Loading...
Permit (7) CITY OF TIGARD MASTER PERMIT V. a ' COMMUNITY DEVELOPMENT Permit#: MST2023-00071 T 16 Alt D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/08/2023 Parcel: 2S112CA15100 Jurisdiction: Tigard Site address: 7872 SW LAYTON LN Subdivision: BROOKSIDE SUBDIVISION Lot: 11 Project: Brookside, Lot 11 Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN PAID. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 888 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25.5 Bathrooms: 3 Second: 1264 sf Garage: 350 sf Front: 10 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 2152 sf Value: $347,284.22 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum>=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 W/Svc or Fdr: 0 Ea add'I 500 sf: 3 201-400 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 2152 Owner: Contractor: BLACKWOOD HOMES INC BLACKWOOD HOMES Required Items and Reports(Conditions) PO BOX 4188 PO BOX 4188 1 Ersn Cntrl 503-639-4175 TUALATIN,OR 97062 TUALATIN,OR 97062 PHONE: PHONE: 503-482-5802 FAX: Total Fees: $22,409.69 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 requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR QS9-nn1 nn1n thr nAR oc ..nn1_nn‘ i i mmr nhtain a rnmi of tha',lac nr riirort ni iaetinne to nl our.h,ralli"n , 1 919 1QR7 nr 1 grin 119 91AA Issued By: 1, Permittee Signature: �\',\ ^')i 7- `�— Call 503.63 4175 by 7:00 a.m.for the next available inspection Date This permit card shall b ept 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 j1P 01 1 1 City of Tigard RECEIVED Received - 01.• (Y" f 3 -( t`� Permit No.: Ili13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �n ? �' Phone: 503.718.2439 Fax: 503 r1960 6 2023 Date/By: 2 ` t{iN �0 i i,,,It O Inspection Line: 503.639.4175 Date Ready/By: Juns: ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIGAQRD Notified/Method:s $? ?J Supplemental Information . . - .. ;� -z;, m1n5, � � TYF , VI _ LLING New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the work indicated on this applicatio CATEGORY OF- CONSTRUCTION 391,��t ' Vk land 2-family dwelling ❑Commercial/industrial Valuation: $ `-� ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder El Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 7 b2 Job site address: 9 '72 c VI Gni Tvl, (./J New dwelling area: 2.1 rj a square feet I'2k9 City/State/ZIP: 7/( fL) Q 9.22.i4 Garage/carport area: 3 So square feet �$ Suite/bldg./apt.no.: Project name: i Covered porch area: Si square feet Cross street/directions to job site: 7 i ToI R L4\ l VI/ Deck area: 0 square feet t Other structure area: 0 square feet REQi IRw D(8I LOMME CIAL4JSE CHECKLIST Subdivision: g I - Lot no.: I 1 Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the '"`+.. AES4g pr c FWO work indicated on this application. �S r)( (,(_� Valuation: $ y Existing building area: square feet New building area: square feet F 9, o _- 0 ..#NANTNumber of stories: Name: Blackwood Homes: INC Type of construction: Address: PO Box 4188 Occupancy groups: City/State/ZIP: Tualatin, OR 97062 Existing: Phone:( ) 7 Fax:( ) New: w< ,� 13-CONwr.4fir PIRSON '11HG' ERM E t '�s_ x. • - - ,.(P�erto.leeaehedak) Business name: Structural plan review fee(or deposit): Contact name: BI8CICIAlOOd Homes, INC PO Box 4188 FLS plan review fee(if applicable): Address: Tualatin, OR 97062 Total fees due upon application: City/State/ZIP: y J � ) Amount received: 7 7( - 3 l Phone:( ) '[Y� sgo Fax::( inai.i 1Tf o ,p' ti, FEES' Email 9aaWttykh0106`PU , !all •�lT\ a j 7, i Commercial and residential prescriptive installation of i �) `Q t roof-top mounted Photo Voltaic Solar Panel System. Submit two(2)sets of roof plan with connection details Business name: Blackwood Hpmgq INC and fire department access,along with the 2010 Oregon Address: PO Box 4188 Solar Installation Specialty Code checklist. City/State/ZIP: Tualatin,OR 97062 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(Sd3 ) £Q"2 ,90L Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: /493 0 9 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Aoki't's' mi.,40.sDate: 1 pl.)3 *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Pertnits\BUP-RESPermitApp.doc 02/24/2011 440.4613T(11/02/COM/WEB) 11 Mechanical Permit ApplicatEne I\V'E FOR OFFICE I SE ONLY V G Received Permit No L�r— �77 City of Tigard Date/By: 1 V" ' f 13125 SW Hall Blvd.,Tigard,OR 97223 C �o Plan Review !.. U 7 Other Pernut. Phone: 503.718.2439 MAR Date/By. TIGARD Inspection Line: 503.639.4175 Date Ready/By Juns ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information CITY OF TIGARD lif ,,r.s, '4 „ i 4iYi l ? Q `x, COMMERCIL FEEL SCHEDULE-USE CHECKLIST New construction ❑ Addition/alteration/replacement Mechanical permit fees'are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑ Other: mechanical materials,equipment.labor.overhead.and profit CA (O Y OF CONS RUCTION Value i 1-and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi-family ❑ Master builder ❑ Other: Description I Qp I Fa I Total �-,'fit`;' ;1i(3 3'fflTES INFORM IATION AND LOCATION Heating/cooling: Job site address: —7g72 svi 01"i'i /,ivi Air conditioning 46.75 Furnace 100.000 BT11(ducts'ems) 46 75 City/State/ZIP: 'rui.4) 0�1 9-7214 Furnace 100.000+BTU(ducts v"cnts) 54 91 t� 1 Suite/bldg./apt.no.: Project name: Heat pump 61 06 Cross street/directions to job site: 71 f''j Duct work 23 2 1 t1 01-‘ oti Hedronic hot waters stem i - _ _ Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46 75 Flue/vent for any of above 23-32 Subdivision: 6KaoK5vE,.... Lot no.: l 1 Other 223 32 , Other fuel appliances: Tax map/parcel no.: Water heater 23.32 5', r Mr ESCRU'TI.N OF WOK . 4 4. ": 33.39 �, , -,�.. �. ��' �� r .s,�• : Gas fireplace/insert AS�� Flue vent for water heater or gas fireplace 23-32 Log liehter(gas) 2332 Wood/pellet stove ( 33 39 Wood fireplace/insert 23.32 Chimney/liner/flue'sent I 23 T' (PROWIYER '..❑ TENANT Other, '3 ,' Name: Environmental exhaust and ventilation: Blackwood Homes, INC Range hood/other kitchen I Address: PO Box 4188 equipment I 13 30 f — Tualatin OR 97062 Clothes dryer exhaust 33 30 City/State/ZIP: + Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23 32 Phone:( ) i Fax:( ) Attic/crawlspace fans 1 23.32 _ 4 a "La6AI'-PPAtT 0 CONTACT PERSON Other 23 322 Business name: Fuel piping: Blackwood I-ones INC � 514.15 for first four;54.03 for each additional Contact name: PO Box 4188 Furnace,etc. i I Address: Tualatin, OR 97062 Gas heat pump City/State/ZIP: Wall/suspended/unit heater Water heater Phone:(SO ) y?'I $i01,_ Fax: :( ) Fireplace I E-mail: j t Range I Barbecue 1 4,. Clothes doer(gas) s 0 . . ., e A �. Other Business name: f t a J u j ri\I G MECHANICAL PERMIT FEES*' Address: TO E,0X ,.,q li„ Subtotal City/State/ZIP: 0 I-,r l^ 01-1 r O , Minimum permit tee(S90 00) Plan review(25°%u of permit fee) Phone:(503) 62.5-3"- 7 0 2.2, Fax:( ) State surcharge(12%of permit fee) CCB lic.: 77/6( TOTAL PERMIT FEE / This permit application expires if a permit is not obtained within 180 Authorized signature: ik) days after it has been accepted as complete. ' Fee methodology set by Tri-County Building Industry Service Board Print name: U_ ,/\ Date: I J!21 3 I:\Building\PermitstBUP-RESPermitApp.doc 02/24/2011 440-46113T(11/02/COM/WI t ,Electrical Permit ApplicatirCE1VED FOR OFFICE 1.SE OyI.I Received / City of Tigard Date/B : Permit#: ' a ��" •6� 1 I 13125 SW Hall Blvd.,Tigard,OR 9722MAR 6 2023 Plan Review Phone: 503.718.2439 Date/B : Related Permit/;: Email: TigardBuildingPermits@Tigard- ry ARD Ready Date/By: Duns H See Page 2 for I 1 t,A 1'1) Inspection Line: 503.639.4175 lntet tt .v t'ti•.-. Notified/Method: Supplemental information _ a . illIkT `1 1 PI New construction 0 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 stones. ❑ Demolition ❑Other: where the available fault current 0 Marinas and boatyards. "s _{4A k .)1 lCO)V - i exceeds 10.000 amps at 150 volts or 0 Floating buildings. 1-and 2-family dwelling 0 Commercial/industrial ❑ Accessory building less to ground.or exceeds 14.000 0 Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family ❑Master builder Ej Other: ❑Fire pump. 0 Installation of 150 KVA or .. ,,w s "° "T O 0 Emergency system. larger separately derived s"'._ 0- system.p- J�-,�,,I ❑Addition of new motor load of Job#: Job site address: �0 7Z s�, (,� 1IV►v (HIV 100HPormore. ❑"A "E -l.2"."I-3 �� p�np 0 Six or more residential units. occupancy. City/State/ZIP: �'��f11"/ Q h cl Zy ❑Health-care 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 street/directions to job site: '7q 11} it) LA`I-0� j `" -`"` �"-,F y tf -, Description i Qts Each I Total I • New residential single-or multi-family dwelling unit. Subdivision: Sikfjog4€' Lot#: /iI Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 i - t - v '_,• ,t,;; ,..,_, Limited energy,residential (with above scL ft.) 75.00 2 I' Limited energy,multi-family 75.00 2 residential(with above sq.ft.) r Renewable Energy ❑ See Page 2 ' t -?'-` ,.4� , _ _ - Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 Blackwood Homes, INC 201 amps to 400 amps 133.56 2 Address: PO Box 4188 401 amps to 600 amps 200.34 2 City/State/ZIP: Tualatin, OR 97062 601 amps to 1,000 amps 301.04 2 Phone:( ) Over 1,000 amps or volts 552.26 '- Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that i own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner srgnatur Date: 401 amps to 599 amps 168.54 2 ,,, ` Branch circuits—new,alteration,or extension,per panel �k" 1,:-.,,,,,,-, roc 4_,`s a "- R " A.Fee for branch circuits with Business name: Ski pi UV'l\I 1liir.C/ above service or feeder fee, 7.42 , each branch circuit Contact name: B.Fee for branch circuits without Sf€ �Lt,o' service or feeder fee,first 56.18 2 Address: branch circuit Each add.]branch circuit 7.42 2 City/State/ZIP: Miscellaneous(service or feeder not included) Phone:( ) Each manufactured or modular 67.84 , dwelling,service and/or feeder Email: Reconnect only 67.84 2 ,; ',.7 --:-",, •'-',,,,,,, ' ,;w. `; Pump or irrigation circle 67.84 2 Business name:SUNLIGHT ELECTRIC INC Sign or outline lighting 67.84 Signal circuit(s)or limited-energy ❑ See Page 2 2 Address:2804 NE 65TH AVE, SUITE D panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/Z1P:VANCOUVER, WA 98661 Additional inspection(1 hr min) 66.25/hr Phone:971-222-5758 I Fax:( ) Investigation(i hr min) 90.00/hr Industrial plant(I fir min) 78.18/fir Email:PETER@SUNLIGHTELECTRICINC.COM inspections for which no fee is 90.00/hr CCB Lie.:172549 i Electrical 2 I Suprv.Lie.:6652S specifically fisted S/:fir min.) Suprv.Electrician signature,requi . Subtotal: Print name:YEGOR ►-EN Date:01/25/2023 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): f•• �hw TOTAL PERMIT FEE: Authorized signature: • I This permit appUcation expires if a permit is not obtained within 180 l Print name:Peter Kozarez I Date:01/25/2023 days after it has been accepted as complete. • Number of inspections allowed per permit. ..10..:u:....11.....a.rcr r pr.mi,Ann FI R FRP doe Rev 06/17/2015 440-4615T(I 1/05/COM/WEB ,, . I! Plumbing Permit Application Building Fixtures RECEIVED I:OR OFFICEl'si: O\i.\ City of Tigard Received f1 Permit N rl-f)o _©00 111111 gl 13125 SW Hall Blvd.,Tigard,OR 97223 �4 AR 6 2023 Date/By: �� I Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Other Permit No.: Date/By: T I t A R I) Inspection Line: 503.639.4175 Internet: www.ti and or. ov CITY OF TIGARD Date Ready/By: Juris: 0 See Page 2 for g g NI� V1SION Nottfied/Method. Supplemental Information . .fir 44 'c'L� °' y 7 C1;F,. Y W - y ".'+�' 7'. ^' s"` '* susl is .aR.Y ='° *r.". m >ti t +di,,d. .cis'.',,', i . .#'+rY. *,,s r . .« ,.d. E«,. , , rAl New construction ❑Demolition For special information use checklist Description I Qty. J Ea. 1 Total 0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) r 's r t cl `,, sy : 1` 1 fi;g e ate " .� SFR(1)bath 312.70 r4 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 0 Other: k'' # k, f.,. _ « ., .:y Fire sprinkler( sq.ft.) Page 2 i i 1x�*' ,ao .I f a,- 4 r .x :4771*" ` Site utilities: -.r"}w Job site address: g a svg tAq-ropt &Ai Catch basin or area drain 18.76 City/State/ZIP: 7�G,��� 0� 9 121.E Drywell,leach line,or trench drain 18.76 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: 7 q 11* To ukl iO IJ 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: K(1\0oV boi, Lot no.: 11 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 .� .;- �v z p..;e‘,' Backwater valve 12.51 � ...- _ E'' 6i ,Yt 4�' ,ter NR�e1*$-'3+ ` Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 - ? r 3 ' '� AW, Expansion tank 12.51 Rom°; . _. _ __,. ;.,'_.2---1,, s<. ii,�.� ,�,, ��w ! �.,L ., ,���• ,. .«��, Fixture/sewer cap 25.02 Name: Blackwood Homes, INC Floor drain/floor sink/hub 25.02 Address: PO Box 4188 Garbage disposal 25.02 City/State/ZIP: Tualatin, OR 97062 Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ra --a r•4 r a .; tyr l{ C - > f ` Interceptor/grease trap 25.02 Business name: yk • C., le u/i't gl A(,� Medical gas(value:$ ) Page 2 t Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Si 4 6UM Npl Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 a s r esny t+ y-s 3yg`.,° -.."�' p. ..-- Water closet 25.02 f _ . :t �. _,, t,., .r �� Water heater 37,52 Business name: V\! f Q Lk) G.. Water piping/DWV 56.29 Address: /bps() (2,1Fa W 11,1 Other: 25.02 City/State/ZIP: d o>J Upl Subtotal Phone:(SO?) 113., 9 2 914 Fax:( ) Minimum permit fee: $72.50 I Plan review (25%of permit fee) CCB Lie.: /66 G99 Plumbing Lic.no.: P gS' State surcharge(12%of permit fee) Authorized.`% --"--- TOTAL PERMIT FEE signature: Date: )//c2./23 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Trim name: " �pr� `Fee methodology set by Tri-County Building Industry Service Board. 1^Building\PennitsPLMU-PermitApp.doc 10/01/09 440-4616T(10i02'COM/WEB) City of Tigard 11111i 1 COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review - Residential T I G A R D Building Permit #: % aid?) 7 21 7/ Site Address: ? -2 �J ) LA J L N LVerified in Accela Project Name: 7J'i2 �S ID E Lot/Unit #: 1 I Proposal: NV1,%) 5i j( `D c4e O Si Zone: R ^ C) Housing Type: FR( Ingle Detached 0 Duplex❑Triplex❑ADU) 0 Rowhouse ❑Cottage Cluster❑CYU ❑Quad ❑Other Requi d Site Plan Elements: 3 co s of site plan on max 11x17" 4rtawn to standard scale 04 IL.' ained trees, drip line/ tree protection h arrow s, treet and site trees shown / labeled a;Ste address, project name, lot # 4 Table calculating tree canopy at maturity :J S et names (N/A for SFR) icant name and phone # 0 ii yard rectangle dimensioned (if applicable) Lot and setback dimensions %` sion clearance triangle )311r Ell xlsting structures &square footage . i ity locations &easements Fo print of new structure and FFE •perty corner elevations walk/driveway dimensioned % A (>1,000 sf disturbance) Lot area and lot coverage percentage Erosion control Required Elevation Plan Elements: (For SF : calcs needed only on street-facing) Surrr(ary table with calculations for: pBwn to standard scale To facade area +d'... eight dimensioned tWfotal window and door area ade dimensioned W' ows and doors dimensioned Garage doors dimensioned 'red Floor Plan Elements: (Not require ❑ Summar u es ❑ Each story dimensioned otal floor area ❑ Each story floor pestory Planning Review The following standards have been met: ,� Setbacks 0 Front: /® Rear: ide: 5— Min/Max Street Side: / /'{?J Garage: Hei ❑ Max. Height: Proposed Height: 2.C. Yes 0 N Landscape r N/A Screening (Quad only) Y U N/A % Window Coverage ✓ -s 0 N/A Garage (SFR Only) Parking (Other Res) • Yes 0 N/A Entrance (SFR, Rowhouse, Quad only) ❑ Yes N/A Other building design standards (Rowhouse only) ❑ Yes N/A Accessory Structure Standards ❑ Yes No Qualifying pre-existing unit exempt from standards (Cottage unit only) Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads: ❑ Yes N/A Unit Count: ❑ Yes N/A Lot Width and Size ❑ Yes N/A Pathway Additional standards for Courtyard Units and Cottage Clusters only: ❑ Yes 0 N/A Unit Area: ❑ Yes 111 N/A Floor Area (per story) ❑ Yes ❑ N/A Courtyard ❑ Yes 0 N/A Fence ❑ Yes ❑ - m-/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995) O Yes ►.'No ❑N/A Public Facilities Improvement (PFI) Permit: Required: ❑ Yes ❑ No Applied For: ❑ Yes ❑� Ns,-stop intake itive Lands: 0 Yes 4o S Land Use Case #s: Va2019-- ccCep 60 Conditions met Applicant notified of land use expiratio d te: B I , 2oQ'y'- Approved By Planning: Date: 3ii/6/Z3 Notes 6 7Ot.Pr Nor cis Revision 1: 0 Approved Uot Approved Date: Revision 2: ❑ Approved ❑ Not Approved Date: Building Permit Submittal / Original Submittal Date: 3!CG [i 5 Site Plans #: Building Plans #: 3 Building Permit #: ilding permit # entered on page 1 Workflow Routing: C7 Planning Er rngineering-Mpermit Coordinator uilding Workflow Sign-off: ❑ Sign-off for Planning (include notes from planning review) Route Documents: I -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. Permit Technici n: Date: ` 4' /2-3 Notes: Engineering Review ❑ PFI Permit: _IV Slope at building pad: 21e M-0Conditions met prior to issuance of permit i Easements (encroachments) per engineering conditions of approval and plat VANater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: 0 Yes Olo Assess Water Quantity Fee in-lieu: ❑ Yes o LIDA Facility on lot: IDYes No Add Fee: 0 Yes 0 No 8 Final Plat Recorded ❑ NOT Approved: Date: Notes: Approved By Engineering: Date: 4/77 5 Revision 1: ❑ Approved Not Approved Date: Revision 2: 0 Approved ❑ Not Approved Date: Permit Coordinator Review Conditions met prior to permit issuance Approved, NOT Released: Date notified applicant: O ENG Revisions Required: Date notified applicant: ` 1SDC Exemption: ❑ Applied for ❑ Received ,iboes not apply SDC Fees Entered: Wash Co Trans Dev Tax: Yes 0 N/A ����.((�� , jai\\,jI Tigard Trans SDC: Yes 0 N/A Deferred 'Sh- -CCU\a �\,--t X Parks SDC: Yes ❑ N/A C Deferred S 1'�" LIDA 0 Yes y� N/A �r� 0 4 OK to Issue/Approved by Permit Coordinator: Date:6 I-\' . Revision 1: 0 Approved ❑ Not Approved Date: 75 Ylk Revision 2: 0 Approved 0 Not Ap proved pproved Date: