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Permit (31)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Request for Permit Action TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard, OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor City Staff Check(✓)one REFUND OR Name: V<D INVOICE TO: (Business or Individual) 7C Lc-X /-/-e9/7 Mailing Address: /?a 5" ,'v'sj l'4. 9 '`= /yL Su erg- /Qa2_ City/State/Zip: a jA / dam- ? 7Od Phone No.: PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): ❑ CANCEL/VOID PERMIT APPLICATION. FUND RMIT FEES (attach copy of original receipt and provide explanation below). OR FEES DUE (attach case fee schedule and provide explanation below). Permit #: ti / aQ/F -ea Site Address or Parcel #: J,2�- =ye, le A-7,7 Project Name: Subdivision Name: S� /y�yEj2,! d � Lot #: EXPLANATION: 7 ZJ, /7*- " -'c#y77o' / • Signature: / C' Date: 1d/2/ 1 Print Name: er7i✓.I�+/ Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. FOR OFFICE USE ONLY Route to Sys Admin: Date /8/ /sp By .f.71111111 Route to Records: Date B Refund Processed: Date fd 2/, �y;If Invoice Processed: Date By Permit Canceled: Date /4- BA, Parcel Tag Added: Date By I:\Building\Forms\RegPermitAction_1209/18.doc 1I UPI TIGARD City of Tigard October 11, 2019 David Weekley Homes 1905 NW 169th P1, Suite 102 Beaverton, OR 97006 Re: Permit No. MST2019-00212 Dear Applicant: The City of Tigard has processed a refund for fees on the above referenced permit(s) as follows: Site Address: 12049 SW Summerbrook Ln Project Name: Summerbrook,Lot 2 Job No.: N/A Refund: ® Check#233550 in the amount of$35.02. ❑ Credit card"return"receipt in the amount of$ . Note: Please allow 2-5 days for this refund transaction to be credited to your account by the company that issued your card. ❑ Trust account"deposit"receipt in the amount of$ . Comments: Charged twice for irrigation backflow. Refund 100% of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov ,. 1111 City of Tigard T I G AR D Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request forPermit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: David Weekley Homes DATE: 10/4/2019 1905 NW 169th Pl, Suite 102 Beaverton, OR 97006 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt#: 425877 Case#: MST2019-00212 Date: 9/17/2019 Address/Parcel: 12049 SW Summerbrook Ln Pay Method: CreditCard Project Name: Summerbrook,Lot 2 EXPLANATION: Collected twice for irrgation backflow. Refund 100% of permit fees. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Plumbing Permit Fee 230-0000-43101 $31.27 12%State Surcharge 100-0000-24001 3.75 TOTAL REFUND: $35.02 APPROVALS: SIGNA RES DATE: If under$5,000 Professional Staff ' If under$12,500 Division Manager If under$25,000 Department Manager If under$100,000 City Manager If over$50,000 Local Contract Review Board C* ' "''„,' - Fog AccalksYSTEM ADMINIVRATIOSE;ONO` ,', ,' ' ''', .- ', ' ,,': ase Refund Processed: Date: cf1d?77�/ By: „,,r249 , I:\Building\Refunds\RefundRequest.doc x 09/01/2010 111 CITY OF TIGARD RECEIPT I 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: Summerbrook, Lot 2 Site Address: 12049 SW SUMMERBROOK LN /� '7:: /Vn Receipt Number: 436105 - 08/27/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID M ST2019-00212 $-35.02 Total: $-35.02 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 233550 DHOWSE 08/27/2021 $-35.02 Payor: David Weekley Homes Total Payments: $-35.02 Balance Due: $35.02 Page 1 of 1 CITY OF TIGARD RECEIPT g 13125 SW Hall Blvd.,Tigard OR 97223 7 503.639.4171 k I Project Name: Summerbrook, Lot 2 Site Address: 12049 SW SUMMERBROOK LN £2/ /� Receipt Number: 425877 - 09/17/2019 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2019-00212 Backflow Preventer 230-0000-43101 $31.27 MST2019-00212 12%State Surcharge-Plumbing 100-0000-24001 $3.75 Total: $35.02 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 5570343 PUBLICUSERO 09/17/2019 $35.02 Payor: Total Payments: $35.02 Balance Due: $0.00 Page 1 of 1 Dianna Howse From: Dianna Howse Sent: Wednesday, September 18, 2019 12:12 PM To: 'Scharer, Hannah' Cc: #Building Permit Technicians Subject: RE: Request to void fees - MST2019-00212 Attachments: MST2019-00212_Receipt_Overpayment.pdf Hello Hannah, Unfortunately, we did not notice that irrigation backflow fees had already been added on this permit and we added them a second time, which you paid online on 9/17/2019 (see attached receipt). We will now need to process a refund for the$35.02 paid. Please allow 2-3 weeks for processing the refund check for the $35.02 in permit and state surcharge fees paid. Since the fee was paid online using a credit card, we will also contact the online payment vendor PayGOV for a refund of the 3%card service fee that you paid. Please allow 2-5 business days for this to appear on your account. Thank you and our apologies for any inconvenience. Dianna 1. Howse Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits From: Steph Toles Sent:Tuesday, September 17, 2019 9:41 AM To: Dianna Howse <Dianna@tigard-or.gov> Subject: Request to void fees- MST2019-00212 Hi Dianna, Summerbrook sent over(10) PLM applications to add backflow preventers to their MST's. (2) of the permits already had backflow preventers added; I caught one but accidentally added another backflow preventer and invoiced the fees for MST2019-00212. I am now unable to void the fees. I asked Branden and he said you would have to look into it. Sorry for the extra work! Attached is the invoice. Thank you, Steph Toles Permit Technician Assistant City of Tigard I Building Department 13125 SW Hall Blvd Tigard, OR 97223 503-718-2452 1 6?A/6 / e roL/ TRANSACTION k I Help CENTRALTM Logout PAYGOV US 866-480-8552 MerchantiD:63880 Credit Details Merchant ADM • * • Account Verify ForceAuth Void Mai View Info Receipt Text Reports Opioaci Batch/ 111=11 View Receipt j Credit ID 14304954 Transaction ID 1591424861 Card Type Mastercard Reference ID 5570343 Account Number 556365 4883 Name on Account michele schiedler Account Address 1111 n post oak road Account Postal Code 77055 Expiration Date 0721 Amount $1.05 Posted Date(Pacific Time) 9/18/2019 12:24:00 PM Settled Date(Pacific Time) Authorization Code Source PG Transactions Processed in the Pacific Time Zone t2019 Total System Services,Inc./All rights reserved worldwide.TSYSt and TSYS Business Solutions are federally- registered U.S.service marks of Total System Services,Inc.TSYS Business Solutions is a registered ISO/MSP of:Wells Fargo Bank,N.A.,Walnut Creek,CA;Synovus Bank,Columbus,GA;and Deutsche Bank,New York,NY;for Visat and MasterCardi:transactions only.TSYS Merchant Solutions is a registered ISO/MSP of Wells Fargo Bank,N.A., Walnut Creek,CA and Synovus Bank,Columbus,GA g CITY OF TIGARD MASTER PERMIT 1 COMMUNITY DEVELOPMENT Permit#: MST2019-00212 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2019 ,. Parcel: 1S134BD07200 ffl Site address: 12049 SW SUMMERBROOK LN if l �� Jurisdiction: Tigard Subdivision: SUMMERBROOK SUBDIVISION Lot: Project: Summerbrook, Lot 2 Project Description: New SF. 11/4/19: REPRINTED permit to include NC unit. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 4 First: 2467 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 29 Bathrooms: 3 Second: 0 sf Garage: 567 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2467 sf Value: $322,545.25 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: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 3 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y 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 add'I 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2467 Owner: Contractor: TRINITY CHURCH OF THE EVANGELICAWEEKLEY HOMES Required Items and Reports(Conditions) 10900 SW 121ST AVE 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 BEAVERTON,OR 97006 PHONE: PHONE: 503-213-4415 FAX: Total Fees: $32,062.30 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may o ' o y of the rules or direct questions to OUNC by calling 50 . 32.1987 or 1.800.332.2344. Issued By: f - r--"-- -, / 7r-�--'' Permittee Signature: '' Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE IISE ONLY City of Tigard Received • Permit No.:/y� il 13125 SW Hall Blvd.,Tigard,OR 97223 5 G9.t"" p atn Review : ,'5 if I00�'pz Phone: 503.718.2439 Fax: 503.598.196I E Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 p �O 19 Date Ready/By: runs: ® See Page 2 for w Internet: ww .tigard-or.gov NOV t Notitied/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ® New construction ❑ Addition/alteration/replacement performed.Indicate thevalue(rounded to the nearest dollar)of all ❑ Demolition El Other: /'i _ mechanical materials,equipment,labor,overhead,and profit. 't CATEGORY OF CONSTRL ' . � Value:$ ` RESIDENTIAL EQUIPi41ENT/SYSTEMS FEES* ® 1-and 2-family dwelling ❑Commercial/industria ■ 4 sory building For special information use checklist. ❑ Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 Job site address: 12049 SW Summerbrook Ln Furnace 100,000 BTU(ducts'vents) 46.75 City/State/ZIP:Tigard/OR/97223 Furnace 100,000+BTU(ductsvents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Summerbrook Duct work 23.32 Cross street/directions to job site:SW 1210 Ave and Summerbrook Lane Hydonic 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:Summerbrook Lot no.:02 Other: 23.32 Other fuel appliances: Tax map/parcel no.:TBD Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas New single family home to be built-2467 sqft,4 bedroom 2.5 bath home with fireplace 23.32 567 sqft 3 car garage Log lighter(gas) 23.32 Add pp��G ��,e� / Wood/pellet stove 33.39 Add 40'�' lrl J7—alt``{ "—CTV/GZ Wood fireplace/insert 23.32 _ Chimney/liner/flue/vent 23.32 ElPROPERTY OWNER Other: 23.32 ❑ TGNANT Environmental exhaust and ventilation: Name:Willow Creek Land,LLC Range hood/other kitchen equipment 33.39 Address:PO Box 1060 Clothes dryer exhaust 33.39 City/State/ZIP:Woodburn/OR/97071 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) _ 23.32 Phone:(971 )235-5003 Fax:( ) Attic/crawlspace fans 23.32 ® APPLICANT 2 CONTACT PERSON Other: 23.32 Fuel piping: Business name:David Weekley Homes $14.15 for first four;$4.03 for each additional Contact name:Michele Schiedler Furnace,etc. Address:1905 NW 169th Place,Suite 102 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Beaverton/OR/97006 Water heater Phone:(503)213-4415 Fax::( ) Fireplace Range E-mail:mschiedler@dwhomes.com Barbecue CONTRACTOR Clothes dryer(gas) Business name:David Weekley Homes Other: MECHANICAL PERMIT FEES* Address:1905 NW 169th Place Suite 102 Subtotal City/State/ZIP:Beaverton/OR/97006 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)213-4415 Fax:( ) State surcharge(12%of permit fee) CCB lie.:213653 TOTAL PERMIT FEE ya,34, This permit application expires if a permit is not obtained within 180 �j�� * Fee methodology after it has been accepted as complete. Authorized signature: 4 , 10-I dology set by Tri-County Building Industry Service Board Print name:Hannah Scharer Date: 11/04/19 I:\Building\Permits\MEC_PerrnitApp_040113.doc 440-4617T(I1/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10.000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50.000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1•\Building\Permits\MEC_PennitApp_040113.doc 2 CITY OF TIGARD __ MASTER PERMIT N . . COMMUNITY DEVELOPMENT Permit#: MST2019-00212 T[GAR(.) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2019 Parcel: 1S134BD07200 Jurisdiction: Tigard Site address: 12049 SW SUMMERBROOK LN Subdivision: SUMMERBROOK SUBDIVISION Lot: Project: Summerbrook, Lot 2 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 4 First: 2467 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 29 Bathrooms: 3 Second: 0 sf Garage: 567 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2467 sf Value: $322,545.25 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 Drains: 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 3 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 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 add!500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2467 Owner: Contractor: TRINITY CHURCH OF THE EVANGELICAWEEKLEY HOMES Required Items and Reports(Conditions) 10900 SW 121ST AVE 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 BEAVERTON,OR 97006 PHONE: PHONE: 503-213-4415 FAX: Total Fees: $31,974.92 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. .pecial 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•=ys of i .uance, •r if work is sus ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificatio Cell Those rul are set forth in OAR 952-001-0010 through OAR• 2-001-0090. You/nay obtain a cop f the rules or direct questions to OUNC by .(ling 503 .32.'14.7 or 1.800.332. 44. Issued By: ,�:_ _., . ..I<L(/ddi.,%/ Permittee Signature: I� / Call 503.639.4175 by 7:00 a.m.for the next available inspec ion date. This permit card shall be kept in a conspicuous place on the Job site until c,mpleti• •f the project. Approvad plane ma raquirad nn tha jab it at tha time Of each t epa ion • Building Permit Application Residential RECEIVED FOR OFFICE USE ONLY Cityof Tigard �} a Received i �y PermitNc s�� "©L/; / - g MAY D O 2019 DateBy:. d • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie ,t./ 1 _ 3 Mk- Other Perini i/ �9 DOS fp 7 Phone: 503.7182439 Fax: 503.598.19 �i Date/By: Inspection Line: 503.639.4175 1 I ur TIGAR Date Ready/By: uris 53 See Page 2 for TIG;Alil> p ig g BUILDING DIN/BI ,' , tified/Method:f0 � Supplemental Information Internet www tt and or ov BUILDING t14 i/1 111 F. Al i0,IM 7 (1< 1` Tirol',.f?F WO ,4 , KKREQL R O D A:1; ND 2 aiii DWELLING =",. ❑Demolition Permit fees*are based on the value of the work performed. ®New construction Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit i r t work indicated on this application. 3 J :. � (; TE�mORY: F OS71i11"f"1'ION � ,: *: Valuation: 00 ® 1-and 2-family dwelling ❑Commercial/industrial Number of bedrooms: 4 ❑Accessory building ❑Multi-family ❑Master builder 0 Other: Number of bathrooms: 3 '. �- JQB STINFORI00141vp LOCATION 4_ — Total number of floors .b(5- 9 Job site address:12049 SW Summebrook Ln New dwelling area: 2467 City/State/ZIP:Tigard/OR/97223 Garage/carport area: 567 square feet Suite/bldg./apt.no.: Project name:Summerbrook Covered porch area: 48 square feet Cross street/directions to job site:SW 121"Ave and SW Summerbrook Lane Deck area: square feet Other structure area: 87 square feet REQUIRED DATA:COMME CIAL=USE CHECKLIST'.:° Subdivision:Summerbrook Lot no.:02 Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax snap/parcel no.: equipment.materials,labor,overhead,and the profit for the `' OF W work indicated on this application. ` Valuation: $ New Single Family Home to be built-2467 SQFT 4 Bedroom,2.5 bath with 567 SQ FT 3 car garage, Existing building area: square feet New building area: square feet i # `� �" Number of stories: ' tR O 1 -lc ©9TENANT Name:Willow Creek Land,LLC Type of construction: Address:PO Box 1060 Occupancy groups: City/State/ZIP:Woodburn/OR/97071 Existing: Phone:(971)235-5003 I Fax:( ) News: `t'(( is, T . . z t CONTACT PERSON .,---,''''e.-13.0.11 G°PE{(4 x ES* 4` F=. k . . Fl'klfs�r,2J'cr`.iir1ecsc�aWte `, Business name:David Weekley Homes Structural plan review fee(or deposit): Contact name:Michele Schiedler FLS plan review fee(if applicable): Address: 1905 NW 169th Place,Suite 102 Total fees due upon application: City/State/ZIP:Beaverton/OR/97006 Amount received: Phone:(503)213-4415 ( Fax: :( ) •� ( 6" OPANELTi `,STEM FE Email mschiedler@dwhomes.com ., s Commercial and residential prescriptive installation of " r : '` roof-top mounted PhotoVoltaic Solar Panel System. Business name:David Weekley Homes Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010. Oregon Address:1905 NW 169th Place,Suite 102 Solar Installation Specialty Code checklist. Permit Fee(includes plan review $180.00 City/State/ZIP:Beave n R/97006 and administrative fees): Phone:(503)213-4415 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:213653 Total tee due upon application: $201.60 Authorized signature: 4 / 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 'nn name: is e e c t4ii, • . Service Board. I:\Building\Permits\BUP-RESPe 'itApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) ,• Building Permit Application Checklist One- and Two-Family Dwelling FOR oFFiCE: USE ONLY City of Tigard Received APermit No.: sociat 4 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: ■ Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 ® Electrical ® Plumbing ® Mechanical TIc,.4Ru El Other: Internet: www.tigard-or.gov THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ® ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ® ❑ ❑ 3 Verification of approved plat/lot. I1 ❑ ❑ 4 Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ 0 ❑ 6 Sewer permit. 0 ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ® ❑ ❑ 9 Erosion control ®plan ❑permit required. Include drainage-way protection.silt fence design and location of catch- ® ❑ ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ® ❑ ❑ 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 ® ❑ ❑ 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 ® ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ® ❑ ❑ 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. ® ❑ ❑ 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 ® ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ 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 ® ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ® ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ® ❑ ❑ 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 ® ❑ ❑ architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review. 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 1 ❑ ❑ 24 Two(2)sets each are required for Items 16, 19.20 and 22 above. ® ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ® ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ® ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard .1 ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ 1 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, ❑ ❑ El 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/WF.B) 1 Mechanical Permit Apphcatl EC I FOR OFFICE USE ONLY Cityof Tigard Received g MAY 2 8 2019 Date/By: Permit No.: ./J 1 i f„OQ 2, 'I 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review / F ' i Phone: 503.718.2439 Fax: 503.598.19 Other Permit: IT OF IGARD Date/By: T I G A R D Inspection Line: 503.639.4175 I Lid ! + Date Ready/By: loris: I 0 See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notitied/Method: Supplemental Information »tteuw. ,''7.'::' ,;,,'-:,::,-,71-:::::5;.,--'.:7:0 1LD � w EtCIECIfLIT .; ' ` � �' � _ --- _ ' --s-- Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ - CA'fEa4RiO CNST`tIICTIOIY .''RESIAETItUIPII16'FYf SYSTEMS FEES* Z 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑ Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total :-A Heating/cooling: 0-tSITE I f. T>WOIY *i- LOCATION :ii Air conditioning NO 46.75 Job site address: 12049 SW Summerbrook Ln Furnace 100,000 BTU(ducts/vents) I 46.75 City/State/ZIP:Tigard/OR/97223 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Summerbrook Duct work 23.32 Cross street/directions to job site:SW 1210 Ave and Summerbrook Lane 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:Summerbrook Lot no.:02 Other: 23.32 Other fuel appliances: Tax map/parcel no.:TBD Water heater I 23.32 + yy Gas fireplace/insert i 33.39 Flue vent for water heater or gas New single family home to be built-2467 sqft,4 bedroom 2.5 bath home with fireplace 23.32 567 sqft 3 car garage Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 ':. i! P t 1Ea . ,*, ;. . • <.2 . <❑=TENANT. :''''';'-4, Environmental exhaust and ventilation: Name:Willow Creek Land,LLC Range hood/other kitchen equipment I 33.39 Address:PO Box 1060 Clothes dryer exhaust 1 33.39 City/State/ZIP:Woodburn/OR/97071 Single-duct exhaust(bathrooms, co toilet compartments,utility rooms) 23.32 Phone:(971 )235-5003 Fax:( ) Attic/crawlspace fans 23.32 � I � 'i ►t iOC1kTAGT PER. N .: Other: 23.32 Business name:David Weekley Homes Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Michele Schiedler Furnace,etc. Address:1905 NW 169th Place,Suite 102 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Beaverton/OR/97006 Water heater Phone:(503)213-4415 Fax::( ) Fireplace Range E-mail:mschiedler@dwhomes.com Barbecue I Clothes dryer(gas) Other: Business name:David Weekley Homes Address: 1905 NW 169'Place Suite 102 Subtotal City/State/ZIP:Beaverton/OR/97006 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)213-4415 Fax:( ) State surcharge(12%of permit fee) _ CCB lic.:213653 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized siy ature: 0°( * Fee methodology set by Tri-County Building Industry Service Board Print name:Ken Pu man Date: I:Building Permits MEC_PermitApp_040113.doe 440-46171(Il 02 COM/WEB) I • Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Toxil aluatiion t , "fermi tFee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional $100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:\Bullaing\PermIts\MEC PermitApp_04u113.doc 2 t . Er)n Electrical Permit Applicafi8tV FOR OFFICE I'SE ONLY City of Tigard MAY 2 8 2019 Received Date/13 : 1211241MIIIMON IN0 13125 SW Hall Blvd.,Tigard,OR 97223Plan Review S° Phone: 503.718.2439 Fax: 5036343CF TIGARO Date/Bv: Related Permit#: T[c;ARD Inspection Line: 503.639.417 huts�41f�sIO ReadyDate/By: turfs. See Page 2 for r Internet: www.tigard-or.gov Notified/MeMad: Supplemental Information ' > TYPE"I3F.WORK .';i. ,. • ..,s':'',:--'.-, .. I;LAN<REYIEW '.•,,,' , ®New construction ❑Addition/alteration/replacement 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. ❑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. 1 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑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 derived ❑Addition of new motor load of system. Job 4:68020002 Job site address: 12049 SW Summberbook Ln 100HP or more. ❑"A","E","1-2","I-3", City/State/ZIP:Tigard/OR/97223 ❑Six or more residential units, occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.4: Project name:Summberbrook ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site:SW 121st Ave and Summerbrook Lane , `FEE`SCHEDULE Description 1 Qty. I Each I moist New residential single-or multi-family dwelling unit. Subdivision:Summerbrook Lot 4:02 Includes attached garage. 1,000 sq.ft.or less I 168.54 168.54 4 Tax map/parcel 4:TBD Ea.add'I 500 sq.ft.or portion 3 33.92 107.76 1 DESCRIPTION,OF'WORIZ', Limited energy,residential 75.00 2 New single family home to be build-2467 sqft,4 bedroom 2.5 bath home with (with above sq.ft.) Limited energy,multi-family 75.00 2 567 sqft 3 car garage residential(with above sq.ft.) Renewable Energy 0 See Page 2 El PROPERTY OWNER 0 TENANT t Services or feeders installation,alteration,and/or relocation Name:Willow Creek Land,LLC 200 amps or less 100.70 2 Address:PO Box 1060 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Woodburn/OR/97071 601 amps to 1,000 amps 301.04 2 Phone:(971)235-5003 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 i 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 -181 APPLICANT: 1 ' h CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name:David Weekley Homes above service or feeder fee, 7.42 2 each branch circuit Contact name: Michele Schiedler B.Fee for branch circuits without service or feeder fee,first Address: 1905 NW 1691"Place Suite 102 branch circuit 56.18 2 City/State/ZIP:Beaverton/OR/97006 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)213-4415 Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:mschiedler@dwhomes.com Reconnect only 67.84 2 .. , .. 'CONTRACTOR: . ." Pump or irrigation circle 67.84 Business name:Garner Electric Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ❑ See Page 2 2 Address:2920 SE Brookwood Ave. panel,alteration,or extension. Cit /State/ZIP:Hillsboro,OR 97123 Each additional inspection over allowable in any of the above y Additional inspection(1 hr mm) 66.25/hr Phone:(503)523-9060 Fax:(503)642-7925 Investigation(1 hr min) 90.00/hr Email:andreap@garnerelectric.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: 121159 Electrical Lie.: 34-30 p ic.: 3707S specifically listed(h hr min) ELECTRI T,PERMIT FEES: Suprv. Electrician signature,required: / Subtotal: Print name: Charles Garnpx-1 Date: 5/23/2019 0 Plan Review Required(25%of permit fee): / State surcharge(12%of permit tee): � �� t a TOTAL PERMIT FEE: Authorized signature: /l j ll > . J This permit application expires if a permit is not obtained within 180 Print name: Andrea Phillips Date: 5/23/2019 days after it has been accepted as complete. Number of inspections allowed per permit. I IBuilding\Permits\ELC_PermitApp ELR ERE.doc Rev 06/17/2015 440-4615T(1I/05/CWId/WEI3 1 Plumbing Permit taElVED Building Fixtures FOR 014 It F 1sl. ONI.l Cityof Tigard MAY 2 8 2019 Received g Permit No. Sr G)/, -x002.11j2- lill " 13125 SW Hall Blvd.,Tigard,OR t Pan Ry: �� d(�tJ,t t Plan Review Il Phone: 503.718.2439 Fax: 503.5 ` ,� i ��� Other Permit No.: Inspection Line: 503 639.4175 E3 I 11�t LJ I V k)R J. e ! 1 1 t,A r..1 Internet: www.ti d-or. ov nate Ready/By: Suns See Page 2 for g Notified/Method: Supplemental Information 1 TYPE OF WORK ! FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist Description I Qty. 1 Ea. I 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 0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 2 437.78 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ' Each additional bath/kitchen 25.02 ❑Master builder 1 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:12049 SW Summerhrook Ln _ Catch basin or area drain 18.76 City/State/ZIP:Tigard/OR/97223 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear tt.:la) ! Page 2 87,55 Suite/bldg./apt.no.: Project name:Summerbrook Manufactured home utilities 50.03 Cross street/directions to job site:SW 121"Ave and SW Summerbrook Lane Manholes 18.76 Rain drain connector 18.76 1 Sanitary sewer(no.linear ft.: ) Page 2 j Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision:Summerbrook Lot no.:02 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 1 25.02 25.02 New Single Family Home 2467 sqft 4 bedroom,2.5 bath with 567sqft 3 car garage Dishwasher 1 25.02 25.02 Drinking fountain 25.02 Ejectors/sump 25,02 ® PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name:Willow Creek Laud,LLC ( Fixturelsewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:PO Box 1060 Garbage disposal 1 25.0225.02 1 City/State/ZIP:Wood burn/OR/97071 f Hose bib %51%3 25.02 ! 50.44 Phone:(971)235-5003 . Fax:( ) lee maker 1 1 12.51 12.51 ® APPLICANT 0 CONTACT PERSON Interceptor/grease trapI 25.02 Business name:David Weekley Homes Medical gas(value:$ ) Page 2 Contact name:Michele Schiedler Primer 12.51 Roof drain(commercial) 12,51 Address:1905 NW 169d Place,Suite 102 Sink/basin/lavatory 4 25.02 100.08 i City/State/ZIP:Beaverton/OR/97006 Solar units(potable water) 62.54 Phone:(503)213-4415 Fax::( ) Tub/shower/shower pan 212.51 25.02 E-mail:mschiedler@dwhomes.com Urinal 1 25.02 Water closet 2 25.02 75.06 1 CONTRACTOR Water heater 1 37.52 37.52 Business name:Malmedal Plumbing Water piping/DW Y 56.29 1 Address:PO Box 207 Other: 25.02 City/State/ZIP:Banks/OR/97106 Subtotal 931.89 Phone:(503)324-0759 Fax:(Sn?j) 324 b s Minimum permit fee: $72.50 CCB Lie.:102535 Plumbing Lic.no.:34-276PB Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature TOTAL PERMIT FEE Print name: (jt Y(?11 L?41, 1--rQ 1 r.�,td oc Date: 5/Z,!J t 9 This permit application expires If a permit is not obtained within ISS days 1 after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board, t'lBuildang1PermitslPLMU-PermitApp.doc 10/01,04 440-4616T(10/02/COWWEB) • City of Tigard 1.1P1 w COMMUNITY DEVELOPMENT DEPARTMENT T 1 c A R D Building Permit Review — Residential Building Permit #: /`757;2p/9 ' 10.2 Site Address: 120 elC s- '( so rya % -o o L.ri . Project Name: S Y-1 ft'LC Lot #: 2- (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: eAJJ S 0 Verify address/suite#active in Accela. ❑ In River Terrace: No ❑ Yes,River Terrace Review Addendum Site Plan Elements: Erosion Control 43 copies of site plan on 8-1/2"x 11"or 11 x 17"paper ' Retained trees with drip line and tree protection measures brawn to scale(standard architect or engineer scale) 'Footprint of new structure(including decks)and FFE J North arrow - Utility locations&easements(required for new and additions) Site address,project or subdivision name and lot number ,@Sidewalk/driveway approach Applicant information(name and phone number) l L- cation of wells/septic systems ,Lot dimensions and building setback dimensions SLI Street tree size,type and location Square footage of buildings to be demolished Street names Sting structures on site "El Corner elevations(2'contours if more than 4'differential) ,'Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? IrYes ❑No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ,LJYes ❑NoS Vg gf Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ❑ No Received: Yes ❑ No Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: A] Yes ❑ No,stop intake Land Use Case#: -cUt Z0 9 7 " OOCO g Zoning: fa .1 ARequired Setbacks: Front: i . Rear: 1 S' Side: .5 Street Side: 1 S Garage: , Building Height: Max. Height: 3 ® Actual He' ht: Z" 9 Zi Landscape Area: IV`A % 1 Lot Coverage Max: "/A' 0/0 Entrance Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows �] Minimum 12%of area of all street-facing facades Garage 7] Garage door is behind widest street-facing wall Yes ❑ No,one of the following is met: ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage. ❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor. Garage door width is ❑ 12'or less X 50%or less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset ❑ Fire shingles 0 Lap Siding 0 Roof pitch 0 Gable,hip,or gambrel roof 0 Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony 2 Visual Clearance 21 Urban Forestry Plan • Sensitive Lands: ❑ Yes No Type: Conditions met prior to issuance of building permit Notes: ❑ Approved By Planning: 149 Date: -C/ 1-1'11/y Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_022819.docx t Building Permit Submittal Original Submittal Date: 57701 Site Plans: # 3 Building Plans: # J Building Permit#: ' Enter building permit#above. Workflow Routing: 2Planning Ctingineering [Permit Coordinator [Building Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: JO 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 Permit Technician: `v- _ Date: -5/A09 Engineering Review L'jlope at building pad: ZS Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No LIDA Facility on lot: 0 Yes ❑ No V Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: (Approved by Engineering: Date: . Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: VSDC Fees Entered: Wash Co Trans Dev Tax: 47Yes ❑ N/A Tigard Trans SDC: Q"Yes ❑ N/A Parks SDC: El"Yes ❑ /A LIDA ❑ Yes 7(.1\T Q N/A ❑ OK to Issue Permit ''f�f f a Approved by Permit Coordinator: /���"O Date: £/ 3 1 I:\Building\Forms\BldgPermitRvw_RES_022819.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 _114 Transmittal Letter I IC,A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: / // DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED JUN 11 2019 FROM: /)44 H112GG CITY OF l'IGARD 3UILDING UILDING DMSION COMPANY: Oc',VVVid P PHONE: (EO ) 7M-- 44 ) By: /z RE: (9OL 1t')Iff)e i CnOk- Large Z/4✓—T / � .0')/,1 (Site Address) (Permit Number) Sumrne'( d�1 eo AU't— - (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. 3 Revisions: Res- FeAd 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: Routed to Permi ec 'clan: Date: ' ( ( 1 Initials: 4 Fees Due: [ I' �No Fee Descri'lion: Amount Due: 1/1_, k_\ c1,Jc� $ MS. , $ pci\ -------' Special Instructions: Reprint Permit(per PE): ❑Yes ►gi o i ❑ Done 1721---- Applicant Notified: GDate: G,1 /,Z // Initials: I:\Building\Forms\TransmittalLetter-Revisions_061316.doc