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Permit (42) w CITY OF TIGARD :., *11.FRMASTER PERMIT II S /,f Permit#: MST2017-00443 � �' COMMUNITY DEVELOPMENT 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/07!2017 Tt �"�-R• � 9 Parcel: 2S110DD10600 Jurisdiction: Tigard Site address: 10940 SW HIGHLAND DR Subdivision: SUMMERFIELD NO.6 Lot: 322 Project: HAYWOOD Project Description: Remodel of(2)bedrooms, (2)bathrooms, new gable end wall, and add 11 sq.ft. bay window addition to living room. 2/5/2018: REPRINT to add 72 sf covered patio. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 2 First: 11 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 24 Bathrooms: 2 Second: 0 sf Garage: 0 sf Front: 0 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Total: 11 sf Value: $75,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF RainStorm Sewer: 0 0 Drains: Heaters: Catch Basins: 0 Tubs/Showers: 0 Garbage Disp: 0 Water0 Water Lines: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 11 Owner: Contractor: HAYWOOD,CHARLES W 1991 REVOCAEJ CHAVEZ DESIGN BUILD Required Items and Reports(Conditions) WIEST-HAYWOOD,G 1999 1327 SE TACOMA STREET#180 REVOCABLE TRU PORTLAND,OR 97202 10940 SW HIGHLAND DR TIGARD,OR 97224 PHONE: PHONE: 503-833-2433 FAX: Total Fees: $1,801.19 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 t ough OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.198 r 1.800.332.2344. r Issued By: /7 Permittee Signature: ri� � ��... , 3. 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. 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 III Transmittal Letter T i c;,\]z n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Tc;rel141,c114r-viie-r- DATE .. ` DEPT: BUILDING DIVISION CC ' 9 2G FROM: fr\ 4— JJOb�UNrl $:.;;)'1411-1:(3`GF'2‘ 1 COMPANY: - Uk Qevyt <E111/64 ��i � ' PHONE: �- SYS--- 9qa By: RE: 109P ) 1-17#1-17#L4/1 4- r451--7,011-r451--7,011- OO (1- 'Lig (Site Ad ess) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s)of plans. Revisions: FOY& figArtt?Jrt 3 Cross section(s) and details. Wall bracing and/or lateral analysis. ?✓ Floor/roof framing. Basement and retaining walls. 7 Beam calculations. Z Engineer's calculations. Other(ex_plain): REMARKS: ift14'131• f3 (.1 t D C(lye/ FOR OFFICE USE ONLY Routed to Permit Te ician: Date: J- 3Q - ) t. Initials: -4' Fees Due:/j Y s u No Fee Description: Amount Due "`� • c H Y 1a 4.`\ Yev ,c....._ $ 11- -- $ $ $ Special Instructions: Reprint Permit(per PE): 1Yes [ No Ione Applicant Notified: Date: 02/S-AInitials: /14, I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 CITY OF TIGARD MASTER PERMIT . ., COMMUNITY DEVELOPMENT Permit#: MST2017-00443 Date Issued: 12/07/2017 T P GA1 T) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110DD10600 Jurisdiction: Tigard Site address: 10940 SW HIGHLAND DR Subdivision: SUMMERFIELD NO.6 Lot: 322 Project: HAYWOOD Project Description: Interior remodel and 11 sq. ft. bay window addition to living room. Remodel will include(2)new bedrooms, (2) new bathrooms, and(1)new gable end wall. The total number of bedrooms will be BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 11 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 24 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 11 sf Value: $75,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 11 Owner: Contractor: HAYWOOD,CHARLES W 1991 REVOCAEJ CHAVEZ DESIGN BUILD Required Items and Reports(Conditions) WIEST-HAYWOOD,G 1999 1327 SE TACOMA STREET#180 REVOCABLE TRU PORTLAND,OR 97202 10940 SW HIGHLAND DR TIGARD,OR 97224 PHONE: PHONE: 503-833-2433 FAX: Total Fees: $1,756.19 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 rul- ••-stions to OUNC by calling 503.232.1987• 1.800.332.2344. Issued By✓v ,i ._ _ - __---.0._— 4311,_:L_ _ Permittee Signature: -- =rcr'" 13.639.4175 by 7:00 a.m.for the next available inspe -•n 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 Residential FOR OFFICE USE ONLY City of Tigard Received a- e �. Date/By: Il/3/17 Permit No.: �^ )1 11 13125 SW Hall Blvd.,Tigard,OR • y _ '�l�# m jt J a Pian Review, ! IN _ Phone: 503.718.2439 Fax: 503.5':.''.. �'° "� Date/By: 1�-p—II Other Permit: i 1 G A It ll Inspection Line: 503.639.4175 Date Ready/By:/ Juri 0 See Page 2 for Internet: www.tlgard-or.gov N O�; 8 ?_017 N. `ed Method: Ip�/ / Supplemental Information curommink . ,,,, TYPE O 't 1 1�" fREQUIRED ' ...,,x :2-FAMIL'DWELLING ' 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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORYOF p work indicated on this application. ,,1111 ®1-and 2-family dwelling ❑Commercial/industrial Valuation: $75,000 ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: `' ,JOB IT OR ON`�O LOCATION : Total number of floors: Job site address:10940 SW Highland Dr New dwelling area: 11 square feet City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: j „01,.41.1 Covered porch area: square feet Cross street/directions to job site: ') "l/-} re ; square feet 4)7 1A5. 1'0,11 p 5-l- .i I..t /q-717-4,- ' other rOstru�ctu�ieararea: (i 0 square feet CyZ tJ w4-7Di Sigv 72 s re#-71,�f . R QUI D T }O. :, . S CH � Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: r Lig 6 5-6— Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the ' D I i ,1, F work indicated on this application. Remdodel of existing residence including bedTbooms,bathr oms,kitchen,and Valuation: $ living space.Includes new gable end wall and bay window.Only addition to Existing building area: square feet habitable area isnew bay window. t,){, ;-", (3 4 J /. h,3; New building area: square feet D PROP RTY•O M S ANT Number of stories: Name:Gail Haywood Type of construction: Address:10940 SW Highland Dr Occupancy groups: City/State/ZIP:Tigard,OR 97224 Existing: Phone:(408)420-4776 ! Fax:( ) 1 ` c14I . .. ��...» ... ,. .... �CO�'I'�t[�"PZIS`it� .;r New: tnEA "I"VtLt"'* -00 Business name:.1-Chavez Design Build ...lPtrixel"er � - Structural plan review fee(or deposit): Contact name:Matti Sjoblom Address:1327 SE Tacoma St.#180 FLS plan review fee(if applicable): City/State/ZIP:Portland,OR 97202 Total fees due upon application:45'7(;M5/ Phone:(503)545-9906 Fax::( ) Amount received: E-mail:matti@jchavezdesign.com PHOTOVOLTAIC ' � : ST F E *+ °._ : O'1' rte,T'4)R Commercial and residential prescriptive installation of er p Business name:J- a.,• .U: ..,. Lm = roof-top mounted Photo Voltaic Solar Panel System. Chavez Design Build Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:1327 SE Tama St.#180 Solar Installation Specialty Code checklist. City/State/ZIP:Portland,OR 97202 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)833-2433 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:196352 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. Print name:Jacob Ch ez Date: 11/8/17 *Fee methodology set by Tri-County Building Industry _ Service Board. I:\Building\Permits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB) City of Tigard III I ' COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Building Permit Review — Residential Building Permit #: /-375y-Roi _coWz"3 Site Address: I O6i9 0 SQ I h land Dr, Project Name: ,f4 ay wood Lot #: (New dwelling=,ubdivision name;Addition or Alteration=last name of owner) Planning Review � Proposal: Rtr'4&i --exis-4114""'j S F R t„//. 1-erfor Wa'r Verify site address/suite#exists and activy in permit system. Nfj River Terrace Neighborhood: V No ❑ Yes,See River Terrace Review Addendum Attached S.ie Plan Elements:Cllyh1 ree(3)copies of site plan LL xisting structures on site [ Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished Vpiyawn to scale(standard architect or engineer scale) >Yoor elevations orth arrow U,( ty locations&easements(required for new and additions) [to address,project or subdivision name and lot number °y��tdewalk/driveway approach pplicant information(name and phone number) ,ocation of wells/septic systems Y Lot dimensions and building setback dimensions pip,xisting trees to be retained with drip line,and tree titSquare footage of buildings to be demolished rotection measures VLot area,building coverage area,percentage of coverage and treet tree size,type and location ,rapervious area(applicable if R-7,R-12,R-25&R-40) Street names B‘ 1 roperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? ❑Yes [ o 4 foot differential) If yes,is a storm water quality facility shown? VA❑Yes ❑No Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):Required: V Yes,applicant was notified CINo Received: es No VA Public Facilities Improvement(PFI) Permit:f 417/1 11 T +��Required: 1:1 Yes,applicant was notified 0 N Applied For: CI Yes ❑ No,stop intake !'! Land Use Case#: ,_../ zoning: 1K-7- L PV L Required Setbacks: Front IS Rear 1 S Side Street Side VA Garages Iitty ft7YLandscape Requirement: Ltd % M/Lot Coverage Maximum: 30 oo Building Height: Maximum Height `35 Actual Height 13 p,,_7,/Visual Clearance Et/ L'✓.! Sensitive Lands: CI Yes Lt" No Type 1(/* Urban Forestry Plan aConditions "Met"prior to issuance of building permit Notes: Approved By Planning: igisq,k CiAN. Date: 11—P 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 061417.docx Building Permit Submittal Original Submittal Date: f//f/7 Site Plans: # -3 Building Plans: # 3 Building Permit#: Center building permit#above. �- Workflow Routing: ['nning C - KI "Vngineering - 1'ermit Coordinatoruilding Workflow Sign-off: -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. ding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: —•' ..ci- Date: ///q//7 Engineering Review Slope at building pad: 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: ,4 /7 Date: -- 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: DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A Tigard Trans SDC: ❑ Yes N/A Parks SDC: ❑ Yes N/A LIDA ❑ Yes N/A OK to Issue Permit ,,._,/ Approved byPermit Coordinator: � '1/VJr "ate: 1)I 1.31 PP I:\Building\Forms\BldgPermitRvw_RES 061417.docx Clean Water Services File Number CleanWater Services 17-003938 Sensitive Area Pre-Screening Site Assessment 1. Jurisdiction: Tigard RECEIVED 2. Property Information (example 1S234AB01400) 3. Owner Information Tax lot ID(s): Name: Gail Haywood Cir(, 7 2017 2S110DD10600 Company: p py�� Address: 10940 SW Highland Dr CITY OF A IGARD Site Address: 10940 SW Highland Dr City, State,Zip: Tigard,OR,97224g� y 1 � �� City,State,Zip: Tigard,OR,97224 Phone/Fax: 408-420-477611L� Nearest Cross Street: Summerfield Dr E-Mail: gailhaywood4@yahoo.com 4. Development Activity(check all that apply) 5. Applicant Information 4Q Addition to Single Family Residence(rooms,deck,garage) Name: Matti Sjoblom-Chambers ❑ Lot Line Adjustment ❑ Minor Land Partition Company: Chavez Design Build ❑ Residential Condominium ❑ Commercial Condominium Address: 1327 SE Tacoma St.#180 ❑ Residential Subdivision ❑ Commercial Subdivision ❑ Single Lot Commercial City, State,Zip: Portland,OR,97202 9 ❑ Multi Lot Commercial Other Phone/Fax: 503-545-9906 E Mail: matti@jchavezdesign.com 6. Will the project involve any off-site work? ❑Yes la No ❑Unknown Location and description of off-site work 7. Additional comments or information that may be needed to understand your project Existing house that we are remodeling.Additional front bay window and concrete patio are only affect to site. This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/Type Name Matti Sjoblom-Chambers Print/Type Title Designer ONLINE SUBMITTAL Date 12/5/2017 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. U Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 17-05, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,State,and federal law. XBased on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20,Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law. U This Service Provider Letter is not valid unless CWS approved site plan(s)are attached. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed by Date 12/7/17 2550 SW Hillsboro Highway • Hillsboro,Oregon 97123 • Phone:(503)681-5100 • Fax:(503)681-4439 • www.cleanwaterservices.org '1301P.:1' 0 4 CD • § m ! _�� I �0 IA1 11 I kl y� -L 1 HIGHOOR $'a „„ ,,,, / 8,..wALK , .,. q _ / / 1,.. I ,,/$ .... t r 1 3 ` _ .... 1 _ _ _ , _ 1 t 9 / ' / SETBACK' tbei, a 1.,,” 41, . ,- -----74;1 1 �/T� r e7,4 l 3t10" ��i i jy� / 1 ii //II 1 G //,',,, ', / 1 r�i��r � /// $I r / I . 8 I ' ' ;, 4/ /A? $ �, ' Az' , �//' i„4-/ i,41 i , - / ; Dem ' l,/,'_„,_-_-_,;-.L.--„„--„1_''_'1:%;-._'_';F / - m b lfw„ 'i I eCONC Fno 41p• i ---_I l / r„ * // / GOLF COURSE Et Gail Haywood Ha wood Remodel J-CHAVEZ 10940 SW Highland Dr N , Tigard,OR 97224 10940 SW Highland Dr DESIGN BUI6L2D ro 7,11 d,CR 97202 www.jchavezdesignmm Sheet Contents: CCB#196352 jacobQjchavezdesign.com FOR OFFICE USE ONLY-SITE ADDRESS: /D , 4!6 SLS t 7& Gf 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 IN " Transmittal Letter T l(i A It l•} 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVEr NOV 2 2 2017 FROM: Matti Sjoblom ITY Of- RGMI COMPANY: J-Chavez Design Build BUILDING DIVISION` PHONE: 503-545-9906 By: RE: 10940 SW Highland Dr, Tigard, OR 97224 M ST 2017 - 004 4j3 • (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: 2c Cross section(s) and details. Wall bracing and/or lateral analysis. 7K Floor/roof framing. Basement and retaining walls. "c Beam calculations. Engineer's calculations. Other(explain): REMARKS: 3 FOR OFFICE USE ONLY Routed to Permit Technician: Date: ).- 30 - /7 Initials: 4 Fees Due: ❑ Yes N Fee Description: Amount Due: Special Instructions: Reprint Permit(per PE): ❑ Yes 1 I; No ❑ Done Applicant Notified: 7r. /,_______ Date: Wcii-) Initials: 1--de _ I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 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 _ al 104 Transmittal Letter 1 c,n R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: 1:-;et titt,6W&r- DATE ' E4 twit 1 ,. ,, DEPT: BUILDING DIVISION JAN 9 2t, FROM: Ma-1-14 S (C7►"n. O 'TG1 ,, • ' _ 'LDINGMit COMPANY: 1-- Uttfxv&z, 015 1 <ko UL By: _ PHONE: �-- 3 c{5-- 9QBIo its#7�I?- yy RE: 1ite ' .. e �� ' - (Permit Number) IV (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: I)/ Copies: Descriptions C r Lies: Description: Additional set(s) of plans. / Revisions: Face 'F,4rtr►Jy 3 Cross section(s) and deta. . ! Wall bracing and/or lateral analysis. ?✓ Floor/roof framing. r . ' Basement and retaining walls. 7 Beam calculations. ` Z Engineer's calculations. Other(ex_plain): REMARKS: "'• p `'i'it) J C c-v e✓ FOR OFFICE USE ONLY Routed to Permit Te cian: Date: )— 3 ) Initials: -�' Fees Due: Yp c u No Fee Description: Amount Due • p 4-"N Ye V $c,� $ ti-- --- �` $ $ $ Special Instructions: Reprint Pe • (per PE): 211Yes El No 1J Done Applicant otified: Date: Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 City of Tigard COMMUNITY DEVFI OPMENT DEPARTMENT ■ T 1 G A R D Building Permit Review — Residential Building Permit #: f-Pis).-Roi 7_cDri4 3 Site Address: 10'19 0 SUI I h laid Pr, Project Name: ,J4aywood Lot #: (New dwelling=tubdivision name;Addition or Alteration=last name of owner) Planning Review ll-- l 1 Proposal: I\ r titl -ex's-4,y S F12 W�el4�cf-or work 5P. ikho Carer: Verify site address/suite#exists and actio in permit system. River Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached , ,Ki Plan Elements: V. ee(3)copies of site plan sting structures on site Siteii plan must he on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished Prawn to scale(standard architect or engineer scale) ..,/•or elevations I.. orth arrow 4fA . 'ty locations&easements(required for new and additions) 7 •te address,project or subdivision name and lot number % idewalk/driveway approach 1':•pplicant information(name and phone number) 1%. .cation of wells/septic systems V Lot dimensions and building setback dimensions xisting trees to be retained with drip line,and tree V '!:.quare footage of buildings to be demolished .rotection measures N t 11 I .t area,building coverage area,percentage of coverage and -et tree size,type and location pervious area(applicable if R-7,R-12,R-25&R-40) 97 treet names � 1 Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? DYes QdNo 4 foot differential) If yes,is a storm water quality facility shown? IMO Yes ❑No -Clean Wat S rvices-Service Provider Letter(lot platted prior to 9/10/1995): ,z a Required: Yes,applicant was notified 0 No Received: es iNo Kat Public Facilities Improvement(PFI) Permit/ / (7 11/37i. Required: 0 Yes,applicant was notified ® No Applied For: 0 Yes 0 No,stop intake V.:' Land Use Case#: ' zoning: K-7- L Poi Oi Required Setbacks: Front IS Rear 15 Side Street Side VA Garage S____snit cA ',Landscape Requirement: 10 % ' Lot Coverage Maximum: 30 VBuilding Height Maximum Height ;;S Actual Height /3 140 Visual Clearance —/ , ad Sensitive Lands: 0 Yes (2 No Type (VAUrban Forestry Plan aConditions "Met"prior to issuance of building permit Notes: ] Approved By Planning: j p CDate: 11-1-1 Revisions(afterB9ikling Submittal only) Reviewer Date Revision 1: E0 Approved 0 Not Approved �.e�n t&, �� ✓r�-v"� ,-11-1)7 Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved I:\Building\Forms\B1dgPermitRvw_RES_061417.docx • rvu (it'�� Building Permit Submittal to , re-ri <,�� Original Submittal Date: 17/9/7 Site Plans: # Building Plans: # 3 Building Permit#: tenter building permit#above. ,.�, - Workflow Routing: [inning Eengineering L�YPermit Coordinator l'f"$uilding Workflow Sign-off: p...-51-off for Planning(include notes from planning review) Route Application Documents: e"Engineering. (1) copy of permit application, (1) site plan, (1)building plan and original plan review routing form. P-Ifiding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: '. IOW Date: 4°/y//7 , Engineering Review Slope at building pad: 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 0 No Assess Water Quantity Fee in-lieu: 0 Yes ❑ No LIDA Facility on lot: 0 Yes 0 No O NOT Approved by Engineering: Date: Notes: Approved by Engineering: �Z 17 Date: -- Revisions (after Bt#Iding Submittal only) Reviewer Date Revision 1: LTJ Approved 0 Not Approved E 5,5..._ /2/' is Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved ❑ Not Approved Permit Coordinator Review 0 Conditions "Met"prior to issuance of building permit 0 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 DC Fees Entered: Wash Co Trans Dev Tax: CI Yes N/A Tigard Trans SDC: 0 Yes N/A Parks SDC: 0 Yes N/A LIDA 0 Yes N/A OK to Issue Permit III/I-4 Approved by Permit Coordinator: D, , ��" / I 2 i% ill I:\Building\Forms\B1dgPermitRvw_RES 061417.docx l