Permit •
Building Permit Application
Ae.. icia4 il.Ck 1 _ y� GG__ FOR OFFICE USE ONLI'
City of Tigard ' E 'J E L -s hnia - Perm t No.: —�' ' 6
.. 13125 SW Hall Blvd_,Tigard,OR 97223 Plan Review a
Phone: 503-718-2439 Fax 503-598-1960 '. '; �s t!'% Da�gv. Related Permit:
1'IGAR D Inspection line: 503 639-4175 Date Ready Ry loci ® Seep 2 for
c Internet www.tigard-or.gov s �" . - t �"il1 Notified) tethod: \7y�di �t�ljl} r' Supplemental Information
TYPE OF WORK r REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑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 El Other:
equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
-and 2-family dwelling El Valuation: $ I f� )
P'�
ElAccessory building El Multi-familyNumber of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB ME INFORMATION AND LOCATION Total number of floors:
lob site address: 'I( 1) 0i P \JA or% New dwelling area: square feet
City/Slate/ZIP: �j( a,l a/ .'2
Garage/carport square feet
Suite/bldg./apt.#: Project name: ef`,!'-` Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: ✓ p + 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.
0e,nit-0 Cy �r�U G S t f Valuatim: S
it-- `rt23-€1,44F- r�r V��r "�! 'I�r l�l(JvI� 1 Existing building area square feet
l ..-�� �?7Ih ",�/3/U iq �jt� New building area: square feet
❑ PROPERTY OWNER `/fit er(/J� v 0 TENANT Number of stones:
Name: 5Gyvve S ( _ h Type of construction:
�' Address: S D o.) . -f'e- • ' ' Occupancy
groups:
F City/State/ZIP: G. •M q • - 2
2_,
- Existing:
Phone:5lS; ) 1 _ S']-_( Fax:( )
// New:
"APPLICANT �" 0 CONTACT
-PERSON BUILDING PERMIT FEES*
1 Business name: --1-` r-r CJX�' a. fl 1 ' l C . avenge re(orer deposit):
e)
Structural plan review fee(or deposit):
Contact name: (� GRr ri..
Address: 2 �1",' kAe 11 CJ �� n FLS plan review fee(if applicable):
U Total fees due upon application:
City/State/ZIP: ek c .( v v
" -Phone. Cn Amount received:
lOf Fax::( )
E-mail: PI i Q h -- -J+\S' a cr t a,�-� 3cs P$OTOYOLTAICSOLARPANELSYSTEMFEES*
*V- CCO�R�`"-iY t Commercial and residential prescriptive installation of
CONTRACT�/^r roof-top mounted PhotoVoltaic Solar Panel System.
Business nam 4 ',1 / S 5 `^ ` Submit two(2)sets of roof plan with connection details
1i I 1 nc and fire department access,along with the 2010 Oregon
Address: t. 3 so,..„ _e_Akz �� Solar InstalationSpecialty Code checklist.
City/State! IP: Sh�L-xiex� p62... (��\ ./C) Permit fee{incl�esptanrevtew $180.00
r _ tt �J and administrative fees):
Phone:t �j + t�fear x:( ) State surcharge(12%of permit fee): $21.60
CCB Lic.: ,3D(_(2.-- - I Total fee due upon application: $201.60
Authorized signature' ✓Z This permit application expires its permit is not obtained
_{ within 180 days after it has been accepted as complete.
Print name:C?ab t C 1(- t-4[1-ct r�a rj Z^-Date: / j//a * Fee methodology set by Di-County Building Industry
G• Service Board.
City of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT
le Building Permit Review - Residential
TIGARD
Building Permit #: I 4P ,Ci — oc�a51
Site Address: A( (11-0 St. ) {{GA g1i d erVerified in Accela
Project Name: LlN - 96no Lot/Unit #:
Proposal (include housing type): POIO SrQ- '&- i „slreck Zone: -S- D
Required Site Plan Elements: 1./'p/* : Pevr $il--/ls:,,,, 0-7
copies of site plan on max 11x17"
E-Brawcrto standard scale ❑ Retarrecrtrees,zmrp_line/ tree protection
E-North.arrow 8- +-tql--7 tts e trees shown / labeled
Site address, project name, lot # atTe calculating tree canopy at maturity
Street names (N/A for SFR)
pplicant name and phone # B-6ebrrtpar d rectangle dimensioned (if applicable)
EtTbratiIrgeltrack-ens isioTtZ1earance triangle
Existing structures & square footage R ir=y locations & easements
nd FFE fl Prvperlycorner elevations
ned ;DUO sf disturbance)
s Lot arca and lot rnvPraoe oercentage 2 Erosion control
Requir Elevation Plan Elements: / �-
(For SFR: c needed only on street-facing) Garage doors dime
El Drawn to st rd scale Summar with calculations for:
El Building height dim i ned otal facade area
❑ Facade dimensioned ❑ Total window and door area
❑ Windows and doors dim i ed ❑ Total garage area
Required Floo an Elements: ❑ Su ry table that includes
❑ Ea ory dimensioned ❑ Total floo a
ach story floor area calculated ❑ Floor area per s
Planning Review
The following standards have been met:
Setbacks El Front: Rear: Side: Min/Max Street Side: / Garage:
He' ht ❑ Max. Height: Proposed Height:
❑ Yes ❑ Landscape
❑ Yes ❑ N/A Greening (Quad only)
❑ Yes ❑ N/A % i dow Coverage
❑ Yes ❑ N/A Garage Only)
Parking (Other )
❑ Yes ❑ N/A Entrance (SFR, Row s-, •uad only)
❑ Yes ❑ N/A Other building desig a :.rds (Rowhouse only)
❑ Yes ❑ N/A Accessory Struc - e Standar. 'i
❑ Yes ❑ No Qualifying p --existing unit exempt'�om standards (Cottage unit only)
Additional standards Courtyard Units, Cottage-`61usters, Rowhouses, and Quads:
❑ Yes ❑ N/A Unit 'ount: '-\
❑ Yes ❑ N/A • Width and Size `�\
❑ Yes ❑ N/, Pathway
Additio - standards for Courtyard Units and Cottage Clusters on •
❑ Ye a N/A Unit Area:
❑ es ❑ N/A Floor Area (per story)
• Yes ❑ N/A Courtyard
❑ Yes 0 N/A Fence
❑ Yes ❑ No)A6/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
❑ Yes ❑ Nd'tN/A Public Facilities Improvement (PFI) Permit:
equired: ❑ Yes ❑ No
Applied For: ❑ Yes ❑ No, stop intake
Sensitive Lands: ❑ Yes No
Land Use Case #: 0 Conditions met prior permit issuance
Approved By Planning: Date: 0\L9. I '
Notes t-50 Low4 VVe ova -CoC , A� Date: /Z//2/Z�
Revision 1: pproved ❑ Not Approved /v'
Revision 2: 0 Approved ❑ Not Approved Date:
Building Permit Submittal
Original Submittal Date: ll Vola
Site Plans #:
Building Plans #: IVA
Building Permit #: Er Building permit # entered on page 1
Workflow Routing: C -Planning 0 Engiering l -Permit Coordinator CI B)ing
Workflow Sign-off: Q/Sign- off for Pla ning (include notes from planning review)
Route Documents: CI
Route (1) copy of permit application, (1) site plan, (1) building plan
and on inal plan review routing form.
CIBui ing: original permit application, site plans, building plans,engineer and
beaarf calcu tions and trust details, if applicable, etc. _-
Permit Technician: 4✓L21 l P C A t Date: ii/a 1/07 ra
Notes:
Engineering Review
❑ Slope at building pad: % _-
❑ Conditio ••-t prior to issuance of permit
❑ Easements (enc .- hments) per engineering conditions of a.� oval and plat
❑ Water Quality/Quantit• .cility:
Assess Water Qua Fee in-lieu: 0 Y- ❑ No
Assess Water Quantity -•- in-lieu: E es ❑ No
LIDA Facility on lot: ❑ Yes CI No Add Fee: CI Yes 0 No
❑ Final Plat Recorded
❑ NOT Approved: Date:
Notes:
Approved By Engi• -ering: —_ Date:
Revisi• - 1: ❑ Approved 0 Not Approved D te.:�
Rev' ion 2: ❑ Approved ❑ Not Approved Date:
Permit Coordinator Review
vt) -b000q z u OW
Conditions met prior to permit issuance 7.d1 x n lf3Q SIN
❑ Approved, NOT Released: Date notified applicant:
❑ ENG Revisions Required: _ Date notified applicant:
\U DC Exemption: CI Applied for CI Received woes not apply
-. SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes N/A ❑ Deferred
Parks SDC: 0 Yes N/A ❑ Deferred
LIDA 0 Yes ❑ N/A
QK to Issue/Approved by Permit Coordinator: °W Date: a ��'
1 Revision 1: Approved 0 Not Approved Date: 14- I2/(1.2•12 'Lti
Revision 2: 0 Approved 0 Not Approved Date:
Branden Taggart
From: Branden Taggart
Sent: Thursday, December 8, 2022 6:01 PM
To: elle@harrisexcavation.us
Subject: Demolition Permits: BUP2022-00289. 290 - 11070, 11120 SW Hall Blvd
Attachments: RegPermitAction_120518.pdf
Importance: High
Hello Elle,
Mark came to the City today to pick up two demolition permits for James Lynch. Unfortunately, I could not issue these
permits because they both needed to be revised. My co-workers who were learning how to create Demolition permits
did not complete them properly. We apologize for this inconvenience. I explained to Mark that we are missing the
sanitary sewer information on the aerial shot provided, and that he can hand sketch the sanitary sewer line on the aerial
shot. Additionally, we would appreciate it if you can also have him draw in the silt fence location with X's(e.g. XXXXX),
provide the missing the square footages for both sheds located at 11070 SW Hall Blvd, and also draw in tree protection
fencing for any trees that could potentially be impacted by the demolition. For future reference, I have included our
demolition permit site plan requirements below:
• Site plan: (2)copies for each address showing the following:
o Footprint of all structures to be demolished with building square footages noted.
o Sanitary sewer, septic tanks locations
■ Decommissioning of septic tanks will require a pump/fill or removal receipt prior to scheduling
final inspection.
o Erosion control measures.
o Tree protection measures, if applicable.
o Pedestrian protection, if applicable.
Lastly,the permit fees that were assessed were incorrect. We would appreciate it if you can complete the attached
Request for Permit Action form so that we can mail a refund check to you. Refund checks are mailed within 6-8 weeks
of receiving the form. If you have any additional questions, please let me know.
Thank you,
Branden Taggart
r City of Tigard
.•„ Senior Permit Technician
Community Development
T"iCAid.I)
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
brandenti tigard-or.gov
1