Permit (101) CITY OF TIGARD MASTER PERMIT
I COMMUNITY DEVELOPMENT
Permit#: MST2018-00267
Date Issued: 11/13/2018
T I i :A Ii.I-, 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110AD10700
Jurisdiction: Tigard
Site address: 10967 SW ANNAND HILL CT
Subdivision: ANNAND HEIGHTS Lot: 9
Project: Annand Heights, Lot 9
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 770 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1114 sf Garage: 392 sf Front: 15 Smoke Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 1884 sf Value: $243,092.40 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
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: 4 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 add!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
601-1000 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 Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 1884
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 Geo Tech Report Required
TIGARD,OR 97223 Prior To Pour
PHONE: 503-780-4375 PHONE: 503-625-6526
FAX: 590-7606
Total Fees: $30,226.09
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: egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 thro 0:- 952-.01-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _ Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspect r.on 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• II
Residential FOR OFFICE USE ONLY
City SW Tigard f^" l xateByeceivecl: kc.
�� Permit No.:MST,),C f� .-Q1 .}-
r 13125 Hall Blvd.,Tigard,OR 97223 € Plan Review
' Phone: 503.718.2439 Fax: 503.598.1960 rr C 2 ( DateBy: 10 is Other Permits . ..- �1;,,
T1CrARD Inspection Line: 503.639.4175 ,7[. I 6 2018 DateReadyBya///// Jur,s: H SeePage2for
Internet: www.tigard-or.govNotified/Method: Supplemental Information
CITY
TYPE OF Woi UILOINO'DIVISION REQUIRED DATA:1-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,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
lei-
/ Valuation: $ ?iLti 09?"-'
le l'and 2-family dwelling 0 Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms: '
❑Master builder 0 Other: Number of bathrooms: - ""5
t
JOB'SITE IsIFOItMATION'AND LOCATION Total number of floors: 2-7(f
Job site address: /790,75t 14/1land Iii I0 (2a r_-'7 New dwelling area: 41
y • .' square feet ,\ILA
City/State/ZIP: "�-,'6&tip 0 1-L q72-a3 Garage/carport area: 51 square feet 770
Suite/bldg./apt.no.: Project name: ,_n, 4116 IICA Covered porch area: square feet
Cross street/directions to job site: /a 9--41.1 Deck area: 610 square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: /n AC[tics il-eV Ais Lot no.: ( Permit fees*are based on the value of the work performed.
v Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
'Veto
cJ�J P12. Valuation: $
Existing building area: square feet
New building area: square feet
❑,PROPERTY OWNER 0 TENANT ` Number of stories:
Name: 0 I Type of construction:
,� �-oo�o eastp-�GT.� x> �
Address: /024 5A.) NO/WI D a-ko f 7c- d Occupancy groups:
City/State/ZIP: 7ia.'2/ 67. 4v)2......2.3 / Existing:
Phone:(�� -70b'---‘1376- Fax:( -a3) syU_7jir
�(r 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:
Amount received:
Phone:( ) Fax: :( )
E-mail: ��Qm(„S//ii..? 0, , li C,,'CO'1 PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
lti�n �� Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: l/lJfii chitt5i.i-� Submit two(2)sets of roof plan with connection details
�+ and fire department access,along with the 2010 Oregon
Address: A-6 5-5- �f tO /l1 ?- ( -h 1)4tk1 (! zt Solar Installation Specialty Code checklist.
City/State/ZIP: 71 �r q 3 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(5- 3) Grp' _t j 7s Fax:( c5l 3 6`9CJ-ZadG State surcharge(12%of permit fee): $21.60
CCB lic.: 5-0/9. Total fee due upon application: $201.60
-- This permit application expires if a permit is not obtained
Authorized signature: - - - - -- ------ —
within 180 days after it has been accepted as complete.
Print name: ��� Q�$ Date: //1t *Fee methodology set by Tri-County Building Industry
! Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Applicatin FC -:JFFICE USE ONLY
City of Tigard Received yi c
Permit No.: --�' J V
• DateBy: \ 3\ r `
w 13125 SW Hall Blvd.,Tigard,OR 972 IVED Plan Review
1 Phone: 503.718.2439 Fax: 503.598.1A4, Date/By: Other Permit:
T I GA R D Inspection Line: 503.639.4175 Date Ready/By: Juris H See Page 2 for
Internet: www.tigard-or.gov )E P 2 6 2018 Notified/Method: Supplemental Information
-.,''XPE`OF W� fi
O GARD. COMMERCIAL'FEE*,SCHEDULE - USE CHIvCKL1ST
e > 1l !N DIVISION Mechanical permit fees*are based on the value of the work
w construction 0 Addition/alteration//r`eplacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
.°::-,;.--:;.',-:'.', CATEGO ZY'OF,CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
j 1'and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
;' , pB STI'E ORI4IA:TIQN AND'LOCATION; Heating/cooling:
Air conditioning 46.75
Job site address: 10/6,7 ,...54_,- , n a /74 1/ /a4„..../ Furnace 100,000 BTU(ducts/vents) .u' 46.75
City/State/ZIP: i^ / Q Furnace 100,000+BTU(ducts/vents) 54.91
y are,/ / �3 Heat pump 61.06
Suite/bldg./apt.no.: Project name: [!n/Qlid A`G ,I5 ADuct work 23.32
Cross street/directions to job site: /� ,...'":4 (� 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
O h Other: 23.32
Subdivision: fin4 Lot no.:.
Other fuel appliances:
Tax map/parcel no.: Water heater ,d 23.32
x DESCR PTION OF=FORK. Gas fireplace/insert ..P"'-- 33.39
/ Flue vent for water heater or gas
/1/C4--/.
l� 1. cP�_ fireplace 23.32
V Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
'", ,ROPERTX'.OWNER-; 0 TENANT
A,..: Environmental exhaust and ventilation:
Name: 6,4)r/���d �51 J _ Range hood/other kitchen
LJ /"1, ,Li pequipment33.39
Address: � T 5 fir Clothes
dd
� S-�' V' ryer exhaust .� 33.39
City/State/ZIP: erg �I Single-duct exhaust(bathrooms,
y �� 4 C./'Z Y o�?'3 toilet compartments,utility rooms) 0 23.32
Phone:( 57 76 d --437t Fax: 3) /70 —7G06. Attic/crawlspace fans 23.32
LIGAN r ;:'ti'CONTACT PERSON_ Other: 23.32
Fuel piping:
Business name: 60e $14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address:
Wall/suspended/unit heater
City/State/ZIP: Water heater
: Fireplace
Fax:
Phone:( ) ( )
Range
E-mail: 1 J lkOmtsiv�®r�1fi�--A (0/71 Barbecue
1.(11 / tt1'Od
CONT32AtTO.R` Clothes dryer(gas)
f l r�/ 64,d / Other:
Business name: . FEES*
MECHANICAL PERMIT
Address: /3/5() //af hin4,5 tLluu` D . Subtotal
City/State/ZIP: dA_ 6S �n y O J Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: '72.6,12,3 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
i Fee days after it has been accepted as complete.
Authorized signature: * methodology set by Tri-County Building Industry Service Board
Print name: irt-eirel /) Date: 9f/ 5/1k fr
T\Building\Permits\MEC PermitAoo 040440`-4617T(11/02/COM/WEB)
Electrical Permit Applicatio• F OFFICE USE ONLY
Received _
City of Tigard `� 'bate : Permit#: , ,°,\
■ 13125 SW Hall Blvd.,Tigard,OR 97223 ;,h, Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DateB : Related Permit#:
Inspection Line: 503.639.4175 SEP 2 6 7 018 Ready Date/By: Juris: B See Page 2 for
TI G A R D
Internet: www.tigazd-or.gov Notified/Method: Supplemental Information
TYPE OF WORICt t y A'1 iGAAD PLAN REVIEW
NeW construction 0 AdditionialteratiakikiDING DIVISION Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately systemderived
// ❑Addition of new motor load of
/.J '' ,4
Job#: Job site address: ^A q,,jc/J I] kp/100HP or more. ❑
0 Six or more residential units. occupancy.
City/State/ZIP: i '�� 9��3 ❑ 0 Recreational vehicle parks.
f Health-care facilities.
❑Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.#: Project name: }�^ � /y 0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: �/y/;fh /' �I (� FEE SCHEDULE,
4-' Description I Qty. I Each I Total
t New residential single-or multi-family dwelling unit.
Subdivision: // -hn4n41 /{,1S 41/5 Lot#: f Includes attached garage.
V 1,000 sq.ft.or less / 168.54 4
Tax map/parcel#: Ea.add'1500 sq.ft.or portion ,2, 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
Ii/}, (with above sq.ft.)
�je..J �! /L Limited energy,multi-family 75.00 2
residential(with above sq.
q ft.)
Renewable Energy 0 See Page 2
'PIUOPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: I0!Ad& ade/ 6 t (Jix 1C 200 amps or less 100.70 2
Address: ,gQ SS dco04-1-41 Palai" " lir-"-/ 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 76 cure,/ 6.-c_ q'72 601 amps to 1,000 amps 301.04 2
Phone:( ' 7 'O._2+3 7s-- Fax:(,5 3 )5,Q 244 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:j/ oitecjittQ/htS /VIA> � 6 11. -( I .(r/,lrk 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: above service or feeder fee,
7.42 2
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'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Orta/I jl(JL4-5( ,�x l/L Sign or outline lighting 67.84 2
/ Signal circuit(s)or limited-energy 0 See Page 2 2
Address: .�.I CL> 6301,f-j f panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: cp: `--. Q,4 (:,,c er,r-- 5 Additional inspection(1 hr min) 66.25/hr
Q Investigation 1 hr min 90.00/hr
Phone:�3) s�! �7�� Fax:�-t�3) ���.s Cf7o23 g ( )
Industrial plant(1 hr min) 78.18/hr
Email: Inspections for which no fee is
! 90.00/hr
CCB Lic.://4,7,224. Electrical Lic.:4-�gyb Suprv.Lic.:� specifically listed(%z hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name /Vr 5 hi 4ij Date I/I i1 0 Plan Review Required(25%of permit fee):
Authorized signature:
State surcharge(12%of permit fee):
f �� _ TOTAL PERMIT FEE:
14 r This permit application expires if a permit is not obtained within 180
Print name: `��' A rip price lj'r Date:9/iii if days after it has been accepted as complete.
n�// /// * Number of inspections allowed per permit.
I.'Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/1772H15 440-4615T(11/05/COM/WEB
Plumbing Permit Applicatia'l 0
• puilding Fixtures FOR OFFICE USE ONLY
City of Tigard ECCV •aea
Permit No.:((A T L\` `()ls
IAv 13125 SW Hall Blvd.,Tigard,OR 97223 „ an Review
. Q
Phone: 503.718.2439 Fax: 503.598.1960 SEP 2 it ZAte/By: Other Permit No.:
TI GARD Inspection Line: 503.639.4175 Date Ready/By: Suris: 0 See Page 2 for
Internet: www.tigard-or.gov Grryd/Method. Supplemental Information
TYPE OF WORK BUILDING DIVISION FEE*.SCHEDULE
ew constructionnstruction 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 s SFR(1)bath 312.70
'
and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath L 500.32
0 Accessory building ❑Multi-family Each additional bath/kitchen 25.02
0 Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
�` 4 �h T/ rT Catch basin or area drain 18.76
-
Job site address:if lk4 ? cJ Cu n,n ((/4
Drywell,leach line,or trench drain 18.76
City/State/ZIP: T, /,1-y/a o/1-- --- T'?;-.2-3' Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 'r Projectename: n 4cJ/t, A-/5 Manufactured home utilities 50.03
Cross street/directions to job site: CJ Manholes 18.76
/ 0 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: ii,:pfi/!C/1. ' t/e A15
I Lot no.:4 Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.: (
Backwater valve 12.51
DESCRIPTION OF WORK
n Clothes washer 25.02
/frs-
J1 $//2. Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 1 0 TENANT Expansion tank 12.51
Name: piodi,lr ff� z-a,-S pC., F
� lsewer cap 25.02
Floor drain/floor drain/floor sink/hub 25.02
Address: 5-5----,_54D (/
� erl/�7 (,t�(/`Z Garbage disposal 25.02
City/State/ZIP: G / a tZ (7-743... 3 Hose bib 25.02
Phone:( `2,-.b-- 7S Fax:(ci3 sg, -7G 2t Ice maker 12.51
APPLICANT 0 CONTACT.PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: 5-am to 12.51
Primer
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
Urinal 25.02
E-mail: bit!lii_ciIvCI ii ®A JAI,-ES/l! s (e /11Qt•4IGS
Water closet 25.02
CONTRACTOR Water heater 37.52
Business name: ,0cr J -/adtd ,1(14 M [L-q i/y /6) `Water piping/DWV 56.29
Address: 104,tift) 5 64 /1/, /til" Other: 25.02
City/State/ZIP: O�`./O/l G O4 f7(/'" Subtotal
Phone:( 3) 3 ^90 Fax:( 7i3) 73
�, S�j(s/ Minimum permit fee: $72.50
�� Plan review (25%of permit fee)
CCB Lic.: 4,0‘.2 /39 Plumbing Lic.no.:J p7 c30 State surcharge(12%of permit fee)
Authorized signature: V 71l 1 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days
Print name: L " Date��� llSi, after it has been accepted as complete.
V *Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
I
COMMUNITY DEVELOPMENT DEPARTMENT
A111
wilding Kermit Review — Residential
Building Permit #: mcj'i C�k - G°�,` 1.r
Site Address: I O9 Sv i f\--nnand iii i t l &-t-
Project Name: AllYlarCI Hel
(New dwelling=subdivis n name;Addition or Alteration=last name of owner)Ws Lot #:
Planning Review
Proposal: NC\n/ S
3 Verify site address/suite# exists and active in permit system.
lit River Terrace Neighborhood; .IR No 0 Yes,See River Terrace Review Addendum Attached
Sit- 'Ian Elements:
II P ee(3)copies of site plan
sig structures on site
• to plan must be on 8-1/2"x 11"or 11 x 17"paper VAawn to scale(standard architect or engineer scale) oorpelevationsrint of w structure(including decks)with finished
rth arrow 2b•I ty locations&easements(required for new and addition
jte address,project or subdivision name and lot number sidewalk/driveway approach s)
V .plicant information(name and phone number) ".'� 'cation of wells/septic systems
• •t dimensions and building setback dimensions j,
xisting trees to be retained with drip line,and tree
IF S uare footage of buildings to be demolished
• •Lection measures
�t area,building coverage area,percentage of coverage and V.S et tree size,type and location
i9apervious area(applicable if R-7,R-12,R-25&R-40) 95treet names
[J4 roperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? ■No
4 foot differential)
If yes,is a storm water duality facility shown? • es ❑No
la Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: 0 Yes,applicant was notified X No Received:
Public Facilities Improvement(PFI)Permit: ❑ Yes CI No
Required: 0 Yes,applicant was notified
No Applied For: 0 Yes 0 No,stop intake
ix Land Use Case#: P D 12'2.0 i s--00
'/Zoning: R-12 C P D)
[ '/Required Setbacks: Front \S Rear tS Side
3 Street Side g Garage 2C�
dscape Requirement: .._.it %
1' Lot Coverage Maximum: %
1I 3
Building Height: Maximum Height Z
,dS Actual Height t?
EdVisual Clearance
,�
/Sensitive Lands: 0, 1 es 8/No Type
I:iv rban Forestry Plan
EL/Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: .g � Date: 1—Z6-��
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
I:\Building\Forms\BldgPermitRvw_RES_061417-docx
Building Permit Submittal
Original Submittal Date: C1 lou.11%
Site Plans: # '
Building Plans: #
Building Permit#: Er Enter building permit#above. Building Routing: 21 Planning 2/Engineering I' Permit Coordinator
Workflow Sign-off: [ "Sign-off for Planning(include notes from planning review)
Route Application Documents: 11(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:
By -,.....*\./"' Date: `�l1 c 1k
Permit Technician:
En:ti neering Review
I' ,Slope at building pad: °b
1 Conditions"Met"prior to ssuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes No
Assess Water Quantity Fee in-lieu: 0 Yes No
LIDA Facility on lot: 0 Yes No
Final Plat Recorded:
Date:
❑ NOT Approved by Engineering:
No/Approved
es:
by Engineering: bA / X....5> Date: /0 • Z•lB
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
massimaimiawar
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of-building pelt —
_
❑ 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 tote Sent t11-S
Fees Entered: Wash Co Trans Dev Tax: es 0 N/A
Tigard Trans SDC: es 0 N/A
Parks SDC: C� Yes 3❑
LIDA 0 Yes N/�
tZ..-.----..
OK to Issue Permit �O[1-- --liv
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitltvw_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
1in
1 = Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.ti.nd-or._ov
TO: C,;A - � (y DATE ' ECEIVED:
DEPT: BUILDING DIVISION RECEIVED
JUN - 4 2019
FROM: . .-. •
Cl_i.11 OF f It
COMPANY: :l . • .� aA . x.111 AI BUILDINGnl`
PHONE: 613 31"'l-'-e=J?-1 By.
RE: IV ji u►. . ,V i1 kj51. 2-DI 8- O02(<'1
(Site Address) (Permit Number)
Alit AeA1 C -4f r
(Project name or subdivision name and 1 number)
ATTACHED ARE THE FOLL i WITEMS:
Co$ies: Descri•tion: Cona` $ies: Descri$tion:
Additional set(s) of p.e`' ` ` 2. Revisions: 3;),,,k
Cross section(s) and d- ails. Wall bracing and/or lateraanalysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
F07.O FICE USE ONLY
Routed to Perm' Technician: Date: ( 1 Initials: A*
Fees Due: [�]Yes 111No Fee Descrlpti n:1/2_ C(..A.C\ r co c_t,-) Amount Due:
$
$
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes No ❑ Done
Applicant Notified: /-7,91,7— Date: 0://9-/— Initials%
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc