Permit Support Document (42) FOR OFFICE USE ONLY-SITE ADDRESS: 1a-500 ' Fe-CI C
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 DEVPWOPMENT DEPARTMENT
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Transmittal Lam .,,,
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: f \ \ 160 In A Fon lj 4-c 01/1 DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: ___ QCC,1/3'\XI ® s liN C k s Jut_IP 2023
CITY OF TIGARD
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COMPANY: ,Sop') pvl S0[ o--)9 BUILDING DIVISION
PHONE: S63 evo -7 By:
EMAIL: J 12R'►^^ Q' gaVki o1c CIO 5v/ i09,COI
RE: 12566 ScA--) all CT -fic,arl aR 972z3 (1ii,S-r2or - 00 Ict C
(Site Address) (Permit Number)
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(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. �J Revisions: 1C/(j//ll( �l �
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain): /
REMARKS: Re tAS(c)u5 G-i It.Q, /Qc�cidr/ Toa� CDy4 t //vine IL
FOR OFFICE USE ONLY
Routed to Permit Technic' : Date: (a/ I 23 Initials: / -
Fees Due: ❑ Yes No Fee Description: Amount Due:
P 7-__
L...., $
$ „(75
Special
Instructions:
Reprint Permit(per PE): / ❑ Yes VNo ❑ Done
Applicant Notified: V Date: 93(1 i / Initials:(YE,
I:\Building\Forms1TransmittalLetter-Revisions_073120.doc