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Permit /A.//34P aiG= .t 6.) / ,� - `. CITY OF TIGAR MASTER PERMIT q IN o ' COMMUNITY DEVELOPMENT Permit #: MST2009-00145 . ,T-1 G'Alt 7. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/31 /2009 Parcel: 1S135CD02702 Jurisdiction: Tigard Site address: 11715 SW 95TH AVE Subdivision: BOETCHERS ADDITION Lot: 6 Project: Jones Project Description: Kitchen addition & remodel, remodel existing bath, add new garage with master suite over. 9/15/09, adding kitchen sink & (1) washing machine. Adding (1) gas fireplace and gas piping. 9/16/09: Note: All electrical work being done for the kitchen remodel is being done by another BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 0 First: 120 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 21 Bathrooms: 0 Second: 720 sf Garage: 720 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $115,108.08 Rear: 0 PLUMBING Sinks: 0 Water Closets: 2 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 1 Catch Basins: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 0 Drains: 0 Bckflw Prevntr: 1 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 0 0 -200 amp: /5 A, 0 -200 amp: 0 W/ Svc or Fdr: 10 Ea add'I 500 sf: 0 20 1 -400 amp: 1 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add! Br Cir: 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: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) LEBEN, ANNES & KOLOLINSE MASTERPIECE CONSTRUCTION INC 11715 SW 95TH AVE 13849 SW MISTLETOE DR TIGARD, OR 97223 TIGARD, OR 97224 PHONE: PHONE: 503 - 750 -5549 FAX: 503 - 524 -4371 Total Fees: $3,704.37 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 • ccor ance 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. TTENTION: Oregon - • requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 01 -0010 through OAR • : - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issu t By: - ✓. . _, 4 ' Permittee Signature: 1 , CITY OF TIGARD MASTER PERMIT III III COMMUNITY DEVELOPMENT Permit #: MST2009 -00145 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/31/2009 Parcel: 1 S135CD02702 Jurisdiction: Tigard Site address: 11715 SW 95TH AVE Subdivision: BOETCHERS ADDITION Lot: 6 Project: Jones Project Description: Kitchen addition & remodel, remodel existing bath, add new garage with master suite over. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 0 First: 120 sf Basement 0 sf Left: 0 Parking Spaces: 0 Height: 21 Bathrooms: 0 Second: 720 sf Garage: 720 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $115,108.08 Rear: 0 PLUMBING Sinks: 0 Water Closets: 2 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 1 Catch Basins: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 0 Drains: 0 Bckflw Prevntr: 1 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc!Feeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 10 Ea add 500 sf: 0 20 1 -400 amp: 1 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add'I Br Cir: 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 asin Other: N Other Description: Ecom P g BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) LEBEN, ANNES & KOLOLINSE MASTERPIECE CONSTRUCTION INC 11715 SW 95TH AVE 13849 SW MISTLETOE DR TIGARD, OR 97223 TIGARD, OR 97224 PHONE: PHONE: 503 - 750 -5549 FAX: 503 -524 -4371 Total Fees: $3,424.37 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 952- 001 -0010 throe OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.gg p. 332. 44. 1 Issued By: � ; �� .� I Permittee Signature: , Building Permit Application RECEIVED Residential FOR OFFICE USE ON IA City of Tigard JUL 0 8 2009 Received DateB Aare, 9 gin Permit No.: M C;r _ , . T 13125 SW Hall Blvd., Tigard, OR 9722361 y OF TIGARD Plan Review rlt Phone: 503.639.4171 Fax: 503.598. DateB : .t /T . a . Other Permit. TIGARD Inspection Line: 503.639.4175 ILDING DIVISION Date Ready/By: luris El See Page 2 for Internet: www.tigard - or.gov Notified/Method � G Supplemental Information TYPE OF WORK . REQUIRED. DATA 1 -AND 2-FAMILY DWELLING ❑ New construction ❑Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all 'ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. < and 2- family dwelling ❑ Commercial /industrial Valuation: $ 35- ID Accessory building ❑ Multi - family Number of bedrooms: r ❑ Master builder El Other: Number of bathrooms: 2 JOB SITE 'INFORMATION AND LOCATION Total number of floors: Z - a p ,41-4 Job site address:' 1 t S i, L& S -1—%- 19 4 C New dwelling area: u 0 square feet City /State /ZIP: IN k rt ivi 1 0 A_ 9 71.-1_ - 3 Garage /carport area: ) lj 0 square feet Suite/bldg. /apt. no.: Project name: K t r 9 Covered porch area: square feet Cross street/directions to job site: q � b L „. y- 0 9 �- Deck area: La 0 square feet C I Other structure area: - V square feet !; 9t ft D r , f 9 4 `e4; 5 w &lea Subdivision: Lot no.: 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. Li 1U( k..,., L l,P Is �- R l . TC� er w Iv e q ooeti°" Valuation: S 3 C 00 11 W t �� IrM 51 L n— x1 ( v l 1 C, jA- 6 :Yu c Existing building area: /2_0 (0 square feet �� New building area: 0 4 square feet ,.,31,J rREitTY OWNER ❑ TENANT Number of stories: Z Name: k A- 3 1,./ ,S Type of construction: b f . Address: l - s t `-- D l c _,/z. f f U u/ T' Occupancy groups: City /State /ZIP: 106 1/...--T f 19 wd Existing: Phone: t(Z ) `D_q ( tk L- Fax: ( ) New a .," re r t :<_ "` p 14 k �®NTACT PERSON �> NOTICE Business name: 11A,43 Q, K-- f' Lt • ' ,_ , A [ / All contractors and subcontractors are required to be J Contact name: j ` 2� ��C'�j`i licensed with the Oregon Construction Contractors Board / ` I �l under ORS 701 and may be required to be licensed in the Address: (' t t ( Cs t S 7( t 7` V & P jurisdiction in which work is being performed. If the " q City /State /ZIP: 2 ` applicant is exempt from licensing, the following reasons I� l G /\ �' '� 2 Phone: ) ? I Fax::(..; c)._q —u3)/ apply E -mail: ,' CONTRACTOR Business name: BUILDING PERMIT FEES* Address: ^ h ,� IQ� (Please refer to feesckedple) .J1 ¥ ` Structural plan review fee (or deposit): City /State /ZIP: N Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lie.: Total fees due upon application: 0 Amount received: a5� . 10 Authorized signature: This permit application expires if a permit is not obtained � � `` p within 180 days after it has been accepted as complete. Print name: n- I L� b � '1/1"( ��� Date: �'� O � U * Fee methodology set by Tri- County Building Industry Service Board. I: \Building\Permits \BUP -RES PermitApp.doc 11/6/07 440 4613T(11/02 /COM/WEB) Building Permit Application Checklist ' One- and Two - Family Dwelling FoR 014 1( Ia si: O.1.1 City of Tigard Received 11 Date/By: No.: 1 3125 SW Hall Blvd., Tigard, OR 97223 Q Phone: 503.639.4171 Fax: 503.598.1960 Associated permits: TIGARD 24- Hour Inspection Line: 503.639.4175 1:1 Electrical 0 Plumbing 0 Mechanical Internet: www.tigard- or.gov ❑ Other: TI E FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW t es No \' t 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ _ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ 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 ❑ ❑ ❑ 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 ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ 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- ❑ ❑ ❑ 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. ❑ ❑ ❑ 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- ❑ ❑ ❑ 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 ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ 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 ❑ ❑ ❑ over 10 feet long and /or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ 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 ❑ ❑ ❑ architect licensed in Oregon and shall be shown to be applicable to the • ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ _ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ _ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ 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, ❑ ❑ ❑ 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- RES- PermitApp.doc 03/21/06 440-4613T(11 /02/COM/WEB) Plumbing Permit Application ECE\ 1 City of Tigard ! Iew e G O 8 �00 7 t � f Permit No /� r i'-0/4/6"- SW Hall Blvd. Tigard, OR 9722�U` r l NI Phone: 503.639.4171 Fax 503.598.1960 Rp DateBy. Other Permit No.: TI GA R D Inspection Line: 503 639.4175 CITY CI; TIGA A Date Ready/By Internet www.tigard - gov �. l v I S` 1`t Notified/Method Supplemental See Page 2 for 1 1�1 pit1 �, p Notified//Metho. Supplemental Information TYPE OF W YC L. FEE* SCHEDULE ❑ New construction ❑Demolition For special information use checklist Description I Qty. I Ea. I Total dition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 1 350.00 Accessory building SFR (3) bath 399.00 El ry g ❑ Multi- family Each additional bath/kitchen J 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION-AND LOCATION Site utilities Job site address: I 1 1 1 s' J" t.4_d 1 s'l• r9tr3 7.1 / '� 1 Catch basin or area drain 16.60 City /State /ZIP: 7"\ O Q._ � Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: /^ c � Footing drain (no. linear ft.: ) Page 2 � T Cross street/directions to job site: G �� l i 70 Manufactured home utilities 110.00 !! Manholes 16.60 S -T". Rain drain connector 1 16.60 t.(00 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.:too) Page 2 0C Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: 4 f _ x �� Absorption valve 16.60 III ION OF WORK Backflow preventer / Page 2 NL ktr ?,J le KA q0541-0-1,e--- Backwater valve 16.60 t,./LT'.. YVt, WJ 1 G2 g - S V ` r e Clothes washer 16.60 Dishwasher 1 16.60 16picA Drinking fountain 16.60 " PROPERTY OWNER . - .I - . - ❑ TENANT Ejectors /sump 16.60 Name: rn ( t e r - v tv- S' Expansion tank 16.60 Address: 4 I Z5 Sw to t cJ . 0 0 s r• Fixture /sewer cap 16.60 City /State /ZIP: P .mR.t`1 , ( 6 91 24 5 Floor drain /floor sink/hub 16.60 Phone: (5 t.) �. fr t�• 2 Fax: ( ) Garbage disposal 16.60 t �. (0d / ❑ APPLICANT ❑ CONTACT PERSON Hose bib 3 16.60 4 Business name: ►y, ,� Ice maker 1 16.60 (6 o 6p * • t A. S �' R L CC CO V`' t I / N- L Interceptor /grease trap 16.60 Contact name: A.tictaj 0 AK. (L C) /z -t`(` Medical gas (value: $ ) Page 2 Address: I Z 4 1 5 t-‘d Ai t s Tit' To the- Primer 16.60 City /State /ZIP: 7t (fy- ilk i 1 V 1 -7 'L'L 3 Roof drain (commercial) 16.60 Phone: (co) s1a-. SS't(l Fax: : (co f 87 I Sink/basin/lavatory 2 16.60 33.24 / Tub /shower /shower pan I,, 16.60 / . , ( ; E-mail: Urinal 16.60 CONTRACTOR Water closet .2 - 16.60 i ( c,O Business name: m ig.. I fd y .- ( I h v,, b t w Water heater j 16.60 6„, Go Address: A„ 0 t 6(11.. ap"' Other: City /State /ZIP: Be "/k4 0 K., 9' 1 ( Q ' Subtotal 2 ,Z(j q i Minimum permit fee: $72.50 Phone: (513 ) 3 I p 11q r Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: / 0 z s --- 3 • Plumbing Lic. no. v I.D 711, P8 Plan review (25% of permit fee) State surcharge (12% of permit fee) ./O.5© Authorized signature: TOTAL PERMIT FEE in it."/ Print name��� ft Date(�� 3''0 S 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: 1Building \ Permits \PLM- PermitApp. doc 12/27/06 440- 46t6T(10/02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: ce Qr F � � 'ermit F Footing drain - 1" 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each 1XtUre or Item Qt y . Fee (ea) Total additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $)48.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device - each additional $100.00 or fraction thereof, to • . (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or • each additional $100.00 or fraction thereof, to specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50,001.00 and up • $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", PI1& "i r Plumbing Installations please indicate work performed by fixture. Failure to Plan review is required for any of the following. accurately report fixtures could result in increased sewer fees * . Please check'all that apply. Quantity by (Fixture) Work Performed ❑ Any new commercial building with water service 2" and Fixture Type: Replace greater, except systems designed and stamped by licensed {j :? Previous Capped Added Existing engineer. Baptistry/Font El New exterior plumbing site utilities for any complex structure Bath -Tub/Shower -Jacuzzi/Whirlpool as defined in OAR918- 780 -0040. CI Car Wash - Each Stall Medical gas and vacuum systems for health care facilities. Drive Stall Li] Any multipurpose fire sprinkler system. Cuspidor/Water Aspirator El Any complex structure as defined in OAR918- 780 -0040. Dishwasher - Commercial - Domestic Submit 2 sets of plans with any of the above. Drinking Fountain Eye Wash a- .ISQ „ultr C ctr I„ser Diagram Floor Drain /sink - 2" ❑ Isometric or riser diagram is required for new buildings - 3 that meet the qualifications above. -4" Car Wash Drain • Garbage - Domestic Comments regarding fixture work: Disposal - Commercial • - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall S ink - Bar/Lavatory *Note: If the fixture work under "this permit results in an - Bradley p - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be.paid before the Swimming Pool Filter plumbing permit can be issued. - Washer - Clothes • Water Extractor Water Closet - Toilet • Urinal Other Fixtures: \Building\Pennits\PLM- PermitApp.doc 12/27/06 Mechanical Permit A s s lica .. '\ FOR OFFICE USE ONE 1 FM Received 1 City Of Tigard tw Phone: 503.639.4171 Fax: 503.598.1 ffffiffini Permit No.: ) / 9 ��15 13125 SW Hall Blvd., Tigard, OR 9 �oOg Plan Review v ? Q Date/By: Other Permit: r_ Q D ME Inspection Line: 503.639.4175 �,UU �D Date Ready/By: Juris ® See Page 2 for Internet: www.tigard- or.gov c11 t O C'�1C�A lo kt Notified/Method: Supplemental Information TYPE OF , r 0 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ � RESIDENTIAL EQUIPMENT / SYSTEMS FEES* LJ ► 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 JOB SITE INFORMATION AND LOCATION Heating/cooling A v L Air conditioning or heat pump Job site address: " w q Tt (requires site plan showing placement) 14.00 City /State /ZIP: T tot A t- 0 Q, 1 ? zz-• Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: f Project name: Jam, T 9,4444 dl t.1 Gas heat pump 14.00 Cross street/directions to job site: GI e tvi-A 'r O 15^7 Duct work 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Flue /vent for any of above 6.80 Subdivision: Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater I 10.00 10 �, l - Gas fireplace 1 10.00 ( 0 /V I 4 J le--`/� �.MT) - �p 'p - Flue vent for water heater or gas Z , _ fireplace 10.00 f •" Ak v° �✓ _ .k• v Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 1f'ROPERTY OWNER ❑ TENANT Chimney/liner /flue /vent 10.00 Other: 10.00 Name: r1 , t. 60 (S Wt Environmental exhaust and ventilation ,'L�'' s w p k, Range hood/other kitchen Address: 1 ^"� S equipment ` 10.00 ( C City /State /ZIP: akIlf..T1 15A-A. t 0 . 9 - 2 , t 1 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: 611.1) 2, b-► S(5 ll...... Fax: ( ) toilet compartments, utility rooms) 2 6.80 13 Er ONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: prow, r ci p t. Vt C %,J ( _ 1%, C • Fuel piping Contact name: I A, ",�? kJ Z) $1,,-b., FuRrt,,_ $5.40 for first four; $1.00 for each additional Address: l f `) ? I4° 6- t IAA. & ii, its ,` D Q Furnace, etc. `J Gas heat pump City /State /ZIP: r Li 14.41..,1 i 0 CL- d I 7 1- -1 Wall/suspended/unit heater Phone: (1.) Q - 5 S' Lick Fax:: (S(s)) s 4 3? / Water heater 1 'SAO Fireplace f E -mail: Range CONTRACTOR Barbecue Business name: & .1 S} r rt Iv., 1 t E- 43 L w G Clothes dryer (gas) Other: Address: 14 44 d ‘k-) Fe A-0" �f ` -. MECHANICAL PERMIT FEES* City /State /ZIP: r t , U R, -l7 Z...-1-3 Subtotal Phone: %113)6 - S� - 4:1 Fax: ( ) Minimum permit fee ($72.50) 72.-5& Plan review (25% of permit fee) CCB lic.: 3e t t 1.-- State surcharge (12% of permit fee) ( C TOTAL PERMIT FEE ) ( z C. This permit application expires if a permit is not obtained within 180 Authorized signature: ae-(2...12„,".„.. arl+A/18--- d ays a i t has been accepted as complete. Print name: A-K t.► D et t,...ruitiTk Date: -e-((S * Fee methodology set by Tri- County Building Industry Service Board I\ Building \Permits\MEC- PermitApp.doc 01/19/07 440- 4617T(11 /02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including - $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and • $1.25 for each additional $100.00 o� . fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $1 00.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 0 w 0 I: \ Building \Pennits\MEC- PermitApp.doc 01/19/07 2 . Electrical Permit Application r FOIr 0I I OT US I.- ON 1 u b f "+3 Received 4 r City of Tigard Date/By: /a- „9.349 Permit No.: l CO/� 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ;:i Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: I I it D Inspection Line: 503.639.4175 Date Ready/By: furls: ® See Page 2 for - -- M: Internet: www.tigard- or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION • 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 ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE - INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. • ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", '1 -3 ", Job no.: Job site address: /�//7/5 o 96 --1- �V 1001 -IP or more. occupancy. J�' not. ❑ Six or more residential units. 0 Recreational vehicle parks. City /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 * New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map/parcel no.: Ea. add] 500 sq. ft. or portion 33.92 I Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 67.84 2 n ," Limited energy, multi - family (� I�YD (a, F447 fes -6 a-c SPt_ o f wo ak . residential (with above sq. ft.) 67.84 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: _ Over 1,000 amps or volts 552.26 2 City/State /ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 125.08 _ 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits — new, alteration, or extension, , er panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 56.18 2 first branch circuit Address: Each add'I branch circuit 7.42 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular dwelling, service and/or feeder 67.84 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: Signal circuit(s) or limited - energy panel, alteration, or Address: extension. Describe: Page 2 2 City /State /ZIP: Each additional inspection over allowable in any of the above Per inspection 66.25 Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 66.25 CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 78.18 ELECTRICAL PERMIT FEES - Suprv. Electrician signature, required: Subtotal: Print name: Date: Plan review (25% of permit fee): State surcharge (12% of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. l:\Building\Permits\ELC- PermitApp.doc 10/01/09 440- 4615T(11 /05 /COM/WEB • Electrical . Permit Application RE CENE) FOR OFFICE USE ONLY Received City of Tigard Q Z �pg Date B : 7if 09 01111:101 Permit No.: h/lJ.TaUd 13125 SW Hall Blvd., Tigard, OR 97223 1 1 Q O Plan Review Phone: 503.639.4171 Fax: 503.598.1960 v ` " Date By: Other Permit: T I G ,1 R D Inspection Line: 503.639 1 T� OF 11GA9 Date Ready/By: Juris 0 See Page 2 for Internet: www.tigard or.gov nn �i �� l l t ^ O V 1�7 , , lid ! N / ((� Supplemental Information ,_, / TYPE OF WO PLAN PLAN REVIEW 1:1 New construction Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural e- 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: 11 ^'t 1 c J t 6 1 r,^'T\ 191/ C 100HP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: 1* ❑ Health -care facilities. ❑ Supply voltage for more than `t+ I 1 _ '7 Z Z ' ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: `G l r -9 #49-'/`4 9/C ❑ Service or feeder 600 amps or more. FEE SCHEDULE G Cross street/directions to job site: l ,. 7--0 ' S ' ' Description 1 Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 75, GCS 2 el •P � �^ Limited energy, multi - family e 1 75,00 2 ` 1' n x"' 1 ' ' k- 1 �t� �-i"» k'' r . a ti4 . � —12 n s tits � • w 1 l residential (with above sq. ft.) y� , ,,. /R $ T --t.�_ C v C Services or feeders installation, alteration, and/or relocation � v 200 amps or less 80.30 2 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps i 106.85 10(0, 2 Name: , Y ` l ics v Liz S 401 amps to 600 amps 160.60 2 I 601 amps to 1,000 amps 240.60 2 Address: get ' S r-$ 0 1,, j r Over 1,000 amps or volts 454.65 2 City/State /ZIP: e0' 'VI 1g ` t 0 R. Q "? Z t 1 Temporary services or feeders installation, alteration, and/or p q relocation Phone: ( s31 v- TO " 5 Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, / 0 each branch circuit 6.65 2 Business name: Yyn .t��T ¢4 �� �. "�'O 1 1 w. t.,... B. Fee for branch circuits " without service or feeder fee, Contact name: 46.85 2 A. k .� ' I>Tr 'y,/(� t Q first branch circuit Address: 1 4a E m `s T 1 �a V e Each add'I branch circuit 6.65 2 t 1 r+` Miscellaneous (service or feeder not included) City/State /ZIP: tgt t_t ( a cj,� ') -_2 Each manufactured or modular 90.90 2 t ' dwelling, service and/or feeder Phone: (5 ) "ci..-, t S �I � Fax:: T ) 3 I Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 �► n r,q 2 L� Signal circuit(s) or limited - Business name: �\ R r. v.. P. 1 i2 A C,r energy panel, alteration, or Address: n .,< , 6 U 1 e g--7 extension. Describe: Page 2 2 City/State /ZIP: & Ax 0,C w e - V O ! de3 c Each additional inspection over allowable in any of the above Per inspection 62.50 p Phone: t { 1 1) 25S" 5-03 Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lie.: ti �L( k S Electrical Lic.: G ).. Suprv. Lic.: 1 8.-S Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: 5E-E. I/ rrederk /#0 Subtotal: t7'33 , .. Plan review (25% of permit fee): Print name: �,� �11,��Q `�R,11 v,..) Date: � 4-- 0 State surcharge (12% of permit fee): 20, Authorized signature:�� TOTAL PERMIT FEE: 1 t 15 Print name: Date: This permit application expires if a permit is not obtained within 180 p , \ �,,,, p y D1 --f - S days after it has been accepted as complete. / J * Number of inspections allowed per permit. I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11/05/COM/WEB /A f j - — 12_, -1 J Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined .. $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls • n Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls O Outdoor Landscape Lighting* ❑ Protective Signaling n Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I: \ Building 'Permits\ELC- PermitApp,doc 03/23/06 Electrical Permit Application RECEIVE r FOR OFFICE I SE ONL\ City of Tigard ' 16 2009 Da t& I / 5 D e e/ B Permit No OO7 �� ® 7 13125 SW Hall Blvd., Tigard, OR 97223 y Plan Review Other Permm ' a Phone: 503.639.4171 Fax: 503.598.1960 Dale/BY: / .– f o i /9-6 Inspection Line: 503.639.4175 CITY OF TIGARD Date Rea lures ® See Page 2 for TIC AFC ° Internet: www.tigard -or.gov BUILDING DIVISIO ' Nm'f'ed/Me'''od: Supplemental Information E OF WORK PLAN REVIEW Please check all that apply (submit 2 sets of plans w /items checked below). ❑ New construction Addition /alteration/replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories. 0 Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGO OF CONSTRUCTION exceeds 10 000 amps at 150 volts or Floating buildings less to ground, or exceeds 14.000 ❑ Commercial -use agricultural and 2- family dwelling ❑Commercial /industrial ❑Accessory building amps for all other installations. buildings. Multi- family 0 Master builder 0 Other: 0 Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system larger separately derived systr JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ A", E",' t - ", I -3 100HP or more. occupancy Job no.: J site address: / /��" a / j ) /0//41.2 ❑ Six or more residential units. ❑ Recreational vehicle parks. �/ City/State/ZIP: ` /1 , � (v(J ❑ Health -care facilities. ❑ Hazardous locations. 0 voltage for more than G 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. 1 Total I New residential single or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1.000 sq. ft. or less 145.15 • Ea. add'I 500 sq. ft. or portion 33.40 . Tax map /parcel no.: Limited energy, residential . 75.00 .. DESCRIPTION OF WORK (with above sq. ft.) - 1 Limited energy, multi - family 75.00 f ; 1 . } A ` ' J di (with above sq. fl.) I . f Services or feeders installation, alteration, and/or relocation iil'L l w _ ..daffl �� 200 amps or less 80.30 ❑ P OP1E O.' R ❑ TENAN- 201 amps to 400 amps 106.85 401 amps to 600 amps 160.60 Name: 601 amps to 1,000 amps 240.60 Address: Over 1,000 amps or volts 454.65 City/State/ZIP: /State/ZIP: Temporary services or feeders installation, alteration, and/or ty relocation Phone: ( ) 1 Fax: ( ) 200 amps or less 66.85 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 . Branch circuits – new, alteration, or ex_ tension, per panel Owner signature: Date: A. Fee for branch circuits with 0 APPIIICANT` l [] CONTACT PERSON above service or feeder fee, 6.65 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, 46.85 Contact name: first branch circuit ' Address: Each add branch circuit 6.65 _ _ : Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 90.90 dwelling, service and /or feeder Phone: ( ) I Fax: : ( ) Reconnect only 66.85 E -mail: Pump or irrigation circle 53.40 ' ` . NTRACTOR • Sign or outline lighting 53.40 Business na e: 71 r... - �. {/ l / � � j Sig circuit(s) or limited - jjj ��� ` energy panel, alteration, or Address: � A' r extension. Describe: Page 2 . Ci Each additional inspection over allowable in any of the above ty /State(ZIP: i L'� /�� - i �� I l �� Per inspection 62.50 Phone: �� ���- Investigation per hour (I hr min) 62.50 CCB • • Jere "' r Suprv. Lic.: Industrial plant per hour 73.75 - -mt♦lr ELECTRICAL PERMIT FEES Suprv. Electrician signature, r uired: Subtotal: Print name: Date Plan review (25% of permit fee): �2 G �i y....n" f.r 3 f I State surcharge (8% of permit fee): Authorized signaty � TOTAL PERMIT FEE: ` — '� This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. Electrical Permit Application - City of Tigard Page 2.- Supplemental Information LIMITED ENERGY PERMIT FEES: j RESIDENTIAL WORK ONLY: Fee for all residential systems combined $67.84 Check Type of Work Involved: n Audio and Stereo Systems* n Burglar Alarm n Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* H Other: COMMERCIAL WORK ONLY: Fee for each commercial $67.84 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls n Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC n Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical n Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1: \ Building \Permits\ELC- PermitApp.doc 10/01/09 IIIII J ,�. n' � RECE JUL 0 8 2009 CITY OFT �=� BUILDING DIVISION ` 71;1 li4 /,t, il .11 fr. (i)it ..ei'i' 'it k ri = 5 .._ .._ tI/ ttti.!4:1(1 ;r. e "' O 4 1 I F I I 0 I ----- .— r — , - -- -- I LU I t 1 1 0 < ()I- • Z X o ~) \I• I 0 Qj c r Z 1q1 __ , - • FFE a-� •+.a• --e ,.s� N I s _ I w it 1 I � 3 I a PORCH(p I w Q 1 0 1 cr 1 1 y - ..._. 1 I L a ____ -, 1 , q - I I g - - 8 Y _ - - -_ __ - I = _= 1 _ SLT FENCE _ 67�— a 95TH AVENUE 1111, SUNNI HOW U BLE FO 11-E �C1 OF ToaoO rNot aTO IT IS LEGAL DESCRPTiON ••"•'• ME SOU I S POP IY OF F TFE ! AOO BADER TO VERIFY ALL SR TU15 95111 AVE xst °■ m. PLACED Tr � TiGARD, OR .� �� OWNERS OF ANY Po1mriiA! FAD 1 . , ... �` a p OWNERS T00/ T00'd £TZO# LT :60 6002 /BO /L0 11 1/1 • CITY OF TIGARD. SITE PLAN REVIEW BUILDING PERMIT NO.: 1* ^ / PLANNING DIVISION: Required Setbacks: rs, Approved 0 Not Aporoved Side: S'treet _ 1 = 5 - F ront. 7-0 4-4- Rear v istial Clearance. lit d 0 Not Approved Viaximum 4.;; • PO 'ec. t:WS Service e rov ' (..\ 7( 0 No ) Teived 133: (1..4.44.....yr-c•---) ENGI 7/24? EERING DEPAP.:"EN1 Actual Slope:1_ % IE roved CI Not Approved Site Pla,p: Approved Not .. A13 . 7ed By: igi,,j,;e -wit> Date: "7-9 Notes: CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO: Street Trees: _Approved 0 Not Approved Protected Tr 0" Approved 0 yt Approved By: Date: 771 I) 4 Notes: re C-1/