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Permit � r� CITY OF TIGARD i ' MASTER PERMIT '''�1 I . • COMMUNITY DEVELOPMENT 12r ,QI,,� Permit#: MST2016-00034 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/24/2016 TIGARD Parcel: 1S135CC03300 Jurisdiction: Tigard Site address: 10050 SW TIGARD ST Subdivision: GREENBURG HEIGHTS ADDITION Lot: 11 Project: CSC CAP HOLDING LLC Project Description: 3/3/16, REPRINTED to clarify description. Foundation and anchoring only for relocated 2,139 sq. ft. house. C of 0 for foundation and anchoring only. Utility&service connections done under /,A4 /x000 i//a1/Up(o --lf J ISf a 7 eokl4 dr-BUILDING,9tiA26 5 STo /006-0 4,<)-776/94D Sr- -1 d.o T Ke-b Cr/ Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right 5 Detectors: Yes Total: 0 sf Value: $20,000.00 Rear: 15 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: 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'I 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 Ecompasing: N Other: N Other Description: P 9 BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 0 Owner: Contractor: CSC CAP HOLDING LLC GROW CONSTRUCTION LLC Required Items and Reports(Conditions) BY GRAY,TIMOTHY 7900 SW HUNZIKER ST 1 Ersn Cntrl 503-639-4175 22846 SW LODGEPOLE AVE TIGARD,OR 97223 TUALATIN,OR 97062 PHONE PHONE: 503-597-2425 FAX: Total Fees: $587.52 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 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 ug 0 throh,OA%�90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issue By: k..._...1 Permittee Signature: ��/ / 10"/(7 ii �- Call 503.639.4175 by 7:00 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. MASTER PERMIT 114 ,, CITY OF TIGARD 4 ii I - COMMUNITY DEVELOPMENT '"�'%� Permit#: MST2016-00034 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/24/2016 Parcel: 1 S135CC03300 Jurisdiction: Tigard Site address: 10060 SW TIGARD ST Subdivision: GREENBURG HEIGHTS ADDITION Lot: 11 Project: CSC CAP HOLDING LLC Project Description: 3/3/16, REPRINTED to clarify description. Foundation and anchoring only for relocated 2,139 sq. ft. house. C of 0 for foundation and anchoring only. Utility&service connections done under BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 0 sf Value: $20,000.00 Rear: 15 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 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 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'I 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: NEW SF VB R-3 0 Owner: Contractor: CSC CAP HOLDING LLC GROW CONSTRUCTION LLC Required Items and Reports(Conditions) BY GRAY,TIMOTHY 7900 SW HUNZIKER ST 1 Ersn Cntrl 503-639-4175 22846 SW LODGEPOLE AVE TIGARD,OR 97223 TUALATIN,OR 97062 PHONE: PHONE: 503-597-2425 FAX: Total Fees: $587.52 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 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-r. •through••- 95 :: -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 5.23,22..11987 or 1.800.332.2344. Issued :y: 1 /iI Ar _ Permittee Signature:`yc . 40-it��.f.-,,yyy'LLL�,��////l Call 503.639.4175 by 7:00 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. p CITY OF TIGARD MASTER PERMIT lilt I ' . COMMUNITY DEVELOPMENT Permit#: MST2016-00034 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/24/2016 Parcel: 1S135CC03300 Jurisdiction: Tigard Site address: 10060 SW TIGARD ST Subdivision: GREENBURG HEIGHTS ADDITION Lot: 11 Project: CSC CAP HOLDING LLC Project Description: Foundation only. Moving an existing 2,139 sq.ft. house to this new location and anchoring it to the foundation. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 0 sf Value: $20,000.00 Rear: 15 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 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 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 addi 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: NEW SF VB R-3 0 Owner: Contractor: CSC CAP HOLDING LLC GROW CONSTRUCTION LLC Required Items and Reports(Conditions) BY GRAY,TIMOTHY 7900 SW HUNZIKER ST 1 Ersn Cntrl 503-639-4175 22846 SW LODGEPOLE AVE TIGARD,OR 97223 TUALATIN,OR 97062 PHONE: PHONE: 503-597-2425 FAX: Total Fees: $587.52 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 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 Notificati Center. T ose rule are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y. .•- .btain a copy of the rules or direct questions to OUNC by calling 50 .232.1987/ 00.332. 4. _AiiIssued By: �� Permittee Signature: - er.639.4175 by 7:00 a.m.for the n• . .Table inspection d e. This permit card shall be kept in a conspicuous place on the job site until comp tion of the project. Approved plans are required on the job site at the time of each ins ection. Building Permit Application Checklist One- and Two-Family Dwelling i o t 01.1.1( I. i s I: 0\11 City of Tigard Date/By: Permit No.: IIIU 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: II Phone: 503.718.2439 Fax: 503.598.1960 Received I I c,: I;I 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov 0 Other: I Land use actions completed. See jurisdiction criteria for concurrent reviews. 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ 0 0 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district: . 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 0 6 Sewer permit. 0 0 0 7 Water district approval. ❑ 0 0 8 Soils report. Must carry original applicable stamp and signature on tile or with application. 0 0 0 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 ❑ 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0 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 0 0 0 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 ❑ ❑ 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ 0 0 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- 0 0 0 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. 0 0 0 I Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. I 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- 0 0 0 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 0 ❑ ❑ 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 0 ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 0 0 0 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 ro'ect under review. 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. ❑ 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ 0 ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ 0 ❑ 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, 0 ❑ ❑ 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. 1:ABuilding\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(l1/02/COM/WEB) City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT illiN a T 1 c Iz n Building Permit Review — Residential Building Permit 715-7-‘26/6,—CC Site Address: 10060 S\ J 7 oJa,y-d 5-+-, Project Name: (jr ay Lot #: (New dbielling= subdivision name;Addition or Alteration=last name of owner) Planning Review Pro► I sal: new SF ei Verify site address/suite# exists and active in permit system. River Terrace Neighborhood: ❑ Yes ' No Sit Plan Elements: ree(3)copies of site plan 1 . isting structures on site NT plan must be on 8-1/2"x 11"or 11 x 17"paper awn to scale (standard architect or engineer scale) ►�Footprint of new structure (including decks)with finished I•or elevations rth arrow T.Utility locations (required for new,may apply for additions) re address,project or subdivision name and lot number 'Tjocation of wells/septic systems M pplicant information (name and phone number) Erosion control(including drainage-way protection, silt fence Lot dimensions and building setback dimensions sign,location of catch basin,etc.) NNZLof area,building coverage area,percentage of coverage and L`rJ Street names mpervious area (applicable if R-7,R-12,R-25&R-40) Street tree size,type and location Property corner elevations (2 foot contour lines if more than Existing trees to be retained with drip line,and tree ), foot differential) protection measures Clean Water �,Srvices—Service Provider Letter (lot platted prior to 9/10/1995): N Required: Yes,applicant was notified ❑ No Received: s ❑ No Public Facilities Improvement (PFI) Permit: rc.e Jib equired: ❑ Yes,applicant was notified X No Applied For: El Yes ❑ No,stop intake and Use Case #: /oning: —y, S L/ Setbacks: Front 20 Rear IS Side 5 Street Side — Garage 20 andscape Requirement: of Coverage Maximum: % JA tuilding Height: Maximum Height 30 Actual Height 12 •S 7i Visual Clearance Easements X Sensitive Lands: ❑ Yes Z No Type X Urban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: %Tim Approved By Planning: 1 1 Date: 2 16 I 6, Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPennitRvw RES 0709I5.docx Building Permit Submittal Original Submittal Date: 16 /(p Site Plans: # 3 Building Plans: # Building Permit#: 'me uilding permit#above. Workflow Routing: P[g'la g Ei—engineering eriiit Coordinator 0 Ihikling Workflow Sign-off: [Sign-off for Planning(include notes from planning review) Route Application Documents: ❑- ngineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. uilding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: /024,lElit71j av c) ( By Permit Technician: v_� — Date: 0.7/4//e, Engineering Review �YJ Slope at building pad: 3.:/ 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 ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No LIDA Facility on lot: ❑ Yes ❑ No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: j 7i) Date: 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: 0 Date: Notes: d ��Tznt:/pA'n " 4d S r3-x d -v'er-ti A. ff. 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 )2%N/A Tigard Trans SDC: ❑ Yes (5217N/A Parks SDC: ❑ Yes , N/A )<JOK to Issue Permit Approved by Permit Coordinator: Date: .2/2.--1//: I:\Building\Forms\BldgPennitRvw_RES_0709 I 5.docx Clean Water Services File Number CleanWate\ Services 16-000689 Sensitive Area Pre-Screening Site Assessment RIECEIVEP 1. Jurisdiction: Tigard FEB 2 4 2016 2. Property Information(example 1S234A801400) 3. Owner Information Tax lot ID(s): 15135CC03300 Name: tommy gray CM OF TI(;ARD Company: BUILDING DIVISION Address: 10060 sw tigard st Site Address: 10060 sw tigard st City, State,Zip: tigard,Oregon 97223 City, State,Zip: tigard,Oregon 97223 Phone/Fax: 503-863-9583 Nearest Cross Street: main st E-Mail: tommygrayl@msn.com 4. Development Activity(check all that apply) 5. Applicant Information ❑ Addition to Single Family Residence(rooms,deck,garage) Name: tommy gray ❑ Lot Line Adjustment U Minor Land Partition Company: ❑ Residential Condominium ❑ Commercial Condominium Address: 10060 sw tigard st ❑ Residential Subdivision ❑ Commercial Subdivision fpSingle Lot Commercial ❑ Multi Lot Commercial City, State,Zip: tigard,Oregon 97223 Other Phone/Fax: 503-863-9583 demo sfr E-Mail: tommygrayl@msn.com 6. Will the project involve any off-site work? ❑Yes XI No ❑Unknown Location and description of off-site work 7. Additional comments or information that may be needed to understand your project This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands andlor Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/Type Name tommy gray Print/Type Title ONLINE SUBMITTAL Date 2/23/2016 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. U Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect 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. Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need 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. ❑This Service Provider Letter is not valid unless CWS approved site plan(s)are attached. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed by el / .:..� •"-"' Date 2/24/16 IJlshnHighs,✓ay • Ore,lon9,7129, • Phone a 511 • Fax i,D3 651-4490 • wvn^✓-cle,anvia tnrservInes.or9 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 10050 SW TIGARD ST, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection FAIL MST2016-00034 David Young Inspection cancelled by contractor, will reschedule when engineers additional requirements are complete. 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 10050 SW TIGARD ST, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection FAIL MST2016-00034 David Young Provide A35 clips per approved plans, page 3. Finish nailing the one clip installed correctly. Provide missing hangers on joist by crawl. Provide missing pier pad and post at broken beam for front cantilevered joists. Remove all wood debris including concrete forms and non pt wood in contact with concrete from crawl. R408.4 Seal all open penetrations from crawl to habital space. Provide proof of vapor barrier and under slab insulation at new garage ﬂoor poured and converted to habital space without permit and inspection. Freeze protect all new water supply lines in crawl. 313.6 1 hr minimum fee to be paid prior to re inspect for crawling the underﬂoor. 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 10050 SW TIGARD ST, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection FAIL MST2016-00034 David Young Provide post under cantilevered beam front of house as noted on previous inspection. Provide support at gaps under sill plate at patched access holes. Provide positive connection at crawl access framing. Correction for A35's at perimeter ok. Ok to install underﬂoor insulation. 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 10050 SW TIGARD ST, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - No C of O MST2016-00034 Chip Barnett Previous corrections completed Permit for foundation and anchoring only as noted on permit Violation Summary: Inspector Contractor 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 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov TO: v` DATE RECEIVED: DEPT: BUILDING DIVISION FROM: 70'''vi `/� // C (/ C A U 016 COMPANY: ✓u�-✓ ee�,c �� ` e ,f- Li ARD L, k N DIVISION PHONE: (F(-) Y G / q 3- 3V (-(U r7 YU BY RE: U o n f � .,� 4 , r .ill i• (Site Address) "e Numier CS c 9e //dilvq SGC 11.15Ta,.olCo— cZX53 t (Project name or bdivision name lot number ATTACHED ARE THE FOLLOWING ITEMS: 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. Enginer's calculations. t/ Other(explain): f REMARKS: Routed to Permit Technician: Date: - ] )-- I C Initials: Fees Due: gi Yes . o Fee )esc(ri tion:� Amount I e: {� 1 e v.CU.,f $ L,VS- $ Special M7 C.' '7 D, ( ,Y i' - , -. C-( STV Mea_ — Instructions: ..7i s e -y• Reprint Permit(per PE): ❑ Yes No ❑ Done Applicant Notified: 70/1/4y Date: qp9// Initials . 1-2 �rvv�Sr�G �a 1-z,� ��,9-� c-� S/0")- E- Pte- .297/l A , 4r/.c' X552 I:\Building\Forms\TransmittalLetter-Revisions_061316.doc /a o 90 d/ v