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Permit (6) CITY OF TIGARD MASTER PERMIT .111 COMMUNITY DEVELOPMENT Permit#: MST2023-00070 T I(_7 A ti I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/08/2023 Parcel: 2S112CA14700 Jurisdiction: Tigard Site address: 7788 SW LAYTON LN Subdivision: BROOKSIDE SUBDIVISION Lot: 7 Project: Brookside, Lot 7 Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN PAID. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 728 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 30 Bathrooms: 3 Second: 1150 sf Garage: 454 sf Front: 10 Smoke Yes Dwelling Units: 1 Third: 455 sf Right: 5 Detectors: Total: 2333 sf Value: $381,158.45 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 2 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: 1 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 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 W/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 2333 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: $22,547.42 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 oc9-nn1-rinln thrni o (lAR QQ9-nM-n at,nhtnin rnrnr of the niloc nr riirvrt no nctinnc to nl iM(:Fit/roll' \Sn9 919 1QR7 nr 1;inn '29 9'14 G --�-. --.-,� Issued By: '�� / Permittee Signature: � Call 03 .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. . Ss 1 s Building Permit Application }-r- 7 ,,,,,,,: i Q I d Pl i l{ 1. t ,l i)\I 1 RECEIVED Received i1� 1 i �� City of Tigard 3 / 3 Kam- Permit No.:AlA S f, Date/By: ;. 13125 SW Hall Blvd.,Tigard,OR 97223 MAR p c Plan Review `� Phone: 503.718.2439 Fax: 503.598.19601d�AR 6 2023 Date/By: 7 r t.Ud23 ..///lee/i 1 1,,,,It U Inspection Line: 503.639.4175 Date Ready/By: Jura. RI See Page for CITY OF TIGARD L)rSupplemental Information Internet: www tigard-or gov Notified/Method:� � �3 $l IU31NGDlV�S Q I�i, ,2�e( �a 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 OF CONSTRUCTION work indicated on this application. dwelling ❑ t_ Valuation: $ 3� t S 46 1-and 2-familyCommercial/industrial t ❑Accessory building 0 Multi-family Number of bedrooms: 3 ❑Master builder 0 Other: Number of bathrooms: 3 ma SfTE INFORMATION AND LOCATION Total number of floors: 3 .7'3.--1 Job site address: -7 84, ,51,4 MINA j_i4 New dwelling area: 2333 square feet 4,55- City/State/ZIP: TI(4 t, ©F'•% 9"1 Z.Z`I Garage/carport area: Zi2.g.t6Liquare feet Z333 Suite/bldg./apt.no.: Project name: Covered porch area: 64 square feet j) Cross street/directions to job site: 77 714 To (.4104 Deck area: 0 square feet Other structure area: 0 square feet REQUIRED WM l OM Rc1 > SE GECKLIST Subdivision: 8 f‘00 p1., Lot no.: 7 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 _`> VoRK1 work indicated on this application. Sip C (-)7' (i(.)_ Cr`jkl ... Valuation: $ f �` _, r Existing building area: square feet a � New building area: square feet �k, t - :a `' Number of stories: Name: Blackwood Homes, INC Type of construction: Address: PO Box 4188 Occupancy groups: City/State/ZIP: Tualatin, OR 97062 Existing: Phone:( V 1d Fax ( ) New1x in1• '4 ''r.. K . . ar ❑:..0 PERSON t• 5,".'r ) 1 Y.&,J I � r y, . Wlreschedu+e):" Business name: Structural plan review fee(or deposit): Contact name: Blackwood Homes, INC PO Flux 4188 FLS plan review fee(if applicable): Address: Tualatin, OR 97062 Total fees due upon application: City/State/ZIP: Phone:(`V .) i S�U� Fax::( ) Amount received: n ��). 31 E-mail 9 04 �`l on,4/5 e alike t •Garb Commercial and residential prescriptive installation of. ' 4 Y _ , , , v:- _ roof-top mounted PhotoVoltaic Solar Panel System. Business name: B�aC1CWOQd Homes, Submit two(2)sets of roof plan with connection details INCN 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:(sO ) Lr2 590i Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: /4930 1 Total fee due upon application: S201.60 Authorized signature: q This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:AAlikmDate: *Fee methodology set by Tri-County Building Industry � l I �� Service Board. I:\Building\Petmits\BUP-RESPetmitApp.doc 02/24/2011 440-46I3T(I 1/02/COM/WEB) 1S 7 Mechanical Permit AppliB6Ci IV FOR 01.1.1(4. I S11 O\1.1 City of Tigard R 6 2023 ReceivDate/Bed 0007 t2 11111 II Permit 1 fr1 x7 13125 SW Hall Blvd.,Tigard,OR 97 y ?v`j Plan Review Phone: 503.718.2439 r� Date/By: Other Permit TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By Jo s ® See Page 2 for I Internet: www.tigard-or.gov BUILDING DIVISION SIGN Notified/Method: Supplemental Information i r , < .., 5:1 1 1 4.140*.14K'1 ;� a v etsti Rc.1M EE4''SG RULE-LJSE CHECKLIST Pi New construction 0 Addition/alteration/replacement Mechanical permit fees*are based on the value of the ssork performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit : :'4 .. ��1t0.$ :t '0N.:04P10ON .1 Value S ['i 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family ❑ Master builder ❑ Other: Description Qh Ea 1 I otal :i$, ' "7 gw 0i In sue° _° .hl r1 D LOCATIOlII Heating/cooling: -7-7Sj t d.1rohl L Air conditioning 4675 Job site address: OO (,I�`( l.1 Y p� Furnace 100.000 BTU(ducts-vents) / 46 75 City/State/ZIP: 11 f.4> f1- 9.1219 Furnace 100,000+BTU(duets vents) 54 91 Suite/bldg./apt.no.: Project name: f Heat pump 61 (l( J 7 9 ,�.'�{ Iv ("Alm,/ Duct work �/ 23 32 _ 1 Cross street/directions to ob site: Hydronic hot water system i 1 `, ,' 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: LKUoKS4*....„ Lot no.: -7 Other. i 23 32 Other fuel appliances: Tax map/parcel no.: ` Water heater I 23.32 '' 'y < ® . ;tag I t 6 Nt,a. -' Gas fireplace/insert f 33.39 sr' Flue vent for water heater or gas fireplace / 23.32 Log lighter(gas) 23 321 Wood/pellet stove 33 39 1 Wood fireplace/insert 23.32 Chimney/liner/clue/vent } 1 23 32 i :":;,„1,-'-; 6 €# t y" y #'''?. =.k 5r, .x A`:J ,�..+ u�' � !`�'I'i Other. I '_ Environmental exhaust and ventilation: Name: Blackwood Homes, INC Range hood/other kitchen I ) I Address: PO Box 4188 equipment j / 1 33 i4 { Tualatin, OR 97062 Clothes dryer exhaust ! 33 39 City/State/ZIP: Single-duct exhaust(bathrooms, Phone:( ) Fax:( ) toilet compartments.utility rooms) y 23.32 Attic/crawlspace fans 23.32 _4.' � �.� , z 0 .. 0 CO T PERSON 23.32 , via- �_���.�.y�x�,i.�3s �;t„ Other Business name: Fuel piping: Blackwood Homes, INC $14.1 S for first four;54.03 for each additional Contact name: PO Box 4188 Furnace,etc Address: Tualatin, OR 97062 Gas heat pump City/State/ZIP: Wall/suspended/unit heater / Water heater Phone:(5st ) q(2_ 5u1,. Fax: :( ) Fireplace / l E-mail: * , 6 i o at V Range t I Barbecue mt Clothes dryer(gas) .' -�'' ) ,; ), .;."��E ""` fir?t, po la Other Business name: 4 I v (All / riq� '�< ,a;— NttAwatARMTi'FE,S+'- Address: TO 60 z ill Subtotal 1 City/State/ZIP: 0 f.,E,G,r. (AN , Ok Minimum permit fee($90 00) Plan review(25%of permit fee) Phone:(SU3) 6s-S, q 0 2 3, Fax:( ) State surcharge(12%of permit fee) ! CCB Iic.:9'1 ( (p TOTAL PERMIT FEE 1 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: \1----- " __ --\ ' Fee methodology set by Tri-County Building Indusm Sers ice Board Print name it....i ,Ntla Date: I /12123 I:\Building\Permits\BUP-REESSPermitApp.doc 02/24/201 1 440-4613T(1 I/02/COM/WE i 7 Electrical Permit Application FOR OFFICE, t.S(1.O\t.l Received Permit# ` City of Tigard 1VE, Date/By: i TaD� aZt : 0 13125 SW Hall Blvd.,Tigard,OR 9 Plan Review s I Phone: 503.718.2439 Date/By: Related Permit#: - Email: TigardBuildingPermits@Tigard v 6 2023 Ready Date/By: Juris: ® See Page 2 for I I( t.II'I) inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: Supplemental information 1 :OF TIGP 0 W �, Please check all that apply(submit 2 sets of plans w/items checked): [ ew constructionAddition/alt ni° ❑Service or feeder 400 amps or more 0 Building over three stories. ❑ Demolition ❑Other: where the available fault current 0 Marinas and boatyards. 1Y - exceeds 10,000 amps at 150 volts or 0 Floating buildings. 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or ^ y y., . , ` e' e y" c � ois, :-I. 0 Emergency system. larger separately derived J'm 7 83 S W LA�To� U 0 AdditionH of new motor load of system. Job#: Job site address: looHP or more. Ci /State/ZIP: T i ❑Six or more residential units. occupancy. ty / `ter tr"/ O l� I I ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: ..701 TD Li io i .' ,cam Description [ Qty.I Each I Total New residential single-or multi-family dwelling unit. Subdivision: Skoltil9fr, Lot#: 7 Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1 -. E F. -' . 1 Limited energy,residential 75.00 2 sr (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 t .,, TIT.. Services or feeders installation alteration,and/or relocation Name: 200 amps or less 100.70 2 Blackwood Humus, 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 2 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 I intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signatur Date: 401 amps to 599 amps 168.54 2 .- #t T, . 11, 1) A T*:- —''tIt1 Branch circuits—new,alteration,or extension,Rer panel A.Fee for branch circuits with Business name: 5tJ QV'lLl ELEL, above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without 5{r€ bi�� service or feeder fee,first 56.18 2 Address W 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 t . �' Y �'� .p ���y u, ti ...'.'2., _; t�_ :; Pump or irrigation circle 67.84 Business name:SUNLIGHT ELECTRIC INC Sign or outline lighting 67.84 2 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/ZIP:VANCOUVER, WA 98661 Additional inspection(1 hr min) 66.25/hr Phone:971-222-5758 Fax:( ) investigation(I hr min) 90.00/hr In Email:PETER@SUNLIGHTELECTRICINC.COM Insspepectioonsnsfor (1 hr min) 78.18/hr r which no fee is 90,00/hr CCB Lie.:172549 Electrical ' .: 2 Suprv.Lic.:6652S specifically listed(1/2hr min) _ Suprv.Electrician signature,requi : Subtotal: Print name:YEGOR , ,EN Date:01/25/2023 ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): TOTAL PERMIT FEE: Authorized signature: dirThis permit application expires if a permit is not obtained within 180 Date:01/25/2023 days after it has been accepted as complete. Print name:PeterKozarez * Number of inspections allowed per permit. i:\Buitding\?crmits\ELC PermaApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I 1/05/COM/WEB Plumbing Permit Application Btuilding Fixtures �j �� i of ohrlcl: t si: ON1.' City of Tigard Received � � -� ,, .- r 13125 SW Hall Blvd.,Tigard,OR 97223 FJ R 6 2°23 DateBy: PetmttJid� 1111 i Plan Review ,�`�Y Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: Inspection Line: 503.639.4175Date/By: 1 t C,rl It[) CITY OF TIGARD Date Ready/By: luris: fa See Page 2 for Internet: www.tigard-or.gov ���jjq + A '1 v in i�?4Nottfied/Method: Supplemental Information Y fi "a "`'ra 4.c`"` z -.!y'rw t -.@ �-'�"' ° �5 !1-1-iev y} �G-. i " x y� t ,fie,, - . _...."� ..r.,_Y� �rc `'' �':t+......r�.�'.s...-ww•:.n.. sa... ... R ..i.. S; '..cA xN 1F x .P - e.- i-cf-mar, PJ New construction ❑Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: I New 1-2-family dwellings(includes 100 ft.for each utility connection) p - 1t r m';t fry ;r a " c 1 SFR(1)bath 312.70 FA 1-and 2-family dwelling 0 Commercial/indu•trial SFR(2)bath 437.78 ❑Accessory building 0 Multi-familySFR(3)bath 500.32 Each additional bath/latchen 25.02 ❑Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2 r� o-) t t�e ,� �e �� - �� Site utilities: Job site address: 7- gg .6W 149 Catch basin or area drain 18.76 City/State/ZIP: G,A� 0 f�1�t Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 0' ill `\u ( ro IJ j 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: g,12\0aK�t0i--- Lot no.: 7 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 ,'� ?w ,. 7; vz ,z 7 w u '-, ,,,.. - � �t�°,i`,,,;; Backwater valve 12.51 > _ . _ ,.._ _ s A.n " " Clothes washer 25.02 ( -K 1 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ra;'-'r,45, = w",:, 7. Expansion tank 12.51 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 t t1 t c z�7 w° ar Interceptor/greasetrap 25.02 Business name: � ; ( i) /�Igi r(� Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: [ Roof drain(commercial) 12.51 Address: Ski tiled Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 Urinal 25.02 E-mail: Water closet 25.02 B,. ss� :. Water heater 37.52 usiness name: t C. 1�(,J fl A } Water piping/DWV 56.29 V Address: /60 SO RI rrIAS \AI Al I Other: 25.02 City/State/ZIP: a�Ek4iJ CA� Subtotal Phone:(SO?) 12. 9 2 9 i.( Fax:( ) Minimum permit fee: $72.50 / J i CCB Lic.: /6 699 Plumbing Lic.no.: g Plan review (25%of permit fee) State surcharge(12%of permit fee) uhoti2ed '� TOTAL PERMIT FEE At J signature: 3 '/r�S This permit application ezpires it a permit is not obtained within 180 days Date: _2 after it has been accepted as complete. lrinl name: MaQr� 'Fee methodology set by Tri-County Building Industry Service Board. I:',Building`Permits'.PLMU-PamitApp.doc 10/01/09 16T(10!02,COM/WEB) City of Tigard II " COMMUNITY DEVELOPMENT DEPARTMENT - Building Permit Review - Residential TIGARD Building Permit #: ,4t 5 T }2_3 i 7 ) Site Address: I-7eV SW LAY r\--) L-&J 0-ife-r-ified in Accela Project Name: $QO(7 C\c tE Lot/Unit #: Proposal: WWI ci N71-E V C-l'ie_O si-P Zone: R - D Housing Type: Sin SFR gle Detached 0 Duplex 0 Triplex❑ADU) ❑ Rowhouse ❑Cottage Cluster❑ CYU OQuad ElOther Requ d Site Plan Elements: 3 co es of site plan on max 11x17" wn to standard scale IJk 1=116rined trees, drip line/ tree protection 01 •rth arrow Street and site trees shown / labeled ddress, project name, lot # �,.Ell Table calculating tree canopy at maturity (N/A for SFR) r--t names ";plicant name and phone # oA op C•urtyard rectangle dimensioned (if applicable) FA, and setback dimensions IR'.''ion clearance triangle fisting structures &square footage % y locations &easements T.Ik tprint of new structure and FFE Zoperty corner elevationsewalk/driveway dimensioned A (>1,000 sf disturbance) d Lot area and lot coverage percentage Erosion control Required Elevation Plan Elements: (For SF : calcs needed only on street-facing) Summary table with calculations for: Irawn to standard scale a l façade area ,� B ' ding height dimensioned rI Total window and door area Fade dimensioned doves and doors dimensioned Garage doors dimensioned Re i rq ed-i Ian Elements: _ . �-a-, (Not required for SFR ❑ Surm arytable`that includes — ❑ Each story dimensioned - `--- otal floor area ❑ Each story floor a a ed ❑ Floor area perster-.y.. Planning Review The following standards have been met: Setbacks ❑ Front: PC) Rear: /C. Side: C Min/Max Street Side: / /0 Garage: Hei 0 Max. Height: ' .1 Proposed Height: r 3 N l Yes ❑ - Landscape ❑ Ye 'N/A Screening (Quad only) ■ N/A % Window Coverage N/A Garage (SFR Only) Parking (Other Res) es ❑ NLA Entrance (SFR, Rowhouse, Quad only) ❑ Yes ZNA Other building design standards (Rowhouse only) 0 Yes 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 ❑ N/A ` •Unit Area: 0 Yes D N/A Floor Area (per story) O Yes Q N/A Courtyard 0 Yes EV N/A Fence ❑ Yes ❑ . r VA Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995) ❑ Yes No ❑N/A Public Facilities Improvement (PFI) Permit: Required: ❑ Yes ❑ No Applied For: 0 Yes 0 No, stop intake e iv Lands: ❑ Yes •a'�Jo ain Land Use Case #s: SCft 2olg -CXD- 0 Conditions met ❑Applicant notified of land use ex 'r ion 1 Zc72 Approved By Planning: Date: W 2/ Notes � P� Coc - /72c)f O 2 Revision 1: ❑ Approved ❑ Not Approved Date: Revision 2: ❑ Approved 0 Not Approved Date: Building Permit Submittal Original Submittal Date: 3/6,(. -3 Site Plans #: Building Plans #: Building Permit #: -Q Building permit # entered on page 1 Workflow Routing: 1Planning�-Engineering- fl ermit Coordinator, -e-Building Workflow Sign-off: .0-Sign-off for Planning (include notes from planning review) Route Documents: .1;1-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. f uilding: original permit application, site plans, building plans, engineer and beam calculations and trust details, if applicable, etc.Permit Technici n: Date: Adz Notes: Engineering Review ❑ PFI Permit: 'Slope at building pad: , 0,0 121,Conditions met prior to issuance of permit IP Easements (encroachments) per engineering conditions of approval and plat PI Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes D'No Assess Water Quantity Fee in-lieu: ❑ Yes IJ'No ���� LIDA Facility on lot: ❑ Yes �'No Add Fee: El Yes ❑ No iB'Final Plat Recorded ❑ NOT Approved: Date: Notes: Approved By Engineering: -T 2 " Date: .4/77/2 Revision 1: ❑ Approve ❑ Not Approved Date: Revision 2: 0 Approved ❑ Not Approved Date: Permit Coordinator Review `Id Conditions met prior to permit issuance ❑ Approved, NOT Released: Date notified applicant: ❑ ENG Revisions Required: Date notified applicant: 41' DC Exemption: ❑ Applied for 0 Received Does not apply / �� , ISDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A £ Deferred Parks SDC: Yes 0 N/A Deferred LIDA ❑ Yes Tql/A �� qq n OK to Issue/Approved by Permit Coordinator: K^) �` ��( Date: t-t Revision 1: ❑ Approved ❑ Not Approved Date: Revision 2: 0 Approved 0 Not Approved Date: