Permit 'PI q CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2022-00159
Date Issued: 07/07/2022
'TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S134CD00700
Jurisdiction: Tigard
Site address: 11825 SW KATHERINE ST
Subdivision: LERON HEIGHTS NO.3 Lot: 77
Project: Killion
Project Description: Remodeling main level including kitchen, (2)bathrooms, and master bedroom. Electrical and
Mechanical permits to be obtained separately.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $220,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 2 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains: 0 Storm Sewer: 0
Tubs/Showers: 1 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: 1
Drywell-Trench Drain: 0
Other Fixture Units: fixture sewer cap
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'l 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 0
Owner: Contractor:
KILLION,RANDALL L RENOVATION MEDYK Required Items and Reports(Conditions)
KILLION,JUI-MEI H 5992 LIPSCOMB STREET SE
11825 SW KATHERINE ST SALEM,OR 97317
PORTLAND,OR 97223
PHONE: PHONE: 503-686-1946
FAX:
Total Fees: $3,816.03
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon law re ires you to fo w the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
oc9_nnii_V11n thrniinh flA c9-nn1- 11 Vn a%i nhfain a n,,of a ndac nr dirarf ni,aetinnc fn fll IN(:by Tallinn Fn1 9 R7 nr 1 Rnn 119 914d
.
Issued By: Permittee Signature: ' ,/l em " ��/�s
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. C%%//1
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
Residential RECEIVED' FOR OFFICE l SE ONLI
City of Tigard Recened / o� �0 „ !
41 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 2 5 2022 p°,atn Re iew
Phone: 503.718.2439 Fax: 503.598.1960 Date/By- ti/ Other Permit:
T 1GAl, . Inspection Line: 503.639.4175 CITY OF TIGARLI Date Ready/By. � Juris RI See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notitied/Mc df .� �� , Supplemental Information
{_. �5 REQUIRED:0,4';A , F`A MIL:y DWEl LING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Et Addition/alteration/replacement tie mac r 0 Other: equipment,materials,labor,overhead,and the profit for the
Crt t�f RY O CoNSTRUc ION work indicated on this application.
$ �e�U U01 i
D,I-and 2-family dwelling ❑Commercial industrial I
0 Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
Total number of floors:
�oB �;1f1tiIiMATtflN+AA>}1.LOCATl1oI+I
Job site address f i b t�.C �� K a re 1,;ram St(. New dwelling area: square feet
City/State/ZIP: t vr. , v' 21 7 a.-Z 7 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Ki,(t u n. Z,f I,,Peet C ' a/ Covered porch area: square feet
Cross street/directions to job site: WI 4 1 1444 f' /o2 / ' Deck area: square feet
Other structure area: square feet
gfp �- RE D D TAt OMMERCIA -UUSE t CKLIST
Subdivision: L e ro 14 1 T •U WI.P S Lot no.: 7 7 Permit fees*are based on the value of the work performed
Tax map/parcel no.: S� T C�/ lc/ 7 �' Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
`. DESCRIPTION OF*OREwork indicated on this application.
l Z e. y e dltiv lX e( d T p�.4, f-Cwe/ Valuation: $
/
t w C t_ kia"f ei ei4 to . b tt-�L yea y ceh� Existing building area: square feet
yvL i- fo e k t.)►n--- New building area: square feet
y i3PERTY O' I 0;. o.AN _ Number of stories:
Name: g4 12 dq q t- Tom •tVtf1 iC'I'it ci CI Type of construction:
Address: /1$ a- 5 S LA./ 4 {..11 P`I .- S 1-k-e'i Occupancy groups:
City/State/ZIP: l' , ref' 0 2
( ( /-/ Existing:
Phone:(�O� 7 U U 2-0 Fax:(`5/04 3 6S' — 7 K,5 New:
' 0 �;,
- ,. " ': El CONTACT'PERSON BUILDING LP om R , S �
Business name: '
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Amount received:
Phone:( ) Fax::( )
E-mail: PHOTOVOLIAICSfliiARI'a!NFL SYSTEM PEES*
� � �� 1 4 "• "14 1 Commercial and residential prescriptive installation of
' roof-top mounted Photovoltaic Solar Panel System.
Business name: }z (tt 0��`Ji o i� J1 p ,, k �u c Submit two(2)sets of roof plan with connection details
P q l Q and fire department access,along with the 2010 Oregon
Address: 6— l �-. 1_ i P S`-0 -b 5+r.e�/` `�ri Solar Installation Specialty Code checklist.
City/State/ZIP: S c1 I.e� Permit Fee(includes plan review
( �� �� and administrative fees): $180.00
Phone:( 0�n % t a y Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: o,1O 4 3 z/ lj
I Total fee due upon application: $201.60
Authorized signature: ' I%-"'_dial/4 This permit application expires if a permit is not obtainedp
r / within 180 days after it has been accepted as complete.
s lA p {/ K tf/ - u ^ L *Fee methodology set by Tri-C aunty Building Industry
Print name: - e (( { a.� Date: ? "V Z Service Board.
I:vBuilding\Pcrmits\BUP-RESPcrniitApp.doc 02/24/2011 440`4613T(II/02/C(3M/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling
City of Tigard Received Permit No.
la 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
1 II ! Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
T I G AR D 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW ',. `o `' 1.
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ❑ ■
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: . ❑ El ❑
5 Septic system permit or authorization for remodel. Existing system capacity T ❑ ❑ ❑
6 Sewer permit. _ El ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑
basin protection,etc. _
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ El El
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ ❑
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
_ Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ' ❑ ❑
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 0 ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ El ❑
1 over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ 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 0
architect licensed in Ore_on and shall be shown to be a. licable 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. ❑ ❑ CI
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ El El
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. 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, ❑ ❑ ❑
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 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.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 1/02/COM/WEB)
S
Plumbing Permit Application
Site Utilities FOR OFFICE: t;Si: ONLY
City of Tigard Received Permit No.:
-r 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
Plan Re
IIPhone: 503.718.2439 Fax: 503.598.1960Ilh Plan Review DatDate/ByOtherp Permit No.:
Inspection Line: 503.639.4175 Date Read B ]uris: la See Page 2 for
T 1 C;A K D Internet: www.ti and-or. ov y Y g
g g Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. Total
®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 111825 SW Katherine St Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard OR Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 1 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 ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
��� Clothes washer 25.02
VeA(,(:�;1/e SVIC '1 t6 -1 :XTCf i.i f1 (I)S1,/'� )-. Dishwasher 25.02
j C1/1 t ) N;OC.) /1 c 4-(..i k / G z\� cJ.t . C 1) L�(-S,/ s' Drinking fountain 25.02
`J Ejectors/sump 25.02
❑ PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: Fixture/sewer cap 1 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Reliant K Plut; :.r,l i-:t.; Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: or Kovaiehuk
g Roof drain(commercial) 12.51
Address: 1435 West Meadows Dr NW Sink/basin/lavatory 25.02 2
City/State/ZIP: Salem OR 97304 Solar units(potable water) 62.54
Phone:( ) 503-999-2203 Fax: :( ) Tub/shower/shower pan 12.51 1
E-mail: reliant k@comcast net Urinal 25.02
Water closet 25.02 1
CONTRACTOR
Water heater 37.52
Business name: Reliant K PlumbingINC
Water piping/DWV 56.29
Address: 1435 West Meadows DR NW Other: 25.02
City/State/ZIP: Salem OR 97304 z3 Subtotal
7 _7 7-/ 4/ Minimum permit fee: $72.50
Phone:( ) 503 999 2203 ) Fax:( /
CCB Lic.: 160364 �/�I /L`' Plumb' Lic.no.: �' Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: 1 or Kovaiehuk Date: 6/1122 This permit application expires if a permit is not obtained within 180 days
g after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I.\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Julie Drinkwater
From: Jill Bentley RECEIVED
Sent: Wednesday, June 29, 2022 10:09 AM JUN 2 9 2022
To: Julie Drinkwater
Cc: Branden Taggart; Allyson Armstrong CITY OF TIGARL)
Subject: RE: protocol for decreased points on the water meter miksillelitiNG DIVISION
Attachments: 11825 SW Katherine St 062922.pdf
Hi Julie,
After reviewing the documentation, the customer should have had a one inch meter but only has a 5/8 inch meter
currently.
With the reduction in fixture units that brings it down to a 3/4 inch meter, we will change the meter to a 3/4 inch at no
cost.
Kind Regards,
Jill
(she/her/hers)
A W01,, Jill
NcRE IOU CAN BEApyth,, '+ City of Tigard -Utility Billing
NG • Senior Accounting Asst
.' l"u.R I)
(888)826-7211 Payments
(503)718-2460 UB Main
jillb@tgard-or.gov
(503)718-2494
13125 SW Hall Blvd.
i. Y. . Tigard,OR 97223
From:Julie Drinkwater<JulieD@tigard-or.gov>
Sent:Wednesday,June 29, 2022 9:55 AM
To:Jill Bentley<JILLB@tigard-or.gov>
Cc: Branden Taggart<brandent@tigard-or.gov>
Subject: protocol for decreased points on the water meter worksheet
Hello Jill
Attached please find the water meter worksheet for the Killion project. Allyson found that there is actually a decrease in
points, but I was wondering if the worksheet should still be reviewed by utility billing.
Thank you
Julie Drinkwater
Permit Technician
City of Tigard I Building Department
13125 SW Hall Blvd
Tigard,OR 97223
503-718-2804
1
Due to an increased demand for services,please expect longer wait times for responses to emails,voice messages and building
inspections. Requests for permit status may not be responded to until the permit is ready to issue. Other requests deemed non-
essential,such as fee estimates, may take longer to respond. In the meantime, please view this quick guide on how to submit
common service requests.
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule."
2
Water Meter Fixture Unit Worksheet for Additions/Remodels/ADUs
Please complete the following information:
Customer Name: Ib„�,),3 . k .1 \d
Service Address: Street/Suite#: 11$25 5 LA) 1<.,�-In2r:tie, S+
City: 1rr& State: 0 r< Zip: q 3
Phone Number: <-03 /04 o2O$ Email: rekt,,okj k z.ei-, E [d4-14,,ar 1. Co;,h
Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add.
Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at
total. the proposed total.
Fixture Unit Current Point Current Proposed Point Proposed
Quantity Value Total Addition Value Total
Bar sink x 1 = 1 x 1 =
Bidet x 1 = x 1 =
Clothes washer 1 x 4 = i.{ x 4 =
Dishwasher 1 x 1.5 = 1 .5 x 1.5 =
Hose bib x 2.5 = x 2.5 =
Hose bib,each 5 x 1 = 3 x 1 =
Kitchen sink ' x 1.5 = 1 .5 x 1.5 =
Laundry sink I x 1.5 = I .5 x 1.5 =
Lavatory x 1 = S 1 x 1 = 1
Water closet, 1.6 GPF Li x 2.5 = i 0 x 2.5 =
Bathtub/whirlpool x 4 = x 4 =
Shower stall ,. x 2 = LI x 2 =
Bath/shower combo 2. x 4 = $ — ) x 4 = —Li
Current Points: . 5 Proposed Increase: — 7-..
,I
Current Points+Proposed Increase= -�k° C =New Total Points =Required Meter Size 3/9
Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points=3/4" 37.5 and over points= 1"
New Meter Size Needed for New Total Points: Cost: $ (see page 1)
Current Meter Size per Utility Billing: Cost: $ (see page 1)
New Meter Size Cost minus Current Meter Size Cost= $
(This is Your Cost to Increase Meter Size Due to Additional Fixture Units) .
)b 'AC-e &..
FOR OFFICE USE ONLY
Current Meter Size Confirmed with UB
Signature of UB Representative Date
I:/Building/Forms/WaterMeters_070119_Add.dOCX Page 2
City of Tigard
1 !NI
_ 4 COMMUNITY DEVELOPMENT DEPARTMENT
I i
TIGARD Building Permit Review — Residential
t
Building Permit #: ,44S G)--Z - w I"-el
Site Address: l\ Y 2S Svc Sh74.6ri(1Q &.
i Project Name: I- \\01A p,VA0,91QA Lot #:
Planning Review ��"��
Proposal: QQ4sl�N�'�10� ��\
%Verify address/suite#active in Accela. ❑ In River Terrace: o ❑ Yes,River Terrace Review Addendum
Site Plan Elements: ❑)Liee.,iea Cu.i1 l
PAP opies of site plan on 8-1/2"x 11"or 11 x 17"paper ❑Retained trees with drip line and tree protection measures
:! drawn to scale(standard architect or engineer scale) )4-Footprint of new structure(including decks)and FFE
►:G orth arrow ❑ ons&easements(required for new and additions)
' to address,project or subdivision name and lot number 51,Sidewalk/driveway approach
'EfLipplicant information(name and phone number) ❑heeatierrof wells/septic systems
,@t dimensions and building setback dimensions I,Street tree size,type and location
age f buildings to be demolished Street names
xisting structures on site ❑C ons(2'contours if more than 4'differential)
❑ a, w ' g coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes ❑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 Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
Water Meter Fixture Unit Worksheet—Ad tions,Remodels and ADUs
.. ,
Required: $.Yes,applicant was notified ❑ No Received: % Yes ❑ No
❑ SDC Exemption for ADU applied for: ❑ Yes /1K.,No Received: ❑ Yes ❑ No
❑ Public Facilities Improvement(PFI)Permit:
Required: ❑ Yes,applicant was notified o Applied For: ❑ Yes ❑ No,stop intake
❑ Land Use Case#: Sul Zoning: ' 'l-S
All .Required Setbacks: Front: 2.4) Rear: S Side: ' Street Side: \S Garage: ?.A
�1 Building Height: Max.Height: 16 Actual Height: \(o
i�' Landscap Area: NA' % ❑ Lot Coverage Max: 1.114. 0/0
Entrance Set back no more than 8'from street-facing wall g,Parallel to street or offset 45 degrees or less
Windows Minimum 12%of area of all street-facing facades
Garage ❑ Ga age door is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
❑ o tends no more than 5'from wall and there is a covered porch extending be o garage.
❑ Door exten s ore than 5'from wall and there is a 12 sq ft.windo e garage on 2°d floor.
❑ Garage door width is ❑ 12 ❑ 50%or less of fa 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entran all offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Sidi Roof pitc Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding indow trim ❑ Window recess indow projection ❑ Balcony
❑ Visual Clearance ❑ Urban Forestry Plan
❑ Sensitive s: ❑ Yes ❑ N Type: --
❑ Con 'tions met prior to issuance of building permit
Notes:
Approved By Planning: -- Date:
Revisions (after Building Submittal only) , Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\B1dgPennitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: S"�2-
Site Plans: #
Building Plans: #
Building Permit#: ter building permit#above.
Workflow Routing: Manning ❑eLegineering'0 Permit Coordinator ,..-aluilding
Workflow Sign-off: sign-off for Planning(include notes from planning review)
Route Application Documents: ,B'—Engineering: (1) copy of permit application, (1) site plan, (1)building plan and
original plan review routing form.
,uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: ���5�1..,1_
Engineering Review
Slope at building pad: 2;4
Mr Conditions "Met"prior to issuance of building permit$ 4_
Easements (encroachments) per engineering conditions of approval and plat 4 h-
2(Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes [3/No
Assess Water Quantity Fee in-lieu: ❑ Yes C1/No
LIDA Facility on lot: ❑ Yes L"No
2/Final Plat Recorded: N 1''
❑ NOT Approved by Engineering: Date:
Notes:
LI Approved by Engineering: 7 1"j Date: S l(/2r7/_
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 Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: Yes 11 N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
Ai.
❑ Yes N/A
OK to Issue Permit
A proved by Permit Coordinator: \\ \ ,r Date: U• tf• iib'l/L
I:\Building\Fonns\BldgPennitRvw_RE S_122419.docx