Permit CITY OF TIGARD COMMERCIAL MANUFACTURED
STRUCTURE PERMIT
8:— COMMUNITY DEVELOPMENT
Permit#: CMS2017-00001
T(GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Date Issued: 09/14/2017
Parcel: 2S101 CB00400
Site address: 12700 SW HALL BLVD E Jurisdiction: Tigard
Project: Wood Trade International Subdivision: None Lot: None
Project Description: New 960 sq.ft.modular building with a new deck. UPON FINAL INSPECTION, DEMO CREDITS FROM
BUP2017-00238 WILL APPLY.
Contractor: ROBERT TODD CONSTRUCTION INC Owner: MCLELLAN ESTATE CO
4080 SE INTERNATIONAL WAY B113 BY CHRISTOPHER M CAVE ESQ
MILWAUKIE, OR 97222 707 OLD COUNTY ROAD
BELMONT, CA 94002
PHONE: 503-653-5704 PHONE:
FAX: 503-653-5729
FEES
Specifics: Description Date Amount
Type of Use: COM MH BLD Permit 09/13/2017 $275.50
Class of Work: NEW Type of Const: 12%State Surcharge-Building 09/13/2017 $33.06
Occupancy Group: MH State Admin 09/13/2017 $30.00
Stories: 0 Height: 0 ft
Project Valuation: $7,000.00
Floor Areas:
First Floor Area: 0
Second Floor Area: 0
Third Floor Area: 0
Total Area: 0
Required Setbacks:
Left: 0 Right: 0
Front: 0 Rear: 0
Required:
Parking Spaces: 0 Fire Sprinklers: Total $338.56
Smoke Detectors: Party Wall:
Required Items and Reports(Conditions)
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 2-001-0090. You ma obtain a co• of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ' rmittee Signature: L,Lc'
•�''
'3.639.4175 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.
N
Building Permit Apallic lw
Commercial
AUG 2 3
City of Tigard 2 Reeeivea r�3 /, /977---, Permit No.:('
111 13125 SW Hall Blvd.,Tigard"1 Plain Revtcw ✓�✓ " � 7.---00a)/
� �
Phone: 503.718.2439 F.a + t i(.71-kJ L:1 DatefBy: *S^.3 I—)-1 Other Permit:
Inspection Line: 503.639.•' i'�� a, S 1Il; dy y. H See Page 2 for
I'IGAIih �.� DatcRea B �/ luris:�
Internet: www.tigard-or.gov Notified/Method: ( 7/i /'� - G Supplemental Information
gg i
'i4t'rtt� ill , 1�lrt ';'1,--.1-t
,; (2':La' r
lila f: tl ,1 1III1'/ t •lit a',i 1, ';" t ,; j,I It l II a111 te.q(il :gi a „• °l 1i t !€ •,Bial F , l:i ? :;v s€tltr:, s:
� �I �1 r�OWN l,l. 2 i� :.l����� 1,V41. i. �l_ � � i - � � `:k S� � �f�� 'd t
uam �1 LRF i.Ti ,ii ,<qs q.a:ln`1x1 j` .!i =t',4` ,. .d r at� -119:
❑New construction 0 Demolition �y Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
prail �i�gt�•1#rlI1i0t ag:r! , iviig c
'ot'�1jj :1��t411 1l. work indicated on this application.
❑ I-and 2-famil Y dwellin Valuation: S
g ®Commercial/ind trial
ElAccessory building 0 Multi-family Number of bedrooms:
❑Master builder []Other: Number of bathrooms:
rIii Iai V �ig't It PIE- :7;1444:4 gillf4 1i.,..,:;„*1 14w1Ii1K .t
Total number of floors:
Job site address:12700 SW Hall Blvd New dwelling area: square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg,/apt.no.: li Project name: 1. t F I Covered porch area: square feet
Cross street/directions to job site: //t/ 1 ji, k area: square feet
Other structure area: square feet
� p� ,p l _F' K1p €t. rt+n"r?' a i� T 3'"tc t1tlS,a"i",Y`rl.itHypi pI[#QFi'I
�vfu.t,l G.c��.;.�1-c.tiS +S 1,9(0.7(.J •Ji.� l�^-�,Q !'"1GZ/�� �� �fEt a ; 't�� "'"t�">ffi�,i� iti`r14� t� � � „�€,
Itiiiitimbi aa,�elialsuili tiE hS'i.blurllalsgtglt alts FEtEni4t agitt;.,;Ll Brit x ill
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no,: Indicate the value(rounded to the nearest dollar)of all
equipment,materials>labor,
overhead,
ad,and the profit for the
[m141411111 il;'E.r ;I :1.r i„iti ,r irctrn1F"pi �"_t,, ' ii � 13 } work indicated on this application.
'eL
replace it with another modular building. i7,'valuation: $57,000.00
Both buildings are 24 x 40 feet-same size.ark/ y t
/�g ark mkt Access M Sk.�l`rt it Existing building area: 960 square feet
6C`f 1-6 lie "67d2$'"lir New building area: 960 square feet
1 r! R, o.INI �!IY.:Itllt;t tIs'i'1;1'
'1;1'lFt':11n:1111li ll 7`i '-t k r tF•i 11 •il!
��,�tN
il���� ,,,. t � �I� # a: hd � >� �a, �``.�t� ���-{ � � Number of stories: 1
Name:McLellan Estate Co - Type of construction: skirting&deck
Address:707 Old County Road Occupancy groups:
City/State/ZIP:Belmont,CA 94002 Existing: office workers
Phone:(650)232-7012 Fax:( )
New: office workerspIiii eiea 'Y'7 ph' 1t11 [�`ty1sitigyRII a ? � 1•4riiiitft kri t'av;
rit�ial rig? .p1 i t. aWU' II l( g aI. { 1Eiy1xt 19:31t :tS(lida121;Business name:McLellan Estate Co.
Contact name:Deborah McCarthy
Structural plan review fee(or deposit):
Address: FLS plan review fee(if applicable):
City/State/ZIP: Total fees due upon application: ' //711
Phone:( ) I Fax::( ) Amount received
li?t1�ti'alri� i('ii !lit7 1'lssi' t,�i+"(itl av r t%FJt,yt i q1P t�'?iFk�`�"jRtHS.,.'�r, r,
E-mail:dmccarth mecrealestate corn z n l r tiFt.5l alit i s faf�, ° t lig,i lE E "'l".t�.f
Y@ lin!t>li�:ti � u�xJt3�l ttt �itt;�tis'�rt„tr,ailt„�(ittta l=�,�€i ::.qi�t n PE il•:ra Fl#
gilt.iT #a€I E 1i sI" i lt +..ai i'a 1 l 1 1 ,
IgiR r 11x Ri? t RrC000mf-me
toprcial and residential prescriptive installation of
mounted PhotoVoltaic Solar Panel System.
Business name;Robert Todd /', f n'`� 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 of 12%surcharge g ( permit fee): $21.60
CCB lie.: 151 7
`+' �j/� Total fee due upon application: $201.60
Authorized signature: `� )(flick //" This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Lrint name:Deborah McCarthy ate: f/2.2.11/?. 7 * Fee methodology set by Tri-County Building Industry
Service
Board.
I:1Building\Permits\BUP-COM Perm /( 'itApp,doc 02/24/2011 440-4613T(11/02/COM/WEB) � /j-
k
111 ` Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS)447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $ 10000
MULTIPLIER(25%bather removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 2500
ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $ 0
(c) An accessible route to the altered area: $ 2500
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $ 2500
I:\Building\Permits\BUP-COM PermitApp.doc 03/03/2011
City of Tigard
II 111 COMMUNITY DEVELOPMENT DEPARTMENT
s
l r c Iz D Building Permit Review — Commercial - No Land Use
Building Permit #: 07j-�v/ 7— 0000/
Site Address: 12 7 p 0 Svv H 7 ,L( 131 v L Suite/Bldg#:
Project Name: biloo:t Tatou- _ eN r
ntot
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: of n ci Pe`01 G L¢,
W 1111 S G1 M� S 2t.. y o d.A.,I cn r b v i I c,( i rl
Existing Business Activity: Y1CAV AV I'►-K4A, / 1/fQo A. -olL 1 n't'ViUi t?o nck
Proposed Business Activity: V) 0 cAV-u i 9€
pr Verify site address/suite#exists and active in permit system.
VRiver Terrace Neighborhood: 0 Yes No
,g Zoning. I— L
cZ Permitted Use: k'Yes 0 No 0 Spec Space
7 Confirm no land use required.
Business License:
Exists: 0 Yes ElNo,applicant notified to obtain business license
Notes:
Approved by Planning: � � ., Date: /2 3 / I-7
Revisions (after Building Submittal only) Reviewer
Revision 1: ❑ Approved 0 Not Approved Date
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date: /„2:3//'?
Site Plans: # 3
Building Plans: # d...-,),; 4 J��,..? ,i- ,,,.2„,,,,Building Permit#: p building permit#above.
% 4j e4 j i 7'6,0 .j
Workflow Routing: 111.12.anning rmit Coordinator
Workflow Sioff: g
- � Sign- ff for Planning(include notes from planning review)
Route Application Documents: wilding. original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes: / Ad/ -, // ; : CO . r iBy Permit Technician: ,� `` J Date:
5142 trh)
I:\BuildingWorms\BldgPernutRvw COM_NoLandUse 060116.docx
Engineering Review ,,
❑ Slope at building pad:
❑ PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP)
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 0 No
Assess Water Quantity Fee in-lieu: 0 Yes 0 No
LIDA Facility on lot: 0 Yes 0 No
❑ NOT Approved by Engineering: Date
Notes:
Engineering: �. hate: 9—h.—17 by ngin ng.
Revisions (after Building Submittal only)
Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 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:
C Fees Entered: Wash Co Trans Dev Tax: 0 Yes "‘N/A
Tigard Trans SDC: 0 Yes k"/A
Parks SDC: 0 Yes ►=4 N/A
K to Issue Permit
Date: 4/ie/i
Approved by Permit Coordinator:
I:\Building\Forms\BldgPermitRvw_COM_W ithLandUse_070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12700 SW HALL BLVD E, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Manufactured Structure CMS2017-00001
Inspection Type: Inspector:
899 MFG-Structure final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor
CITY OF TIGARD; ILCOMMERCIAL MANUFACTURED
�. STRUCTURE PERMIT
IN ' COMMUNITY DEVELOPMENT
TI CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Permit#: CMS2017 00001
Date Issued: 09/14/2017
Parcel: 2S101 CB00400
Site address: 12700 SW HALL BLVD E Jurisdiction: Tigard
Project: Wood Trade International Subdivision: None Lot: None
Project Description: New 960 sq.ft.modular building with a new deck. UPON FINAL INSPECTION,DEMO CREDITS FROM
BUP2017-00238 WILL APPLY.
Contractor: ROBERT TODD CONSTRUCTION INC Owner: MCLELLAN ESTATE CO
4080 SE INTERNATIONAL WAY B113 BY CHRISTOPHER M CAVE ESQ
MILWAUKIE, OR 97222 707 OLD COUNTY ROAD
BELMONT, CA 94002
PHONE: 503-653-5704 PHONE:
FAX: 503-653-5729
FEES
Specifics: Description Date Amount
Type of Use: COM MH BLD Permit 09/13/2017 $275.50
Class of Work: NEW Type of Const: 12%State Surcharge-Building 09/13/2017 $33.06
Occupancy Group: MH State Admin 09/13/2017 $30.00
Stories: 0 Height: 0 ft
Project Valuation: $7,000.00
Floor Areas:
First Floor Area: 0
Second Floor Area: 0
Third Floor Area: 0
Total Area: 0
Required Setbacks:
Left: 0 Right: 0
Front: 0 Rear: 0
Required:
Parking Spaces: 0 Fire Sprinklers: Total $338.56
Smoke Detectors: Party Wall:
Required Items and Reports(Conditions)
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 2-001-0090. You ma obtain a co• of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued By: ->?s ••rmittee Signature:
� ess(
<03.639.4175 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.
1
4
Building Permit AplplicCE
1
Com me rcial FOR OFFICE Itch ON IN
Cityof Tigard AUG 2 5 2017 Received i...3
g Date/By: �/7 /�,✓1J Permit No.:G/�� J j 7.---00a7/
• 13125 SW Hall Blvd.,Tigard • '+r :may C
lz, Plan ttcvicw
77 Phone: 503.718.2439 F.,i. ,. ?si(i,.., Date/By: 2-3�.^)- Other Permit.
Z'I Ci A ti h Inspection Line: 503.639.•" 'I. ri f\/j,qi fl r Date Ready/By: Jj Juris: 65 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: 1 '7// Tre.. Supplemental Information
y9 r , s�F {Ck'+it , : "ki"i E Vit
�' III
qi.� i i i� E 111 I �l c1.1434[1
�1 °rIS� {E ) d�r'ipiAt 1�{t t a� •
1 �t € t1bt ExEdEEj€g�g�€ `l! tli 11 .�1,.11111 t'»t ihlts � 9nfN.�ai�fN2€."' #�;?:434[ f ft i11 i tia ,•:' 1 t 4r ir[Elyi f
P+taJ4 +7 ens q•Eli ttill itd, ..- 3 Al i..a.rt 1111 tuft
0 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 ['Other: equipment,materials,labor,overhead,and the profit for the
1 ty•1111191111111 cEaig( i , E„€ ra�t.hl3 `i4� £�+�� ryI1,14k: 1t€€Y
1work indicated on this application.
Valuation:❑ 1-and 2-family dwelling ®Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
1 i s E„{_p,,.<:¢ �} ��� #t r[a d iii•<€€ii n€4”
r i1 0114
ii: 3 1 S EE i ir�t , � i III 1' n
t( (11�•1 I 3 1 41 t { '4.It s� ,�,' t l ` �'4'1 44 ' � � � 1.ii! 1• s. Total number of floors:
Job site address:12700 SW Hall Blvd New dwelling area: square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bidg/apt.no.: li jJ Project name: j, t F l Covered porch area: square feet
Cross street/directions to job site: j:^r >L ed k area: square feet
,p Other structure area: square feet
I - 1,_ v'/ etai hili'# at{°otM"`i[[� '"nay® t�ti•€F iaIital e ua ai la'+�'l`d'� ly`IE
it till h ut gsa[tiodeafika,.lt} € mt aims:t ,a'agttfItumfwmittrot,Ito
Subdivision: 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.:
t,f equipment,materials,labor,overhead,and the profit for the
i ( E r E:9 : u :, . j { �t
t
...�_'_l I i.l il i;1111,l3l ai rli;,ki t1 tt3a s ut l B7 l I,t u'l `,i tmLgul is,{i i!ilc3i 1€:P dl i,1# Ii i1 I t t.p •i�t+ill '
i?l �ewLLork indicated on this application.
replace it with another modular building. q'1•'Valuation: $57,000.00
Both buildings are 24 x 40 feet-same size..NEW bkl,Ei•sit Ai,_ itExisting building area: 960 square feet
gut L/) ((( ,67LMi 7- New building area: 960 square feet
iflll ::;.11174.'1 ',; 16W-1111401
'N a a€, `,111 t >{ 1 i :�tYEi€rt "" 6 j a , Number of stories: 1
i � nven p' l�'1 P 1 ri1i������� �� 3}t^ 891�e'9�z� 6 1 } �:,���.I � 2 i
Name:McLellan Estate Co Type of construction: skirting&deck
Address:707 Old County Road Occupancy groups:
City/State/ZIP:Belmont,CA 94002 Existing: office workers
Phone:(650)232-7012 Fax
( ) New: office workersHtptNik' l litz . 411t 111,11IN ?INIIpIT 1 pesta,9tLgp .11 1 s g''PfH „ ,11 Y4itE” 14,
f . t �J"ms "jx4i l " r `, 'ad ' H 1 .Business name:McLellan Estate Co.
Structural plan review fee(or deposit):
Contact name:Deborah McCarthy
FLS plan review fee(if applicable):Address:
Total fees due upon application: ' /17
City/State/ZIP: r
Phone:( ) I Fes;:( ) Amount received:
4, I I •om.10M1 Ul�rr , II
E-mail:dmccarthy@mecrealestate.com tt:sui 1/1 R4';,» u,>i 1. ,ttyfri it, ;
,11,ii14�(,E` its' il� li ...' A i I t l"�="..ii F��f pup
,,,,, liltt h °� ' ; Commercial and residential prescriptive installation of
jElf dA ;MI i A' i t€, A.e,,,I, =14 , ,,4,; ,i.,,i 1,li f_• , II .4}I Mgr*d, I roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Robert Todd /,iP�f n"V� Submit two(2)sets of roof plan with connection details
J 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 lie.: `i5� 7 Total fee due upon application: 5201.60
Authorized signat+ure: /f'r ` - I/" �j�
This permit application expires if a permit is not obtained
K t d within 180 days after it has been accepted as complete.
LPrint name:Deborah McCarthy Gate: $/Z.z,//7 * Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permitsl6UP-COM PennitApp.doc 02/24/2011 440-4613T(l1/02/COM/WEB) t (r -.lv� /-Pi .'"...'
IIII ii
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS)447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $ 10000
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 2500
ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $ .0
(c) An accessible route to the altered area:a 2500
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $ 2500
I:\Building\Permits\SUP-COM PcrmitApp.doc 03/03/2011
City of Tigard
111 _ COMMUNITY DEVELOPMENT DEPARTMENT
1 ►c z D Building Permit Review — Commercial - No Land Use
Building Permit #: CM$2 )17- 000/
Site Address: 12700 S'VV I-roti(. J3 lv dL Suite/Bldg#:
Project Name: L1,l00h1 TirLk - d'/vd/vcg
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 01 n d 1e is
Wtitl' SCi SRA.. odam,Icir 1� vi ( d r15
Existing Business Activity: ►�1(%��1'1"1't -tel. , 10/Q17 A 01011_ 1 rl Vltil'1'70►'ictA.
Proposed Business Activity: 1/f 0 .p)n e.
Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: 0 Yes No
fLl Zoning. (— L
vf Permitted Use: f Yes 0 No 0 Spec Space
7 Confirm no land use required.
Business License:
Exists: 0 Yes 0 No,applicant notified to obtain business license
Notes:
Approved by Planning: Date: l 2 3 / 1-1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date: --0-3/17
Site Plans: # 3 �'- rI ale �` '.✓ if C% ,ecjz '
BuildingPlans: # % 4v; ei 1,/'` l 7-0 ?-35--
Building Permit#: ( nt'er—building permit#above.
Workflow Routing: [� - j'ng Ermit Coordinator ding
Workflow Sign-off: L'V'Sign ff for Planning(include notes from planning review)
Route Application Documents: ding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: - 1 Ai
By Permit Technician: Date: 57, /,
I:\Building\Forms\BldgPermitRvw COM_NoLandUse_060116.docx
Engineering Review
❑ Slope at building pad: 4,
❑ PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP)
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 0 No
Assess Water Quantity Fee in-lieu: 0 Yes 0 No
LIDA Facility on lot: 0 Yes 0 No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: J /late: 9 z4 /7
Revisions(after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: ❑ 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:
C Fees Entered: Wash Co Trans Dev Tax: 0 YesN/A
Tigard Trans SDC: 0 Yes A '/A
Parks SDC: 0 Yes N/A
7ig)K to Issue Permit
Approved by Permit Coordinator: Date: 4/6//
I:\Building\Forms\BldgPermitRvw_COM_WithlandUse_070915.docx