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HomeMy WebLinkAboutPermit (57) IPI CITY OF TIGARD MASTER PERMIT i Permit#: MST2022-00170 COMMUNITY DEVELOPMENT T 1 G A R.r) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/25/2023 Parcel: 1 S136AC03300 Jurisdiction: Tigard Site address: 10705 SW 71ST AVE Subdivision: METZGER ACRE TRACTS Lot: 2 Project: Fakih Project Description: Addition of 673 sf habitable space and 421 sf of deck with stairs. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 673 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke No Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Total: 673 sf Value: $98,674.78 Rear: 15 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 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 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 0 Drywall-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Fum<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!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 3 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-3 673 Owner: Contractor: FAKIR,HAIDAR&LAMA SUPERIOR FRAMING AND CONTRACTING Required Items and Reports(Conditions) 10705 SW 71ST 2373 NW 185TH AVE#286 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 HILLSBORO,OR 97124 PHONE: PHONE: 971-226-1906 FAX: Total Fees: $4,302.24 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 wit approved plans. This permit will expire if work is not started within 180 days of is ante, or if work is suspended for more the 180 days. ATTENTION' on law requires follow the rules adopted by the Oregon Utility Notificatio enter. ose rules are set forth in OAR g59J1M_ant n rhrnnnh ri m-noon \rem rnn,of fho nilne nr rliront ni iocfinnc in(111NC by Tallinn Sn4 9 Issued By: P12i/G Permittee Signal . Call 503.639.4175 by 7:00 a.m.for the next available inspectio This permit card shall be kept in a conspicuous place on the job site until c pie on of the project. Approved plans are required on the job site at the time of each Insp tion. ectrical Permit Application FOR OFFICE USE ONLY l ♦t City of Tigard :.'j.. Received Date/By: Permit/A/6(�&e —00( CI7 y' • 13125 SW Hall Blvd.,Tigard,OR•97223 Plan Review RR�� r ':III ` Phone: 503.718.2439 Date/By: Related Permit#: Email: TigardBuildingPermits@Tigard-or.gov Ready Date/By: tuns: ® See Page 2 for I IGARD Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: Supplemental Information ' PE OF WORK PLAN REVIEW ❑ New construction 4r�, A—dddition/alteration/replacement Please check all that apply(submit2 sets of plans w/items checked): ❑Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current ['Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO volts or ❑Floating buildings. i i' and 2-familydwellingCommercial/industrial less to ground,or exceeds 14,000 0 Commercial-use agricultural ❑ ❑ Accessory building ❑ Multi-family ID Master builder 0 Other: amps for all other installations. buildings. ❑Fire pump. El Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived 0 Addition of new motor load of "- s stem. ' Job#: Job site address: 10705 Sf� .?/54 y � ]OOHP or more. ❑"A" "E" "I-2" "1-3" City/State/ZIP: t tir �^� - 0 Six or more residential units. occupancy. / e/ 9 22 ❑Healthcare facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for mom than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPT{ON OF WORK Limited energy,residential 1 �) ` r (with above sq.ft.) 75.00 2 e5(r7)r0oz 0/ D) /+�4 f Limited energy,multi-family are/ Usa ,� CO/4/(1. n 1 residential(with above sq.ft.) 75.00 2 ,,�—,! / Renewable Energy ❑ See Page 2 tl f'1 OPERTY OWNER ` 0 TENANT Services or feeders installation,alteration,and/or relocation Name: J I C6 I/ / t �- (f 200 amps or less 100.70 2 Address: /0 7o S W —2/c y 1 e 201 amps to 400 amps 133.56 2 '-� 401 amps to 600 amps 200.34 2 City/State/ZIP: / / tis. ? ` D / 7123 601 amps to 1,000 amps 301.04 2 Phone:(],3) `72 0-6 /f ' � ��/3�a��f ��7 t Over 1,000 amps or volts 552.26 2 Email: �ti✓• /Z] (� �" Temporary services or feeders installation,alteration,and/or � relocation Owner installation:This inst. atio is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,r-r .c-.i.••- . .rding to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: -s/riy � Date: 401 amps to599amps 168.54 2 APPLICANT Branch circuits—new,alteration,or extension,per panel ❑ El PERSON A.Fee for branch circuits with Business name: above service or feeder fee, \ each branch circuit 7.42 2 Contact name: Ha(C ✓ (6(A)n�/r/ B.Fee for branch circuits without Address: service or feeder fee,first 3 56.18 2 branch circuit City/State/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 • Business name: ' lift tilVn N' k1 l ,11Uctit Sign or outline lighting 67.84 2 r Signal eircuit(s)or limited-energy Address: ,�� S G M ,ys. panel,alteration,or extension. El See Page 2 2 6V t r W`qO�W S I O . Ql G$G Each adAdditional inspection al inspection over allowable in any of the above City/State/ZIP: to Additional ins ection 1 hr min 66.25/hr Phone:(t\) A 13- a O 16 Investigation(1 hr min) 90.00/hr Email: Uv\ ( pr.Ai h'^'nr Industrial plant(1 hr min) 78.18/hr Y J��Y ?� Inspections for which no fee is CCB Lie.: ' 3`i' Electrical Lie.: C/41 Suprv.Lie.: 0 TOS specifically listed(h hr min) 90.00/hr L a ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: ,,� Subtotal: Print name: Date: ❑Plan Review Required(25%of permit fee): f State surcharge(12%of permit fee): Authorized signature: vni/ TOTAL PERMIT FEE: t �A This permit application expires if a permit is not obtained within 180 Print name: Hai dam ! r. �/ Date: 6/2/2'2— days after it has been accepted as complete. * Number of inspections allowed per permit. I aBuilding\Pemtits\ELC PermitApp_ELR_ERE.doc Rev 10,26/2017 440-4615T(11,'05/CDM.M1VEB .r Electrical Permit Application—City of Tigard Page 2—Supplemental Information ik Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Uzi, Description I Qty. Each Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 n Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: n Other: Each additional inspection is 66.25/hr charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(1/2hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page I): 3' • Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ M• edical ❑ Nurse Calls n O• utdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations l:\BuildingWermits\ELC_PermitApp_ELR_ERE.doc Rev 10/26'2017 dim E!iectrical Permit Application FOR OFFICE USE ONLY Received •I City of Tigard Da .A ► Permit L ' I gi • , 61 IVI13125 SW Hall Blvd.,Tigard,OR'97223 Plan Review t C Phone: 503.718.2439 Date/By: Related Permit Is. Email: TigardBui1dingPermits®Tigardor.gov Ready Date/By: kris: ® See Page 2 for "AitEt Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: Supplemental Information '7 EsQ .- , "iar"-,4: "' -,,..JBrt ., ' ,,,,,yi.t2ast;Iare ',-. %:. i5: ❑New construction Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards, CATEGORY OF CO O , .?` exceeds 10,000 amps at 150 volts or 0 Floating buildings. .1du leas to ground,or exceeds 14,000 0 Commercial-use agricultural land 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or ' _ � JOB SITE INFO~'' ON AND LOCATION ❑Emergencysystem. larger separately derived ❑Addition of new motor load of '0—,are,m - Job site address: /O 05 S(a 7/s'C 100HP or more. "E""I-2""I.3" ❑Six or more residential units. occupancy. City/State/ZIP: t ty I /b ti r,/ / 0 9 7'Z2 3 ❑Healtb-caro facilities. ❑Recreational vehicle parks. ['Hazardous locations. 0 Supply voltage for more than Suitelbldg./apt.#: Project name: ❑Service or feeder 600 amps or more. 600 volts nominal. Cross sticet/duectionsto job site: '_F.EEr•�q34ti4 ", 4.4'*e: Description I Q45 Each I Toed • New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'1500 sq.R or portion 33.92 1 DE$C4 PT ON'Y1 I ' !,-,..it tt,:l ' 3ti' Limited •energy,residential 75.00 2 n r�o� • G,r „ L (with above sq.fl.) / Ciw- rC Limited energy,mufti-family 75.00 2 a . Sw/ 1,- ('f�tG o4 residential(with above sq.ft.) l Renewable Energy ❑ See Page 2 WA, t�IfROPERTY OW, E)2r' ❑ TENANT'' ,,,N.,,--,.,- I Serv[ces or feeders installation,alteration and/or relocation Name: t �`(� 200 amps or less 100.70 2 Address: /0 20-- S w -7/971- - /9• e / 201 amps to 400 amps 133.56 2 .-� // p^� 401 amps to 600 amps 200.34 2 City/State/ZIP: / / f�✓z ! d2 / /2 Z 3 601 amps to 1,000 amps 301.04 2 Phone:(Sbb3) 7.2 f 0.6 2 � t Over 1,000 amps or volts 552.26 2 F�!'r 0 j `�a//J Temporary services or feeders installation,alteration,and/or F�niu]; r��yi� ^T J[,P ��7 relocation Owner installation:This ins atio r is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,r- r. • : ..r ring to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 �!�/�� ��� Date: 401 amps to 599 amps 168.54 2 Owner signature: _ - q�ACT: PERSON Branch circuits-new,alteration,or extension,per panel x.. D APPLICANT . M,. " A.Fee for branch circuits with may/ Business name: above service or feeder fee, /1. 7.42 2 /� each branch circuit CY I Contact name: Ai ✓ (OW/1(f) B.Fee for branch circuits without 3 56.18 2 service or feeder fee,first Address: branch circuit Each add'l branch circuit 7.42 2 City/State/ZIP: Miscellaneous(service or feeder not included) Phone:( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: Reconnect only 67.84 2 .vc CONTRACTOR ms,E Pump or irrigation circle 67.84 2 Business name: ,(., 'soto `" tazot Sign or outline lighting 67.84 2 '� a-`t--�.1 �I. � Signal circuit(s)or limited-energy 0 See Page 2 2 Address: S panel,alteration,or extension. \ w � �'�� (�, Each additional inspection over allowable in any of the above City/State/ZIP: n PCYA/�h $ U S 1 ©R• ci � `' Additional inspection(I hr min) 66.25/br Phone:(a)j 3�O) `4_ U Investigation(1 hr min) 90.00/hr Email:MI\ P'f .CtS I (Jw"N '1•.' L- I Inetiolf (1in ) 78I8/hr Inssppecctionss forr which no h fee is 90.00/hr CCB Lic.:t,14J31 t�yy'� 1 Electrical Lic.: ^^ '',,� Suprv.Lic.:�0-' specifically listed('A hr min) 1J -'�T r ELEC litcg FE)Z11'1r9kF.E _ . • Suprv.Electrician signature,required: ` X4 \fix/v\A Subtotal: Print name: \„AZ\( P yL 4 .)' J r k`4 Date: 'Yf,'• ., ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: (J • TOTAL PERMIT FEE: �rr /� / This permit application expires if a permit is not obtained within 180 Print name: a /CYav / 1� f7 / b�Date: 6 4 2 2 - » days after It has been accepted u complete. Number of inspections allowed per permit I:\Building\Pmnits6ELC 1PermitApp_EIR_ERE.doc Rev 10/26/2017 440-4615T(1 I/05/COM/WEB City of Tigard 71 e■ COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential Building Permit #: Li cT2O2.-Co(70 Site Address: lfl-r1()S. W - `Et f Project Name: ¶,0„;,1M t''ddA11-tiw\ Lot #: Planning Review Proposal: Verify address/suite#active in Accela. ❑ In River Terrace: ❑ No ❑ Yes, River Terrace Review Addendum Site Plan Elements: S'M,• '. • trol FrAi, copies 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) ' of e== �r�•rfi`e(i;>y jtutdgcks)and FFE Itin orth arrow tility locations&easements(regnirrrl for new and additions) Site address,project or subdivision name and lot number N3 rtveway approach VApplicant information(name and phone number) ❑;✓eeatit ol'wells/septic systems "Lot dimensions and building setback dimensions ❑Seer tree size,type and location ❑Squaca—feetage of buildings to be demolished 4Street names IgExisting structures on site ❑C contours if more than 4'differential) Otot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑YesI,No impervious area(applicable if R-7,R-12,R-25&R-40) • If es,is a storm water .uality facili shown? ❑Yes ❑No 7� Clean Wate�r,(Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: �l Yes,applicant was notified El No Received: ❑ Yes ❑ No Water Meter ixture Unit Worksheet—Additions,Remodels and ADUs i Jo F I X,'N Q. ' Required: ed p• No Received: ❑ Yes El No ❑ SDC Exemption for ADU applied for: El Yes &No Received: ❑ Yes El No ❑ Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified f No Applied For: El Yes Cl No,stop intake ❑ Land Use Case#: Zoning: •c XRequired Setbacks: Front: Rear: \C) Side: Street Side: 1S Garage: 20 'f. Building Height: Max.Height: 30 Actual Height: ❑ Landscape Area: Islik % ❑ Lot Coverage Max: ►slAe Entrance ❑ i'ii than 8'from street-facing wall El Parallel to street or offset 45 degrees or less Windows ❑ Mirthnurrrt g/o of area of all street-facing facades Garage El GargFriiir is behind widest street-facing wall ❑ Yes El No,one of the following is met: ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage. El Door extends no more than 5' from wall and there is a 12 sq ft.window above garage on 2n°floor. El Garage door width is ❑ 12'or less ❑ 50°,/o or less of facade El 60%or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave El Roof offset ❑ Fire shingles El Lap Siding ❑ Roof pitch El Gable,hip,or gambrel roof El Dormer ❑ Accent siding El Window trim ❑ Window recess ❑ Window projection El Balcony ❑ VJs„^t-Clearance ❑ Itn Forestry Plan Sensitive Lands: ❑ Yes No Type: ❑ Conditions met prior to issuance of building permit Notes: XApproved By Planning: J- 1 n/r `(6i i n Ii3 Date: Revisions(after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:1Building\Forms\B1dgPermitRvw RES 122419.docx Building Permit Submittal Original Submittal Date: (27/22— Site Plans: # Building Plans: # 'J Building Permit#: L 'Enter building permit#above. Workflow Routing: 114tanning ❑ Engineering ❑ Permit Coordinator C/Building Workflow Sign-off: [ 'Sign-off for Planning(include notes from planning review) Route Application Documents: I_I 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 t details,if applicable,etc. Notes: By Permit Technician: Date: 6(7/2�Z Engineering Review L7 Slope at building pad: '7% Conditions "Met"prior to issuance of building permit y/H- Easements (encroachments)per engineering conditions of approv. -. plat g Water Quality/Quantity Facility: �/ Assess Water Quality Fee in-lieu: ❑ Yes L�7/No Assess Water Quantity Fee in-lieu: El [ No LIDA Facility on lot d Yes d No Final Plat Recorded: ( , ❑ NOT Approved by En:' eering: Date: Notes: '1Approve. .y Engineering: i Date: 4/(r(2.07LZ Revisi. after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review OrConditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to ' pplicant: Revision Notice 2: Date S- to Applicant: "12 SDC Exemption: ri Received Does not apply SDC Fees Entered. Wash Co Trans Dev Tax: ❑ Yes Z.'N/A Tigard Trans SDC: ❑ Yes N/A Parks SDC: ❑ Yes N/A LIDA ❑ Yes N/A Vf OK to Issue Permit Approved by Permit Coordinator: "Arri/C—N- Date: 2o27— 1:\Building\Fortes\BldgPennitRvw_RES_122419.docx Clean Water�rServices SENSITIVE AREA PRE-SCREENING SITE ASSESSMENT Clean Water Services File Number 22-001579 w 1 1. Jurisdiction: Washington County 2. Property Information(example: 1S234AB01400 EKED 3. Owner Information Tax lot ID(s): R Name: Haidar and Lamma Fakih 1S136AC03300 `111N 2021 Company: JU Address: same as above -11 OR Site Address: 10705 SW 71st Ave C'SY 0 G ,J\S ON City,State,Zip: City,State, Zip:Tigard,Oregon,97223 Btj11-ON Phone/fax:Nearest cross street: Email: 4. Applicant Information 4. Development Activity(check all that apply) 0 Addition to single family residence(rooms, deck, garage) Name: Karen Linder ❑ Lot line adjustment ❑ Minor land partition Company: Karen Under Interior Desgins ❑ Residential condominium ❑ Commercial condominium Address: ❑ Residential subdivision 0 Commercial subdivision City, State,Zip: „ ❑ Single lot commercial ❑ Multi lot commercial Phone/fax: so3-515-4745 Other Email: karen@karenlinderinteriordesigns.com 6. Will the project involve any off-site work? ['Yes I] No ❑Unknown Location and description of off-site work: 7. Additional comments or information that may be needed to understand your project This application does NOT replace Grading and Erosion Control Permits, Connection Permits, Building Permits,Site Development Permits, DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality, Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local, state,and federal law. By signing this form, the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/type name Karen Under Print/type title Principal Designer Signature ONLINE SUBMITTAL Date 5/27/2°22 FOR DISTRICT USE ONLY 0 Sensitive areas potentially exist on site or within 200'of the site.THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. ® Based on review of the submitted materials and best available information sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5,Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and approvals must be obtained and completed under applicable local,State and federal law. ❑ Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5, Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and approvals must be obtained and completed under applicable local,state and federal law. ❑ THIS SERVICE PROVIDER LETTER IS NOT VALID UNLESS CWS APPROVED SITE PLAN(S)ARE ATTACHED. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2).NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed by 6744/4"- Date 5/272o22 Once complete,email to: SPLReview@cleanwaterservices.org • Fax: (503)681 4439 OR mail to: SPL Review,Clean Water Services,2550 SW Hillsboro Highway, Hillsboro,Oregon 97123 Revised 2/2020 Main Office • 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 • p: 503.681.3600 f: 503.681 3603 • cleanwaterservices.org CleanWater Services SENSITIVE AREA PRE-SCREENING SITE ASSESSMENT Clean Water Services File Number I22-001579 1. Jurisdiction: Washington County 2. Property Information(example: 15234AB01400) 3. Owner Information Tax lot ID(s): EGONI� Name: Haider and Lamma Fakih 1 S136AC03300 Company: p 20Z2 Address: same as above OR Site Address: 10705 SW 71 st Ave F.j\�R O City,State,Zip: City,State,Zip:Tigard,Oregon,97223 G\'(`( 0 Gl\\J 1 Phone/fax: Nearest cross street: o31191 Email: 4. Development Activity(check all that apply) 4. Applicant Information ® Addition to single family residence(rooms,deck,garage) Name: Karen under ❑ Lot line adjustment El Minor land partition Company: Karen Linder Interior Desgins 0 Residential condominium ❑ Commercial condominium Address: ❑ Residential subdivision 0 Commercial subdivision City,State,Zip: „ ❑ Single lot commercial ❑ Multi lot commercial Phone/fax: 503-515-4745 Other Email: karen@karenlinderinteriordesigns.com 6. Will the project involve any off-site work? ['Yes I] No 0 Unknown Location and description of off-site work: 7. Additional comments or information that may be needed to understand your project This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits, Site Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality, Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form,the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/type name Karen under Print/type title Principal Designer Signature ONLINE SUBMITTAL Date 5/27/2022 FOR DISTRICT USE ONLY 0 Sensitive areas potentially exist on site or within 200'of the site.THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. ® Based on review of the submitted materials and best available information sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5,Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and approvals must be obtained and completed under applicable local,State and federal law. ❑ Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5,Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and approvals must be obtained and completed under applicable local,state and federal law. ❑ THIS SERVICE PROVIDER LETTER IS NOT VALID UNLESS CWS APPROVED SITE PLAN(S)ARE ATTACHED. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2).NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed by ei t- Date 5272022 Once complete,email to:SPLReview@cleanwaterservices.org • Fax: (503)681-4439 OR mail to: SPL Review,Clean Water Services,2550 SW Hillsboro Highway,Hillsboro,Oregon 97123 Revised 2/2020 Main Office • 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 • p: 503.681.3600 f: 503.681.3603 • cleanwaterservices.org ENERGY EFFICIENCY R-3 occupancy,when such calculations demonstrate Exception: Additions that are less than 225 square feet similar performance to the requirements of Table (20.9 m2) in area shall not be required to comply with , Nl 101.2. Table Ni 101.1(2)or Table NI 101.3. N1101.3 Additions.Additions to existing buildings or struc- N1101.4'Information on plans and specifications.Plans tures may be made without making the entire building or and specifications shall show in sufficient detail all perti- structure comply if the new additions comply with the nent data and features of the building and the equipment and requirements of this chapter. systems as herein governed, including, but not limited to: N1101.3.1 Large additions.Additions that are equal to or exterior envelope component materials;R-values of insulat- more than 600 square feet(55 m2)in area shall be required ing materials; fenestration U-factors; HVAC equipment to comply with Table N1101.1(2). efficiency performance and system controls; lighting; an additional measure from Table N1101.1(2); and the other N1101.3.2 Small additions. Additions that are less than pertinent data to indicate compliance with the requirements 600 square feet(55 m2)in area shall be required to select of the chapter. one measure from Table N1101.1(2)or comply with Table N1101.3. TABLE N1101.1(1) PRESCRIPTIVE ENVELOPE REQUIREMENTS' STANDARD BASE CASE LOG HOMES ONLY BUILDING COMPONENT Required Performance Equiv.Value' Required Performance Equiv.Value" Wall insulation-above grade U-0.059° R-21 Intermediate° Note d Note d Wall insulation-below grade' C-0.063 R-15 c.i./R-21 C-0.063 R-15/R-21 Flat ceilings` U-0.021 R-49 U-0.020 R-49 A" Vaulted ceilingse U-0.033 R-30 Rafter or U-0.027 R-38Ah R-30Ag h Scissor Truss Underfloors U-0.033 R-30 U-0.033 R-30 Slab-edge perimeterm F-0.520 R-15 F-0.520 R-15 Heated slab interior' n/a R-10 n/a R-10 Windows' U-0.27 U-0.27 U-0.27 U-0.27 Skylights U-0.50 U-0.50 U-0.50 U-0.50 Exterior doors" U-0.20 U-0.20 U-0.54 U-0.54 Exterior doors with>2.5 ft2 glazing' U-0.40 U-0.40 U-0.40 U-0.40 For SI: 1 inch=25.4 mm,1 square foot=0.0929 m2, 1 degree=0.0175 rad,n/a=not applicable. a. As allowed in Section N1104.1,thermal performance of a component may be adjusted provided that overall heat loss does not exceed the total resulting from conformance to the required U-factor standards.Calculations to document equivalent heat loss shall be performed using the procedure and approved U-factors contained in Table N1104.1(1). b.R-values used in this table are nominal for the insulation only in standard wood-framed construction and not for the entire assembly. c. Wall insulation requirements apply to all exterior wood-framed,concrete or masonry walls that are above grade.This includes cripple walls and rim joist areas.Nominal compliance with R-21 insulation and Intermediate Framing(N1104.5.2)with insulated headers. d.The wall component shall be a minimum solid log or timber wall thickness of 3.5 inches. e. Below-grade wood,concrete or masonry walls include all walls that are below grade and do not include those portions of such wall that extend more than 24 inches above grade.R-21 for insulation in framed cavity;R-15 continuous insulation. f. Insulation levels for ceilings that have limited attic/rafter depth such as dormers,bay windows or similar architectural features totaling not more than 150 square feet in area may be reduced to not less than R-21.When reduced,the cavity shall be filled(except for required ventilation spaces).R-49 insulation installed to minimum 6-inches depth at top plate at exterior of structure to achieve U-factor. g.Vaulted ceiling surface area exceeding 50 percent of the total heated space floor area shall have a U-factor no greater than U-0.026(equivalent to R-38 rafter or scissor truss with R-38 advanced framing). h.A=Advanced frame construction.See Section NI 104.6. i. Heated slab interior applies to concrete slab floors(both on and below grade)that incorporate a radiant heating system within the slab.Insulation shall be installed underneath the entire slab. j. Sliding glass doors shall comply with window performance requirements.Windows exempt from testing in accordance with Section NFl 111.2,Item 3 shall comply with window performance requirements if constructed with thermal break aluminum or wood,or vinyl,or fiberglass frames and double-pane glazing with low-emissivity coatings of 0.10 or less.Buildings designed to incorporate passive solar elements may include glazing with a U-factor greater than 0.35 by using Table N1104.1(1)to demonstrate equivalence to building envelope requirements. k.A maximum of 28 square feet of exterior door area per dwelling unit can have a U-factor of 0.54 or less. I. Glazing that is either double pane with low-e coating on one surface,or triple pane shall be deemed to comply with this requirement. m.Minimum 24-inch horizontal or vertical below grade. 450 2021 OREGON RESIDENTIAL SPECIALTY CODE