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Permit (242)
CITY OF TIGARD MASTER PERMIT It ■ COMMUNITY DEVELOPMENT Permit#: MST2016-00442 T r i:;ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/28/2016 Parcel: 2S103BB12800 Jurisdiction: Tigard Site address: 12275 SW ANN CT Subdivision: LAKE TERRACE NO.2 Lot: 21 Project: SITARA Project Description: 147 sq. ft.addition to the east side of house and adding bathroom and laundry room to garage. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: First: 205 sf Basement sf Left: 5 Parking Spaces: Height: 26 Bathrooms: 1 Second: sf Garage: sf Front: 20 Smoke Dwelling Units: 1 Third: sf Right 5 Detectors: No Total: 205 sf Value: $23,093.25 Rear: 15 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 1 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 4 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: 3 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-3 205 Owner: Contractor: SITARA,SUNITA LIVING TURST JAMES QUINN CONSTRUCTION LLC Required Items and Reports(Conditions) 12275 SW ANN CT 52167 SE 8TH STREET TIGARD,OR 97223 SCAPPOOSE,OR 97056 PHONE: PHONE: 503-481-8002 FAX: Total Fees: $1,524.72 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. A • a.• Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-1: -0010 through•AR 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.x344. I -ued By: /_ 7i_I��I� _` Permittee Signature: Call 503.639.4176 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 LT (1, a Residential I OR 01 r1( ►. I ',I OyI_1 City of Tigard F . /c/ 7 i( A'T' PermitNo.:1111 • 13125 SW Hall Blvd,Tigard,OR 97223 ew 1!L+ (Y _ Phone: 503.718.2439 Fax: 503.598.1960 ° ' l Date/By: 1 11 Other Permit: Ins Inspection Line: 503.639.4175 Date Ready Q Juris: BI See Page 2 for T I(;n E:1� p t ,r}1 Notified/Method:/p� P7 if Supplemental Information • Internet: www.tigard-or.gov Cla04,-- 4 D�--s1 TYPE OF WORD.,�i %1 11 REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑DemolitioAl Permit fees*are based on the value of the work performed. El New constructions ' , Indicate the value(rounded to the nearest dollar)of all ®Addition/alteration/replacement ❑ 1 icAO equipment,materials,labor,overhead,and the profit for the CATEGORY OF CO x ;' work indicated on this application. Valuation: .02/060---.R 5 — ® 1-and 2-family dwelling ❑Commercial/industrial Number of bedrooms: 3 0 Accessory building ElMulti-family 0 Master builder 0 Other: Number of bathrooms: 2.5 JOB SITE INFORMATION AND LOCATION Total number of floors: 1 Job site address:12275 SW Ann Ct. New dwelling area: /. square feet City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet Suite/bidg./apt.no.: Project name:Sitara Addition Covered porch area: square feet Cross street/directions to job site:SW 121' Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot no.: 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. Add 21'X 7'addition to the East side of the house and add 1/2 bath and laundry Valuation: $ Existing building area: square feet to the garage New building area: square feet 0 PROPERTY OWNER 0 TENANT Number of stories: Name:Sunita Sitara Type of construction: Address:12275 SW Ann Ct. Occupancy groups: City/State/ZIP:Tigard,OR 97223 Existing: Phone:(503)941-9806 Fax:( ) New: Ell APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name:James Quinn Company LLC Structural plan review fee(or deposit): Contact name:Aaron Lothrop FLS plan review fee(if applicable): Address:52167 SE 8th Street 15 5 3) y�O Total fees due upon application: b City/State/ZIP:Scappoose,OR 97056 Amount received: Phone:(503)481-8002 Fax::( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail:Aaron.JQC@gmaii.com Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name:James Quinn Comstruction Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:52167 SE 8th Street Solar Installation Specialty Code checklist. Permit Fee(includes plan review $180.00 City/State/ZIP:Scappoose,OR 97056 and administrative fees): Phone:(503)481-8002 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:207465 '/q//7 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Date:10-24-2016 *Fee methodology set by Tri-County Building Industry Print name:Aaron Lothrop Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application l OR()F► ►( I. ► til ()NI ' City of Tigard Received Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Pian Review N . Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: I) Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPEOF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ 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 0 Master builder 0 Other: Description Qty. . Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: . Z2 5� Air conditioning 1 46.75 Job site address S ,4hh G+- Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,Oregon 97223 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 1 23.32 Cross street/directions to job site:SW 121st Near Walnut 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 Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OR WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas Move AC Unit, Extend Gas Line, Modify Duct Work Venting fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 og PROPERTY OWNER IDTENANT Other: 23.32 Environmental exhaust and ventilation: Name:Sunita Sitara Range hood/other kitchen equipment 33.39 Address. j 72.-7 S tv 41,A t f . Clothes dryer exhaust 1 33.39 City/State/ZIP:Tigard, Oregon 97223 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 1 23.32 Phone:(503)941-9806 Fax:( ) Attic/crawlspace fans 23.32 0 APPLICANT +.1 CONTACT PERSON Other: 23.32 Fuel piping: Business name:Metro HeatingCooling and Mechanical Services $14.15 for first four;54.03 for each additional Contact name:Bill Ford Furnace,etc. 4 Address:13810 SW 100th Ave Gas heat pump Wall/suspended/unit heater City/State/ZIP:Tigard, Oregon 97223 Water heater Phone:(503)680-0471 Fax::( ) Fireplace Range E-mail:metroheating@comcast.net Barbecue CONTRACTOR Clothes dryer(gas) Business name:Ford Foundation LLC I Metro Heating Cooling Other: MECHANICAL PERMIT FEES* Address: /3 it/ o►w MOIL- L Subtotal City/State/ZIP:_.-/-1,,q 7)I.6 A 77-2-3 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)680-0471 Fax:( ) State surcharge(12%of permit fee) CCB lic.:202269 3/!I(f( TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 r days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name:Bill Ford Date:9/12/2016 I:\BuildingWermits\MEC PermitApp 040113.doc 440-4617T(11/02/CWM/WEB) Electrical Permit Application FOR OFFICE l SE oNL1 City of Tigard Received r� `J Date/By: Permit No.: v)sra.�it,L1D/� I3125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ` A r vv 'I Phone: 503.718.2439 Fax: 503.598.1960DateBy: Other Permit: ` T I G A R D Inspection Line: 503.639.4175 Date Ready/By: auris: H See Page 2 for Internet: wt W.tigard-or.goy Notified/Method: Supplemental Information E OF �Add ionlalteratOonR/replacement PLAN REVIEW ❑New construction Please check all thatapply(submit 2 sets of plans w/items checked below): ❑ ❑Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition Other: where the available fault current 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 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for alt other installations. buildings. ❑Multi-family ❑Master builder 0 Other. 0 Fire pump. 0 Installation of 75 KVA or ]OB Ste IIVFQRMATIOAI A 1D LOCt1TiON. ❑Emergency system. larger separately derive, system 0 Addition of new motor load of 0'"A","E","1-2,,"13,., Job no.: Job site address:) �')5 S w ANA C } 100HP or more. occupancy. 2 1]Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP: I C t,.../2 0 P 9'-72 2 3 ❑Health-care facilities. 0 Supply voltage for more than J ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name:St'kid is. A,Q r-.i.,.n 0 Service or feeder 600 amps or more. FEE:SCHEDULE Cross street/directions to job site: f ( 5�' Description I Qty. I Fee. 1 Total I R New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 7 Tax map/parcel no.: Limited energy,residential Disc R 'ITOhi'OF WOR (with above sq.ft.) 75.00 2 /� 1 , Limited energy,multi-family f-�C e i I'l S r vt``^j b,A QUI t1,-(V S \-}O d\C.l,,/ r�-t'c),- residential(with above sq.It) 75.00 2 Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 0,PROPERTY OWNER [] TENA201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: (_ -7 S „J iUo C. Over 1,000 amps or volts 552.26 2 City/State/ZIP: .7. ;.�uv d (9(A -7 11-3 Temporary services or feeders installation,alteration,and/or relocation Phone:(SO 3) C-% / -a?,�(.2 b Fax:( ) 200 amps or less 59.36 1 Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Branch circuits—new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with ❑ Ak, CAN above service or feeder fee, CQNTACT"PERSON each branch circuit 7.42 2 Business name: B.Fee for branch circuits without l 1 service or feeder fee,first I 56.18 2 M Contact name: ;44,f0 v. (t,1 1+,,vr� branch circuit Address: 59_1 �� �y Each add'l branch circuit Z 7.42 2 �l 4 b Miscellaneous(service or feeder not included) City/State/ZIP: (� r Each manufactured or modular ty 6 t ,v,, l d 12. Ct'7 ce7 dwelling,service and/or feeder 67.84 2 Phone:( 7_C3) L 1( - O o Z Fax::( ) Reconnect only 67.84 2 E-mail 4_4_014<I." ,, 5 L. e._t/v�y f ( Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 CONTRACTOR • . Signal circuit(s)or limited-energy Business name: 'tin` t'ry panel,alteration,or extension. Page 2 2 C i� (Pf sl Each additional inspection over allowable in any of the above Address: Po /y as Additional inspection(I hr min) 66.25/hr City/State/ZIP: �� ��l�Q Investigation(hu min) 66.25/hr na�`� r ,Q Ds Industrial plant(14r min) 78.18/hr Phone:( ) Fax:( ) Inspections for which no fee is 9000/hr /� �/ /7 // specifically listed(t4 hr min) CCB Lic.: ea �y t Electrical Lic.: r 111P 1 Suprv.Lic.: Z/3/s - ELECrRICAL PERMIT;FEES /_ / Subtotal: Suprv.Electrician signature,required: prtegI,'/'� BI 'I l y Plan review(25%of permit fee): Print name: Date: State surcharge(12%of permit fee): TOTAL PERMIT FEE: Authorized signature: This permit application expires if a permit is not obtained within 180 Print name: days after it has been accepted as complete. Date: * Number of inspections allowed per permit. 1:\Building\Pmnits\ELC-PermitApp.doe 07/01/10 440-4615Tp1/05/COM/WEB Plumbing Permit Application Building Fixtures FOR OFFICE t SE OVA City of Tigard Received q 13125 SW Hall Blvd.,Tigard,OR 97223 Plate/By: Permit No.: �v'Ttt/ c W y; f� S Phone: 503.639.4171 Fax: 503.598.1960 Plan Review T i u l� Inspection Line: 503.639.4175 Date/By: Other Permit No.: Internet: Line:igard-or.gov Date Ready/By: tuns: See Page 2 for Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE 0 New construction 0 Demolition For special information use checklist Description Qty. Ea. Total El Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 50032 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: I 7s 5 b,/ 6 Catch basin or area drain 18.76 r< City/State/ZIP: TlSt,„/z 0 a 4 7 273 Drywell,leach line,or trench drain 18.76 1 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name:e-,i c(�o v.;J f Manufactured home utilities 50.03 - Cross street/directions to job site: )1,1 s1-1 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 AAClothes washer I 25.02 C, G✓ [rn5Y- '0/ ' Dishwasher / 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 jI PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: 5 J`,i F, S( «r Fixture/sewer cap 25.02 Address: $Z 7 Floor drain/floor sink/hub 25.02 5 5w A' " 6,f City/State/ZIP: 1 0 2 1 Garbage disposal 25.02 ai2 1 � � Hose bib 25.02 Phone:(503) .(i _ 4c-Ot7 Fax:( ) Ice maker 12.51 iAPPLICANT VI CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Contact name: `'0.1 �,.-,1(1✓jG Primer 12.51 Address: j�+v�y J 5 y) Roof drain(commercial) 12.51 Sink/basin/lavatory 25.02 City/State/ZIP: 7C((� ( 0/2 C, '0+ / C Solar units(potable water) 62.54 Phone:(,j©3) y i (- i-002,, Fax::( ) Tub/shower/shower pan 12.51 E-mail: 4cvov, J C9(_. on9 i t C o-1/4" Urinal 25.02 C6NTRACTOR Water closet ' 25.02 • Water heater 37.52 Business name. (L\:\USS \�ie ic\ Co Water P t in V P P/DWV 56.29 Addres _"It..c, _c_1 Other: 25.02 City/State/ZIP. ` VGX��.. Vc° /[� til/V� Subtotal Phone:4�`Z i I C Fax lq�w IQ�' Minimum permit fee: $72.50 CCB Lic..-: 1 $I 4. Plumbing Lic,no Z'3 Plan review (25%of permit fee) State surcharge(12%ofpermtt fee) Authorized signature: TOTAL PERMIT FEE Print nate ed ' ,es cos td S Dat9,/ f j(::, This permit application expires if a permit is not obtained within 180 days C•� "� Qin/ after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:1Bailding\Pe mits‘PLMU-PmnitApp.doe 10/01/09 440-4616T(10/o2/COM/wEB) City of Tigard 1114 'I COMMUNITY DEVELOPMENT DEPARTMENT T 1 c A R D Building Permit Review — Residential Building Permit #: 175 7-020 1[e oC)`iLM Site Address: /' '29-c 5260 - Project Name: sgI=Fire d(;WlbJSv"-- Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: /S-A Sg 4 d.fK)yt V' Verify site address/suite# exists and active .` permit system. d UJi(liver Terrace Neighborhood: l! No ❑ Yes,See River Terrace Review Addendum Attached Si9g Plan Elements: Vree(3)copies of site plan 9f" 'sting structures on site e plan must be on 8-1/2"x 11"or 11 x 17"paper 74 Footprint of new structure(including decks)with finished V awn to scale(standard architect or engineer scale) floor elevations orth arrow J ty locations (required for new,may apply for additions) e address,project or subdivision name and lot number OIt Io•cation of wells/septic systems .plicant information(name and phone number) V xisting trees to be retained with drip line,and tree IPt•t dimensions and building setback dimensions •rotection measures i!lig e t area,building coverage area,percentage of coverage and `e eet tree size,type and location ;Impervious area(applicable if R-7,R-12,R-25&R-40) T Street names Property corner elevations (2 foot contour lines if more than oot differential) 4 ) Clean Water ervices—Service Provider Letter(lot platted prior to 9/10/1995): Required: rtYes,applicant was notified ❑ No Received: Yes ❑ No I 'ublic Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified V No Applied For: ❑ Yes ❑ No,stop intake eland Use Case#: cii,Zoning: ,e-' Li_ vor Required Setbacks: Front Q() Rear /5' Side Street Side Garage ,2(: Landscape Requirement: cyo 11 °1 of Coverage Maximum: % ke04ch— j q Building Height: Maximum Height 30 Actual Height P)'/S7j/l fl' isual Clearance F14° asements SII Sensitive Lands: V(Yes ❑ No Type rOS 'i/r7lie an,iC'/11, iI)rban Forestry Plan lc .conditions "Met"prior to issuance of building permit Notes: Approved By Planning: �_ -� ii, .� Date: /0 �•- 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\BldgPermitRvw_RES_091216.docx Building Permit Submittal Original Submittal Date: t ilPPU Site Plans: # 3 Building Plans: # 3 Building Permit#: [ - it building permit#above. ,� ���� Workflow Routing: lanningneering 1'ernut Coordinator tricilding Workflow Sign-off: 13-51n-off for Planning(include notes from planning review) Route Application Documents: [ - gineering: (1) copy of permit application, (1) site plan, (1) building plan and ori al plan review routing form. wilding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: _..ice as Date: /OA Engineering Review Slope at building pad: It\ 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: ,ez_ '7 Date: / - ---(.4 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: Revison Notice 3: Date Sent to Applicant: r),Fees Entered: Wash Co Trans Dev Tax: ❑ Yes /A Tigard Trans SDC: ❑ Yes N/A Parks SDC: El Yes �N/A /leOK to Issue Permit Approvedby Permit Coordinator: 4 Date: //////0' I:\Building\Forms\BldgPermitRvw_RES 0912 16.docx / City of Tigard IIIICOMMUNITY DEVELOPMENT DEPARTMENT ■ i_ ;,�1,l� Building Permit Review — Residential Building Permit #: n57-.2.0/1rT L 1f itoi Site Address: j4;Q9-C- S2j ) i9 2 - Project Name: SjgiMpy ..__ Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: /CS SZ 94 �qi bn Verify site address/suite#exists and active permit system. truer Terrace Neighborhood No 0 Yes,See River Terrace Review Addendum Attached Site Plan Elements: Oyhree(3)copies of site plan V 'sting structures on site re e plan must on 8-1/2"x 11"or 11 x 17"paper 'r.Footprint of new structure('including decks)with finished awn to scale(standard architect or engineer scale) floor elevations Orth arrow `1's:'ty locations(required for new,may apply for additions) Oe address,project or subdivision name and lot number ! .% ation of wells/septic systems CV plicant information(name and phone number) 7 sting trees to be retained with drip line,and tree IPL.t dimensions and building setback dimensions .rotection measures J, ri t area,building coverage area,percentage of coverage and i`t eet tree size,type and location imperpervious area(applicable if R-7,R-12,R-25&R-40) .T Street names vious corner elevations(2 foot contour lines if more than 1 4/foot differential) 1 Ur Clean Water yervices—Service Provider Letter(lot platted prior to 9/10/1995): Required: V Yes,applicant was notified ❑ No Received: Yes 0 No • ( 1ublic Facilities Improvement(PFI)Permit: Required: 0 Yes,applicant was notified V No Applied For. 0 Yes 0 No,stop intake tad Use Case#: CAI/Zoning: E— 1), Required Setbacks: Front Qv Rear /5 Side Street Side rage 2c) Landscape Requirement: II '' .t Coverage Maximum: % MOkA- 1► Building Height: Maximum Height _ Actual Heighthl_./ m-e r ' isual Clearance L t/4' asements ' Sensitive Lands: L/Yes 0 No Type Ovs )&elkozi an,74,- gikrban Forestry Plan fO.RConditions"Met"prior to issuance of building permit Notes: Approved By Planning: -- S--; - Date: /0 . i Revisions(after Building Submittal only) Reviewerte Revision 1: A Approved 0 Not Approved M p n I' - (311 cD 6.624 AA 7/11/0 Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved I:\Building\FonnslBldgPennitRvw_RES 091216.docx Building Permit Submittal Original Submittal Date: l 1�7/�(J Site Plans: # 3 Building Plans: # 3 Building Permit#: Z1,<n,,ser building permit#above. ,�� �, - Workflow Routing: Tanning a eering -ger :mit Coordinator Q Building Workflow Sign-off 121-5 gn-off for Planning(include notes from planning review) Route Application Documents: Ig--Engineering: (1)copy of permit application,(1) site plan,(1)building plan and orig}nal plan review routing form. 6,'uilding. original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: VOL By Permit Technician: IIIIL »r,`_ _ Date: / s► Engineering Review Slope at building pad: 14\ 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: 0 Yes 0 No Assess Water Quantity Fee in-lieu: ❑ Yes 0 No LIDA Facility on lot 0 Yes 0 No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: 1'l2.. /2 Date: /— _ -‘,._‘t4'• '— Revisions(after 'ding Submitt.:.:4:,; 1)7"..p Date 744.-/7 Revision 1: Approved r's- of Approved Revision 2: 0 Approved ■ Not Approved Revision 3: 0 Approved 0 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 r,c Fees Entered: Wash Co Trans Dev Tax: 0 Yes ion Tigard Trans SDC: ❑ Yes N/A Parks SDC: 0 Yes Pr'N/A OK to Issue Permit I/ 14/9-- , Approved Permit Coordinator: Date: i �1/f 0 by / I:\Building\Fonns\BldgPennitRvw_RES 091216.docx A Albert Shields From: Albert Shields Sent: Wednesday, July 19, 2017 5:05 PM To: Steve Martin Subject: Shed intrusion into greenway. Attachments: Shed Site 12275 SW Ann - 07-19-2017.pdf Steve, while we were reviewing a building permit application for the owner of 12275 SW Ann Ct. we noticed that there appears to be a shed or small building set on the rear property line and possibly intruding into the Jack Park Greenway. We don't have a complaint on this so we aren't planning any enforcement action but I thought I'd forward this to you to see if you wanted to verify whether there actually is an intrusion and whether you wanted us to open an enforcement case. If it is an intrusion and you want us to act we'll be happy to try to get it moved, or, if it is an intrusion but Parks is OK with it being there we could direct the homeowner to get an Encroachment Permit. Homeowner is Sunita Sitara, 503-942-9806. Albert Shields. City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12275 SW ANN CT, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2016-00442 Inspection Type: Inspector: 299 Final inspection Allyson Armstrong Result: PASS - NoCofO Comments: Correction complete Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12275 SW ANN CT, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2016-00442 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS Comments: Violation Summary: Inspector Contractor