Permit (7) IL CITY OF TIGARD MASTER F.
COMMUNITY DEVELOPMENT
Permit#: MST2023-004.
Date Issued: 01/22/2024
T(GAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S106DC20400
Jurisdiction: Tigard
Site address: 13855 SW 172ND AVE n (�
Subdivision: RIVERSIDE AT SCROLLS MEADOW Lot: 41 MS1 W I/Q O V J Al
Project: Riverside at Scholls Meadow, Lot 41 Project Description: New detached dwelling. . Ni
Y
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1006 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 22 Bathrooms: 3 Second: 1286 sf Garage: 390 sf Front: 12 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2292 sf Value: $411,467.16 Rear: 10
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: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
gBckflw Prevntr: 1
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0
Drywell-Trench Drain: 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 2292
Owner: Contractor:
RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions)
15350 SW SEQUOIA PKWY STE 320 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97224 BEAVERTON,OR 97006
PHONE: PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $49,896.40
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon I requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
oc9-nn1_nn1n thr nh OAR Qc9_nn1_nn Vn 1 may n4tain a rnrnr of thin rsiloc nr rtircrt nnoctinnc to fll intr.Mr Tallinn CfrA 919 1QR7 nr 1 AM 3'29 9'2dd
Issued By:
Permittee Signature: e t' 0 it ccl:d4--j
Call 50 .639.4175 by 7:00 a.m.for the next available inspection date.
This permit card sh be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
1
Residential FOR OFFICE USE ONLY
Received 4j(?
3�,,Inspection Line: 503.639.4175 Date Ready/By Juns: ® See Page 2 for
1 1 G A It 1) Notified/Method: i/7 J 2.3 AF Supplemental information
Internet www.tigard-or.gov
, «ra aY S ".�:,"$ ";,y �t�". [[ ))�� O }�t�_.. ,- IN1 S lI IICItt� .
SCP 1 'T 'uu fV ��I�6 l'
0 INNG DIVISION Permit fees*are based on the value of the work performed. ..
El New constructionIndicate the value(rounded to the nearest dollar)of all Ili
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
* =icated on this application. Kt
;. . ^ r ' x . - n: $ ��� ��� ..�
El1-and 2-family dwelling 0 Commercial/industrial
Number of bedrooms: 4
❑Accessory building ❑Multi-family
Number of bathrooms: 2 3
❑Master builder ❑Other:
iTotal number of floors: 2 iLPSri—
k''
Job site address: 13855 SW 172ND Ave New dwelling area: 2292 square feet I
City/State/ZIP: Tigard/OR/97140 Garage/carport area: 390 square feet L b ac
Suite/bldg./apt.no.: I Project name: Riverside at Scholls Meadow Covered porch area ?,,o square feet
Cross street/directions to job site: Roy Rogers & Jean Louise Rd Deck area: square feet
Other structure area: square feet
M1� i 4.::•'. ::.r'fx' �.,pv.i,iy. '. .�'. F<r r, "ai't•
Subdivision: Riverside at Scholls Meadow I Lot no.: 41 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.: WCTM 2S 106DC20400 equipment,materials,labor,overhead,and the profit for the
"_ � • � work indicated on this application.
• . �" if,t s 'P w ,� =},'. Fa 5 C�" k t:.� ;r ce;I § ;'"z�, ."*a'.
Valuation: $
Construction of single family detached residence
Existing building area: square feet
New building area: square feet
i-tvzal + F ^ ':" ::,,,,_-:-,:::.1....,..; e '. , Number of stories:
Riverside Homes wa . _
Name: eS Type of construction:
Address: 15350 SW Sequoia Pkwy, Suite 320 Occupancy groups:
City/State/ZIP: Portland, OR 97224 Existing:
Phone:(971) 371-1310 Fax:( ) New:
1
0
.: ■ r a m,, ... �.. . aT$ 1 tt1 �. . t * '
Business name: Riverside Homes Structural plan review fee(or deposit):
Contact name: Jennifer Doty FLS plan review fee(if applicable):
Address: 15350 SW Sequoia Pkwy, Suite 320 Total fees due upon application:
City/State/ZIP: Portland, OR 97224
Amount received:
Phone:(971 ) 371-1310 I Fax: :( )
E-mail jdoty@riversidehome.com d
Y , , • ., Commercial and residential prescriptive installation of
.���§ ,r r r .3 ' rt , a > a,.< ,f x ,.;; roof-top mounted Photovoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name: Riverside Homes and fire department access,along with the 2010 Oregon
Address: 15350 SW Sequoia Pkwy, Suite 320 Solar Installation Specialty Code checklist.
Permit Fee(includes plan review $180.00
City/State/ZIP: Portland, OR 97224 and administrative fees):
Phone:(971) 371-1310 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 189148 Total fee due upon application: $201.60
This permit application expires if a permit is not obtained
Authorized signature: ���..--.- within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name: Jennifer Doty Date: 8/28/23 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
1
Building Permit Application Checklist
One- and Two-FamilyDwelling g FoR 0141(T 1,sF oNtl
City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223 DateBy: Permit No.:
Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
_ y 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
Internet: www.tigard-or.gov 0 Other
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l es 1„ 'v A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ® 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ® ❑ 0
3 Verification of approved plat/lot. 0 0
4 Fire district approval required. Name of district: Tualtin Valley Fire&Rescue ® 0 0
5 Septic system permit or authorization for remodel. Existing system capacity 0 El 21
6 Sewer permit. 0 0
7 Water district approval. El 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. ® 0 0
9 Erosion control $J plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ® 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ® 0 0
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ® 0 0
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ® 0 0
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ® 0 0
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ® 0 0
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ® 0 0
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ® ❑ 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ® 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ® 0
0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ® ❑ 0
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or N 0 0
architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review.
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ® 0 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ® ❑ 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ® ❑ 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 ❑27 "Drawn to scale"indicates standard architect or engineer scale. ❑ 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ® 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ 0
El
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0
El
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE l SE ONLY
City of Tigard
Received
Date/By: �+Permit No.: %/VW 1j . 1 to
13125 SW Hall Blvd.,Tigard,OR 97223 Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 RECEIVE `'Inspection Line:ne: 503.639.4175 6311.11.111
<+ate Ready/By: orris: 0 See Page 2 for
Internet: www.tigard-or.gov
T I( A R D Notified/Method: Supplemental Information
P- F a -ry . ,., ti ,;" ." s
l e 2 N. Mechanical permit fees*gare based on the value of the work
aAR� performed.Indicate the value(rounded to the nearest dollar)of all
New construction ❑Addition/alteratio 6 1
DIVISION mechanical materials,equipment,labor,overhead,and profit.
❑Demolition ❑Other: Value:$
Cl 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
of7tt Heating/cooling:
� s �) I `' e�. �t, Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address: 13855 SW 172ND Ave Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
ty Tigard/OR/97140 Furnace 100,000+BTU(ducts/vents) 54.91
Ci /State/ZIP: Heat pump 61.06
Suite/bldg./apt.no.: I Project name: Riverside at Scholls Meadow Duct work 23.32
Cross street/directions to job site: Roy Rogers &Jean Louise Rd Hydronic hot water system 23.32Residential 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
Other: 23.32
Subdivision: Riverside at Scholls Meadow I Lot no.: 41
Other fuel appliances:
Tax map/parcel no.: WCTM 2S106DC20400 Water heater 1 23.32 23.32
Gas fireplace/insert 1 33.39 33.39
'' Flue vent for water heater or gas
Construction of single family detached residence fireplace
23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
. s ` k Other: 23.32
„ , g r-„, ,"., -�„ ;;� _ «o. ' Environmental exhaust and ventilation:
Name: Riverside Homes Range hood/other kitchen
equipment 1 33.39 33.39
Address: 15350 SW Sequoia Pkwy, Suite 320 Clothes dryer exhaust 1 33.39 33.39
Single-duct exhaust(bathrooms,
OR 97224
City/State/ZIP: Portland, toilet compartments,utility rooms) 5 23.32 116.6
Phone:(971 ) 371-1310 Fax ( ) Attic/crawlspace fans 23.32
y tq� " ^ Other: 23.32
,� p� Ems. "R:,iy-,,t ..av�v rt
a .s :' �. Fuel piping:
Business name: Riverside Homes $14.15 for first four;$4.03 for each additional
Contact name: Jennifer Doty
Furnace,etc. 1
Gas heat pump
Address: 15350 SW Sequoia Pkwy, Suite 320 Wall/suspended/unit heater
City/State/ZIP: Portland, OR 97224
Water heater 1
Fireplace 1
Phone:(971 )371-1310 I Fax::( ) Range 1
E-mail: jdoty@riversidehome.com Barbecue
' 74 rA*A'**:ir,ggi.VrVZZI Clothes dryer(gas)
Other:
Business name: Proheating & Cooling 4< ''' _. ' S.Il
iA
Address: 2123 NE Aloclek Dr, Suite 1209 Subtotal
Minimum permit fee($90.00)
City/State/ZIP: Hillsboro/OR//97124 Plan review(25%of permit fee)
Phone:( 971) 205-4989 Fax:( ) State surcharge(12%of permit fee)
TOTAL PERMIT FEE
CCB lic.: 209001 This permit application expires if a permit is not obtained within 180
I days after it has been accepted as complete.
J� -... * Fee methodology set by Tri-County Building Industry Service Board
Authorized signature:
I Print name: Jennifer Doty
Date: 8/28/23
I:\Building\Permits\MEC_PermitApp_040I13.doc 440-4617T(11/02/COM/WEB) -
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Famil Fee Schedule:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1:\BuildingWermits\MEC_PermitApp_040113.doc 2
Electrical Permit Application FOR OFFICE 1 SE ONLY
Received
City of Tigard Permit#: MS��� '� g15
IN Date/By:
e 13125 SW Hall Blvd.,Tigard,OR 97223 eview Related Permit#:
• Phone: 503.718.2439 Fax: 503.598.1960 F E C E IV; 'e•y.
Inspection Line: 503.639.4175 'ea.y Date/By: iuris: ® See Page 2 for
T I C A P.D Notified/Method Supplemental Information
Internet www hgard or gov P �s . ', 7..„ .
',.4td `a '` _
.
sk., u 3K w` f . , . , U4K4,.. x .S; z, .:"z. . a, ➢ 7�El New construction ❑Addition/alteration/repla ztO -rGAfiD Please check all that apply(submit 2 sets of plans whtems checked).
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition 0 Other: Uil,DING t where the available fault current ❑Marinas and boatyards.
1 xa ¢s exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi family 0 Master builder El Other: ❑Fire pump. Installation15
& • ¢^ram l- , �'" 0 Emergency system. separatelylarger derived
KVA or
system.
mo.- ,.,� .. �„ � � � u.. ,.,,:<.,� ".�
�.; Addition of new motor load of
Job#: Job site address: 13855 SW 172ND Ave 100HP or more. ❑"A","E","1-2", '1-3",
0 Six or more residential units.
occupancy.
City/State/ZIP: Tigard/OR/97140 ❑Health-care facilities. ❑Recreational vehicle parks.
0 Hazardous locations. El Supply voltage for more than
Suite/bldg./apt.#: I Project name: Riverside at Scholls Meadow ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: Roy Rogers & Jean Louise Rd _
Description Qty. Each Total
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Riverside at Scholls Meadow Lot#: 41 1,000 sq.ft.or less 168.54 4
Tax map/parcel#: WCTM 2S106DC20400 Ea.add'l 500 sq.ft.or portion 33.92 1
,,,* ;, ,„,,.-� Limited energy,residential 75.00 2
" (with above sq.ft.)
Construction of single family detached residence Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
_.
R
�,
t.< ,, Renewable Energy El See Page 2
`" ��,� * Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
Name: Riverside Homes 201 amps to 400 amps 100.70 2
Address: 15350 SW Sequoia Pkwy, Suite 320 401 amps to 600 amps 200.34 2
City/State/ZIP: Portland, OR 97224 601 amps to 1,000 amps 301.04 2
Phone:(971 ) 371-1310 I Fax:( )
Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
1
Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 59.369. 6 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps
Date: 2
401 amps to 599 amps 168.54 2
Owner signature: Branch circuits—new,alteration,or extension,per panel
✓ , " m „" ; , P „„.. 'f -`^(.s"I t', L ,. A.Fee for branch circuits with
above service or feeder fee, 7.42 2
Business name: Riverside Homes each branch circuit
Contact name: Jennifer Doty B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: 15350 SW Sequoia Pkwy, Suite 320 branch circuit
Each add'1 branch circuit 7.42 2
City/State/ZIP: Portland, OR 97224 Miscellaneous(service or feeder not included)
Phone:(971 ) 371-1310 I Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: jdoty@riversidehome.com Reconnect only 67.84 2
v Pump or irrigation circle 67.84 2
Sign
name: Sunlight Electric or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: 2804 NE 65th Ave, Ste. 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:
(360) 518-7589 Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email: yegor@sunlightelectricinc.com Inspections for which no fee is 90.00/hr
s ecificall listed('/z hr min) ,,
CCB Lic.: 172549 Electrical Lie.: C230 Suprv.Lie.: 6652S .
Exp 10/01/25ii w '-
Suprv.Electrician signature,required: Subtotal:
Print name: Sunlight Electric I Date: 8/28/23 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
, TOTAL PERMIT FEE:
Authorized signature: This permit application expires if a permit is not obtained within 180
Date: 8/28/23 days after it has been accepted as complete.
Print name: Jennifer Doty * Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
Fee for all residential systems combined: $75.00 Description
Qty. Each Total
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
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
Heating, Ventilation and Air Conditioning
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
El
Each additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is
3ry s ectficall listed hr min)
+ 90.00/hr
CA
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
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*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits TLC_PermitApp_ELR_ERE.doc Rev 06/17/2015
Plumbing Permit Application
• Building Fixtures
City of Tigard Received Permit No.: J \V V �15
111111 Date/By:• 13125 SW Hall Blvd.,Tigard,OR Plan Review
■ Phone: 503.718.2439 Fax: 503.KCENED
Date/By: Other Permit No.:
l�nlit�
Inspection Line: 503.639.4175 q 4 2023 Date Ready/By: Duds: ® See Page 2 for
SEP 9
Internet: www.tigard-or.gov Notified/Method: Supplemental Informahon
t�,,tt��±±DIV1SI6\ For special information use checklist
Q New constructionipIl{tw�l Description 1 Qty. 1 Ea. 1 Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
".,n w --- , ,: lir SFR(1)bath 312.70
❑✓ 1-and 2-family dwelling SFR(2)bath 437.78
❑Commercial/industrial
SFR(3)bath 1 500.32 500.32
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
_. ,.1 ..' Site utilities:
Job site address: 13855 SW> �172ND Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard/OR/97140 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: Riverside at Scholls Meadow Manufactured home utilities 50.03
Cross street/directions to job site: Roy Rogers & Jean Louise Rd Manholes 18.76
Rain drain connector 1 18.76 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Riverside at Scholls Meadow I Lot no.: 41 Fixture or item:
Tax map/parcel no.: WCTM 2S 106DC20400 Backflow preventer 31.27
.1' Backwater valve 12.51
', '~� '' Clothes washer 1 25.02 25.02
Construction of single family detached residence Dishwasher 1 25.02 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
'. '` tt Expansion tank 12.51
z,: .
Fixture/sewer cap 25.02
Name: Riverside Homes
Floor drain/floor sink/hub 25.02
Address: 15350 SW Sequoia Pkwy, Suite 320 Garbage disposal 1 25.02 25.02
City/State/ZIP: Portland, OR 97224 Hose bib 2 25.02 50.04
Phone:(971 ) 371-1310 Fax:( ) Ice maker 1 12.51 12.51
✓ ' ' - > a tf`ad ,. Interceptor/grease trap 25.02
'" Medical gas(value:$ ) Page 2
Business name: Riverside Homes
Primer 12.51
Contact name: Jennifer Doty Roof drain(commercial) 12.51
Address: 15350 SW Sequoia Pkwy, Suite 320 Sink/basin/lavatory 6 25.02 150.12
City/State/ZIP: Portland, OR 97224 Solar units(potable water) 62.54
Phone:(971 ) 371-1310 Fax::( ) Tub/shower/shower pan 3 12.51 37.53
Urinal 25.02
E-mail: jdoty@riversidehome.com
,, �y,- 7 f Water closet 3 25.02 75.06
,., ., ,:" <, e. .. . ,. Water heater 1 37.52 37.52
Business name: H & H Mechanical Waterpiping/DWV 56.29
Address: 5757 SE Willow Ln Other: 25.02
City/State/ZIP: Milwaukie/OR/97267 Subtotal
Phone:(503) 975-9787 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lie.: 178122 Plumbing Lie.no.: PB414
State surcharge(12%of permit fee)
Authorized signature: / ___ TOTAL PERMIT FEE
Print name: Jennifer Doty Date: 8/28/23 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.
L•\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(I0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression S stems
Footing drain-1 s'100 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
Sewer-1st 100' 62.54 3,601 to 7,200 $233.20
7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas S stems'
Water Service-each additional 100' 37.52
Storm&Rain Drain-1st 100'
62.54 a 9 s � ° � ., 6
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
each additional$100.00 or fraction thereof,to
and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr
each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
1,17
accurately report fixtures could result incr ineased sewer fees*.
�rl e a 4�dd� RCt Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath -Tub/Shower ElAny new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic El multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain
❑ Iso ric or riser diagram is required for new buildings
Garbage -Domestic-non-food
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\npruett\Downloads\PLMF_PermitApp.doc 2
Plumbing Permit Application
Building Fixtures RECEIVED FOR OFFICE USE ONLY
City of Tigard SEP 14 2023 eceived
RDateBy: DI'' I��t k Permit No.: n!1 J�`�5
13125 SW Hall Blvd.,Tigard,OR 97223 �'\ ULL
b' Plan Review
■ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: i Other Permit No.:
J
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: 1 Juts: ® See Page 2 for
T I G K D •
Internet: www tigard-or gov E3VILDING DIV1S1ON Notified/Method. ,, Supplemental Information
For special information use checklist
Q✓ New construction (Demolition Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
m '" ,xxv ''' SFR(1)bath 312.70
El 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder Other: Fire sprinkler( sq.ft.) Page 2
t W �? Site utilities:
.. . �:.;�' � ,,.. ,, ,ter , e k
Job site address: 13855 SW 172ND Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard/OR/97140 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: Riverside at Scholls Meadow Manufactured home utilities 50.03
Cross street/directions to job site: Roy Rogers & Jean Louise Rd 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: Riverside at Scholls Meadow I Lot no.: 41 Fixture or item:
Tax map/parcel no.: WCTM 2S 106DC20400 Backflow preventer 1 31.27 31.27
71- a y f Backwater valve 12.51
f: }R _i.: w ` . �„. °, 'f, -r,;:. %. Clothes washer 25.02
Construction of single family detached residence Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
P 7 r - Expansion tank 12.51
✓
Fixture/sewer cap 25.02
Name: Riverside Homes
Floor drain/floor sink/hub 25.02
Address: 15350 SW Sequoia Pkwy, Suite 320 Garbage disposal 25.02
City/State/ZIP: Portland, OR 97224 Hose bib 25.02
Ice maker 12.51
Fax:( )
Phone:(971 ) 371-1310 _
t,IV
A ,1, ; ea r ._t , a: °.°a. Interceptor/grease trap 25.02
Medical gas(value:$ ) Page
Business name: Riverside Homes
Primer 12.51
Contact name: Jennifer Doty Roof drain(commercial) 12.51
Address: 15350 SW Sequoia Pkwy, Suite 320 Sink basin/lavatory 25.02
City/State/ZIP: Portland, OR 97224 Solar units(potable water) 62.54
Phone:(971 ) 371-1310 Fax::( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: jdoty@riversidehome.com 25.02
� ,iiiiu Water closet
j. < . .... . . F o.F _w4. Water heater
37.52
Business name: Truscapes Water piping/DWV 56.29
Address: 7800 NE Walker Road Other: 25.02
City/State/ZIP: Hillsboro/OR/97124 Subtotal -
Phone:(508)531-9216 Fax:( ) Minimum permit fee: $72.50 4
Plan review (25%of permit fee)
CCB Lic.: Plumbing Lic.no.: LCB #7962
State surcharge(12%of permit fee)
Authorized signature: ' �%a ,. ..- TOTAL PERMIT FEE J
Jennifer Doty Date: 8/28/23 This permit application expires if a permit is not obtained within 180 days
Print name: after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
h\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Sup ression S stems
,
Footing drain-1"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
Sewer-1st 100' 62.54 3,601 to 7,200 $233.20
7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54
Medical Gas S stems:
Water Service-each additional 100' 37.52 •-
Storm&RainDrain-1st100' 62.54 " .,.t f .ti ' 7 !„- v ,.. � a _ ;
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
a j t f , r fi each additional$100.00 or fraction thereof,to
�� ' ' " '"' '''' and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased ye sewer fees*.
l+' Type[ar quanitY l3Y e iltpp
i'p e/' a °, i E t M . is °
or &rmed. ap� ": (Added, ate to" " Plan review is required for any of the following.
Baptistry/Font k, Please check all that apply.
Bath Tub/Shower 0 Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Than ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinlder system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain :.. .s \i, . FJ + ie
Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\npruett\Downloads\PLMF PermitApp.doc 2
--- K=Issomaigoialn . 6yri-ArtJL /i .D .-. afio ravJ
III ® Building Division
C
One & Two-Family Dwelling
TIGARD Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION ..)l/ �
Permit#: Plan #: Floors: 1
'Tzoz" - Ov4-ZS� 2 Z-
Valuation: y��/ 4�,, ! Covered Porch: Basement
LisBedrooms: 1 Deck: -^ 1"Floor C -,( _
WC (toilets) 3 Deck Cover: 2"d Floor ' D. cacc.
Lavatories Patio Cover 3`d Floor
Tub/shower . Accessory Struct. ---- R-3 Total W- 9 i-
Laundry Tray ji.-.& Water Heater \ /JO Elec Garage 3 Q, O
Exhaust Vents 1 Gas Flue Vents Total for Elec. 2A.A.7i
Backflow Prey. ,�l AD Heat Pump (�ll. # for Electrical 4
BBQ Gas Fireplace 1.-X-fi #Fue
l Lines L,
FEES: Description: Fee Applies: Fee Entered:
DC Prov Revw: Planning ✓/
Info Proc/Arch: Lg$2.00 (over 11x17) 17
Info Proc/Arch: Sm$.50 (up to 11x17) L/Le
Metro CET: Residential Use
School CET: District: i,i( f
Tigard CET: Admin v
Tigard CET: ODHCS
Tigard CET: AH t7
Electrical Permit: Permit Fee:
L.
Limited Energy: 6- .
12% State Surcharge C/
Mech. Permit: Permit Fee: l/
12% State Surcharge &.----v
Plumbing Permit: Permit Fee:
12% State Surcharge
Erosion Control: w/Permit-Ping
I:\Building\Forms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
Page 1
FOR OFFICE USE ONLY—SITE ADDRESS: ViSS 51*1 fllr'.4I, ,I PtNdi
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 DEVELOPMENT DEPARTMENT
III
Transmittal Letter
r<<;A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov
TO: Hope Pollard DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Jennifer Doty OCT 0 9 2023
COMPANY: Riverside Homes CITY OF TIGARD
PHONE: 971-371-1310 BUILDING DIVISION,:
R.otitc 4C.- ft,P
EMAIL: jdoty@riversidehome.com
RE: 13855 SW 172nd Ave MST2023-00475
(Site Address) (Permit Number)
Riverside at Scholls Meadow Lot 41
(Project name or subdivision name and lot number)
(ATTACHED BARE THE FOLLOWING ITEMS: }� ^may+
FCQ,�les'' `,1 Desit� io.a , .'. I..,i. `t» ,t.'i::: .;fi P to 4 :.^Sq�fi iit �' �"�4,1, ,14 -tt '' '..
Additional set(s) of plans. 3 Revisions: Site plan
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:
Routed to Permit Technici : Date: 11 1 /rZ_ Initials: Me—
Fees Due: 0 Yes No Fee Description: Amount Due:
( b e
$
Special
Instructions:
Reprint Permit(per PE): ❑Yes 10 ❑ Done
Applicant Notified: Date: Initials:
City of Tigard
1111 m
° COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD Ze,2
Building Permit#: ( / �t -- 00 4,7)
Site Address: 13855 T 172nd Ave a4 Verified in Accela
Project Name: Riverside at Scholls Meadow Lot/Unit #: 41
Proposal: New Single Detached SFR Zone: RES-C
Housing Type: I$(SFR(X Single Detached ❑ Duplex❑Triplex 0 ADU)0 Rowhouse❑Cottage Cluster❑CYU OQuad 0 Other
Required Site Plan Elements:
X 3 copies of site plan on max 11x17"
X Drawn to standard scale
X North arrow ® Street and site trees shown / labeled
CI Site address, project name, lot #
14 Street names (N/A for SFR)
X Applicant name and phone # 0 Ceirt,e,d ,....Le„yl.. d;,,,...,.,k,,,..J (;f 4l.,,11;..uble)
ISI Lot and setback dimensions
❑ C..;01.;„y AL....t..1..., &J.,M..,c f.,-I.,.7.. X Utility locations&easements
M Footprint of new structure and FFE ti Property corner elevations
M Sidewalk/driveway dimensioned ® LIDA (>1,000 sf disturbance)
X Lot area and lot coverage percentage ® Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
181 Drawn to standard scale E Total façade area
J1;j Building height dimensioned IE Total window and door area
IA Façade dimensioned
IM Windows and doors dimensioned
RI Garage doors dimensioned
Requur n Elements:
(Not required for SFR) ❑ Summary table that includes
❑ Each story dimensioned oor area
O Each story floor area calculated ❑ Floor area pe
Planning Review
The following standards have Open.met:
12'buildingbuilding
Setbacks ® Front:A'pnrrh Rear:10'coy. Side: 3' Min/Max Street Side: 8' / Garage: 20'
35' patio/deck
LE Max. Height: Proposed Height: 22' 2.5„
at Yes 0 N/A Landscape 41% Proposed 7 detailed design elements met, shown on C1. 60%
0 Yes N/A Screening (Quad only) garage width allowed for meeting these design
® Yes 0 N/A 0/0Window Coverage 15% Proposed elements; proposed width <60%.
® Yes 0 N/A Garage (SFR Only) Parking (Other Res) tA,i ei , a r �r .Fr h r ` r
El Yes 0 N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes RI N/A Other building design standards (Rowhouse only)
❑ Yes l2 N/A Accessory Structure Standards
❑ Yes ® No Qualifying pre-existing unit exempt from standards (Cottage unit only)
Additi al standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
❑ Yes ❑ N/A t:
❑ Yes 0 N/A Lot Width and i
❑ Yes 0 N/A Pathway
Ad ' Tonal standards for Courtyard Units and Cottage Clusters only:
❑ Yes ❑ Unit Area:
❑ Yes 0 N/A Floor er story)
❑ Yes 0 N/A Courtyard
0 Yes 0 N/A Fence
❑ Yes 0 No XN/A Clean Water Services - Service Provider Letter(lot platted prior to 9/10/1995)
IA Yes 0 No ON/A Public Facilities Improvement (PFI) Permit:
Required: lA Yes ❑ No
Applied For: 0 Yes 0 No, stop intake
[X Sensitive Lands: 0 Yes lXl No
® Main Land Use Case #s: PDR2021-00001 0 Conditions met
Lid Applicant notified of land use ex iration te: sub it allpermits b 8/5/24 obtain c of o by 8/5/26
Approved By Planning: r-- ti- Date: 8/30/2023 5 / iLi i.-0A-3
Notes --e 1 '' G-t t� \ t k•AJl C i) L
Revision 1: VApproved C Not Approved ' Date: rn/'3O f x.-'3
Revision 2: 0 Approved 0 Not Approved Date:
Building Permit Submittal
Original Submittal Date: 1 1141 11,0
Site Plans #:
Building Plans #:
Building Permit #: EMI Building permit # entered on page 1
Workflow Routing: is/Planning Engineering al/Permit Coordinator ''Building
Workflow Sign-off: r 'Sign-off for Planning (include notes from planning review)
Route Documents: Li Engineering: (1) copy of permit application, (1) site plan, (1) building plan
a d original plan review routing form.
in/Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
Permit Technician: kL `/ Date: t(ti2I�,'�
Notes: 'Pwomn YD OR., a Mil-•f4 J
Engineering Review
❑ PFI Permit: e
C Slope at building pad: 2-4. cyo
lfConditions met prior to issuance of permit
L'Easements (encroachments) per engineering conditions of approval and plat
klWater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes Lilo
Assess Water Quantity Fee in-lieu: 0 Yes ico
LIDA Facility on lot: 0 Yes CNo Add Fee: ❑Yes 0 No
inal Plat Recorded
?I NOT Approved: /�2Y/ '' 4 r/i1 _lf'{/C es it Date: ld/7e,
Notes:
Approved By Engineering: Date: L////Z 3
Revision 1: El Approved Not Approved Date:
Revision 2: 0 Approved ❑ Not Approved Date:
Permit Coordinator Review
'onditions met prior to permit issuance
❑ Approved, NOT Released: Date notified applicant:
..,21-ENG Revisions Required: t Date notified applicant: l0`Z1'J,trle,
.0-SDC Exemption: ❑ Applied for ❑ Received X-Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: . Yes 0 N/A
Tigard Trans SDC: ,-Yes 0 N/A 0 Deferred
Parks SDC: e1 es 0 N/A El Deferred
LIDA 0 Yes 0 N/A
70K to Issue/Approved by Permit Coordinator: Date:
,V \ '2'3
Revision 1: 0 Approved 0 Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date: