Loading...
Permit CITY OF TIGARD MASTER PERMIT 114 ', COMMUNITY DEVELOPMENT Permit#: MST2015-00271 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/22/2016 TIGARD Parcel: 1 S136AA14200 Jurisdiction: TIGARD Site address: 10131 SW 67TH AVE Subdivision: OAK STREET ESTATES Lot: 37 Project: Oak Street Estates, Lot 37 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1384 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 22 Bathrooms: 3 Second: 1508 sf Garage: 494 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2892 sf Value: $352,216.26 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Tvoes Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 5 201-400 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: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2892 Owner: Contractor: LENNAR NORTHWEST INC LENNAR NORTHWEST INC Required Items and Reports(Conditions) 11870 NE 99TH ST,STE 1170 11807 NE 99TH STREET SUITE 1170 1 Ersn Cntrl 503-639-4175 VANCOUVER,WA 98682 VANCOUVER,WA 98682 PHONE: PHONE: 360-216-6423 FAX: 360-258-7901 Total Fees: $24,298.38 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 0 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 1Permittee Signature: 1/ti /3L--JC'lz-T-7e4 Call 603.639.4176 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the Job site at the time of each inspection. Building Permit Application RECEIVED Residential FOR OFFICE USE ON��L1 �J/� DEC 2 2 2015 Received C �- v07. 0��- .ermit N°67;201-( 7;2 1�TJ4e �� City of Tigard Date/By: 1� �� 7 l�f.lr III 2 v 13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGARD Plan Review!' Other Permit. ��AA y�� Phone: 503.718.2439 Fax: 503.598.1 n DateBy: S") Z eaeoV/ST/t/�0 a _ TIGARD Inspection Line: 503.639.4175 bouILDINC DIVIS:ONDateReadyBy:� l Juris: 53 See Page 2for Internet: www.tigard-or.gov Notified/Method: ` ea Supplemental Information k^CMG+,1.+.. s ct- S TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® 1-and 2-family dwelling 0 Commercial/industrial Valuation-) 1 6$ ?3 / ElAccessory building 0 Multi-family Number of bedrooms: _r— ❑Master builder 111 Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 Job site address: /02/ SW % 7rf./ A/6, New dwelling area: 2, 99 Z square feet at33$H City/State/ZIP: L L qR g f) DR q7 2 Z.3 Garage/carport area: 4 q 4 square feet Suite/bldg./apt.no.: /Project name: Covered porch area: 2 32... square feet). --t3 g Cross street/directions to job site: Deck area: square feet g ()— Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: 044- _57'6T L 57fri r 5 Lot no.: _57 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. NSFR Valuation: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:LENNAR NW,Inc. Type of construction: Address:11807 NE 99th Street,Suite 1170 Occupancy groups: City/State/ZIP:Vancouver,WA 98682 Existing: Phone:(360)258-7900 Fax:(360)258-7901 New: ® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name:Lennar NW,Inc. Structural plan review fee(or deposit): Contact name:Charles Webb FLS plan review fee(if applicable): Address:11807 NE 99`h Street,Suite 1170 Total fees due upon application: City/State/ZIP:Vancouver,WA 98672 Phone:(360)258-7900 Fax::(360)258-7901 Amount received: E-mail:PORPermits@lennar.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name:same as above Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: /9 53 t' 7 Total fee due upon application: $201.60 Authorized signature: / This permit application expires if a permit is not obtained „..„,d4 within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name: ec y , L L 6 y Date: (Z Z _/ :'5 Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011/ 440-4613T(11/02/COM/WEB) r�..,.,:;%-,i0,',',ISP %-u.5..,.r. - Electrical Permit Application i-01-01-2ti DEC2 OH 1( I t l. O\1 ' 2 2 rn1 J 15 Received City of Tigard DaierBve Permit No/15 !/ .nog 2, i III 13125 SW Hall Blvd..Tigard,OR 972 - f , "s I) Plan Review s Phone: 503.718.2439 Fax: 503.598.40 94(I .i. 1 Date ': Other Penni': i i r l3 Inspection Line: 503.639.4175 ' -' , _ : B-Date Ready/By: mos ® See Page 2 for Internet: www.tigard-or.gov NotifiedMethod: Suppkmeatal Information TYPE OF WORK PLAN REVIEW New constructionPlease check all that apply(submit 2 sets of plans w/items checked below) ❑ 0 Addition/alteration/replacement 0 Service or feeder 400 amps or more 0 Building over three stories. ❑ Demolition 0 Other: where the available fault Laurent 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. less to ground,or exceeds 14,000 0 Commercial-use agricultural 0 I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or ❑Emergency system. larger separately derived system. JOB SITE INFORMATION,AND LOCATION ❑Addition of new motor load of ❑`A",-E",`I-2"."I-3' Job no.: lob site address: IOOHP or more. occupancy. l 7 f .S w Cp / { f y V 0 Six or more residential units. ❑Recreational vehicle parks. CIh7StatelZlF: A , 9 72 ❑Health-care facilities. 0 Supply voltage for more than CI Hazardous locations. 600 volts nominal. Suite/bldg.lapt.no.: Project name: ❑Service or feeder 600 amps or more. .{ , , FEE SCHEDULE Cross streetidirections to job site: Description I Qrr. 1 Fee T Total l • New residential single-or multi-family dwelling unit. Includes attached garage. /' / 1.000 sq.ft.or less / 168.54 I 4 Subdivision: v0qie ,7vL L 7 C:�i4%L S Lot no.:3 7 > add')Soosq.fr.orportion 33.92 I Tax map/parcel no.: Limited energy,residential 75.00 2 DESCRIPTION OF WORK - (with above sq.II) J Limited energy.multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy 0 See Page 2 Services or feeders installation,alteration,andfor relocation - a.` PROPERTY OWNER- :0 TENANT. _ . 200 amps or less i 100.70 _ 201 amps to 400 amps 133.56 2 Name: JI A Y L. I 401 amps to 600 amps _ 200.34 Address: 601 amps to 1.000 amps 301.04 2 ' 4i8�rf iV� �.e1,960 11� 1(3 Rau - � -2 Overm 1.000 amps volts 552.26 2 Cit;'iSta[t'ZIP: iV/ Temporary services or feeders installation,alteration,and/or Phone:O )r) )I52— 1q.V® Fax: )'a ,=7�j1 r relocation 1 200 amps or less 59.36 1 1 Owner installation:This installation is being made on property that I own which is notsot amps io 4o0amps 125.08 ' 1 , intended for sale.lease,rent.or exchange.according to ORS 447.449.670.and 701. 401 amps to 599 amps 168.54 12 Owner signature: Date: Branch circuits-new.alteration,or extension,per panel 'X APPLICANT . ❑ CONTACT PERSON: A.Fee for branch circuits with � p �� 7.42 2 above service or feeder fee. Business name: I-=ff YA it. N 1� �)` in,, each branch circuit _ V 1/ B.Fee for branch circuits without Contact name: ( We service or feeder fee,first V �t � branch circuit 56.18 2 Address 1 FYI N (9 . - 1 I Each add'I branch circuit 7.42 2 rMiscellaneous(service or feeder not included) Cih'StateiZlP: a�rqt;t vQ/� ` 1 9%3�0�-- Each manufactured or modular 67 84 Phone: U ) )i.-• 1 city)) Fax: :(500 �J� —74o1 dwelling,service and.or feeder �x v\ [ l ^^ V Reconnect only _ 67.84 2 E-mail: 0p,Q p'-rm j-f I , Ie,nrYa( . C o'I 1 Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 , \ •� "G� s'f C Signal circuir(s(or limited-energy See Business name: [cmec l. panel,alteration,or extension. _ Page 2 2 Address: 1\03 ` S\ mC, 9c,_ Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25.'hr Cit)!State/ZIP: ?ock,\,00,ea j Gs?... q-12.GG Investigation 11 hr min) 66.25-hr Phone:(sill) E15_3` I Fax:( I Industrial plant(1 hr min) 78.18'hr �7 Inspections for which no fee is 90.00'hr CCB Lic.: r(ro Electrical Lie.: (, ‘Q Suprv. Lic.:5 305 S specifically listed(!:hr min) ELECTRICAL PERMIT FEES Supp.Electrician signature,required: Subtotal: Print name: r �yr ate: Plan review(25%of permit fee): ( IG r !L . ___. State surcharge(12%of permit fee). 1 Authorized signatur . •VO\V ?- e TOTAL PERMIT FEE: \ { L i This permit application expires if a permit is not obtained within 180 Print name: �_s l,,3e(�� �l�`�����L I Date: days after it has been accepted as complete. • Number of inspections allowed per permit. I nuildine,Pcr:nes SLC_PenniL4pp_ELR_ORE doe Rei 05/21.2013 440-46151111r05-COM'WEE • _Mechanical Permit Applicati ;ar f i i r-- f--, FOR OFFICE USE ONLY' t-... .. % ;,1 +-.f f. ` Received City of Tigard Permit Nylii72720,5,00a 7/ 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: 11 I Phone: 503.718.2439 Fax: 503.598.1960 C E C 2 ✓ 2015 Plan Review Date/By: Other Permit: Inspection Line: 503.639.4175 _ Juris: T t G A R D `� / Date ReadyBy: I ® See Page 2 for Internet: www.tigard-or.gov ryry t f l� i S _) Notified/Method: Supplemental Information 13U b..li.:r i?. ._' 7' r. TYPE OF WORK 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 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning i 46.75 Sw t� Job site address: / e, / 3 / 6 / 4✓L� Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP: i �TR2� � 2 c '7223 Furnace 100,000+BTU(ducts/vents) 54.91 l Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: 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 Flue/vent for any of above 23.32 Other: 23.32 Subdivision: ®pf,r, 5/..---26-6 s 7317-6,75Lot no.: 7 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 Flue vent for water heater or gas NSFR 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 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name:LENNAR NW,INC Range hood/other kitchen equipment 1 33.39 Address: 11807 NW 99th Street,Suite 1170 Clothes dryer exhaust 1 33.39 City/State/ZIP:Vancouver,WA 98682 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 5 23.32 Phone:(360)258-7900 Fax:(360)258-7901 Attic/crawlspace fans 23.32 ® APPLICANT 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name:LENNAR NW,Inc $14.15 for first four;$4.03 for each additional Contact name:Charles Webb Furnace,etc. Address:11807 NW 99th Street,Suite 1170 Gas heat pump WalUsuspended/unit heater City/State/ZIP:Vancouver,WA 98682 Water heater Phone:(360)258-7900 Fax::(360)258-7901 Fireplace Range _ E-mail:PORPermits@Lennar.com Barbecue CONTRACTOR Clothes dryer(gas) Business name: i / 7 Other: M�G O f-c©� / 1 L U AA a l ioMECHANICAL PERMIT FEES* Address: /©7- k, 1-bS TD R/G CD L LIMB/11 MVe72 NWy Subtotal City/State/ZIP: 7 a u r i)4/ � bR 9 706 Q Minimum permit fee($90.00) !! / Plan review(25%of permit fee) Phone:(3 Q1 ( 6 7../79/4,_-17..soy Fax:(5'4,3 ) 66 7- 989/ State surcharge(12%of permit fee) CCB lic.: j / 22 2 O b TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 • O " days after it has been accepted as complete. Authorized signature: to * Fee methodology set by Tri-County Building Industry Service Board Print name: eL//�� f,„,„,,,4/ Date: 9,f6 , /5 I:\Building\Permits\MEC_PermitApp_040113.doc 4404617T(11/02/COM/WEB) 1 • Plumbing Permit Application Building Fixtures i'.;1.rf , ; D FOR OFFICE USE ONLY Cl of Tigard Received Permit No 99 13125 SW ll Blvd.,Tigard,OR 97DEC 2 2 2015 Date/By: /t f f 70/��02 7/ II Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Date/By: Other Permit No.: T I G n K D Inspection Line: 503.639.4175 CI Y a is 1( r P D Date Ready/By: Iuris: ® See Page 2 for Internet: www.tigard-or.gov : .� `-.: rs +I. 'CM Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist Description Qty. Ea. Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 1 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: / / 3 1 51-4/ �p 77/, .4 Air Catch basin or area drain 18.76 City/State/ZIP: 7 Drywell,leach line,or trench drain 18.76 4 A��j CR 9 7 2 Z-' Footing drain(no.linear ft.:, ) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 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: 04 f" . X77 6 T _5 jZ765 I Lot no.: .87 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 1 25.02 NSFR Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name:LENNAR NW,Inc Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:11807 NW 99th Street,Suite 1170 Garbage disposal 1 25.02 City/State/ZIP:Vancouver,WA 98682 Hose bib 2 25.02 Phone:(360)258-7900 Fax:(360)258-7901 Ice maker 1 12.51 ® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:LENNAR NW,Inc Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Charles Webb Roof drain(commercial) 12.51 Address:11807 NW 99th Street,Suite 1170 Sink/basin/lavatory 5 25.02 City/State/ZIP:Vancouver,WA 98682 Solar units(potable water) 62.54 Phone:(360)258-7900 Fax::(360)258=7901 Tub/shower/shower pan 3 12.51 E-mail:PROPermits$Lennar.com Urinal 25.02 CONTRACTOR Water closet 3 25.02 Water heater 1 37.52 Business name: WO t 'C- /n 7'l> pt.u m 8/.479 '`Water piping/DWV 56.29 Address: /076 W , iLl57e. /C Ce,4,u/�/3//� � /rzog r: 25.02 City/State/ZIP: 7A,u 74446-1 e' 9706-0 Subtotal Phone:(563)66'7..179( k,,sei Fax:(503) 6 T_ ggq( Minimum permit fee: $72.50 CCB Lic.: /1 22200 Plumbing Lic.no.:. 4 .-824 pa Plan review (25%of permit fee) 7j_ State surcharge(12%of permit fee) Authorized signature: X7lf✓l ld,7 TOTAL PERMIT FEE 7 This permit application expires if a permit is not obtained within 180 days Print name: C��-/: �D� �,41 Date: 5' after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\BuildingWermits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) 7 . City of Tigard 11111 • COMMUNITY DEVELOPMENT DEPARTMENT T I G A R D Building Permit Review — Residential Building Permit #: '/S'r',32p/,S"-- 3O 2 7/ Site Address: /O/3/ S&) 694 , e _ Project Name: - 'AP_g Lot #: 37- (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: Nee() "ie //Verify site address/suite# exists and active in permit syste . ( f Iver Terrace Neighborhood: ❑ Yes V No SiY,E Plan Elements: ree(3)copies of site plan ,511 '-sting structures on site e plan must be on 8-1/2"x 11"or 11 x 17"paper II Footprint of new structure (including decks)with finished rawn to scale(standard architect or engineer scale)ri I•or elevations rth arrow li Utility locations (required for new,may apply for additions) l/LSIa address,project or subdivision name and lot number Ill' 'cation of wells/septic systems Vplicant information (name and phone number)Eie, IP rosion control(including drainage-way protection,silt fence .t dimensions and building setback dimensions sign,location of catch basin,etc.) lr A t area,building coverage area,percentage of coverage and I eet names )mpervious area (applicable if R-7,R-12,R-25&R-40) Street tree size,type and location Vroperty corner elevations (2 foot contour lines if more than isting trees to be retained with drip line,and tree 4 foot differential) protection measures Oklean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): /Required: ❑ Yes,applicant was notified V No Received: ❑ Yes ❑ No IV Public Facilit,i Improvement (PFI) Permit: equired: Ila Yes,applicant was notified ❑ No Applied For: Z'es ❑ No,stop intake and Use Case#: t2 t.2n" _ C 'oning: �_ 4f Lk/Setbacks: Front aO Rear /S Side ,� Street Side 5— Garage Idkandscape Requirement: 2e.)°o Jof Coverage Maximum: Buildin Height: Maximum Height 30 Actual Height Illi Visual Clearance IN kasements ensitive Lands: E Yes VNo Type rban ForestryPlan Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: Date: AVO/g- Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: El Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved l:\Building\Fonns\BldgPennitRvw RES 0709I5.docx Building Permit Submittal Original Submittal Date: /2/2 a//j Site Plans: # __3' Building Plans: # -3 Building Permit#: Ei'tnter building permit#above. �/ Workflow Routing: [Planning -Er-Engineering O'�ermit Coordinator L� Building Workflow Sign-off: g--Sign-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: ' ta - - Date: ,��P-7/>-s Engineering Review 4. 'lope at building pad: Conditions "Met"prior to issuance of building permit asements (encroachments)per engineering conditions of approval and plat frE Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes yNo Assess Water Quantity Fee in-lieu: CI Yes 1No LIDA Facility on lot: ❑ Yes /2/No 1:1 NOT Approved by Engineering: Date: Notes: Approved by Engineering: ii� 2) Date: j2,22.32.. 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: WYes ❑ N/A Tigard Trans SDC: ❑ Yes /RP N/A Parks SDC: 12 Yes ❑ N/A KPOK to Issue Permit Approved by Permit Coordinator: 41* Date: /Z 1:\Building\Fonns\BldgPennitRvw_RES_070915.docx 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 10131 SW 67TH AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical final PASS MST2015-00271 Chip Barnett Violation Summary: Inspector Contractor