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Permit i , CITY OF TIGARD MASTER PERMIT 1 - =' . COMMUNITY DEVELOPMENT Permit #: MST2011 -00163 d OR 97223 503.718.2439 i 13125 S Hall Blvd., Tigard Date Issued: 11/18/2011 ?Ix Parcel: 2S115AD02100 Jurisdiction: Tigard Site address: 10452 SW TUALATIN DR Subdivision: DOVER LANDING Lot: 3 Project: SORENSEN Project Description: 224 sq. ft. office addition. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 224 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 11 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 224 sf Value: $22,826.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain. 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell- Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 1 Furn <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn > =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: 0 Ea addl 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 2 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: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R -3 224 Owner: Contractor: SORENSEN, ERIK R SQUARED CONSTRUCTION LLC Required Items and Reports (Conditions) MOYLE, SASHA 6926 NE GARFIELD 10452 SW TUALATIN DR PORTLAND, OR 97211 TIGARD, OR 97224 PHONE: PHONE: 503 - 381 -5323 FAX: Total Fees: $1,238.85 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other ap• cable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuanc- if work is s pended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification C • fr. Those r. es are set forth in OAR 952- 001 -0010 through 0' : • - 001 -0090. You may • • - • • , • - • •r d questions to OUNC by calling 503.23 � 17 0 8.0.33 .2344. Issued By:`--�_L� �� _�i `ermittee Signature: /.>//1 Call 503.6 '.417.'' 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. F • wilding Permit Application Residential FOR OFFICE USE ONLY City of Tigard Received Date/B : 0 1 �" Permit No.: it _ 00 4 ,I q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review r {/` �0� Ill • Phone: 503.718.2439 Fax: .503.598.19 1 1 DateB : '_ l� Other Permit: T I G A R D Inspection Line: 503.639 `l� Date Ready/By: el See Page 2 for I Internet: www.tigard- Or.gOV 0 71 d ` Notified/Method: I/ ( �>i1� M Supplemental Information SV TYPE OF WORK �si O ��q°� Pk ��� I` ` REQU R DATA: LC- 2= FAMILY DWELL LNG m ❑ New construction ❑ Deglgivi;;�;• ;�%`''• Permit fees* are based on the value of the work performed. V,-, Indicate the value (rounded to the nearest dollar) of all *Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. K 1- and 2 -famil dwellin Valuation: $ l9 r s -G�d y g ❑ CommerciaUindustrial t ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE 'INFORMATION AND LOCATION Total number of floors: Job site address: f (5 ( 5 4 , 7 AJ't ryh a, New dwelling area: square feet City /State /ZIP: 1; Pct d O( Garage /carport area: square feet Suite/bldg./apt. no. no.: Project name: S, � N Covered porch area: square feet Cross street/directions to job site: ✓L Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST 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.' One One /1 ovol, „ 66 �. 1 r , , rrVn Valuation: $ /C (J7`r fJ�oYJ Existing building area square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: F ,,,,t_ ,corp „son Type of construction: Address: , B 1 -16 — g s( ru fu T i n p Occupancy groups: City /State /ZIP: / e Og Existing: Phone: ( ) Fax: ( ) New: ❑ APPLICANT - ❑ CONTACT PERSON BUILDING :PERMIT FEES* (Please refer to fee schedule) Business name: Structural plan review fee (or deposit): Contact name: FLS plan review fee (if applicable): Address: )-� Total fees due upon application: ,Sc City/State /ZIP: Phone: ( ) F es:: ( ) Amount received: E -mail: PHOTOVOLTAIC SOLAR PANEL-SYSTEM. FEES* Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System. Business name: Submit two (2) sets of roof plan with connection details / CQ/!s r /` UC T Oh and fire department access, along with the 2010 Oregon Address: 69 , b E el� /( ., Solar Installation Specialty Code checklist. Permit Fee (includes plan review City/State /ZIP: �, r .tarl� © ) $180.00 and administrative fees : Phone: (ce3) 3 csA 3 Fax: ( ) (.c C__ State surcharge (12% of permit fee): $21.60 CCB lie.: J ( 3 9Y3 P H,1; 7 02- - 78( . ,D Total fee due upon application: $201.60 Authorized signatur This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: no _y " 7 n Date: 4 * Fee methodology set by Tri -County Building Industry `�/7 ” Service Board I:\ Building \Permits\BUP- RESPermitApp.doc 02/ 24/2011 440- 4613T(11/02 /COM/WEB) Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE USE ONLY City of Tigard Received Date/By: No.: v 1 3125 SW Hall Blvd., Tigard, OR 97223 Associated permits: ?1 M : Phone: 503.718.2439 Fax: 503.598.1960 TtGA 24- Hour Inspection Line: 503.639.4175 ID Electrical ❑Plumbing ❑Mechanical Internet: www.tigard - or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes ; No N/A 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- El ❑ ❑ 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 ❑ ❑ El 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 Ore: on and shall be shown to be a, .licable to the sro'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- RESPermitApp.doc 02/24/2011 440- 4613T(11 /02 /COM/WEB) t ' Mechanical Permit Application ----- _ _ __ FOR - R OFFICE USE ONLY City of Ti gar Received Permit No.: /� il � � e ` g Date /By: iii d-Q�,t ka - ' t 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: T IG A R D Inspection Line: 503.639.4175 r10�\ Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard -or.gov y ® `, , otified/Method: Supplemental Information TYPE OF WO <:\ ` r`� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ,�° w va Mechanical permit fees * are based on the value of the work ❑ New construction g Addition /alterationnZreplac tri $nt performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition 0 Other: q * \' mechanical materials, equipment, labor, overhead, and profit. V Value: $ CATEGORY OF CON RUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* 4 . 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Job site address: `6/SZ Cu / n � (requires site plan showing placement) 46.75 1 CJ / / � � Furnace 100,000 BTU (ducts /vents) 46.75 City /State /ZIP: y", ��� 0 g Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: �� Project name: 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: Lot no.: Flue /vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater 23.32 Gas fireplace 33.39 Ph ( F e - tl - (t) I(,(Cr t ry Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32 Other: 23.32 Name: r , ( SfX.,en-,a107 Environmental exhaust and ventilation: Range hood /other kitchen Address: f 06/ cc._ �4✓ rC4'4 /Gt or. equipment 33.39 City /State /ZIP: 7 ` ( ©e Clothes dryer exhaust 33.39 Fax: Single -duct exhaust (bathrooms, Phone: ( ) ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Business name: Other: 23.32 Fuel piping: Contact name: $14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range CONTRACTOR Barbecue Business name: Q /• / Ua r - C 04 n -it(3 Poifi dryer (gas) Other: Address: 6 fig 6 p • /,,� - 6', t , / / A P MECHANICAL PERMIT FEES* "r Lam' Subtotal City /State /ZIP: �� j P7 J L � Z d � ) / Fax: ( ) Minimum permit fee ($90.00) Phone: ( 3 � / 7 Plan review (25% of permit fee) CCB lie.: / a- 5 9 Y3 State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized signature. / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 0 ��i�� f q Date: 9 /2 z /// * Fee methodology set by Tri- County Building Industry Service Board 1 \Building\Permits\MEC- PermitApp doe 09/09/10 4-4617T (I 1 /02/COWWEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi - Family Fee Schedule: Total Valuation: Permit. Fee: $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. I:\ Building \Permits\MEC- PermitApp.doc 09/09/10 2 • Permit A 1 1 lication City of Tigard r O Received • 13125 SW Hall Blvd., Tigard, OR 97223 $i.,., DateBy: Permit N o.: } > 11 Phone: 503.718.2439 Fax: 503.598.1960 Fs Dat Review (�O Date/Ely: Other Permit: t t i ‘ it b Inspection Line: 503.639.4175 ' �, Date Ready Internet: www.ti ard -or. ov M ~ r m "5 - g g ;1 � Notified/Method : I S 2 1 Supplemental In formation TYPE OF WORK ..... -a� rtik' PLAN REVIE • ❑ New construction Addition/alteration/re lacemer* a Please check all tha a I ilo p , Pp y (submit 2 sets of plans w /items checked below): ❑ Demolition Other: ❑Service or feeder 400 amps or more ❑ Building over three stories. where the available fault current CATEGORY OF CONSTKU ' UN exceeds 10,000 amps at 150 volts or ❑ Marinas and boatyards. ❑ 1 - and 2 dwelling less to ground, or exceeds 14,000 0 Commercial-use buildings. a, Y g ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildngs.t� use agriculd,ral ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", `y _y> "1 - 3 ", Job no.: Job site address: J�9 y� <94/ l�u r 100HP or more. occupancy. I" ❑ Six or more residential units. ❑ Recreational vehicle parks. ❑Health -caze facilities. City/State /ZIP: 7 � Q ❑ Supply voltage for more than ^ � '` ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: SO - t// SD,.1 I¢dd ,' r ,; 90 ❑ Service or feeder 600 amps or more Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Fee. I Total New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: 1,000 s Lot no.: q. ft. or less 168.54 4 Tax map /parcel no.: Ea. add' l 500 sq. ft. or portion 33.92 I Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi - family RdG z /jet✓ c.itet(t }S residential (with above sq. ft) 75.00 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: l r (x s o/ , Qn59n 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 • Address: i 0 U J ` 1. cs-(� 7;44 �ri7 Over 1,000 amps or volts 552.26 2 City/State /ZIP: 77�j�� j m Temporary services or feeders installation, alteration, and /or JJ V relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I 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, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: :Ng( F C O� B. Fee for branch circuits without ( e� S Tr K 7r �./ service or feeder fee, first Contact name: S rfpAex4ie f Coge,Hy^ / �y U7 branch circuit r 56.18 �i8 2 Address: ^ r Each add'I branch circuit 14 . 7.42 2 9 t- / i/ /L" 6 6' ' t - Woo Miscellaneous (service or feeder not included) $14 City /State /ZIP: � T tGr Ley Each manufactured or modular 67.84 O I /�- �� dwelling, service and/or feeder 2 Phone: (c� g3) 3 4 1 _ 6-3 F ax: : ( ) Reconnect only 67.84 2 E - mail: Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited - energy Business name: panel, alteration, or extension. Page 2 2 /47...&$r Each additional inspection over allowable in any of the abov Address: / Additional inspection I hr min City/State /ZIP: © �� C� C,/ Investigation (1 hr min) 66.25/ hr Phone: ( ©© 7t5 / Industrial plant (I hr min) 78.18/ hr V 2.5- Q _ 7,203 Fax: Inspections for which no fee is S S - � 3 7 specifically listed (,4 hr min) 90.00/ hr CCB Lic.• Electrical Lic. Suprv. Lic. ELECTRICAL PERMIT FEES 'Z • Suprv. Electrician signa r , r equired: r% � � 10 I 1) Subtotal: i Print name: (/ v . r.� / Plan review (25% of permit fee): • r t te: State surcharge (12% of permit fee): Authorized signatur / /i t/ // �s TOTAL PERMIT FEE: _ This permit application expires if a permit is not obtained within 180 Print name:`/ �„ days after it has been accepted as complete. Date: * Number of inspections allowed per permit. I: \B u il ding\Permits\ELC- PermitApp doe 07/01/10 440- 4615TQ 1 /05 /COM/WEB B uilding Division Development Code Provision Review TIGARD Residential Projects Building Permit No: ST�oll L60.' CWS Service Provider Letter Received: Yes ❑ No ❑ -/A ❑ CnrNfi e( c 4- q/- Routed Plans: Original Plan Submittal Date: a /��'�( 6 . 1st Revision Submittal Date: ❑ Site Plan Only 2nd Revision Submittal Date: ❑ Site Plan Only To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. Staff: please check items along left only if approved. Planning Review (contact ALEGJ.1 , at 5503- 718 -0 or @ tigard- or.gov) Land Use Case No. 5 56 L Name Y °YL - 1^-- © Zoning ` S QD 0 Setbacks: Front t Rear / Side (. Street Side L Garage 12r Maximum Building Height Actual Building Height ii Visual Clearance El Easements l' Sensitive Lands Type: 4000 a' Notes: Original Plan: Approved W Not Approved ❑ Date: 114244 Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov) Actual Slope: cyo Notes: • Original Plan: Approved Not Approved ❑ Date: Z /i Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov) Street Trees Q Protected Trees Notes: no q w, r Original Plan: Approved E Not Approved ❑ Date: Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or abert@tigard- or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applican Revision 2: Date Sent to App " nt Okay to Issue Permit: Yes No ❑ Date Routed to Building: / r e - r • Page 2 of 2 0