BUP2021-00086 (2) Site Address: q.D-`-f 1. s kid 0 -Lk-
:
Building Division
TIGARD Deferred Submittal Transmittal Letter
TO: i D wl i4• DATE RECEIVED:
DEPT: BUILDING DIVISION ECEI'VEL-
FROM: r i S{:4-.-► /1 P.v'Y1 DEC 14 2023
CITY OF TIGARD
COMPANY: �j "el 6641 fail.( ,C 5 (5 3UILDING IVIS!ON
PHONE: 35 ( - 6 4 a- 3 8 7 7 By:' —
RE: 1 a-L-I S w 0-4- 131hP..3 t 3-( - OD C2 8 6
(Site Address) (Permit/Case Number)
/
A-eo ilof 7Gvt O✓ Jiu``�
/
cl
(Project me or subdivision name and lot number)
Valuation of Deferred Submittal: $ ( 9 1, tj 7 S
ATTACHED IS THE FOLLOWING DEFERRED SUBMITTAL ITEM:
Copies: Description:
Remarks:
NOTE: Documents for deferred submittal items shall be submitted to the registered design professional in
responsible charge who shall review them and forward them to the building official with a notation indicating that
the deferred submittal documents have been reviewed and been found to be in general conformance to the design of
the building.The deferred submittal items shall not be installed until the design and submittal documents have been
approved by the building official. Oregon Structural Specialty Code Section 106.3.4.2
FOR OFFICE USE ONLY
Routed t`o Permit Technician: Date: Ica - .o • at3 Initials:
Fees Due›.j Yes ❑ No Fee Description: Amount D e:
Deferred Submittal Fee: $
Additional fee based on valuation: $ B y 9 . go
Other: j- L Li g• : - t2i, -.). ) $ i.a,L. o0
Total Fees Due: $ i 0 7 0 9 0
Special
Instructions:
Reprint Permit(per PE): ❑ Yes No ❑ Done
Applicant Notified 1Date: q /11,,Li Initials: ;
The fee for processing an reviewit i deferred plait submittal shall be an amount equal to 65%of the building based
on the valuation of the particular portion or portions of the project with a minimum$200.00 fee.This fee is in
addition to the project plan review fee based on the total project value.
1:Building\Forms\TransmitlalLetter-DefrdSubmtl.doc 04/04/07