Permit CITY OF TIGARD COMMERCIAL MANUFACTURED
11/111
5/ / ;�/ STRUCTURE PERMIT
111 COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Permit#: CMS2019 00001
Date Issued: 01/16/2019
Parcel: 2S107AA23200
Site address: 16774 SW ROCKHAMPTON LN Jurisdiction: Tigard
Project: Polygon at Roshak Ridge,Lots 232&233 Subdivision: ROSHAK RIDGE Lot: 232
Project Description: Sales trailer across(2)lots at site addresses: 16774&16790. Work for ADA accessibility ramps,covered porch,
building modifications,and all trade permits to be under separate permits. 4/30/2019: REPRINT permit for revised
plans for new structure to replace original structure due to dry rot.
Contractor: MODSPACE CORP Owner: POLYGON WLH LLC
13132 N WOODRUSH WAY 703 BROADWAY ST STE 510
PORTLAND, OR 97203 VANCOUVER,WA 98660
PHONE: 866-322-0120 PHONE: 360-695-7700
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM MH BLD Permit 01/16/2019 $275.50
Class of Work: NEW Type of Const: VB 12%State Surcharge-Building 01/16/2019 $33.06
Occupancy Group: B MH State Admin 01/16/2019 $30.00
Stories: 1 Height: 15 ft Info Process/Archiving-Sm$0.50(up to 01/16/2019 $2.50
Project Valuation: $0.00 11x17)
Erosion Control w/Development 01/16/2019 $80.70
Misc Administration Fee 04/30/2019 $4.25
Additional Plan Review 04/30/2019 $180.00
Floor Areas:
First Floor Area: 1183
Second Floor Area: 0
Third Floor Area: 0
Total Area: 0
Required Setbacks:
Left: 3 Right: 3
Front: 36 Rear: 5
Required:
Parking Spaces: 5 Fire Sprinklers: No Total $606.01
Smoke Detectors: Yes Party Wall: No Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
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 OAl3 952-001-0090. 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: �`>i r Permittee Signature: 0� 417€'/°e.-/c'c - 7o /N
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.
Tonja Morris
From: Dennis Heier <dennis@vistastructural.com>
Sent: Monday, March 25, 2019 2:30 PM ®
To: Tonja Morris;Angela Grajewski EV V
Subject: RE: Roshak Sales Trailer R $ 2p19
Attachments: Roshak Sales Trailer- Foundation Plan.pdf NIA
FT
O
1GpBOON
SY 1S1
GI p1V
gv11-pING
Tonja,
.
I just spoke with Tom. He's looking for the foundation plan from the manufacturer, which is attached.
Dennis Heier, P.E.
Vista Structural Engineering, LLC
14718 NW Delia Street
Portland, Oregon 97229
Cell: 971.645.0901
► V` 15TA
--sTrzucTURAL-^
From:Tonja Morris<Tonja.Morris@polygonhomes.com>
Sent: Wednesday, March 20, 2019 8:53 AM
To:Angela Grajewski<An ela.Grajewski pofYgonhomes.com>• Dennis Heier<dennis@vistastructural.com>
Subject: RE: Roshak Sales Trailer
The number Tom left for me was 503-718-2432.
Tonja Morris
Permit Specialist
Tonja.Morris(a.Polygonhomes.com
Office 360-695-7700 Fax 360-693-4442
www.polyqonhomes.com
POLYGONPOPK;ON NO 'WEST
Ate. . . 3 g/
Viiliam 1#u„eu
From:Angela Grajewski
Sent:Tuesday, March 19, 2019 8:24 PM
To:Tonja Morris<Tonja.Morris@polygonhomes.com>
Subject: FW: Roshak Sales Trailer
Hi
Do you have Tom's direct line? Please send it to Dennis below.
thanks
Angela Grajewski
1
PROJECT MANAGER
Angela.Grajewski@polygonhomes.com
Office 360.695.7700 Cell 971.212.2144
Fax 360.816.7817
PolygonHomes.com
POIXCONrte+NO DIWE 1'
Isis Hoots
From: Dennis Heier<dennis@vistastructural.com>
Sent:Tuesday, March 19, 2019 3:44 PM
To:Angela Grajewski<Angela.Grajewski@polygonhomes.com>
Subject: Roshak Sales Trailer
Angie,
I called Tigard Building Department and left a message on their office voicemail for Tom (nobody answered and I
couldn't find a direct line for Tom). I'll let you know as soon as I hear back. I have a reminder set to call them tomorrow
at 3:00 if I haven't heard back by then.
Dennis Heier, P.E.
Vista Structural Engineering, LLC
14718 NW Delia Street
Portland, Oregon 97229
Cell: 971.645.0901
V 1 S TA
2
City of Tigard
w COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 G A R D Building Permit Review — Commercial - With Land Use
Building Permit #: (v 5 elf) I ? — Oczo/
����� )((7 i76 7i< Irl ��_
Site Address: c��,,, Suite/Bldg#:
Project Name: /v/te0cam- Ak .VQ/S 770-/ter`
(N f commercial mmercial business occupying the sp a If vacant,enter Spec Space.)
Planning Review 2/i/kg /2 - '- " crd/77,- /9--,v0.77,-Ex- ' cc-
,57-1-el em,z `,
Proposal: irpor. .su les -71-Aa,Ler cai aLI-i2mpor7 ,I 2 -
rifr
site address/suite#exists and active s stem.
permitY
ver Terrace Neighborhood: Yes ❑ No
and Use Case#: / oP o1 c-- Qoo/
AO Pl. - atch Approved Land Use: �,(�. {��
d Site Plan 'El ' andscape Plan Ig\T�ther:
•
IV 0 rban Forestry Plan 1:3 evation Plan
FA Building Height: Maximum Height Actual Height
12° •nditions Met: 0 Prior to Submittal ❑ Prior to Permit Issuance
/
►4 Business Licen
xists: ./ Yes ❑ No,applicant notified to obtain business license
i,.• Public Facilitie mprovement(PFI) Permit: �� kQ Ci 6-016?)Required:I Yes,applicant was notified ❑ No Applied For: /Yes ❑ No, stop intake
Notes:
Approved by Planning: ------ .— 4/c, Date: /1Sh9
Revisions (after Binding Submittal only) •, l; Reviewer , Date
Revision 1: Approved CI Not Approved Y;! t., _.l 1-,,, „,i,
Revision 2: I
0 Approved CI Approved
Revision 3: 0 Approved ❑ Not Approved
Building Permit Submittal /
Original Submittal Date: 7(
Site Plans: #
Building Plans: #
Building Permit#: ciI=Enter building permit#above.
Workflow Routing: .i --Planning [ ngineering N.-Permit Coordinator �•Building
Workflow Sign-off: (ign-off for Planning(include notes from planning review)
Route Application Documents: "-Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: IF-i,1. 4 , A.Aid A_L�itj/ Date:
.,<, f " -, ' I 3/0?
I:\Building\Fonns\BldgPermitRvwCOM WithLandUse 060116.docx
Engineering Review
Slope at building pad: 7 d
❑ PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
El Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP)
,3"-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes No
Assess Water Quantity Fee in-lieu: ❑ Yes Er No
LIDA Facility on lot: ❑ Yes B No
❑ NOT Approved by Engineering: Date
Notes: L F-5 j 72-t�y L -, I"j i i ��-
Approved by Engineering: M Ki- (Li . Date: , ,1
Revisions (after Building Submittal only) Reviewer ate
Revision 1: ❑ Approved El Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
O Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
"evision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ YesEf/N/A
Tigard Trans SDC: ❑ Yes IJ /A
Parks SDC: U Yes N/A
�
_� lira
�OK to Issue Permit
/J#
�/ , 14119
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPennitRvw_COM_W ithlandUse_070915.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
= Transmittal Letter
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: 7D /`7 7/, DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
/ MAR 07 2019
FROM: /9/"1i n/ 6,(7�'vi CITY OF TIGARD
BUILDING DIVISION
COMPANY: /6'0 y
PHONE:
6 o ?S=- 2Z'C By:
RE: /6 7 7y S /20 ek/ '9F'TD✓✓ Z-A =20/17 -0e00 /
(Site Address) (Permit Number)
/ �yCL's✓ /9-7-/Los/N4/ _ ie./1)6-6- LOTS 3.7.- X33
(Project name or subdivision name and lot number) 5191-- 5 772-4-/
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions: ,VE7L i/ L.C3/A/C---
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: ALr-C E /'2 a 6/t S t f L?it,/77--&-z / k7 €ce
S772-61 C Tzt/�c u 7-b Z/2-7
y
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: - o _ ) N Initials:
Fees Due: ] Yes ❑ No Fee Description: Amount Due:
Mr �J�v y J.c�,� $
$
_t EA tfL'l1 24/"f $ Lf`'
.5 i__ 4-(' rV _` j•� $
Special
Instructions:
Reprint Permit(per PE): [' Yes [ Al No [' Done
Applicant Notified: Date: Initials:
I:\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
TIGARD, 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: I j'n DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
MAR 2 8 2019
FROM: /UNJi rl�/j)oReIS
CITY OF TIGARD
COMPANY: BUILDING DIVISION
PHONE: 3 (00 - to 7^7 O O By:
RE: 16-1 RD "O Y 1 10'\
(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: -41 vtuiyoo
R, -p6A.
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑ No Fee Description: Amount Due:
Special
Instructions:
Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: Date: Initials:
I:\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 itprovides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
ii 111111 .
Transmittal Letter
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: \(SMA DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
muAPR11Z019
FROM: 6)/L,. f\ ,0x. , CITY OF TIGARD
BUILDING DIVISION
COMPANY: (N\ -e
PHONE: 3ln0 - to q.S ,
10 0 By:
RE: 1 611 Li 5k) oGC. I'nIp-nA/ id Gems Zola-0b00 I
Site Address (Permit Number)
OS tL \bet,L,- Sy t 5 °PEI — 232 233
(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. X Engineer's calculations.
Other (explain):
REMARKS:
t/
fV : lal Zee-srr-- a-1, (t14 •/ ,- -,r-�/7) Rl '7t .7G`Gi�r ar C ?- ef
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑No Fee Description: Amount Due:
$
$
$
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes D No ❑ Done
Applicant Notified: Date: Initials:
C\Building'Forms`TransmittalLetter-Revisions 061316.doc
CITY OF TIGARD COMMERCIAL MANUFACTURED
STRUCTURE PERMIT
IN-. COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Permit*: CMS2019-00001
T t c;, i?.C� 9 Date Issued: 01/16/2019
Parcel: 2S107AA23200
Site address: 16774 SW ROCKHAMPTON LN Jurisdiction: Tigard
Project: Polygon at Roshak Ridge,Lots 232&233 Subdivision: ROSHAK RIDGE Lot: 232
Project Description: Sales trailer across(2)lots at site addresses:16774&16790. Work for ADA accessibility ramps,covered porch,
building modifications,and all trade permits to be under separate permits.
Contractor: MODSPACE CORP Owner: POLYGON WLH LLC
13132 N WOODRUSH WAY 703 BROADWAY ST STE 510
PORTLAND,OR 97203 VANCOUVER,WA 98660
PHONE: 866-322-0120 PHONE: 360-695-7700
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM MH BLD Permit 01/16/2019 $275.50
Class of Work: NEW Type of Const: VB 12%State Surcharge-Building 01/16/2019 $33.06
Occupancy Group: B MH State Admin 01/16/2019 $30.00
Stories: 1 Height: 15 ft Info Process/Archiving-Sm$0.50(up to 01/16/2019 $2.50
Project Valuation: $0.00 11x17)
Erosion Control w/Development 01/16/2019 $80.70
Floor Areas:
First Floor Area: 1183
Second Floor Area: 0
Third Floor Area: 0
Total Area: 0
Required Setbacks:
Left: 3 Right: 3
Front: 36 Rear: 5
Required:
Parking Spaces: 5 Fire Sprinklers: No Total $421.76
Smoke Detectors: Yes Party Wall: No Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
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 rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
t
IssuedBy: •
Permittee Signature:
,�iIA�t,!LL/�� /., � 75,yr L C,,a7-7 L.j
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.
Manufactured Dwelling
RECEIVED
Placement Permit Application FOR OFFICE USE ONLY
City of Tigard JAN 3 2019 Received DateBy: ( � �3 !�1 &, 1 e1_ ',/
• 13125 SW Hall Blvd.,Tigard,OR 97223 ,r ,.• -i Plan Review �(
' 2 Phone: 503.718.2439 Fax 503.598.1.Q¢Q a ' ` DateBy: ) )s"--. j 'J J Other Permit:
Inspection Line: 503.639.4175 l��j t11 L.''�z i'i .. U• -'`" Date ReadyBy: /� Jaris: H See Plan Submittal
TIGARI3 Internet: www.tigard-or.gov ,otiir�yethod: ( !(O /r Requirements
JOB SITE INFORMATION OWNER INFORMATION
Site Address: 1 0:-`Li. t, '�n 1 OD w pa...yrIN,, 014 Name: 'YD,1 r 0 � 1 i , L� 1 L,
n�k'ry,/�"I V 3 HJI�F-' `f/�lp y� r pYt1 V �/��/y`J V • , _,,,)
Sub Name: Ol�JUI �� IL�I W Address: n' ' 1 Os ' J i 1`�- J
Subdivision&Lot#:
Directions to inspection site: Ir,W�D r� i4 City: "V/ 111 f VI`. ';;n )(i 1--1
. g i n`00 ,
0t ._/ j
Phone: ,-/ ►� .D,(igc.'- 06�1[ Fax: too 1p"IC, u vt/
Is property inside city limits? ti Yes 0 No E-mail: y ' Al fir A / IAII / 4 it a III 1 A 1 l 10Ilit
LOCAL GOVERNN!ENT APPROVALS
Zoning Sanitation
Signature: Signature:
Jurisdiction: Jurisdiction:
Date: Date:
MANUFACTURED DWELLING PLACEMENT;PERMIT FEES
(1) Installation/re-inspection Cost(each) Nf Sum
Items
(a) Placement(includes placement,electrical feeder,30'of water/sewer connection). $ 275.50 s 1 $ 2.1S,SO
(b) State surcharge at 12%(of placement fee only)- $ 33.06 t $ 3?,, Oto
(b) Re-inspection(includes inspection and 12%state surcharge). $ 100.80 $
Placement permit to be obtained only by homeowner,or Oregon-licensed manufactured dwelling installer.
(2) Electrical
(a) Service and/or feeder(new service installation or alteration/relocation of existing service)- $ See Electrical Permit Application
Electrical service permit to be obtained only by homeowner performing work or signing supervisor of Oregon-licensed electrical contractor
performing work.
(3) Plumbing
(a) New water service(for services over 30 lineal feet)- $ See Plumbing Permit Application
(b) New sanitation/storm sewer or rain drain(for services over 30 lineal feet). $ See Plumbing Permit Application
Plumbing permit to be obtained only by homeowner performing work or Oregon-licensed plumbing contractor performing work.
(4) Miscellaneous fees
(a) Administrative fee(State of Oregon)- $ 30.00 I $ 3 b .00
(b) System development fees(sewer connection,storm water,parks development&traffic impact). $ See Permit&System Development Fees
SUB-TOTAL $
SET-UP OR INSTALLATION CONTRACTOR APPLICANT
Name: i DMA A\V�A`FS i ' e: 4 r •11 .Ai 6 Name: , 1 L■ LV
Address: _ / & / • ,i, v Address: lD
1 /. h .AI �PSIO
City: ,FerAA)
, ,n State: ' n n ZIP: " as i City: 1 o n,hn r +/,'�v x Stat•: ,n, n I nZIP:01 p we
Phone: C 1 ID._ V ►2_ Fax Y f7, Phone:Vp7 WVVl_tots__
110D ( Fax 2 W 5 ti ci ti
CCB No.: 11 • S MDI No.: E-Mail: be r f 1 1 ✓t 0 Y Y t ► 'I-Al S 17D1t T Iv lo l WG) ,ctik
SKIRTING CONTRACTOR 3
Name: V\
I hereby certify that the information above is true and correct
1V` t M li ., _ A its 116 nes All work to be performed shall be in accordance with all
Address: 10 .1, /,A ` ` , "1 (�(1� Bove ing laws and rules. 2
City:Vol 1 IVCD l� / State: ry ZIP"l b (11.00 I J 51 1
Phone: a20(OUSq� Fax:2i nVD�'nG•�(,f 1 1 r Auth. ed Signature Date
CCB No.: -01b-1 rte' 1-1 1
MDI/LSII Noo.: U! "'`�`i Print Name: il n�n 1 n k r1(AV 1 i
I 'V 1.V 1 /� V V I
I:\Building\Permits\SFM-PennitApp.doc 10/16/2014
City of Tigard
14 p COMMUNITY DEVELOPMENT DEPARTMENT
■
TIGARD Building Permit Review — Commercial - With Land Use
Building Permit #: lvyk S W) 1c1 _ Oc 2 /
Site Address: /((-9:? --0 )C&7-1') -/(6 .-0 „, r? Suite/Bldg#:
Project Name: Pla r cam- k &4G ,£Q b,c 77--.1q,,, Cer—
(N �f commercial business occupying the sp e. If vacant,enter Spec Space.)
Planning Review
- /`
Proposal: /mporLL7 ,2 �sJ� �ArLer. cat,et_ rporcay, _ 9- ., 'F' d r g__,/
7Verifysite address/suite#exists and active ermit s stem.
�p Y
•:ver Terrace Neighborhood: Yes ❑ No
0PFA/Land Use Case#: J t f/,2 o i c-- too/
Pla : atch Approved Land Use: \4\. {Q�/�
M Site Plan `El landscape Plan w'ther:
Ill ' rban Forestry Plan 1D ` evation Plan
A Building Height: Maximum Height s. kf Actual Height
11'° •nditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issuance
fI Business Licen :
xists: Yes ❑ No,applicant notified to obtain business license
Public Facilitie mprovement(PFI) Permit: 7 kOile— 60,1
Required: Yes,applicant was notified ❑ No Applied For: /Yes ❑ No, stop intake
Notes:
Approved by Planning: .--- -- C
Date: //_:-.7)/9
i
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date:
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: (12—Planning [5.Ungineering L`.-Permit Coordinator �•Building
Workflow Sign-off: (ign-off for Planning(include notes from planning review)
Route Application Documents: 'Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ,e-i..... 41 , 41.A_��j/ Date: //3
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse_060116.docx
Engineering Review
I7Slope at building pad: Q
❑ PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP)
.Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes -No
Assess Water Quantity Fee in-lieu: ❑ Yes Er No
LIDA Facility on lot: ❑ Yes B No
❑ NOT Approved by Engineering: Date
Notes: ht.-i—S fl2-t i L --./ or-FT l c.--F .
Approved by Engineering: /A(K1. GC_i . Date: f (1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
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:
"evision Notice 3: Date Sent to Applicant:
fra SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes f.
N/A
Tigard Trans SDC: El Yes :/)>4/A
Parks SDC: ❑ Yes N/A
pi/
to Issue Permit )
«V 11 146 i /
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM_W ithIandUse_070915.docx