Permit (66) iii ,1 CITY OF TIGARD MASTER PERMIT
it: ' COMMUNITY DEVELOPMENT Permit#: MST2016-00058
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/26/2016
Parcel: 2S109DB01700
Jurisdiction: Tigard
Site address: 13147 SW KOSTEL LN
Subdivision: SUMMIT RIDGE NO.5 Lot: Multiple
Project: Summit Ridge No. 5, Lot 137
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 3 Bedrooms: 3 First: 195 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 32 Bathrooms: 3 Second: 919 sf Garage: 450 sf Front: 20 Smoke
Dwelling Units: 1 Third: 997 sf Right 5 Detectors: Yes
Total: 2111 sf Value: $258,386.15 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Bckflw Prevntr: 0 Catch Basins: 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 Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<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.'500 sf: 3 201-400 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 2111
Owner: Contractor:
DR HORTON INC. DR HORTON INC PORTLAND Required Items and Reports(Conditions)
4380 SW MACADAM AVE,STE 100 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97239 PORTLAND,OR 97239 2 A geotechnical report is
required before the footing
PHONE: 503-222-4151 PHONE: 503-222-4151
FAX: 503-222-1304
Total Fees: $28,316.78
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 71'e-- Permittee Signature: .`✓ f'e- /e.-,9-7---/c,"/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
(Fb(o A-1._
I.'` Building Permit Application tS 2q J
V Residential , ,- . ,, FOR OF FILL [:SF.011.1'
g � Y
Cityof Tigard 4 51:1'A. ,. k 1 '. Received . Permit No: —y—�,`/ /�
g Date;By: �' f fi;S/ o�CJt{J ta-�,%J?
13125 SW Halt Blvd.,Tigard,OR 97223 Plan Revie Other Perntit:
Phone: 503.718.2439 Fax: 503.598.196027F-8 4 j f Date,By:
fic &,A,tf 0201b-- /6,
` r ¢! loris: 1a a Page 2 for
Inspection Line: 503.639.4175 Date Ready: y:
T t G.�RI)
Notified/Method:=fSS� .. Supplemental Information
Internet: www.tigard or.gov ¢
Al
TYPE OF Nir
.fiitAl ? '�t(` �� t .?s`$xr`' REQUIRED DATA:1-AND 2-FAMILY DWELLING
. 1 - m
3 New construction ❑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. _
Valuation: $ /3„,--"1111111"11M11111.11,
ir
[it 1-and 2-family dwelling 0 Commercial/industrial
Number of bedrooms:
❑Accessory building 0 Multi-family
0 Master builder ❑Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: 3 a&C(;,. I
Job site address: l�„f--i.' 5 J3 Lamle., New dwelling area: 2,\E\t square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: LAS-13 square feet 9 9 1Suite/bldg./apt.no.: Project name:SUmmit Ridge jl ft ,j i L, 13-7 Covered porch area: 5D square feet 9 19
Cross street/directions to job site: Deck area: square feet )q s
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: ‘#)1.---- Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
New SFR
Existing building area: square feet
New building area: square feet
PROPERTY OWNER 0 TENANT Number of stories:
Name: DR Horton Inc. Type of construction:
Address: 4380 SW Macadam Ave Suite 100 Occupancy groups:
City/State/ZIP: Portland, OR 97239 Existing:
Phone:( 503) 222-4151 Fax:( ) New:
0 APPLICANT $ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer ro fee schedule)
Business name: DR Horton Inc. Structural plan review fee(or deposit):
Contact name: Emerald Weeks
FLS plan review fee(if applicable):
Address: 4380 SW Macadam Ave Suite 100
Total fees due upon application:
City/State/ZIP: Portland, OR 97239
Amount received:
Phone:(503 )222-4151 x1107 Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: esweeks@drhorton.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: DR Horton Inc. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:4380 SW Macadam Ave Suite 100 Solar Installation Specialty Code checklist.
1 Permit Fee(includes plan review
City/State/ZIP: Portland, OR 97239 and administrative fees}: S180.00
Phone:(503 )222-4151 Fax:( ) State surcharge(12%of permit fee): 521.60
CCB lie.: 130859 Total fee due upon application: $201.60
r This permit application expires if a permit is not obtained
Authorized signature: f� '�-' � within 180 days after it has been accepted as complete.
2016 *Fee methodology set by Tri-County Building Industry
print name: Fyn e i z 4 �, L Service Board.
'ding Permits BUP-RESPennitApp.doc 02/2412011 Date:2016 1(11/02?COMIWEB)
a , '
, • Electrical Permit ApplicationFOR OFFICE USE ONLY
City ofTigard _ ;1 N t.:. 'f-., '4'-i. t:,, .;Received
. 13125 SW Hall Blvd.,Tigan1,OR 97223 '''it4(k-''''?' s':4'''''' ' DaPlantelaRevi:ew
Ili FE' stiffigitiMMI
Related Permit#:
: I Phone: 503.718.2439 Fax: 503.598.1960 i` ' . Date/B :
Inspection Line: 503.6394175 ,k )vok R.,—.1),D-,BY, ' El See Page 2 for
Tit.SARD •
Internet: www.tigard-or.gov t-l„:?, . - Notified/Method: Supplemental Information
.
*(101;),A}C4',./..
•New construction 0 AdditionialterationtregiOanbrit ,,,,,,,--111 ,,',,y,7:`tt Please check all that apply(submit,1,sets of plans weitents checked):
. ,C,,',.:', :' ' 0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: v‘01,:%--
v; „.... where the available fault current 0 Marinas and boatyards.
0,410,04xocZOS:ttk=9,0;,;44.:Ji-: k,-;,4714::44:A , exceeds 10.000 amps at l50 volts or 0 floating buildings.
4 1_and 2-family dwelling 0 Commercial/industrial 0 Accessory building les'to grmad,or exceeds 14,0°0 0 Commercial-use agricultural
snips for all other installations. buildings.
CI Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 installation of 150 KVA or
/E84:4ittt Siftitiia1****-4X*47Witil/41 0 Emergency sY5lem- larger separately derived
' 0 Addition of new motor load of System.
Job#: Job site address: rbl 4-4- kA,1•- v-lo ...A 100HP or more.
City/State/ZIP:Tigard, OR 97223 . Et;rh:::residential
i units' 0 occupancy
vehicle parks.
Project name: Summit Ride
Suite/bldg./apt.#: g 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal
Crossstreet/directions to job site: irk;',':577rigg„1,$` -',C::$4.1tOtltkliZ:.'„="-%,-,,i4, ,:;.,V,14,
Description I Qts. I Each I Total I t
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: t954.. Includes attached garage.
1,000 sq.ft or less i 168.54 4
Tax map/parcel#: Ea add'l 500 sq fior portion ---2., 33.92 1
0:1VOM0140 '.,,,V:0-TW-:!;,!IN;i:,.' :,nE:,J', Z,-PftfT:Z.: Limited energy,residential 'r
New SFR (with above sq.I) 1 75.00 2
Limited energy,multi-family
75.00 2
residential(with above sq.IL)
„m„,,7,,,,,...,,;,,,,,„ „......,..,r.„: a,,,,;ouir,„„„!1„,, ,,,:i,„;„i,i,,,,,,. .„ Renewable Energy 0 See Page 2
,teAttfAttrAINV,,,7..f.,:21„ !.,..f.'...).s .„.,uiv.qc.6.4:A.OsaAn,rk.',,-,-Al*5LJ, ,lt;,..M=:,'RXOTMZ Services or feeders installation,alteration,and/or relocation
Name: DR Horton Inc. 200 amps or less 1 100.70 2
201 amps to 400 amps 133.56 2
Address: 4380 SW Macadam Ave Suite 100 401 amps to 600 amps , 200.34 2
City/State/ZIP: Portland,OR 97239 601 amps to 1,000 amps 301.04 2
Phone:(503 )222-4151 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: esweeks@drhorton.com relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
Tirzilta-0,41*-4,i.Tioki -:./.51kvtf, BAnre:litiocribrIzict:—einert,s,alteration,or extension,t er panel
Business name: DR Horton Inc. above service or feeder fee, 742 2
each branch circuit
Contact name:Emerald Weeks B.Fee for branch circuits without
Address: 4380 SW Macadam Ave Suite 100 branch circuit 56.18 2
service or feeder fee,first
Each adtflbranch circuit 7.42 2
City/State/ZIP:Portland, OR 97239 Miscellaneous(service or feeder not included)
Phone:(503 )222- 4151 x1107 Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:esweeks@drhorton.com Reconnect only 67.84 2
OSTR-.4.00:Wittit:,,.'1.'e.! „il'Ilig.-'irr,Artg.,/,`,A7lr Pump or irrigation circle 67.84 2
Business name: Wright 1 Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 see Page 2 1
Address: 11490 SE Jennifer St. panel,alteration.or extension. -
Each additional inspection over allowable in any of the above
City/State/ZIP:Clackamas,OR 97015 Additional inspection(1 hr min) 66.25/hr
Phone:(503)760-8522 Fax: 7) In%esogation 0 hr mi n) 90.00/hr
.*.
Industrial plant(1 brim ) 78.18/hr
Email: rlane@wrightlelectri.com Inspections for which no fee is
90.001 hr
CCB Lic.:162368 Electrical Lic,:3-332C Suprv.Lie.:
A',.--,:"-'. :1:!' ;E•017110CiAtill*Pi.N1 tt)*E.W''.------'-'::
Suprv.Electrician signature.required:
0. - lit'44 .. Subtotal:
Print name:1,01.s k.A.. E.Le..),,t- rDate: 2016 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized si 1. . ure: .40P -- This permit application expires if a permit is nor obtained within 180
Print name: Ai 5 of Date: 2016days after it has been accepted as complete.
* Number of inspections allowed per permit.
Liluilding"PerruissTI.C_PorrrnitApp_ELIURE Aloe Rev Of 17 2015 44446151111,05V0WWEB
1
. r
Mechanical Permit Application ��'s FOR OFFICF l Si OyI.'4
` Cityof Tigard i 4 i k. Date/By: •� ,1
, ' 13125 SW Hall Blvd.,Tigard,OR 9723"`'' Plan Review
_ Phone: 503.718.2439 Fax: 503.598.1960 ?t,,, Date/By: Other Permit.
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Jura' Ed See Page 2 for
Internet: www.tigard-or.gov Notiiied/Method: Supplemental Information
?5r
TYPE OF W g " r l ,',ort'.., COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
tp'c 1'( ),,,d"" " ' Mechanical permit fees*are based on the value of the work
•New construction 0 Addition/alt ttid*tlreplaeement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
lIE 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATI N AND LOCATION Heating/cooling:
- �Q �� Q Air conditioning 46.75
Job site address: v7j11 -4, �f.w ��j _J",C Lai t... Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tigard,OR 97223 Furnace 100,000-1 BTU(ducts vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Summit Ridge 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: Lot no.:
'✓
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
New SFR Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
10 PROPERTY OWNER 0 TENANT
Environmental exhaust and ventilation:
Name: DR Horton Inc. Range hood/other kitchen
equipment 33.39
Address:4380 SW Macadam Ave Suite 100 Clothes dryer exhaust 33.39
City/State/ZIP:Portland,OR 97239 Single-duet exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503 ) 222-4151Fax:( ) Attic/crawlspace fans 23.32
. . 23.32
0 APPLICANT * CONTACT PERSON Other:
Fuel piping:
Business name: DR Horton Inc. $14.15 for first four;$4.03 for each additional
Contact name: Emerald Weeks Furnace,etc.
Gas heat pump
Address: 4380 SW Macadam Ave Suite 100 Wall/suspended/unit heater
City/State/ZIP: Portland,OR 97239 Water heater ,
Phone:(503 )222-4151 x1107 Fax::( ) Fireplace
E-mail: esweeks@drhorton.com Barbecue .
CONTRACTOR Clothes dryer(gas)
Other:
Business name: Birchfield Heating&Air MECHANICAL PERMIT FEES*
Subtotal
Address: b 130 X o2__ Minimum permit fee($90.00)
City/State/ZIP: )�R-v ( d' �l z- l Plan review(25%of permit fee)
Phone:(5`11 ) q Z(v— 13 -7 if Fax:(94) ) i 2,b '7 Z-7 ir State surcharge(12%of permit fee)
CCB lie.: '&S'-'CI Ty TOTAL PERMIT FEE
This permit application expires ifs permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: sof 6,4a e * Fee methodology set by Tri-County Building Industry Service Board
Print name: J a.r e 5 1?/‘."(`'r5 to 1 ) Dare: � 0\ (0 J
1;\Building\Perm0s+MEC_Perm0App_040113.do, 440-4!/61 TI(11/02/COM/WEB)
k LA-16(‘) A I.-
Plumbing Permit Application ECEI\"
Building Fixtures MAR 2 9 2016
City of Tigard
_p�eel t , Received. �`,////k, 414: .remit No./1-/,57;26/ Sp
w 13125 SW Hall Blvd„Tigard,OR 97Z4�3�1��Y- �i + plan Review /
2 Phone: 503.718.2439 Fax: 503.- u l D14 V f IAf t "f-''
!baggy; Other Permit No.:
Inspection Line: 503.639.4175 nate Ready/By: bins: la See Page 2 for
Internet: www.t;gard-or.gov Notified/Method: Supplemental information
Tin OF WORK FEE°
❑New construction 0 Demolition .For special iufoneratina use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 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
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other: 'Fire sprinkler(VI I sq.ft.) % Page 2
JOS SITE INFORMATION AND LOCATION Site utilities:
XJob site address: J 3 )v . S L o 5-+ / �,� Gatch basin or area drain 18.76
J / +/� Drywell,leach line,or trench drain 18.76
City/State/ZIP: 1-7Gy O if-7-2.:2_
(1 ' Forming drain(nolinear ft.: ) Page 2
Suite/bldg./apt.no.: + Project name: Summit Ridge 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: i`��'.ot no.: 13-7 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
- Clothes washer 25.02
Dishwasher 25.02
NSFR Thinking fountain 25.02
Ejectors/sump 25.02
in PROPERTY OWNER i a TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPliC.ANT Q CONTACT PERSON Interceptor/grease trap 25.02
Business name: DR Horton Inc Medical gas(value:$ ) Page 2
Contact name: Emerald Weeks Primer 12.51
Roof drain(commercial) 12.51
Address: 4380 SW Macadam Ave Ste. 100 Sink/basin/lavatory 25.02
City/State/ZIP: Portland,OR 97239 Solar units(potable water) 62.54
Phone:(503 ) 222-4151 ext 1107 Fax::( ) Tub/shower/shower pan 12.51
E-mail: esweeks@drhorton.com Urinal 25.02
Water closet 25.02
CONTRACTOR
(�t {� -7 Water beater 37.52
Business name:Grew 1.k,1 `r 1 u- )tL-o J-v C Water piping/DWV 56.29
Address: �,tiet' 5 S, 6-s-pe,,, -I.V"-Ce JOs- other: 25.02
City/State/ZIP: or4urrt -Li ibtIL qi 04 5 Subtotal
Z Minimum permit fee: $72.50
Phone:(5.-h ) �'iD-a'1(�3 Fax:(9P1 ) 2.-SO`3ta o 43
CCB Lic.: 1l 945o5- c Plumbing Lic.no.: P6 I 0(oS Plan review (25%of permit fee)
{ State surcharge(1T Z/o of permit fee)
Authorized signature: (l\�U- TOTAL PERMiT FEE
Print name: �n Dale' This permit application cspres if a permit k not wised within 180 days
Se Wig• t after It has beta accepted as complete.
*Fee methodology set by Tri-County Building industry Service Board.
MBuildiugTamiu\PLMU-PcrmitApp.doc iOfOUW +4446161(Io/a2/COM/WE8)
City of Tigard
IIIIICOMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: ,/►')i'�, h,;,--CXx,5';'
Site Address: /3/`"?. ��4) ,k6.4j 1 c3 _
Project Name: �cif,,U9,0>4- kb Lot #: /379-
(New dwelling= subdivision na dition or Alteration=last name of owner)
Planning Review
Proposal: 141e6t )
/Verify site address/suite# exists and active ' permit system.
iIiver Terrace Neighborhood: No ❑ Yes,See RiverTenace Review Addendum Attached
Sits Plan Elements:
trey( ree(3)copies of site plan W ting structures on site
e plan must be on 8-1/2"x 11"or 11 x 17"paper I Footprint of new structure (including decks)with finished
I,1►rawn to scale(standard architect or engineer scale) or elevations
Aerth arrow Utility locations (required for new,may apply for additions)
address,project or subdivision name and lot number 1 rl If 'cation of wells/septic systems
licant information(name and phone number) 1l rosion control(including drainage-way protection,silt fence
vep
dimensions and building setback dimensions sign,location of catch basin,etc.)
of area,building coverage area,percentage of coverage and eet names
pervious area(applicable if R-7,R-12,R-25&R-40) treet tree size,type and location
isting corner elevations �
(2 foot contour lines if more than if , 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):
equired: E Yes,applicant was notified No Received: El Yes E No
rolPublic Facilitie mprovement(PFI) Permit:
quired: Yes,applicant was notified E No� Applied For: l® Yes ❑ No,stop intake
Lnd Use Case#: � �� �('�/�
oning: P-9--
iv etbacks:
-9--
etbacks:weailS Front / Rear /5"- Side Street Side NM Garage Q'
ndscape Requirement: cQQ %
t Coverage Maximum:
i Building Height: Maximum Height Actual Height 3
1 ,*sual Clearance
111 asements
vri*e Lands: /Yes E No Type
V Urban Forestry Plan
❑
Conditions " et"prior to issuance of building p rmit /°
Notes: 0147;6*' rnug 1- •tee Atl/1- ley- /0 > ,C'iv e ,J
// v
Approved By la�: .' Date: 02 40,
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Fonns\B1dgPennitRvw_RES_012116.docx
Building Permit Submittal
Original Submittal Date:
Site Plans: #� ��/k)
Building Plans: #
Building Permit#: ,enterbuilding permit#above.
Workflow Routing: 1L-41ai ing ngineering ermit Coordinatording
Workflow Sign-off: 1E-5ign-off for Planning(include notes from planning review)
Route Application Documents: neering: (1) copy of permit application, (1) site plan, (1) building plan and
original��-� plan review routing form.
L" nilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: C rte ..— Date: „)--/A4
Engineering Review
fr Slope at building pad: /7f lam'
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: %( Date: 2-- 9.-��
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:
C Fees Entered: Wash Co Trans Dev Tax: 0!-0' es ❑ N/A
Tigard Trans SDC: , _Yes ❑ N/A
Parks SDC: Yes ❑ N/A
OK to Issue Permit
Approved by Permit Coordinator: Alie
Date: 9' / k
I:\Building\Fonns\BldgPermitRvw RES 012116.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.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
,1111
Transmittal Letter
11(,A 1?t) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: ieX / 1 A DATE >� t
DEPT: BUILDING DIVISdN
AUG022016
(1
FROM: �C/ � .
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COMPANY: Dia 1kJ -
PHONE: (-:S/U 42> 11//.5-1 CZI)
(Site Address)
(Permit Number)
( )ti MIA 1 12:aZ✓ /3 7 011.4:4a r►n 0 c� C
(Project name or subdivision nar and lot number) ta-
ATTACHED ARE THE FOLLOWING ITEMS:
9(67b' ,- a ye' fl' Fr, * a „te- r
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. Engineer's calculations.
Other(explain):
REMARKS:
7 7 a i a5 r r " rod, °
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑No Fee Description:p Amount Due:
$ /69. 62
t
4.64
i,.a" `'�,r`
Special
Instructions:
Reprint Permit(per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions 061316.doc
RECEIVED
Mechanical Permit Application 14114 nl , 14 I 4 .1 44\I e
SiCiti of Tigard S,EP 21 2016 ia�::74.; 9/a3 �� I•rrrn.,Y?.5��0/6 DOO.SP
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I'l1:im 444.144.2404, )at Si!!!S9}.E■,yTlwVOF T Ty 1�'�■ ( N� SMIa�Y<n r•
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BUILDING DIVISION _ ,-.COMMERCIAL E*sclleoln 1 MISE CIIEl�iL1Sl
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