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Permit 1t CITY OF TIGARD MASTER PERMIT I COMMUNITY DEVELOPMENT Permit#: MST2015-00140 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/10/2015 Parcel: 1 S135CD01001 Jurisdiction: Tigard Site address: 11585 SW 98TH AVE Subdivision: GREENBERG HEIGHTS Lot: 4 Project: Taylor Project Description: Addition of 16 square feet and remodel kitchen. Electrical work under separate permit. BUILDING Floor Areas Reauired Setbacks Reauired Stories: 1 Bedrooms: 0 First: 16 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes Total: 16 sf Value: $19,751.00 Rear: 0 PLUMBING Sinks: 1 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 0 Garbage Disp: 1 Water Heaters: 1 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 1 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 1 Heat Pump: N Hoods: 1 Other Units: 0 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 add?500 sf: 0 201-400 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 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 16 Owner: Contractor: TAYLOR,ROBERT H&NANCY A PRO LINE REMODELING Required Items and Reports(Conditions) 11585 SW 98TH AVE PO BOX 393 TIGARD,OR 97223 BANKS,OR 97106 PHONE: PHONE: 503-324-8812 FAX: Total Fees: $1,036.52 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 don' - • •- - 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 da ATTENTION: Ore•-n I- quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules - set forth in OAR • 2-001-0010 through OAR 9 -001-0 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19 or 1. 0.332.23 Issued By: Permittee Signature: f1/�/� '�i/// Call 503.639.4175 by 7:00 a.m.for the next available inspect of n 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. CITY OF TIGARD RECEIVED _ a - er �' i c,-,, : : e—s-/S• AUG 3 2015 i CITY OF TlGARD Initials: �� BUILDING DIVISION # ‘•--L-- F.-- • LA` 3 6_ -7\ \ # -� N n O o kg zi t 1- T- �a -a •., , ___-, -6- , --1 4 Z • 0 . lei) j 0[4 KERRYW. no 1 155 5w clb � ARCHITECT P Z T r 4-1G.,64-4) . cioLi 9-11:2-4, ? S ,„ . ° ' • O �� |—~- &QU� U ;y i� ' / 11 , � o�wmma�rm*m�w � �Nwmb� `~ –00°4 � � [ ] C !\ Sensitive Pre-Screening Site Assessment /')-� �� 7�' 1. UuASd�Hon` c�-n/ o/ ' '�^�|`, ~, ~ 2. Property Information(example 1S234AB01400) 3. Owner Information Tax lot ID(s): / /)CJ/co/ Name: Nancy Taylor Company: Address: nmmmmmm` Q Site Address: 11585 mm98 m City,State,Zip Tigard Orego 97223 City, State,Zip Tigard Orego 97223 Phone/Fax: Nearest Cross Street: sre»»buro s-Mail: 4. Deyelopment Activity(check alithat apply) LA..1.444. 6. Applicant Information 4 Addition to Single Family Residence(rooms,deck,garage) Name: Vince Re/chow fj Lot Line Adjustment [J Minor Land Partition �nmpuny� pm'uov�mmomnnn U Residential Condominium C] Commercial Condominium Address: po box o»» [2 Residential Subdivision p Commercial Subdivision U Single Lot omnmauiu| [� Mv|hLot Commercial Q�uohme.�ip� oa^�o^wonar�oo Other Phone/Fax: 503'260-1541 Email: prolioommvde/mo@nmuo.com 6. Will the project involve any off-site work? Ca Yes Vi No U Unknown Location and description of off-site work 7. Additional comments or information that may be needed to understand your project Kitchen foot print extension,x*'"^`0" This application(lees NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits, NmAmyGOE. AUmqui,odpermits and uppmxu|omu�hmoh�inod and completed under applicable local,nla�.and�dmro|law. ` By signing this form,the Owner or Owner authorized agent or representative,acknowledges and agrees that employee 01 Clean Waler Services have authority to enter the project site at all reasonable limes lor the purpose of inspecting project site conditions and gathering inlormation related io the project si� |�N�m�Iam bmi|i�m@hVm�N��noo�*m��Nhd�om�t.mNb the�gNmyk�*o�omWbN�.N�iokxmx�oio|/a.�mV|o�.and�o —o. Print/Type Name Vince nwm`^* phnU7ypwTa|w Owner Signature Date 7/21/15 FOR DISTRICT USE ONLY Li Sensitive areas pote m|lyom*wmtemmNin00'W||msituTHEAPpLC&NTMUSJPERFDHMA8ITEASQE&OMENTP0|DRTW0SU8NCEOF A SERVICE PROVIDER LETTER. ||Sensitive Areas exist oo the site or within 2OO feet oo adjacent pmyo/Um.oNx�m|Kmo �mAumomno��p �may also be required. ' a Based on review of the submitted materials and best available information Sensitive areas do not appear to to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NO.I eliminate the need to evaluate and protect water amaxi|��amsmhmqmmUyUknwwmd This document will mx�oqwx 8mv|�Pmvidm|��/oomq�oNyHmm|oUoo and 8NurO/'20. --i`/3V2.|'N|mquimUpmmibonduypm�bmog- oNamUmNomnpokWo�o4m|kmNoWm|.S�omNk�mdbm Section ' be a Based on review ot the abmittedmaterials and best available information the above referenced project wiVnot x|gnifioNly impact the existing mpotentially -sensitive area(s)lound near tIre site.This Sensitive Area Pre-Summi/g Site Assessment does NOT etiminale the teed to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20,Section 3 02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law. LI This Service Provider Letter is not valid unless _ CWS approved site plan(s)are attached. j The proposed activity does riot meet the definition o|development or the lot was platted after 9/9/9S ORS S2.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed by /~�-�%�~�� ~ . Date '�/� ��,vr , (/~��/� Once complete,email to: SPLRm*|evv@o1ommwateramrvicea'org • Fax: (603)681-4439 OR mail to: SPL Review, Clean Water Services,2550 SW Hillsboro Highway, Hillsboro,Oregon 97123 Revised 2/2015 | . https://instagram.com/sloan and cot https://www.facebook.com/sloanandcol https://www.pinterest.com/sloanandcoshop/ No virus found in this message. Checked by AVG - www.avg.com Version: 2015.0.6086/ Virus Database: 4392/10338 - Release Date: 07/30/15 2 building Permit Application Residential RECEIVED ' "'' " I ' I '' "" , City of Tigard Permit No: Mr 5c3 )/5-..co/ O 13125 SW Hall Blvd.,Tigard, 1872233 2015 Plan Revinc Phone: 503.718.2439 Fax: 503.5}}998.1960 p DateB : 'wpm Other Permit: -r:6,_`D btspectimLine: 503.639.? 1Y OF TIGARD DateReM : �l/ � SupplementalInformation See Page 2 for Internet: www.ttgara ILDIN a DIVISION j,iy., {ter r/ vt� 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 tion/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION wor on this application. p and 2-family dwelling ❑Commercial/industrial Valuation. S 1 1`751 " - ❑Accessory building El Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: ii S 85 5L J q a New dwelling area: square feet City/State/ZIP: 714 N(? ) C Q.,, T7 22 3 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: ( �� i or. Covered porch area: square feet Cross street/directions to job site: ns.. 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. k.0 r.1 refit mM�cl (4 I0�F /17,77/7-/a A) Valuation: S Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER J ❑ TENANT Number of stories: Name:a�� 'F�_(,ter Type of construction: Address: (t SASS so c 8 M Occupancy groups: City/State/ZIP: —r4.4 pL et 7223 23 Existing: Phone:( ) Fax:( ) New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: Meese refer so fee arl rf) Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: Total fees due upon application: 4? fc City/State/ZIP: V Phone:( ) Fax::( ) Amount received: E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-to• 'counted PhotoVoltaic Solar Panel System. Business name: ' Submit two sets of roof plan with connection details and fire departm-. access,along with '> t 10 Oregon Address: t7 Seta Solar Installation Spe Cr'• Iecklist. City/State/ZIP: „�s M. C ,to c, Permit Fee(includes . .1 review 5180.00 and:...I.:. strativ- b-.): Phone:)24.0,1 1 Fax:( ) State sure i:. 2%of permit fee): 521.60 CCB lic.: tQ 65-L.4 /01/-al To . fee due upon application: $201.60 / Authorized signature: __ relorA" This permit application expires if a permit is not obtained -4111111. within 180 days after it has been accepted as complete. * Print name: r / Date: Fee methodology set by Tri-County Building Industry i . ' //s Service Board. I:\Building\Pernits\BUP-RESPernitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Appli�cftio� I t■12 t l I1 I ∎ l>v l III City of Tigard II��C(;EI VED Date/B"' Permit N°.: --�t�� \ Ste}1 • 13125 SW Hall Blvd.,Tigard,OR 97223 DatdBy. �� /�� i� Plan Review Phone: 503.718.2439 Fax: 503.59 V g" 3 2015 bate/ Other Permit: Inspection Line: 503.639.4175 Date R /B tuna: Ready/By: 63 See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method. Supplemental Information BUILDIP�?G DJViS:ON TYPE OF WORK COMMERCIAL FEE* SCHEDULE— USE CHECKLIST Mechanical permit fees'are based on the value of the work ❑New construction ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling ❑Cotnmercial/industrial ❑Accessory building For special information use check list ❑Multi-family ❑Master builder ❑Other: Description ' Qty. I Ea I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning ur 46.75 Job site address: 1(E 5 g',8 g',8 Fnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: r.42.6_ i flE- T2� Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct uct work 23.32 Cross street/directions to job site:Git° Hydronic hot water system 23.32 W�a Residential 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 Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 K _`� - Flue vent for water heater or gas � �e�` al ( fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 — Chimney/liner/flue/vent 23.32 ❑ PROPERTY OWNER I ❑ TENANT Other: 23.32 `` Environmental exhaust and ventilation: Name: N ` Range hood/other kitchen K ,M equipment ` 33.39 Address: Its� ) �{g e Clothes dryer exhaust I 33.39 City/State/ZIP: tea_ as 9—z z2 3 Single duct exhaust(bathrooms, 5 toilet compartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: Fuel piping: S14.15 for first four,$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace Range E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Business name: *_2 L l,t a �C�O `,�� Other: Address: 3�3 MECHANICAL PERMIT FEES' v Subtotal City/State/ZIP: �7��5 CSQ_ c1:7((lc, Minimum permit fee($90.00) 2.3t'z'L Phone:(553) Z� .(54 ( Fax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lie.: ri 5,Sl[) TOTAL PERMIT FEE _ This permit application expires if•permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name: v�.tCe Gr Cola a,-...1 Date: y/2.43AS/1 I:\Building\Pemtits\MEC_PennitApp 040113.doc 440-4617r(1 1/02/COId/WEB) Plumbing Permit Application Building Fixtures RECEIVED FOR OFFICE 1-'F. ONLY / City of Tigard • 1, �, Permit No M'a7 9 5-66( (,l ea 13125 SW Hall Blvd.,Tigard,OR � 960 3 2015 Plan Ret �y�" v v • Phone: 503.7182439 Fax 503 Other Permit No.. Inspection Line: 503.639.4175 I I F D CITY D Date Notified/Method: kris ® See Page 2 for Internet: www.tigard-or.gov V OF T1GAR Ned Meth Supplemental Information TYPE FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist Description I Qty. I Ea I Total ddition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 and 2-family dwelling ❑C:onlmercial/industrial SFR(2)bath 437.78 building SFR(3)bath 500.32 ❑Accessory b ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 11585 SCA..) l S 14 Catch basin or area drain 18.76 City/State/ZIP: ---1-4-4.6A., ©2 G'1 Z'Z- Dry well,leach line,or trench drain Page 2 l Footing drain(no.linear ft.: ) Page 2 Su ite/bldgJapt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: G` p,�,,,, trt� 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: I Lot no.: Fixture or item: - Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 " � Clothes washer 25.02 Kt-iG‘ne I.CGVYttXG1 Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 14 PROPERTY OWNER , ❑ TENANT Expansion tank 12.51 Name: u�M.C.t (s*.6C-. Fixture/sewer cap 25.02 Address: Ise 5- st.� 9s-r Floor drain/floor sink/hub 25.02 Garbage disposal ( 25.02 City/State/ZIP: 11-41 PAtiI/. act.. • 9:7223 Hose bib 1 25.02 Phone:( ) Fax:( ) Ice maker f 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:S ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory g 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Nlt�4 . Water heater 37.52 Business name: �,u, V1A, 1tr1C� Water pipingfDWV 56.29 Address: 9 ) l., `cl'iK Other: 25.02 City/State/ZIP: (j��Qesha nQ R? 3O Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: I 1 I 7, 3 i 7 Plumbing Lic.no.: •��-.0 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signatu a:. , /3! ?, 17 TOTAL PERMIT FEE Print name: t / Date: �I / permit application expires ita permit is not obtained within 180 days v V! ,,,e,' / after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board I:\Building\Permits\PLMU-PemulApp.doc 10/01/09 440.4616T(10/02/COM/WIB) • RECEIV'n City of Tigard AUG 3 2015 r COMMUNITY DEVELOPMENT DEPARTMENT CITY OF TlG. . ' • BUILDING DIVi i.:; i T I G A R D Building Permit Review — Residential Building Permit #: \' p9Dt 5— CC )4 0 Site Address: // c U 6t/ 51-6 Project Name: 746//G- /410094-1 94.1 Lot #: (New dwellin(=subdivision name;.Addition or Alteration=last name of owner) Planning Review 1 h (1 Proposal: ke�/I1i01ti l 4,/iiii(ia--% <erify site address/suite# exists and active in permits stem. g River Terrace Neighborhood: I=1 Yes XNo " Site P . Elements: ■" e (3)copies of site plan Ee;g structures on site L! itean must be on 8-1/2"x 11"or 11 x 17"paper • ootprint of new structure(including decks)with finished 'Drwr to scale(standard architect or engineer scale) ••r• t'•. "• �No arrow Utility locatio • ed for new,may apply for additions) L' ' address,project or subdivision name and lot number `$Eacaion of wells/septic systems nplicant information (name and phone number) ❑Erosion control (including drainage-way protection,silt fence LgLot dimensions and building setback dimensions des*i ,location of catch basin,etc.) area,building coverage area,percentage of coverage and l'Street names impervious area (applicable if R-7,R-12,R-25&R-40) ❑Street tree size,type and location r—B-Property corner elevations(2 foot contour lines if more than ❑Existing trees to be retained with drip line,and tree 4 foot differential) protection measures D-tleari water S ices-Service Provider Letter(lot platted prior to 9/10/1995): )R quired: Yes,applicant was notified CI No Received: "es Cl No Ii Public Facilities Improvement (PFI)Permit: Required: ❑ Yes,applicant was notified "No Applied For: Cl Yes ❑ No,stop intake L 1 and Use Case #: fr// oning: fr/it IL LYSetbacks: Front /5" Rear /4--- Side 5a Street Side — Garage , ^ ndscape Requirement: °ya ---9--lo Coverage Maximum: a-Butlding Height: Maximum Height 3) Actual Height -0- Visual Clearance ❑ Easements S'"-Sensitive Sensitive Lands: CI Yes [E No Type -12-Urban Forestry Plan ❑ Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: fiX6 Date: cP 3-6- Revisions (after Building Submittal only Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved El Not Approved Revision 3: ❑ Approved El Not Approved I:\Bui iding\Forms\BldgPermitRvw_R ES_070915.docx Building Permit Submittal Original Submittal Date: Site Plans: # Building Plans: # Building Permit#: CEnter building permit#above. Workflow Routing: 'Planning �EEngineering L1-1‘rmit Coordinator 121-1 ilding Workflow Sign-off: .0. ign-off for Planning(include notes from planning review) Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and ,..original plan review routing form. �{Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Date: 4 Engineering Review q ❑ Slope at building pad: -1 6 / ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes /ErNo Assess Water Quantity Fee in-lieu: ❑ Yes ZrNo LIDA Facility on lot: ❑ Yes ZrNo ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: lit i e L-. Gt' - Date: �/ 71s.-r Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: ❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A Tigard Trans SDC: ❑ Yes ❑ N/A Parks SDC: ❑ Yes ❑ N/A 7>Q0K to Issue Permit 'O" Approved by Permit Coordinator: i / dir Date: 3 >S- I:\Building\Forms\BldgPennitRvw_R ES_0709I 5.docx 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. 11111 Is City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter 1 ,,\1: > 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: ID ` v t - DATE RECEIVED: DEPT: BUILDING DIVISION REC . D FROM: Q p 136�T -rAtY) r- , p 14 2015 COMPANY: ITY OF M.:1ARD PHONE: £j0 £461 44 J�1 BUI LC;', :..,�� Lg a 3 3 674) G‘-66 .IIi33 p'LI) gg7N ��T 20'IS- DD'/�C� RE: J t K' rt> 47)z �'77 2� (Ste Address) (Permit Number) (ojeg/e or subdivision name and It numb• ) 1-� ATTACHED ARE THE FOLLOWING ITE' Copies: Description: I o es: Description: Additional set(s)of plans. 3 Revisions: Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. b Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: /l P c n-TE la C'91US Fo t2. R- /1/t t7 !_- 7Q /1761,1EJJ i (A e'D ii) tf < cji e,, 4S1 "n1 i Ak,r l t-,Lkile.,.,, JD FOR OFFICE USE ONLY Routed to ermit T.chnician: Date: 9-/S'- /• - Initials: 7� Fees Due: Y; ❑No Fee Description: Add 06,11 re v ; v) , Amount Due: $ 9 0 .`''s $ $ $ Spec'. Instructions: Reprint Permit(per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: U 4-- I. Date: ¶/j,/1-s— Initials:( 7. I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 11585 SW 98TH AVE, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - No C of O MST2015-00140 David Young Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 11585 SW 98TH AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal PASS MST2015-00140 David Young Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 11585 SW 98TH AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal PASS MST2015-00140 David Young Violation Summary: Inspector Contractor