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Permit
CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2023-00150 TtG.ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/30/2023 Parcel: 2S108DC15000 Jurisdiction: Tigard Site address: 15643 SW VANDERWOOD AVE Subdivision: RIVER TERRACE CROSSING Lot: Project: River Terrace Crossing, Lot 14 Project Description: New detached dwelling w/243 sq ft covered deck. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN PAID. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1362 sf Basement: sf Left: 3 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1414 sf Garage: 664 g sf Front: 12 Smoke Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Yes Total: 2776 sf Value: $478,659.44 Rear: 10 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckfw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 6 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 add9 500 sf: 5 201-400 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 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 2776 Owner: Contractor: STONE BRIDGE HOMES NW LLC STONE BRIDGE HOMES NW LLC Required Items and Reports(Conditions) 4230 GALEWOOD ST#100 4230 GALEWOOD STREET#100 1 Ersn Cntrl 503-639-4175 LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 2 Geo Tech Required PHONE: PHONE: 503-387-7577 FAX: 503-387-7615 Total Fees: $26,019.89 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 equires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR oc ..n 11-nnl n thrni inh flAP S 9_nny_nno i,maw nh in a rnrnr of tha r nr riirort ni mctinnc to fli Intr. Tallinn rin'3 9 1 QR7 nr 1 Win't29 9144 Issued By: .� Permittee Signature: A e60.1I G- 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. Building Permit Application 'Residential FOR OFFICE I SE ONL1 City of Tigard J3243 Recei RTC 14 Date/Bved: `i Permit No.: al 13125 SW Hall Blvd.,Tigard,OR 97223 r /� �� — * y Phone: 503.718.2439 Fax: 503.598.1960 ® I '� / 2 _ (� j iY Other Permit: le 1. T I v A R D Inspection Line: 503.639.4175 ae Read B ! Internet: Line:g 03.639.41 y y 5 i 2Z io i Q, po See 'age for Notified/Method: J YINNI APR 2 0 202. E M PI IE j '1l RNr1 Supplemental Information TYPE OF WORK G ffREQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction CITY OF TIt^ARD ❑Demolitipll.CITY Permit fees*are based on the value of the work performed. ❑Addition/alteration/replacement t3tJ Indicate the value(rounded to the nearest dollar)of all ❑Other: equipment,materials,labor,overhead.,.and the profitf,4 th CATEGORY OF CONSTRUCTION work indicated on this application. 1, Cal (t 01-and 2-family dwelling 0 Commercial/industrial Valuation: ❑Accessory building El Multi-familyNumber of bedrooms: 5 ❑Master builder El Other: Number of bathrooms:3 JOB SITE INFORMATION AND LOCATION Total number of floors:2 399 b Job site address: 15643 SW Vanderwood Ave. New dwelling area: 2,776 square feet 191 C City/State/ZIP: Tigard, OR 97224 Garage/carport 0 3(Q . g arport area: 664 square feet Suite/bldg./apt.no.: I Project name: River Terrace Crossing Front Covered porch area: 60 square feet Cross street/directions to job site: >�.� Deck area j ' J5 7"0N uare feet Ot r ] j i-I3 square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: River Terrace Crossing I Lot no.: 14 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. New, single family residence Valuation: $ Would like to request SCD deferral Existing building area: square feet New building area: square feet ® PROPERTY OWNER I ❑ TENANT Number of stories: Name: Stone Bridge Homes NW, LLC Type of construction: Address: 423-Galewood St. Suite#100 Occupancy groups: City/State/ZIP: Lake Oswego, OR 97035 Phone:(503)387-7577 Fax:( ) Existing: New: Ea APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: Stone Bridge Homes NW, LLC (Please refer to fee schedule) Contact name: Permit Tech Structural plan review fee(or deposit): Address:4230 Galewood St. Suite#100 FLS plan review fee(if applicable): City/State/ZIP: Lake Oswego, OR 97035 Total fees due upon application: Phone:( 503) 387-7577 I Fax::( ) Amount received: E-mail: portlandpermits@stonebridgehomesnw.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof top mounted Photo Voltaic Solar Panel System. Business name: Stone Bridge Homes NW, LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 4230 Galewood St. Suite#100 Solar Installation Specialty Code checklist. City/State/ZIP: Lake Oswego, OR 97035 Permit Fee(includes plan review Phone:(503)387-7577 I Fax:( ) and administrative fees): $180.00 CCB tic.: 173318 State surcharge(12%of permit fee): $21.60 Total fee due upon application: $201.60 Authorized signature: eawe.T ,w/1 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. I Print name: Tiana Rudolf I Date: 4-20-2023 ( *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR OFFICE t SE O\L, City of Tigard Received Date/By: Permit No.: . 7- 13125 SW Hall Blvd.,Tigard,OR 97223r5/ —CTG�t j?� ' _ Phone: 503.718.2439 Fax: 503.598.1960 lan Review Other Permit: �.l 1z n Inspection Line: 503.639.4175 Internet: www.tigard-or.gov ate Ready/By: kris: El See page 2 for Notified/Method: Supplemental Information APR 2 0 2023 TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST it Oti 7 TK3ARD Mechanical permit fees*are based on the value of the work 0 New construction ❑Addition/alteration/re U D1 J€ A performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 0 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 Job site address: 15643 SW Vanderwood Ave. (requires site plan showing placement) 46.75 City/state/ZIP: Tigard, OR 97224 Furnace 100,000 BTU(ducts/vents) 1 46.75 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: River Terrace Crossing Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Subdivision: River Terrace Crossing Lot no.: 14 Flue/vent for any of above 1 23.32 Other: 23.32 Tax map/parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater 1 23.32 New, single family residence Gas fireplace 1 33.39 Flue vent for water heater or gas fireplace 2 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 0 PROPERTY OWNER 0 TENANT Name:Stone Bridge Homes NW, LLC Other: 23.32 Environmental exhaust and ventilation: Address: 4230 Galewood St. Suite#100 Range hood/other kitchen 1 equipment 33.39 City/State/ZIP: Lake Oswego, OR 97035 Clothes dryer exhaust 1 33.39 Phone:( 503)387-7577 Fax:( ) Single-duct exhaust(bathrooms, 6 toilet compartments,utility rooms) 23.32 ICJ APPLICANT 0 CONTACT PERSON Attic/crawlspace fans 23.32 Business name: Stone Bridge Homes NW, LLC Other: 23.32 Fuel piping: Contact name: Permit Tech $14.15 for first four;$4.03 for each additional Address: 4230 Galewood St. Suite#100 Furnace,etc. 1 City/State/ZIP: Lake Oswego, OR 97035 Gas heat pump Wall/suspended/unit heater Phone:(503)387-7577 Fax::( ) Water heater 1 E-mail: portlandpermits@stonebridgehomesnw.com Fireplace 1 Range 1 CONTRACTOR Barbecue Business name: Comfort Zone Clothes dryer(gas) Address: 1032 NW Corportate Dr. Other: MECHANICAL PERMIT FEES* City/State/ZIP: Troutdale, OR 97060 Subtotal Phone:( 503)667-5595 Fax:( ) Minimum permit fee($90.00) Plan review(25%of permit fee) CCB tic.: 110091 State surcharge(12%of permit fee) �, TOTAL PERMIT FEE Authorized signature 1;s"- • l YX �!-.) •" This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: David Heldstab Date: 4-20-2023 * Fee methodology set by Tri-County Building Industry Service Board 1:\Building\Permits\MEC-PermitApp.doc 09/09/10 440-4617T(11/02/COM/WEB) . Electrical Permit Application FOR OFFICE 1.SE ONE City of Tigard Received ° 13125 SW Hall Blvd.,Tigard,OR 97223 I'�y 1 Ilate/B : Permit#: .M -_jr, ,,- 4,5 t/ _ Phone: 503.718.2439 Fax: 503.598.19 Related Permit#: ii Inspection Line: 503.639.4175 ReadyDate/By: Bl See Page 2 for f 1 G A R ll Internet: www.ti and-or. ov wrist g g APR 0 � �? Notified/Method: A f\ J Supplemental Information TYPE OF WORK PLAN REVIEW El New construction ❑Addition/atteration/re c IIQi"t TI GARD Please check all that apply(submit 2 sets of plans w/items checked): Lli l v L�I1N Is�SI 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other: ail where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. El 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations, buildings. ❑Multi-family El Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived .lob#:3243 Job site address: 15643 SW Vanderwood Ave. ❑Addition of new motor load of system. 100HP or more. ❑`A","E","1-2","1-3", City/State/ZIP: Tigard, OR 97224 0 Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: River Terrace Crossing 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: FEE SCHEDULE Description I Qty. I Each I Total I r New residential single-or multi-family dwelling unit. Subdivision:River Terrace Crossing Lot#: 14 Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 2 168.54 4 DESCRIPTION OF WORK Ea.add'I 500 sq,ft.or portion 2 33.92 1 Limited energy,residential New, single family residence (with above sq.ft.) 75 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy 0See Page 2 ® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: Stone Bridge Homes NW, LLC 200 amps or less 100.70 2 Address:4230 Galewood St. Suite#100 201 amps to 400 amps 133.56 2 City/State/ZIP: Lake Oswego, OR 97035 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:( 503)387-7577 Fax:( ) Over 1,000 amps or volts 552.26 2 Email: portlandpermits@stonebridgehomesnw.com Temporary services or feeders installation,alteration,and/or 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 signature: Date: 401 amps to 599 amps 168.54 2 Branch circuits—new,alteration,or extension,per panel ® APPLICANT 0 CONTACT PERSON A.Fee for branch circuits with Business name: Stone Bridge Homes NW, LLC above service or feeder fee, each branch circuit 7.42 2 Contact name: Permit Tech B.Fee for branch circuits without Address: 4230 Galewood St. Suite#100 service or feeder fee,first branch circuit 56.18 2 City/State/ZIP:Lake Oswego, OR 97035 Each add'l branch circuit 7.42 2 Phone:( 503)387-7577 Fax::( ) Miscellaneous(service or feeder not included) Each manufactured or modular Email: portlandpermits@stonebridgehomesnw.com dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Garner Electric Sign or outline lighting 67.84 2 Address: 2920 SE Brookwood Ave. Suite A Signal circuit(s)or limited-energy panel,alteration,or extension. 0 See Page 2 2 Each additional inspection over allowable in any of the above City/State/ZIP: Hillsboro, OR 97123 Additional inspection(1 hr min) 66.25/hr CrPhone:( 503)648-4552 Fax:( ) Investigation(1 hr min) 90.00/hr I�7 Email: chelsea@garnerelectric.com Industrialplant(lhrmin) 7g_18/hr Inspections for which no fee is C CC13Lic.: 2322v91 Electrical Lic.:34-305C Suprv.Lic.: specificallylisted(%hrmin) �/hr p pp 3101 ELECTRICAL PERMIT FEES ��tti Suprv.Electrician signature,required: aa.Gecb g <1.4.414.2 Subtotal: Prim name: Charles Garner Date: 4-20-2023 0 Plan Review Required(25%of permit fee): / / State surcharge(12%of permit fee): Authorized signature: ,j?;,/j( , �� �ff-0 TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Tiana Rudolf ' Date: 4-20-2023 f days after it has been accepted as complete. * Number of inspections allowed per permit.C\Building\Permits 1E.C_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-461ST(I I/05/COM/WEB Plumbing Permit Application Building Fixtures FOR OFFICE I SE ovl_l City of Tigard Received le 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit No.: 4 <.TO).0-3 _(jd i Plan Review J Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permitt No.:: I 1 c :1 k p Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Date Ready/By: June: El Page 2 for N Notified/Method: Supplemental Information TYPE OF NRE.CFEE* SCHEDULE ®New construction 0 xis:.=oliti t 2023 For special infornurtion use checklist Description ElAddition/alteration/replacement ❑Other: Q1Y. Ea. Total .�,����� New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTfit,t� i ` I SFR(1)bath 312.70 0 I-and 2-family dwelling i�Y'871i�erc al%i�nd> Y��rial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 50032 ❑Master builderEach additional bath/kitchen 25,02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 15643 SW Vanderwood Ave. Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard, OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name:River Terrace Crossing Manufactured home utilities 50.03 Cross street/directions to job site: 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: River Terrace Crossing 1 Lot no.: 14 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 New, single family residence Clothes washer 1 25.02 Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: Stone Bridge Homes NW, LLC Fixture/sewer cap 25.02 Address: 4230 Galewood St. Suite#100 Floor drain/floor sink/hub 25.02 Garbage disposal 1 25.02 City/State/ZiP: Lake Oswego, OR 97035 Hose bib 2 25.02 Phone:(503)387-7577 Fax:( ) Ice maker ® APPLICANT12.51 0 CONTACT PERSON Interceptor/grease trap 25.022 Business name: Stone Bridge Homes NW, LLC Medical gas(value:$ ) Page 2 Contact name: Permit Tech Primer 12.51 Address: 4230 Galewood St. Suite#100 Roof drain(commercial) 12.51 Sink/basin/lavatory 7 25.02 City/State/ZIP: Lake Oswego, OR 97035 Solar units(potable water) 62.54 Phone:(503 )387-7577 Fax::( ) Tub/shower/shower pan 4 12.51 E-mail: portlandpermits@stonebridgehomesnw.com Urinal 25.02 CONTRACTOR Water closet 3 25.02 Business name: Edward Mullen Plumbing Water heater 1 37.52 Water piping/DWV 56.29 Address: S. E. River Road Other: ' 25.02 City/State/ZiP: Hillsboro, OR 97113 Subtotal Phone:( 503) 640-0113 Fax:( ) Minimum permit fee: $72.50 CCB Lie.:92689 Plumbing Lic.no.: 34-260PB Plan review (25%of permit fee) Authorized signature: FA•e.., State surcharge(12%of permit fee) TOTAL PERMIT FEE Print name: Jeremy Crace Date: 4-20-2023 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:l Building\Permits\PLMU-PermitApp,dos 10/01/09 440-4616T(10/02/COM/WEB) City of Tigard .71 COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review - Residential TIGARD Building Permit #: /1,57-?j/1-3--Oc.7i i Site Address: L 56(4'5 cam" \Jandert v od Ave Verified in Accela Project Name: C.ry(Z� SS1il Lot/Unit #: 0 LJ Proposal: � & i-- Zone: S-G Housing Type:pt.FR(XSingle Detached 0 Duplex 0 Triplex 0 ADU) 0 Rowhouse ❑Cottage Cluster 0 CYU ❑Quad 0 Other Required Site Plan Elements: copies of site plan on max 11x17" ,C Drawn to standard scale .❑ Rctaincd trees, drip line/tree protection ,la-North arrow ,.Is6treet and site trees shown / labeled ;Z(Site address, project name, lot # 0 cu ating tree canopy at maturity Street names (N/A for SFR) Applicant name and phone # o-Q'C urtyrdrectangle dimensioned (if applicable) /Lot and setback dimensions -Visi.on_clearance triangle L7 Existing structures &square footage XUtility locations &easements 'Footprint of new structure and FFE roperty corner elevations %Sidewalk/driveway dimensioned sf disturbance) %Lot area and lot coverage percentage Erosion control Required Elevation Plan Elements: (For SF : talcs needed only on street-facing) Summary to a with talc lations for: ❑ Dra o standard scale ❑ Total facade ❑ Building he dimen ' ed ❑ To endow an or area ❑ Facade dime ❑ Win and doors dimen ' ed arage doors dimensioned Required Floor Plan Elements: (No SFR) 0 Summary table that includes ❑ Each story dime ' ❑ Total floor area ❑ Eac oor area calculated ❑ Floor area per story Planning Review The following standards have been met: 3 Setbacks ront: CZI&> Rear: 70 Side: Min/Max Street Side: / Garage: 20. Height �ax. Height: (\JR Proposed Height: ICI' .12Kes 0 N/A Landscape ❑ Yes, N/A Screening (Quad only) ❑ Yes,-N/A % Window Coverage&Pe✓ PPP-Zolto-o ooi6 ❑ Yes VN/A Garage (SFR Only) Parking (Other Res) ❑ Yes,121'1\l/A Entrance (SFR, Rowhouse, Quad only) ❑ Yes Ja'N/A Other building design standards (Rowhouse only) ❑ Yes uN/A Accessory Structure Standards ❑ Yes.VNo Qualifying pre-existing unit exempt from standards (Cottage unit only) Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads: es 0 N/A Unit Count: ❑ Yes N/A Lot Width and 'ze ❑ Yes 0 N Pathway Additional sta for Courtyard Units and Cottage Clusters only: ❑ Yes ❑ N/A nit ❑ Yes A Floor Area (p tory) ❑ El N/A Courtyard Yes 0 N/A Fence ❑ Yes ❑ No,1N/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995) DI Yes ❑ No�A Public Facilities Improvement (PFI) Permit: Required: ❑ Yes ❑ No Applied For: ❑ Yes ❑ No, stop intake ,ensitive Lands: 0 Yes /12'No ,(Main Land Use Case #s: f P-2alb-aoOhdb i PPR-7pl -0000S 2rConditions met D Applicant notified of land se expir tion date: I Approved By Planning: Date: ill- Z3 Notes PAkess it.clef o. , bdk oko.ka is Co(r'C Revision 1: 0 Approved 0 Not Approved Date: Revision 2: 0 Approved ❑ Not Approved Date: Building Permit Submittal Original Submittal Date: 4 I2o 113 Site Plans #: 3 Building Plans #: 3 Building Permit #: E'Building permit # entered on page 1 Workflow Routing: grPlanning NAngineering hermit Coordinator C"Building Workflow Sign-off: 5a'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: ' V'VY\A',L, Date: 41/0 113 Notes: Engineering Review ❑ PFI Permit: o ['Slope at building pad: J©� londitions met prior to issuance of permit Q2asements (encroachments) per engineering conditions of approval and plat I(Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑SIGo Assess Water Quantity Fee in-lieu: ❑ Yes o / LIDA Facility on lot: El Yes No Add Fee: 0 Yes 0 No lrl Final Plat Recorded ❑ NOT Approved: Date: Notes: Approved By Engineering: Date: 04 Z-3 Revision 1: 0 Approved 0 Not pproved Date: Revision 2: ❑ Approved ❑ Not Approved Date: Permit Coordinator Review • Conditions met prior to permit issuance ❑ Approved, NOT Released: Date notified applicant: ❑ ENG Revisions Required: Date notified applicant: /SDC Exemption: 0 Applied for 0 Received ❑ Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: /Yes ❑ N/A Tigard Trans SDC: /Yes ❑ N/A Deferred Parks SDC: /Yes ❑ N/A Deferred LIDA ❑ Yes N/A , /OK to Issue/Approved by Permit Coordinator: Date: [�-L( 2021 Revision 1: ❑ Approved ❑ Not Approved Date: Revision 2: ❑ Approved 0 Not Approved Date: