Permit (43) CITY OF TIGARD MASTER PERMIT
' COMMUNITY DEVELOPMENT Permit#: MST2017-00456
T{ AR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/03/2018
Parcel: 2S110AD 10800
Jurisdiction: Tigard
Site address: 10979 SW ANNAND CT
Subdivision: ANNAND HEIGHTS Lot: 10
Project: Annand Heights, Lot 10
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 871 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 35 Bathrooms: 3 Second: 1239 sf Garage: 340 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 2110 sf Value: $258,350.30 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
0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 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 add9 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+am -10 0 amp:601-1000 0v: 0
p p 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 2110
Owner: Contractor:
ANNAND HILL LLC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions)
BY RICHARDS,M DALE 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503-639-4175
12655 SW NORTH DAKOTA ST TIGARD,OR 97223 2 1 hour Fire Raved Eaves
TIGARD,OR 97223
PHONE: PHONE: 503-625-6526
FAX: 590-7606
Total Fees: $29,808.70
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 folk -s 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 • -s or direct questions to OUNC by calling 503.232.1987 or 1.800.33 - .
i
Issued By: - .aillliscPermittee Signature:
II °0 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.
A
III
Building Permit Application
•
ResidentialRECEIVED FOR OFFICE USE ONLY
Received f
City of Tigard Date/B : �i r -- Permit No: r 17, �L/5()
- a 13125 SW Hall Blvd.,Tigard,OR 97223 U Y 1Q�� Date/BPlan eview 411,_--
:
� ' Other S sj.A v w�j+
Phone: 503.718.2439 Fax: 503.598.19600
TIGARD Inspection Line: 503.639.4175 CITY
TIGARD
Date Ready/By: luris: 0 See Page 2 for
Internet: www.tigard-or.gov tl A!l A ® Ia 1JftFsl9 Notified/Method: I - Supplemental Information
TYPE,OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
/New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,a d the profit for Co
CATEGORY OF CONSTRUCTION work indicated on this application. ilii •
� Valuation: $ •a+-
1�1'and 2-family dwelling 0 Commercial/industrial AI
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms: , . 3
JOB SITE INFORMATION AND LOCATION Total number of floors: .
Job site address:/0/79 iQ.) 14AAand'tit/14" (O4 r-1 New dwelling area: . 6 square feet '2, '
City/State/ZIP: .77 / -ft c i-A q? - ---3 Garage/carport area: 'leg. ware feet g i
Suite/bldg./apt.no.: Project name: ,i-nn4ac/ J/CV Al Covered porch area: •
square feet
Cross street/directions to job site: s�'y Ili Deck area: lesquare feet
Other structure area: square feet
REQUIRED DATA.COMMERCIAL-USE CHECKLIST
Subdivision: thl ngAI il- '< A Lot no.: /0 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: V Indicate the value(rounded to the nearest doll4r)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this a..lication.
d. j Pia Valuation: $
��/ Existing building area: square feet
New building area: • square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: l,(, AJD o - Type of construction:
Address: 42/45.-5' 54_, Nd a„9h Daha fc, eiyrd Occupancy groups:
City/State/ZIP: 77 a ( Q')2:2-32:2-3 Existing:
79tom
Phone:4 t3 7
L/ Fax:(vp,) 5--yo---7e)4 New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Phone:( ) Fax::( ) Amount received:
E-mail: tAl1n li9QNC10'v9 14 on es N w0, a/t�-g/r Coin
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
>/ Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: 40 l l d//(!,f-5/ice Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: A-4 5"`5— (5 O /Vert 714 )O4- h- (5'4Lt f Solar Installation Specialty Code checklist.
City/State/ZIP: 7i �2 9'72,2-3 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(53) j i _ 7s Fax:( 6z3 6-9°0--zaci‘ State surcharge(12%of permit fee): $21.60
lic.: 6-0/5o/91 .. Total fee due upon application: $201.60
ure: o - _____ This permit application expires if a permit is not obtained
* within 180 days after it has been accepted as complete.
2 Qcris Datet/ 17 *Fee methodology set by Tri-County Building Industry
6 Service Board.
3UP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Applicatice Fl OFFICE USE ONLY
RECE1VEI)
ReceivedCity of Tigard Date/By: Permit No.:; o ,7_ o O ` C'
71
- . 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960Other Permit:
Date/By:
TIGARD Inspection Line: 503.639.4175 NOV 21. 2017
Date Ready/By: Juris H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
,,,%)YPE'OF >.,.. .�'�DIVISION ii I .COMMERCIAL FEE* SCHEDULE USE CHECKLIST
� f�F'
Mechanical permit fees*are based on the value of the work
ew construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
❑Demolition ❑Other:
Value:$
CATEGOII;Y-OF.;CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
j i-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
; ` ..6 3kB'STTE IIVFORMA.TION ,I,ND'LOCA'TION , : Heating/cooling:
Air conditioning 46.75
Job site address: �
f 7?/O5ci 1i,G� / 1/ Q�p J Furnace 100,000 BTU(ducts/vents)
s >.•*'''''. 46.75
City/State/ZIP: J/,are,/ Ofe /J 23 Furnace 100,000+BTU(ducts/vents) 54.91
Q '7 Heat pump 61.06
Suite/bldg./apt.no.: Project name:64 A.0 4h-Duct work 23.32
Cross street/directions to job site: 110¢ I 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: A/74 fid /71-€0h./j Lot no.: ,6 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater ./ 23.32
41..:;,,l',.4-',' DE$ - ONO RUIiK Gas fireplace/insert -�� 33.39
. _ „ _ .. , ,-
Fluewaterheater '
vent for ea er or gas
/f l/j(� 5'//� fireplace 23.32
`� Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
RO' -1- ,`g0 OWNER 0 TENANT _ Environmental exhaust and ventilation: •
Name: ®�I i�(�U � �j��5� Range hood/other kitchen
Address: �f` - 5-5" 5' KAId d 00) 1) 5 Cleqothes dryer
nt33.39
GJ /" r erre/ Clothes drexhaust .e."" 33.39
� 3 Single-duct exhaust(bathrooms,
City/State/ZIP: 6 ®Z
� 477;2'3 toilet compartments,utility rooms) 5 23.32
Phone:( 5-03 d .-L ax:
7� F 3) /70 ,---74-06 Attic/crawispace fans 23.32
i:3APPLICANT '.❑ CONTACT'PERSON Other: 23.32
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
tt -' Range
E-mail:
tV!/j d ittocri l.("esfti 6!9ftC-! A (CIM Barbecue
CONTRACTOR= Clothes dryer(gas)
F[rr V- C4-// Other:
Business name: MECHANICAL PERMIT FEES*
Address: /3/5z) z(/aye inft5 2/c p. � .. Subtotal
City/State/ZIP: l�/Ctk (.0`�/ [1� , a25---
1 y 5--- Minimum permit fee($90.00)
Phone:( ) Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.: `7.2.603 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
d signature: * Fee methodology set by Tri-County Building Industry Service Board
.e: fr `�i�,>3,r/ Date://211/
e\Permits\MEC PermitAoo 040 13.doc 44`0-4617T(11/02/COM/WEB)
Electrical Permit ApplicatimARECEIVE :. Fk JFFICE USE ONLY
City of Tigard Received Permit
. r� 2 1 ryry 7 DateDate/By:y: #: ins/r R))7_cc,Li s
IIII e 13125 SW Hall Blvd.,Tigard,OR 97223 NOV U 201! Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Related Permit#:
Inspection Line: 503.639.4175 g "�"�j /��j Ready Date/By: luris El See Page 2 for
TIGAR , Internet: www.tigard-or.gov t +��r�p��""jj_/�'�xiNotified/Method: Supplemental Information
TYPE;OF wj iii G DIVISION
PLAN REVIEW
New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or El Floating buildings.
0 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder ❑Other:
El Fire pump. ❑Installation of]50 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Job#: Job site address/077 r/,7 /44 Acted ® El Addition of new motor load of system
`f ilat/b-/ 100HP or more. ❑`A ,„E„ 1.2„ 1.3„
/f9,72,2:3 ❑Six or more residential units. occupancy.
City/State/ZIP:
5 aid ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: �J Project name: // f'}i^ l
nal,d eo/ 1- ❑Hazardous locations. IDSupply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: /yr f„h FEE SCHEDULE
Description I Qty. I Each I Total I "
New residential single-or multi-family dwelling unit.
Subdivision: nit/IQ,ti/ /,t/15,t j Lot#:/U Includes attached garage.
V 1,000 sq.ft.or less / 168.54 4
Tax map/parcel 4: Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
/Va.) S,C (with above sq.ft.)
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
—PRROPERTY`OWNER`; 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: toy.`/ add 6,4 chat JA/ 200 amps or less 100.70 2
Address: i44,5-S 6C N2,- SOa-i�� S'1/w-i 201 amps to 400 amps 133.56 2
cure,/
401 amps to 600 amps 200.34 2
City/State/ZIP: 76 cure,/ q72
601 amps to 1,000 amps 301.04 2
Phone:/(10 • 7rQ__L/3 7S Fax: 3 )570 7 Over 1,000 amps or volts 552.26 2
Whe)(� itd� ` S /10"� Temporary services or feeders installation,alteration,and/or
Email: �/ 6,/lQ t �((/r1� 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
ICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: ,'�/j ,le above service or feeder fee,
7.42 2
LJ each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:
branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: 4,,„,4,„.5, frirc l7 c. Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: „.2.,:xa/ 54a D(}4 `rtp® panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP: ,r— •,k C'.c Gf 1-2-rj'' Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:r.---c,3) 5 79 .6'2 i 1 Fax:b.--ti ) f fI)-973 Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:
^! Inspections for which no fee is
CCB Lic.:®16,7 -'— ff Electrical Lic.:� Suprv.Lic.: j(5 O specifically listed(%hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name /,n 5 hi 4A Date: ///0.1//7 ❑Plan Review Required(25%of permit fee):
'/ State surcharge(12%of permit fee):
Authorized signature:
-,—.-` TOTAL PERMIT FEE:
- This permit application expires if a permit is not obtained within 180
Print name: �, r1'- Ina !Lfine" Date: 11/X///2 days
,//,7days after it has been accepted as complete.
* Number of inspections allowed per permit.
I.`Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/15 440-4615T(11/05/COM/WEB
1
Plumbing PermitApplicatilwlr CTEIVE ''''''
Building Fixtures FOR OFFICE USE ONLY
City of Tigard , 2 O p q 2017 PRleacneRiveevdi
ewDateBY Permit No.:
IIII
/l1$'Tcioj•-2.--j•-2.--0045-6e 13125 SW Hall BlvdTigardOR 97223
• •.
Phone: 503.718.2439 Fax: 503.598.1 , �� g.� �Yy p q Date/By: Other Permit No.:
Inspection Line: 503.639.4175 I 1liD
TIGARD Internet: www.ti ard-or. Ov Date Ready/By: Juris: 0 See Page 2 for
g g 4. 1 11 Ilk 1.;�1 ,' ,;i otified/Method: Supplemental Information
TYPE.OF WO'i FEE* SCHEDULE
,PI, ew construction 0 Demolition For special information use checklist
Description Qty. Ea. Total
0 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
,2-1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78
SFR(3)bath S 500.32
0 Accessory building ['Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION•AND LOCATION Site utilities:
Job site address:/Q f?f (.5 cu 4 /IQ.. ih //(�4 r.-¢ Catch basin or area drain 18.76
A J
City/State/ZIP: 'T� � ��L� .r.2 ,-.7...3Drywell,leach line,or trench drain 18.76
Suite/bldg./apt.no.: {' Project name: Footing drain(no.linear ft.: ) Page 2
/1/lG//l�i/C0 A Manufactured home utilities ■ 50.03
Cross street/directions to job site: Manholes 18.76
l® 9 i 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: gri iv 4, // /�/$ Lot no.:
Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
t.-) 5f-2 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER 1 0 TENANT Expansion tank 12.51
Name: /4/11106,,r)cir� 1a/is - Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 4a /s5 5&D /1/ori-/-h/1/ori-/-h,jOS/Z � dGarbage disposal 25.02
City/State/ZIP: �� a-� Hose bib 25.02
Phone:( ,,' 7S--- Fax:(123,S`?�j-7o(/,4" Ice maker 12.51
'a APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: oin Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
® p; V < /t`c Urinal 25.02
E-mail: k/i �J�Li /'.-�J/1'I-t S/�/G�.� /J'1�2 6
Water closet 25.02
CONTRACTOR
"
/I flk.#4.,6 Iy /� Water heater 37.52
Business name: �Q r / Water piping/DWV 56.29
Address: /; /if/if() 6 6! Iva Other: 25.02
City/State/ZIP: ( G/t iff ` C1/l (/ - Subtotal
Phone:(5'3) -70_3 ^gb'C Fax:633) fj ,o/ Minimum permit fee: $72.50
CCB Lic.: ®�.2 /3 9 Plumbing Lic.no.:c3-30�J Plan review (25%of permit fee)
P / State surcharge(12%of permit fee)
Authorized signature: 1 1TOTAL PERMIT FEE
Print name: J?4 4..r 7 Date:I/4,7/ 7 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(]0/02/COM/WEB)
111 City of Tigard
p COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: 7+-1 St- j '7- (y-/
Site Address: (0°17 c S W Pr n r c n cR. •4n}• MI r ]r..
Project Name: A 1'1 nog h at- -v r Lot #: 1
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: kt,QA&) S' r--12
AVerify site address/suite# exists and active in permit system.
pRiver Terrace Neighborhood: A No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
/Three(3)copies of site plan El-Existing-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
/Drawn to scale(standard architect or engineer scale) floor elevations
North arrow ,Utility locations&easements (required for new and additions)
/JSite address,project or subdivision name and lot number Sidewalk/driveway approach
Applicant information(name and phone number) ❑Location of wells/septic systems
7iLot dimensions and building setback dimensions C xisting trees to be retained with drip line,and tree
re-footage of buildings to be demolished protection measures
Lot area,building coverage area,percentage of coverage and ZStreet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) 'Street names
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced?4Yes ❑No
4 foot differential) If yes,is a storm water quality facility shown? M/4
Std
Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): PD2
Required: ❑ Yes,applicant was notified /No Received: I r%f Yes El No
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: g Yes ❑ No,stop intake
A Land Use Case#: P P ZO IS- 0OOO5 1 Q u9 f S- 000 IS
A Zoning: 2 I2
Required Setbacks: Front I S Rear IS Side 3 Street Side S Garage Zo
7] Landscape Requirement: 2/0 %
Lot Coverage Maximum: %7 %
7 Building Height: Maximum Height 3s Actual Height I
in Visual Clearance
ASensitive Lands: El Yes El No Type
AUrban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: //1 Date: (i /2 I /11
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: El Approved El Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Fonns\BldgPermitRvw RES 061417.docx
Building Permit Submittal
Original Submittal Date: 1ik/1/7
Site Plans: #
Building Plans: #
Building Permit#: tenter building permit#above.
Workflow Routing: [Manning [ Eigineering111.--Kr-1-nit Coordinator K�Building
Workflow Sign-off: talf3ign-off for Planning(include notes from planning review)
Route Application Documents: 12..,E1 gineefing: (1) copy of permit application, (1) site plan, (1) building plan and
�i originalinplan review routing form.
l a..--$ lding: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: /0//7
Engineering Review
7.%)
Slope at building pad: I
❑ 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 SCJ NO
Assess Water Quantity Fee in-lieu: ❑ Yes ,No
LIDA Facility on lot: ❑ Yes .2 No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: ) /l� cc' Date: ///2—
Revisions
1' 2-Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: S.Yes ❑ N/A
Parks SDC: X-Yes ❑ N/A
LIDA ❑ Yes M N/A
XOK to Issue Permit
Approved by Permit Coordinator: jet,11/1 , Date: t(2� n
I:\Building\Fonns\BldgPennitRvw_RES_061417.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10979 SW ANNAND CT, TIGARD, OR, 97224 January 10, 2019 at
1 :12:42 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00456
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Water pressure = 65 psi
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10979 SW ANNAND CT, TIGARD, OR, 97224 January 10, 2019 at
1 :13:41 PM
Record Type: Record ID:
Residential - Master Permit MST2017-00456
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
No A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10979 SW ANNAND CT, TIGARD, OR, 97224 January 16, 2019 at
10:41 :01 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00456
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - CofO
Comments:
Final erosion control passed
Moisture content form received
Moisture barrier acknowledgement form received
High efficiency lighting form received
Insulation certification verified
Blower door and/or duct seal test certificate received
C of 0 left on counter.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10979 SW ANNAND CT, TIGARD, OR, 97224 January 16, 2019 at
10:16:09 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00456
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Previous corrections completed.
No A/C installed
Violation Summary:
Inspector Contractor