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Permit
FOR OFFICE USE ONLY—SITE ADDRESS: 13 if 9 ' 5 W Or 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 !PI : Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: A l l y5ov Arm..5d-ro hg DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: 54eU2 Scoff JUL 19 2023 COMPANY: CITY OF TIGARb 3UILDING DIVISh( PHONE: 50S ¢o1 S131 EMAIL: Sccsfco but[di j , cleSlc1 h 3maiI • ce111 RE: 13+58 SW O►-(ton Off ) Tt 9 and I(1'6T 2otZ — mo480 (Site Address) (Permit Number) Lot'5 Lbnna Pav-k (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: _Copies: Description: Copies: Description: Additional set(s) of plans. 3 Revisions: dew ,c rrl acr `oect Joni Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. 3 Other(explain): i ru.% enslneP..x'e119 REMARKS: 8ecat..se_ of t nad e$ate ° cl entry race_ -C4fr head-dud rh C' u / Spa, toe Mou&l (arq Inct)) t n >!o a t►15t,1 L 0.+ed arid n(rt, rra 6/ d c�tsar, pace, , Alec,) pla'is suh Mch,ed re { +ha*, FO1 .OFFICE USE ONLY Routed to Pe it Technician: Date: 7 ( iz3 Initials: AA,' Fees Due: Yes ❑ No Fee Descnptio Amount Due: $ Do /i f'V rears< ►,� „��`� $ L15 . Special Instructions: Reprint Permit (per PE): / ❑ Yes No [Done Applicant Notified: "/ Date: /,)-4Id-3 Initials: 3 Electrical Permit Application I I FOR OFFICE.1,SE o\I.'11 City of Tigard �D112120 Received i omo No Mg-262z-QC14,0O a 171z5 SW 11a11 isivd.,Tigard.OK 97223 q Nessew I a Phone. 503.711.2439 Fas. 503.591 196D t nc uy: Orlin rtrma 7I r;Aar, Inspection line-. 503.639.4175 Oak Rink is mud CI SwPanP. l r. Inlcmcl. owls,;lpt •or.gos NotamtMethod. Su►pkmraral lafurmaltua ';':;i PS170 ', £1 .,' PLAN REVIEW 1 'I Nr is construction CIAddillonValterationircplucement Pkaw rh<.1all neat Nook(submit l I. err pimp ssn m nas 5h,<ked hrl. , /' 0$rYK<a Ice.n 000 e,.ps a.molt ❑BUIldta#ones duet wn<, ❑ Demolition ❑Other A where ih<srslatle rank raneni (]Mannar atd boon aid, CATEGORY Of CONSTRUCTIOi4 f '"` earent.10 000 amps at 150 sons or 0 Floating tannings km to around.or ranee*14.000 0 Commnrtsl•are agnsultnr,J „El I•and 2-family duelling 0 Commeretal'industriai 0 Accessory building gnpsfor all mho mrdlarwn, tannings ❑Multi-Tamil} 0 Master builder ❑Otter: 0 Fie pump Cl Natalia too of 71 KVA or JO0 SITL INFORMATION AND LOCATION 0 h,aeeiency natal Iaraer rtpa as 1y dented as Jrnl ❑A4dihon of(PM inns load or ❑^A".'3:"."I-Y'.-1.1" 1001IP a muse steCt u,S). lob no' Job site address: 1 zy6 r- e 1!r\Q‘j1 c # ❑bit lare me rniders,al ISOM ❑Ramosional unlink palm r .. 6-\`�r 0 lk.Jth•care fxahlks CI Snorts sultan tie man*W, C iiViStakiZIP: •--r ip�`a, l/Y 1K- ❑Nafardan h catwas 690 Yolk nominal Istbldg..rapt-no.: 1 Project name: ❑Strom or rank,boo antrum mom FEE SCHEDULE C i 16 street/directions to job site: iS D 1 iz1E7 sr,..... 1 riled j Me, 1 Too 1 Ness reaidenlial slagk-or mult{•hmllt duetting unit. Iaetodn attached garage. Subdivision: Lol no, LoaO.y n to km - I61.54 Tea ma roll Ea add'i 5001y ft or portion 3792 lopa la: Limited energy.midential ,,,,L. 7100 2 ' •DPStRIPTION40F WORK if-TWA', J� ., nh , ;with Mots lq 111 + Limited energy,mute-faintly 75W •1 thrs01.1. 9,so.fildharstia1 1^sorv'a At elm r'3R.ars Y ���"` fr suk rcnet»y alhatu+ssy IY.} , _ _I T s" tiers lees m littler,toalallattrrotalkralioo,and/or relocation yv 42-16 lb.�.,l.L7C/�; '�L txnT4• 200 amps a less I W.70 s._ __.. _; PROPERTY NrivER I .,,..(i eTEPANT, 201 amps m 400 amps 1)3 S6 1 ; 401 amps to 600 amp. 200 34 Name: . . a24__ C_1274St601 amps itt 1,000 amps . 301.04 2 ; Address: 134fi7s 6UJ ba i, CI- Over 1,000 amps or volts $52 26 City/Slatel2lP' Temporary aervknor feeders instaHatiw,alteration,aadlor 1 -T..�a�� cog. q-'12- j Phone:L��,zn1 Fax:( 1 no amps or km 59 36 I Hirt - 13 201 amps to 400 amps 123.01 2 Owner installation:This installation is being made on properly that I own which is not 401 amps toSo9 amps 16E S1 + intended for sale,lease,real.or exchange.according to ORS 447,449.670.and 701. -- Branch elrruln-nor,alkr,thfn.or ealna me. rpaael Oss tier signature: Date. A.Fee lea branch Circuits aoh 0 APPLICANT'; " ' ( © CO'CONTACT PERSON .tore service a fcc kr lie. 7.42 • __ each branch curun Ikisinuss name: B.Fee for Mash circuits widow �� ..— mince or(eosin Inc,lint 56 11 Contact name' branch circuit Each midi branch urcust 7.42 1 Address: MI relianrous(ten lee or feeder not int'adrd) Cil}'/SlalelZlP: 1 ach manufactured a rlwaluk 67 •14 . damning.sQVire and or feaiQ Phone:( ) Fax::( ) Reconnect only 6764 2 1 Pumper inimoion circle 67.14 E-mail. ` _ j Sian.,,,ou11�M halsh; 6714 �w,,°w<>�_ .r" TR4111Ogli •. a . ` ` Signal timings)or limited-energy I panel,allerahun,ur ostont,set Par 2 Rosiness name: Dnamilouse Electric,LLC Each addiliaaal{empire Nun WV et-allow***to may of the plane A(Wress: 221 StuASoonridge Pique Adds'loon,mpahon(I hi man 0625 hr C Ll '13iSCIIe?7.IP: Portland,OR 97225 < InreshgatamtI Its mini 66.25 hr Phone (5031 519-6711 hut:(SO3I 64E-9723 Industrial phi 11 hi mast 71.1$err UCH Lie• 196726 Electrical Lie.: C-348 Suprv.l.ie,: 4S60S inspections far which no teem yo_a,hr - - specifically loins'Ca to min) Suprt,Electrician signature.required: ELECTRICAL PERMIT FEES Subtotal I Prins name: Chris Mahon 7 Date: -2, ,y� Plan reYtuw 05%of permit fee} y Authorized signature, / 4/ Sank surciwrge i 1245 of permit fee). 'I� / 3OtAl.Pf:8611'I'II-Eli Iimin+,nn+trc i 12„�3 /1O1 '-4 I Date: Co/1 12_3 _. , ,:,i:11,r,,, ,,,I6 1.(4.u.na. u),uum i .ua.nitnt,.,YcoMwho y CITY OF TIGARD MASTER PERMIT ''l a COMMUNITY DEVELOPMENT Permit#: MST2022-00480 T f G A R.U) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 1S1332023 Parcel: 1 S 133DC19300 Jurisdiction: Tigard Site address: 13458 SW ORLIN CT Subdivision: DONNA PARK Lot: 5 Project: Donna Park, Lot 5 Project Description: New detached dwelling. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 2 First: 1777 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 3 Second: 490 sf Garage: 670 sf Front: 10 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 2267 sf Value: $392,554.87 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 2 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 200 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckfiw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: Bar sink MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 4 Clothes Dryers: 2 Natural Gas Heat Pump: Y Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 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 WI Svc or Fdr: 0 Ea add'I 500 sf: 4 201-400 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 2267 Owner: Contractor: SCOTT,STEVEN&JANET OWNER Required Items and Reports(Conditions) 11665 SW 98TH AVE 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 PHONE: PHONE: FAX: Total Fees: $42,950.90 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law require ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR nl R n oc9_nnt_nn thin, nA oc9_n non m nhfaain o re. Ri of the n m C 0 dee nr riirerf ni elinne in fll IN by rnllinn Sin 919 1R7 nr'I Ann TT)9'2dd Issued By: ' /a rmittee Signature: GGf Call 503.639.4175 by 7:00 a.m.for the next available inspection date. • %� This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONIX Dar Phone: 503.77182439 Fax: 503.598.1960 ° <; E' Received City of Tigard eB3 PeraitNo.: MC y, }� p� 13125 SW Hall Blvd.,Tigard OR 97223 f ' �/�/f �9�0� Plan Review S �...„, te/By: Other Permit: TI GAR U Inspection Line: 503.639.4175 LLL44��� Date ReadyBy: Jun H See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK ° ; � a COMMERCIAL FEE* SC ,, E -USE:CHEC °, „ °°' . �1 , ,F Mechanical perimt fees*arc based on the value of the work New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑ Other: mechanics!materials,equipment,labor,overhead,and profit. Value:$ uI yCATEGORY OF CONSTRUCTIO� I ' _ RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist ❑Multi-family 0 Master builder 0 Other: Description Qty. Ba. Total .TOR SITE INFORMATION AND LOCATION v Heating cooling: z 1 Air conditioning __ 46.75 .. Job site address: ( 74 C✓E2 G) ©le-Ito.' Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP, TL[l a(rd -2 z Pj Furnace 100,000+BTU(duets/vents) 1. 54.91 ,J Heat pump 61.06 Suite/bldg./apt.no.: Project name: �anria ?At-k- Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 _ ,h, Residential boiler(radiator or t,� i- j-1Je_ hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. ; 46.75 , Flue/vent for any of above I 23.32 Subdivision:. 90i,t 06\ T;;r I k Lot no.: 5 Other. 2332 t Other fuel appliances: Tax map/parcel no.: 12 LZ- 1!e ;'„ Water heater i 23.32 ''r` '''1 '".)x r "` "' Gas fir lace/insert t 33.39 DESCRIPTION OF WORK , .�;� fireplace/insert "" Flue vent for water heater or gas fireplace Z 23.32 Ili( {� Log lighter(gas) 23.32 l; SY t,4 �/� - - Wood/peilet stove ' 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 PROPERTY OWNER I Other: 23.32 0 TENANT Environmental exhaust and ventilation: Name: J' E ,Jr-t� Range hood/other kitchen d equipment I 33.39 Address: ( �O 60.) Or(1Y1 ' -- Clothes dryer exhaust I 33.39 City/Slate/ZIP: ( ZZ3 Single-duct exhaust(bathrooms, r , OL toilet compartments,utility rooms) ' 23.32 Phone:6-8) 4r; ! , -7.�1 Fax:( ) Attic crawlspace fans 23.32 -,n.. - ,.: .. ;k1 CONTACT PERSON Other: 23.32 Fuel piping: Business name: $14.15 for first four;$4.03 for each additional Contact name: SJe SCozi-t Furnace,etc. I Address: i 1(06. ..64.5 [g'r1't Aue Gas heat pump q' Wall/suspended/unit heater City/State/ : It3avd, oil � l q j Water heater Phone:( ) 40 7 bi 3/ I Fax: :( ) ' Fireplace ' E E-mail: --',-„t Cf fCdr Barbecue Range 1 E-mai bat/d' - l esji el @ P16 11 , -'r> l 'CONTRACTOR ri Clothes dryer(gas) Other: Business name: L/! i etli)Qv r MECNANICAl.PERMIT FEES* Address: Subtotal City/State/ZIP: Minimum-pz,inn lee(S90.0 ) , t Plan review(25%of permit fee) Phone:(93 ) 40/ 5-1 51 Fax:( ) Slate surcharge(12%of permit Feel CCB lie.: 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: edif . Fee methodology set by Tri-County Building Industry Service Board Print name: 5 jott' S Date: ///i /zL IABuao enairwti `r a; pp_134tnasame 44o-a`eris(ialtntcoratwan) 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 to 7,200 , $233.20 Sewer-1st 100' 1 62.54 7,291 and greater $327.54 Sewer-each additional 100' . 37.52 Water Service-1st 100' / 62.54 Medical i./{iedical Gas Systems: Water Service-each additional 100' 3752 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' f 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to P and including$10,000.00. Inspection of existing plumbing or for $io,00T.o01o$25,000.00 Y $148.50 for the first$10,000.00 and$1.54for which no fee is specifically indicated 90.00/hr g ; S each addnionat$400.00 or fraction thereof,to (minimum charge—1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00to$ti 000.01/ $379:50 for the first$25,000 00 and$i 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 future. 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. Baptistry/Font 0 Any new commercial building with water service 2"and Bath: Tab/Shower greater,except systems designed and stamped by licensed engineer. -Jacuzzi/Whirlpool Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive Thru as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic 0 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 t►r s=gram 4 _ Isometric or riser diagram is required fur 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: -LavBar 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 Wa E Clothes fees assessed for the sewer increase must be paid before the Water ter 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 ili .: " COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review - Residential TIGARD to Building Permit #: MS 22—nOL-1,8r) Site Address: RS' 9A) Or10 Ci ❑ Verified in Accela Project Name: £bINNR. 'P49L,ltt. t-AT' 5 Lot/Unit #: S Proposal (include housing type): 04AN St004, dectC O 8f- Zone: S -e- Required Site Plan Elements: eEr3 copies of site plan on max 11x17" %Drawn to standard scale 2-Retained trees, drip line/tree protection North arrow .elStreet and site trees shown / labeled efl'Site address, project name, lot # O-Tabie-calr_uating tree canopy at maturity XJ Street names (N/A for SFR) Applicant name and phone # - ou d rectangle dimensioned (if applicable) /Lot and setback dimensions p'Vision clearance triangle fEl-Existing structures &square footage Utility locations & easements Footprint of new structure and FFE J✓�Property corner elevations (/Sidewalk/driveway dimensioned PfLIDA (>1,000 sf disturbance) f 'Lot area and lot coverage percentage R(Erosion control Required Elevation Plan Elements: (For SFR: calcs needed only on street-facing) Garage doors dimensioned „EfDrawn to standard scale $ fteeo►to Jevdj Summary table with calculations for: .Building height dimensioned 14 d°a,slM5 Jd'Total facade area 1/Facade dimensioned Total window and door area ❑ Windows and doors dimensioned , Total 3rAgP-P,rom W der-- Required Floor Plan Elements: yiyummary table that includes ach story dimensioned Total floor area Each story floor area calculated ZIfloor area per story Planning Review The following standards have been met: Setbacksront: I v Rear: �5 Side: Min/Max Street Side: / Garage: 7 Height J2KMax. Height: 3S Proposed Height: es ❑ N A Landscape ❑ Yes N/A Screening (Quad only) es ❑ N/A % Window Coverage -7 12-f i YYnv) (-Yes ❑ N/A Garage (SFR Only) e So7. Parking (Other Res) el"flErc'es 0 N/A Entrance (SFR, Rowhouse, Quad only) Co # " wL75tCJ f pvreti O Yes%N/A Other building design standards (Rowhouse only) ❑ Yes 2(N/A Accessory Structure Standards O Yes ZNo Qualifying pre-existing unit exempt from standards (Cottage unit only) Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads: 0 s 0 N/A Unit Count: ❑ Yes A Lot Width an ' e ❑ Yes Cl N/ hw Additional stan ds and Units and Cottage Clusters only: ❑ Yes 0 N/ Unit Area: O Yes /A Floor Area (per story) O s 0 N/A Courtyard 0 Yes 0 N/A Fence ❑ Yes El No I /A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995) ❑ Yes ❑ No FIN/A Public Facilities Improvement (PFI) Permit: Required: ❑ Yes El No Applied For: El Yes ❑ No, stop intake 'Sensitive Lands: ❑ Yes 2T-No C/Land Use Case #: SU52.011- 0000 1 p Conditions met prior permit issuance Approved By Planning: Date: II I (#'�2 Notes Revision 1: El Approved ❑ Not Approved Date: _ Revision 2: El Approved ❑ Not Approved Date: Building Permit Submittal / Original Submittal Date: I l /l(e ! ZOZZ- Site Plans #: Building Plans #: Building Permit #: 1uilding permit # entered on page 1 Workflow Routing: ,fanning .12-56-g-ineering,rmit Coordinator ,ilding Workflow Sign-off: 'Sign-off for Planning (include notes from planning review) Route Documents: '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. / / Permit Technician: Date: i l! /6 /2 Notes: Engineering Review Slope at building pad: 2.% f nditions met prior to issuance of permit [easements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: El Yes IErNo Assess Water Quantity Fee in-lieu: El Yes I"No LIDA Facility on lot: El Yes 2/No Add Fee: 0 Yes ❑ No E3 FinaI Plat Recorded El NOT Approved: Date: Notes: Approved By Engineering: ref /34.-il"(--' f Date: I /24(UreZ Revision 1: ❑ Approved 0 Not Approved Date: Revision 2: El Approved El Not Approved Date: Permit Coordinator Review 4Conditions met prior to permit issuance Approved, NOT Released: Date notified applicant: El ENG Revisions Required: Date notified applicant: \(SDC Exemption: El Applied for ❑ Received ❑ Does not apply .SDC Fees Entered: Wash Co Trans Dev Tax: b Yes ❑ N/A Tigard Trans SDC: 0 Yes El N/A ❑ Deferred Parks SDC: ❑ Yes ❑ N/A ❑ Deferred LIDA ❑ Yes 'JN/A C(310K to Issue/Approved by Permit Coordinator: ic\ cA)M.) (C)A Date: 'I I "'!� J" 2 2- Revision 1: 0 Approved ❑ Not Approved Date: Revision 2: 0 Approved ❑ Not Approved Date: 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 $11 . Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: A II cf go V) A r v151-iron q DATE RECEIVED: DEPT: BUILDING DIVISION �J FROM: 5J-teUe so--1- RECEIVED COMPANY: JAN 12 2023 PHONE: Q2j 4-01 31 BUILDING DIVISIION By �CITY TI � EMAIL: 510-H-Ca , bU( 01 k1G , ciesop (° 70, h. Cowl RE: 13 4 5 8 Stec/ 0 tom-f I n Cf That-] (15f^ ZOZZ—Gt21-b0 (Site Address) (Permit Number) POvlv1a Park (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. 3 Revisions: Pale z c.)-r Prat h S Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. 3 Engineer's calculations. Other(explain): f REMARKS: sc�e Gi•iac%['ai I e- -I- -- FO OFFICE USE ONLY Routed to Permit Technic' n: Date: I I°i 23 Initials: Fees Due: ❑ Yes No Fee Desc ption: Amount Due: L $ $ 7' $ Special Instructions: Reprint Permit(per PE): ❑ Yes No El Done Applicant Notified: PE):, Date: ( /,1-')fa-A) Initials: ,