Permit Support Document (3) FOR OFFICE USE ONLY—SITE ADDRESS:
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
Transmittal Letter
T I G A R E) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: DATE RECEIVED:
DEPT: BUILDING DIVISION
FROM: Allison May AUG 2 7 2020
COMPANY: Westwood Homes LLC. /q DING Di CITY OF TI(3/21.FiD
ISInN
PHONE: 503-713-6294 I'By:
EMAIL: allison@westwoodhomesllc.com
RE: 12050 SW Viewcrest Ct.Tigard OR 97224 MST2020-00219
(Site Address) (Permit Number)
Estates at Aspen Ridge Lot 2
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
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: Submitting sprinkler permit-Continuous System
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes n No Fee Description: Amount Due:
Special
Instructions:
Reprint Permit(per PE): ❑ Yes ❑No ❑ Done
Applicant Notified:(9-4, i # J Date: • /' /2,!) Initials:
1:\Building\Forms\TransmittalLetter-Revisions 073120.doc
Plumbini Permit Application
Building Fixtures 4�it-1)
FOR OFF I( 1' I SE ON! 1'
City of Tigard I i 2 7 2020 Received
• 13125 SW Hall Blvd.,"Tigard,OR 9�7223 Date/By: pvmitNa.: D2�_
IliC Phone: 503.718.2439 Fax' 503.598.060 M•D Plan Rev ew
Inspection Line: 503.639.4175 �(` I'9a.;an� , IhteJBe q�tlln AC OtherlcmtNo.: t7�ZI�
17C:i\F'.)1 .' Nir. '. 1 Ls 1spIs✓!\ hateed dethy: r H See P e2for
Internet Lrne g 03 63 gov tune:
NotifiedlMetbod: F/� . �!CI Supplemental Information
TYPE OF WORK 1 YYY FEE'-SCHEDULE
El New construction 0 Demolition For special Lrfnr r,,,r! h use ekeckl&
Description Qty. 1 Ea. ] Total
■ ■ Other.
New 1-2-family dwell,_. (includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath IIII 312.70
® 1-and 2-family dwelling ❑Conunemial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(ad bath 50032
❑Master builderEac
h additional kitchen
0 Other: 2
Fite sprinkler(2.7/01 ft.) I Page 2
2
JOB SITE INFORMATION AND LOCATION • Site utilities:
lob site address: ' 2_ /S 613'1/'/,Wre S ,.... . Catch basin or area drain
18.76
City/State/ZIP:Tigard OR q72 Doting leach lice,or trench drain Page18.76
2
Footing drain(no.linear ft.:
Suite/bldgJapt.no.: I Project name:,9 5 e.�, �./ ) 2
I �C Manufactured home utilities 50.03
Cross streeildrections to job site: Manholes
18.76
Rain drain connector 18.76
Sanitary sewer(no.linear It: ) Page 2
Storm sewer(no.linear ft.:____) Page 2
Water service(no.linear R.: ) Page 2
Subdivision: Lot
Z Fixture oritem:
Tax map/parcel no.: Badcflow preventer
31.27
12.51
DESCRIPTION OF WORK Backwater valve
moire s', r1fi e� P-ernvc.1 fClothes washer
Dishwasher 2525..0022
CO444I/1U01I3 S[ evh---r Drinking fountain
Ejectors/sump 25.02
® PROPERTY OWNER . .0 TENANI
Name:Westwood Homes LLCFixture/sewer cap
t
Address:12700 NW Cornell RoadFloor' i
City/State/ZIP:Portland OR 97229
Garbage dispose/Hose bib t
t
Phones 7/3 pZ4 Fax:(503)342-2403 Ice maker 12.51 '
®APPLIC * .. a CONTACT PERSON . '.. Interceptor/grease top
/ t
Business name:(A),9�f west) f S l�
APrimer 12.51
Contact name: [ UJ c
Roof drain(commercial) 12.51
// /
Address: (� r L
City/State/ZIP: ii,ci iterfff: 0,2-- 1 77,0 Saar units(potable water) 62_54
Phone: b �` - /2 ' Fax::( ) Tub/shower/shower pan 12.51 -
E mail da • /
nICJS)-t1J 'ZJ i /SL A rr ®i
CONTRACTOR. t
Business name:H&H Mechanical
._____
Address:5757 SE Willow Lane
t
City/State/ZIP:Milwaukie OR 97267
Subtotal
Phone:(503)975-9787 Fax:(503)659-2979 Minimum permit fee: 572.50
CCB Lic.: 178122 5�.-. Plumbing Lic.no.:PiL/i Li Plan review (25%of permit fee)
'� f/ 3 State surebarge(12%of permit fbe
signature: y� )
Authorized
TOTAL PERMIT FEE
Print name:Dus' 'ogre Dale. 07
0 This permit appiicatla expires if a permit Is not obtained within 180 days
aher it has been accepted as complete.
'Fee methodology set by Tri-County Building Industry Service Board.
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