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Permit CITY OF TIGARD MASTER PERMIT IN1 COMMUNITY DEVELOPMENT Permit#: MST2018-00208 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/17/2018 T r C; It C s 9 Parcel: 25101 DB00616 Jurisdiction: Tigard Site address: 13355 SW 76TH AVE Subdivision: ROLLING HILLS Lot: 21 Project: NESSETH Project Description: 756 sq.ft. RV garage addition. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 17 Bathrooms: 0 Second: 0 sf Garage: 756 sf Front: 20 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Total: 0 sf Value: $36,136.80 Rear: 15 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 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 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 addl 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 Ecompasing: N Other: N Other Description: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 0 Owner: Contractor: NESSETH,JERRY S&TRACY J OWNER Required Items and Reports(Conditions) 13355 SW 76TH AVE JERRY&TRACY NESSETH 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 13355 SW 76TH TIGARD,OR 97223 PHONE: PHONE: 503-686-0793 FAX: Total Fees: $1,376.87 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 95 001-0090. Yo may obtain a cosy of the rules or direct questions to OUNC by calling 503.23 r 1.800,.2.2�� Issued By: ` �� Permittee Signature: — - ---'%i g " —"MILCall 503.639.4175 by 7:00 a.m.for the next available inspection d� This permit card shall be kept in a conspicuous place on the job site until co ,,. tion of the project. Approved plans are required on the job site at the time of each inspection. c Building Permit Application Residential FOR OFFICE USE O\I.I Cityof Tigard c r" r 4 c;,n.‘ Received Permit No.: ■ 131SW Hall Blvd.,Tigard,OR 1 ^ Date/By: 4j / /�Sjv( ��—` a'tC g r i Plan Review �j Q C Phone: 503.718.2439 Fax: 503 50. $I " Date/By: p 1-1 'CJ Other Permit: Ail— Inspection Line: 503.639.4175 s s �'\ $ T I G A R D Date Ready/ y: /O ( i 1 J s: ® See Page 2 for Internet: www.tigard-or.gov \Fisk.- tified/Metho Cil ! el 6 , • �,=� Supplemental Information �C-�•�E,,4 pia cry TYPE OF v)l ci 1 � v, /QUIP I DATA:1-AND 2-FAMILY DWELLING °4. Permit fees*are based on the value of the work performed. ❑New construction LJ.Demolition Indicate the value(rounded to the nearest dollar)of all ®Addition/alteration/replacement ❑Other: equipment,materials,labor,o /overhead,and the profit or tl � CATEGORY OF CONSTRUCTION work indicated on this ablication. JJ I 1-and 2-familydwellingValuation: ® ❑Commercial/industrial , t 0 Accessory building ElMulti-familyNumber of bedrooms: 1:1 Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address:/3 3SS SE,, 76 r' Awe New dwelling area: square feet City/State/ZIP: TI$ar) o Q 1'72 t3 Garage/carport area: �� square feet Suite/bldg./apt.no.: Project name: I�/cssok &,I,I„de/ Covered porch area: 7 square feet Cross street/directions to job site: f;r St- 7 2♦d Avv_ Deck area: square feet / Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST 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,and the profit for the DESCRIPTION OF WORK work indicated on this application. gv Co..ra,ta_ AdI lia", .. elc.:4b ; ekr"d'` Valuation: $ 6 ' G " i 4/' Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: ~ Name: 1 'i J. fr4c7 /lle S Se)'H Type of construction: Address: "� / 3 3.55 $bJ ? ` T A ttC Occupancy groups: City/State/ZIP: Tr,4 itr of D 2 1 7 2 2 3 Existing: Phone:(SO 3) 6 5 A — D 7 113 Fax:( ) New: 0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: ,,,,,Li. 4 5mj—C_ Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: City/State/ZIP: Total fees due upon applicatior ?6 / , Phone:( ) Fax::( ) Amount received. �C E-mail: .O ! PHOTOVOLTAIC SOLAR'PANEL SYSTEM FEES* _ferry C D. e�-t�., ���(✓��.�. �y � . Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name: ��he� 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. Permit Fee(includes plan review City/State/ZIP: and administrative fees): $180.00 Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: 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. h *Fee methodology set by Tri-County Building Industry Print name:Ie./.r y NG SS G`k Date: 7/2 B/ 2 or S Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE LSI. oyl.l City of Tigard IIIReceived Dateive Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: = Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical I'IGARD Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les 10 1/1 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ 0 0 3 Verification of approved plat/lot. 0 ❑ 0 .. 4 Fire district approval required. Name of district: • 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 0 6 Sewer permit. 0 0 0 7 Water district approval. 0 0 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0 building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 0 there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0 ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0 furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ 0 ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 ❑ 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ 0 systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. _ 20 Manufactured floor/roof truss design details. 0 0 ❑ 21 --Energy-Code-compliance. Identify the prescriptive path or provide-calculations. A gas-piping schematic is required— 0 — ❑ 0— for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 ❑ ❑ architect licensed in Ore.on and shall be shown to be a.s licable to the s ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ 0 ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ 0 ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ 0 ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ 0 ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Electrical Permit Application FOR OFFICF. LSE OyLI City of Tigard ,, )v�;.� `k� E. ,.'Received Permit#: U 13125 SW Hall Blvd.,Tigard,OR 97223 Date/B g Plan Review Phone: 503.718.2439III 1J ) Related Permit 6: Date/B Email: TigardBuildingPermits@Tigard-or.gov Ready Date/By: Juris: fa See Page 2 for T I G A R i) Inspection Line: 503.639.4175 Intemet" t -o( v, :.y y- Notified/Method: Supplemental Information TYPE OF webidUILDING DIVISION PLAN REVIEW ❑New construction Igi 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. ❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amp b ❑Multi-family 0 Master builder 0 Other: Fire forallother installations. ngs. 0 Fire pump. Installation❑ of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address:/3355 SW 76 1.4' AIK 100HP or more. ❑"A","E","1-2","1-3", c ❑Six or more residential units. occupancy. City/State/ZIP: TSO ar•A v' 1� 7 Z 2 3Recreational vehicle parks. / 9 ❑Health-care facilities. 0 Suite/bldg./apt.#: Project name: Ne ss Lid L., RGv►1dji..4 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: 7 6 '/"* f F.r FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 3" s f �� ,��'„ (with above sq.ft.) f4. 5 dtr` q Limited energy,multi-family 75.00 2 residential(with above sq.ft.) (,8 PROPERTY OWNER ❑ TENANT Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: Serf s xle s s e,.11 200 amps or less 100.70 2 Address: /33 S y� 201 amps to 400 amps 133.56 2. --.5' S W 76 /�- 401 amps to 600 amps 200.34 2 City/State/ZIP: 7--,•s(.,f Oft 4 7 2.-t,3 601 amps to 1,000 amps 301.04 2 Phone:(503 ) ‘ g b - o-9 3 Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: ;e r,y e deter,^a,J�.vJ.,r.c..s A J^ relocation Owner installation:This installation is being made on propertyihat I own which is not 200 amps or less 59.36 1 intended for sale,lease,re. ore/,ch. ge,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: ..— — Date: 1/2 2/zoic 401 amps to 599 amps 168.54 2 0 ICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'I branch circuit 7.42 2 Phone: Miscellaneous(service or feeder not included) ( ) 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: Sign or outline lighting 67.84 2 Address: Signal circuit(s)or limited-energy 0 See Page 2 2 panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(''A hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: 0 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: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB , Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE 4. ° w .. ..F.. } ..- Description I Qty. Each � Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: 111 Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed %hr min) '14! CAS ES .x.;PERMIT FE ,a COIVIMERC 4 .:WORK ONLY: Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems [] Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom aria Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 1�t * : Information Notice to Owners About ���n iii' `t7`1'"1-7"d'`� Construction Responsibilities \Es kr�_ . (ORS 701.325 (3)) Homeowners acting as their own general contractors to construct a new home or make a substantial improvement to an existing structure, can prevent many problems by being aware of the following responsibilities: • Homeowners who use labor provided by workers not licensed by the Construction Contractors Board, may be considered an employer, and the workers who provide the labor may be considered employees. As an employer, you must comply with the following: • Oregon's Withholding Tax Law: Employers must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503-378-4988. • Unemployment Insurance Tax: Employers are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. • Oregon's Business Identification Number(BIN): is a combined number for both Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or go to http://www.oregon.gov/DOR/BUS/docs/211-055.pdf for the appropriate forms. • Workers Compensation Insurance: Employers are subject to the Oregon Workers Compensation Law, and must obtain Workers Compensation Insurance for their employees. If you fail to obtain Workers Compensation Insurance, you could be subject to penalties and be liable for all claim costs if one of your workers is injured on the job. For more information, call the Workers Compensation Division at the Department of Consumer and Business Services at 503-947-7815. • Tax Withholding: Employers must withhold Social Security Tax and Federal Income Tax from employee wages. You may be liable for the tax payment, even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-800-829-4933 or visit their website at www.irs.gov. Other Responsibilities of Homeowners: • Code Compliance:As the permit holder for a construction project, the homeowner is responsible for notifying building officials at the appropriate times, so that the required inspections can be performed. Homeowners are also responsible for resolving any failure to meet code requirements that may be found through inspections. • Property Damage and Liability Insurance: Homeowners acting as their own contractors should contact their insurance agent to ensure adequate insurance coverage for accidents and omissions, such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be redone. Liability Insurance must be sufficient to cover injuries to persons on the job site who are not otherwise covered as employees by Workers Compensation Insurance. • Expertise: Homeowners should make sure they have the skills to act as their own general contractor, and the expertise required to coordinate the work of both rough-in and finish trades. CONSTRUCTION CONTRACTORS BOARD PO Box 14140, Salem, OR 97309-5052 Telephone: 503-378-4621 —Fax: 503-373-2007 Website Address:www.oregon.gov/ccb f/property_owner adopted 9-23-08 This Copy for Permit Applicant Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building,electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants,exempt from licensing under ORS 701.010(7), need not submit this statement.This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. 0 I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. -1-err 7 ',It_ss ems. Print Name of Permit Applicant 41111F, Ai/ 7/23 / Z D/f Si. ature of Permit Applicant Date Permit#: .1�. Address: 4 ' � , *74 Issued by: Date: E-i- This Copy for Permit Offices City of Tigard 1111 ~ COMMUNITY DEVELOPMENT DEPARTMENT T 1 c A R D Building Permit Review — Residential Building Permit #: MS-7-2.018/ OOLU Site Address: 13 5g3:: ,c\jJ --7-6' `) A Project Name: \\R,SSI.q gC(''.:a-1 Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review i Proposal: GQr9 "' o j—!v' t1 �'56�- ✓ j ar-.c, IC t' T.1( Lerify site address/suite# exists and actiive/in permit system. L7 River Terrace Neighborhood: L" No ❑ Yes,See River Terrace Review Addendum Attached Site elan Elements: L P ree(3)copies of site plan r sting structures on site 2fe plan must be on 8-1/2"x 11"or 11 x 17"paper 111% ootprint of new structure(including decks)with finished � wn to scale(standard architect or engineer scale) fl..r elevations LI�'North arrow li ,tility4locations&easements(required for new and additions) IDSIte address,project or subdivision name and lot number Sr. ewalk/driveway approach I,d'Applicant information(name and phone number) cation of wells/septic sys ems tirit dimensions and building setback dimensions Existing trees to be retained with drip line,and tree quare footage of buildings to be demolished protection measures ! z 7vot area,building coverage area,percentage of coverage and eet tree size,type and location �1 pervious area(applicable if R-7,R-12,R-25&R-40) trees names �� L 'roperty corner elevations(2 foot contour lines if more than C ,000 sf of impervious area created or replaced? EYes LiGNo 4 f.ot differential) I yes,is a storm water quality facility shown? ❑Yes ❑No l! Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): D4 ._i : -quired: �/1 Y Yes,applicant was notified ❑ No Received: es ❑ No i Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified NJ No Applied For: ❑ Yes ❑ No,stop intake ki nd Use Case#: IV/Zoning: K'1,5 L"I Required Setbacks: Front a Rear IS Side S Street Side id Garage .)) Landscape Requirement: 1 A of Coverage Maximum: % l I. ding Height: Maximum Height 30 ' Actual Height ,G' ,. Ig Visual Clearance [U. Sensitive Lands: ❑ Yes ❑ No Type \ iJrban Forestry Plan 2'Conditions "Met"prior to issuance of building permit I (�� Note 6'-‘ S 41. d'- t..,c,A '✓1�4. /�W 6�1An.,..,c,� v�1) w ti,,,I� t i.,..rep✓1�'v,� c'w✓2�1 Approved By Planning: 'J( A. „` C / Date: 7 L3-15 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 A Building Permit Submittal Original Submittal Date: 7/2/AP Site Plans: # ,3 Building Plans: # Building Permit#: erEnter building permit#above. Workflow Routing: [planning {ngineering EL-Kermit Coordinator Building Workflow Sign-off: [..Sign-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. Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: r � By Permit Technician: Date: 7 el// Engineering Review Slope at building pad: 4,7a CV Conditions "Met"prior to issuance of building permit tir Easements (encroachments) per engineering conditions of approval and plat 21 Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes a No Assess Water Quantity Fee in-lieu: ❑ Yes ❑' No LIDA Facility on lot: ❑ Yes C]1 No ❑ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Sewe,— RQeiM4�,sern e'-- D;s7tr:C.71- /L/ ho-/- yeiL expired 1,,A4-;/ A,Dr;/ a.c' /Approved by Engineering: Y,.,41 j Date: 7 •- 3 1 - oaf g 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 0 /A Tigard Trans SDC: ❑ Yes 1111 T/A Parks SDC: ❑ Yes ►= N/A LIDA ❑ Yes ►_ N/A OK to Issue Permit ' Approved by Permit Coordinator: Date: y/, - -' I:\Building\Fonns\BldgPermitRvw RES_010118.docx FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT NI Transmittal Letter 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: 41/t j s a DATE RECEIVED: DEPT: BUILDING DIVISION w.. AUG 14 ao 3 FROM: � /7 Ale r5edf- COMPANY: Ul .Dv: PHONE: )3 _. 4'7q 3 RE: /J3 575 S '' -4 k4i_,_ AST Z 1)!1( — OO ao8 (Site Address) (Permit Number) 7':es4,0 v2 97 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. x Other(explain): rf tAs s Pae, ` REMARKS: FOR FFI E USE ONLY Routed to Permit Technici . ate: (0 IL/ (� Initials: kr Fees Due: ['Yes [ NVFee Desc ' tion: Amount Due: N $ $ Special Instructions: Reprint Permit(per PE): ❑Yes ❑ Done Applicant Notifiedy Qz Date: / Initials: L•\Building\Forms\TransmittalLetter-Revisions_061316.doc 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 Transmittal Letter r c; \Ei r) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED Ales /,, ©CT - 8 2018 FROM: Jerry Nies Se"� CITY OF i llD COMPANY: BUILDING DIVISION PHONE: 5193 —6 $4 - 0793 By: 85- RE: /3 355 S W 7o'4' A-v-e-, T's /yr S T 2.0/S' -- o v Z�Fr (Site Address) (Permit Number) l`lesselI e-/ (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 3 Additional set(s)of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Z Engineer's calculations. Other(explain): REMARKS: FOR F E USE ONLY Routed to Pe ' cian: Date: I(7 (`f `� Initials: Fees Due: �No Fee Desc tion: Amount Due: 1/ C p P $ (is .$ $ Special Instructions: 1;Reprint Permit(per PE): U Yes o U Done Applicant Notified: Date: l v//c--r Initials: 14,L--- I:\Building\Forms\TransmittalLetter-Revisions 0613 16.doc