application: $201.60 Authorized signature: y �/ This permit application expires if a permit is not obtained I//`�/e 7 / %(%f/LC within 180 days after it has been accepted as complete. Print name: Dan ern Date: 4/5/2022 methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling 1-OR orflcl: USE ()NIA City of Tigard p By: Y Permit No.: 1111 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: • Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing ❑ mechanical I I U e\H I? Internet: www.tigard-or.gov ❑ Other: '1-lih. FULL(A11\G iTEN1S ARE RI;QUiRh,D FOR PLAN REVIEW )0, No 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. 0 0 ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: 00 0 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. 0 0 0 7 Water district approval. 0 0 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ 0 0 basin protection,etc. 10 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0 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 0 0 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 ❑ 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- ❑ 0 0 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. ❑ 0 0 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- 0 0 0 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 0 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0 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. 0 ❑ 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 ❑ ❑ 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 ❑ 0 0 architect licensed in Ore on and shall he shown to be licable to theproject under review. 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. 0 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 ❑ 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 ❑ 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, 0 0 ❑ 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-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Plumbing Permit Application Building Fixtures RECEIVED FOR OFFICE USE ONLY Cityof Ti and 6.! Received .� g Da e/B Permit No.: • 13125 SW Hall Blvd.,Tigard,OR 97223M Ay 3 2022 Plan Review i ' Phone: 503.718.2439 Fax: 503.598.1 Other Permit No.: DateBy: Inspection Line. 503.639.4175 r.n- TIGARD .A ,V nF--Ti5ARD Date Ready/By: Suns: ® See Page 2 for Internet'. www.tigard-or.gov - Notified/Method. Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑x New construction ❑Demolition For special information use checklist Description I Qty. I Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ©Accessory buildingSFR(3)bath 500.32 ❑Multi-family Each additional bath kitchen 25.02 ❑ Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:14185 SW 117th Ave Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard, OR 97224 Footing drain(no linear ft.:_) Page 2 Suite/bldg.lapt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: SW Grande St,SW Cole Ln Manholes 18.76 Rain drain connector 1 18.76 1 Sanitary sewer(no linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 24'x24' ranch style garage Dishwasher 25.02 On their property. Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: Sharon Hickok Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 14185 SW 117th Ave Garbage disposal 25.02 City/State/ZIP: Tigard, OR 97224 Hose bib 25.02 Phone:( 503)5394967 Fax:( ) Ice maker 12.51 ® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Permit Services Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Dani Romero Roof drain(commercial) 12.51 Address:980 Hopper Ave Sink/basin/lavatory 25.02 City/State/ZIP:Santa Rosa,CA 95403 Solar units(potable water) 62.54 Phone:(707 )527-7727 Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:Tuff Shed Inc. Waterpiping/DWV 56.29 Address: 6500 NE Halsey St Other: 25.02 City/State/ZIP: Portland,OR 97213 Subtotal Minimum permit fee: $72.50 Phone:( 503 )848-6090 Fax:( ) CCB Lic.: 105914 Plumbing Lic.no.: Plan review (25%of permit fee) � //J�/�J/ nn� State surcharge(12%of permit fee) Authorized signature: p r C'.2 /GBhtd449 TOTAL PERMIT FEE Print name: Danielle Romero Date: 5/3/P2 This permit applicafion expires ita permit is not obtained within Igo days after it has been accepted as complete. 'Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Pennies\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) • • Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain- 1"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation:` Permit Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspection's or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and Baptistry/Font . greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Tlvu Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. IDAny multipurpose fire sprinkler system. Dishwasher: -Commercial Domestic El Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram 4" 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -lav/Bar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 City of Tigard i0 illCOMMUNITY DEVELOPMENT DEPARTMENT T l c A R D Building Permit Review — Residential Building Permit #: ,01-(f�Z-JU9�J Site Address: 11.� SW 11''w,(4WC- Project Name: C lCO LtC Lot #: Planning Review Propos.1: AGGe S'd2)/ S7720C U2 U. ■ erify address/suite # active in Accela. 0 In River Terrace: No 0 Yes,River Terrace Review Addendum Sit Plan Elements: E rosion Control , i 3 .pies of site plan on 8-1/2"x 11"or 11 x 17"paper .' dRstained trees with drip line and tree protection measures .wn to scale(standard architect or engineer scale) IQ'Foo rint of new structure(including decks)and FI'1!. IA I�srth arrow locations&easements (required fox new and additions) e address,project or subdivision name and lot number Sidewalk/driveway approach il"Applicant information(name and phone number) Location of wells/septic systems CJLyt dimensions and building setback dimensions �S eet tree size,type and location Square footage of buildings to be demolished Yr�Su et names ErExisting structures on site 1GCorner elevations (2'contours if more than 4'differential)— Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes 2No im.ervious area(applicable if R-7,R-12,R-25&R-40) If es,is a storm water .uali facili shown? ❑Yes LJNo— i Clean Waterces—Service Provider Letter(lot platted prior to 9/10/1995): Re uired: YJ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No Plai Water Meter Fixture Unit Worksheet—Addition Remodels and ADUs quired: ❑ Yes,applicant was notified I�Io Received ❑ Yes El No D Exemption for ADU applied for: ❑ Yes t. 'No Received: ❑ Yes ❑ No er"Public Facilities Improvement (PF1) Permit Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake O Land Use Case#: 4 Zoning. p—ti equired Setbacks: Front: 27 Rear: /S' Side: L Street Side: /,T Garage: 7 ❑ Building Height: ,� Max. Height: —t Actual Height 11/ O Landscape Area: N�— % ❑ Lot Coverage Max: Entrance t back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows ❑ Minim °°of area of all street-facing facades Garage ❑ Garage door is behm t street-facing wall ❑ Yes ❑ No,one of the following is met ❑ Door extends no more than wall and there is a covered porch extending beyond garage. ❑ Door extends no more than 5'from wall an e is a 12 sq ft.window above garage on 2"d floor. ❑ Garage door width is ❑ 12'or less ❑ 50%or less of a 0 60%or less and includes 7 of following: ❑ Covered porch 0 Recessed entrance 0 Wall offset f eave ❑ Roof offset ❑ Fire shingles 0 Lap Siding ❑ Roof pitch ❑ Gable,hip,or gam f ❑ Dormer � ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection alcony IQ V al Clearance ❑ Urban Forestry Pla Sensitive Lands: ❑ Yes No Type: O Conditions met prior to issuance of building permit Notes: Approved By Planning: Date: t- �2 Revisions (after Building Submittal only) Reviewer Date Revision 1: D Approved ❑ Not Approved Revision 2: ❑ Approved 0 Not Approved I:1Building\Fonns\BldgPermitRvw RES_122419.docx Building Permit Submittal Original Submittal Date: ‘YlS-75-2. Site Plans: # 3 Building Plans: # 3 Building Permit#: la Enter building permit#above. Workflow Routing: 1;1—Planning igineering Permit Coordinator Building Workflow Sign-off: 'Sign-off for Planning(include notes from planning review) Route Application Documents: l Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Building. original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Engineering Review £ Slope at building pad: 4°,/ C>r Conditions "Met"prior to issuance of building permit I!I.- Er Easements (encroachments)per engineering conditions of approval and plat d Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: Cl Yes ErNo Assess Water Quantity Fee in-lieu: ❑ Yes Er No LIDA Facility on lot: ❑ Yes C3"No Add Fee: El Yes ❑ No 'Final Plat Recorded: 17 /1- ❑ NOT Approved by Engineering: Date: Notes: Er--Approved by Engineering: / ¢—&-i � Date: `E/1 2-/Z02 Z- Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: El Approved ❑ Not Approved Permit Coordinator Review 0Conditions "Met"prior to issuance of building permit El Approved, NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: f SDC Exemption: El Received 7 Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A Tigard Trans SDC: ❑ Yes yr N/A Parks SDC: ❑ Yes I� N/A LIDA CI Yes /C� N/A l OK to Issue Permit / �J Approved by Permit Coordinator: Date: lr1 ' ' v .14 1:\Building\Fomrs\BldgPemtitRvw_RES_1208021.docx