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Permit (12) CITY OF TIGARD MASTER PERMIT 11111 , I. COMMUNITY DEVELOPMENT Permit#: MST2019-00406 T t C;A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/14/2019 Parcel: 2S111AA13500 Jurisdiction: Tigard Site address: 8909 SW INEZ ST Subdivision: IRMA DELL BUTTERFIELD Lot: 13 Project: Butterfield Park, Lot 13 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 2198 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 4 Second: 1635 sf Garage: 936 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3833 sf Value: $520,118.16 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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: 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: 5 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: 8 201-400 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 3833 Owner: Contractor: LWD LLC SOLSTICE CUSTOM HOMES Required Items and Reports(Conditions) FOUR D CONSTRUCTION CO 5740 SW ARROWWOOD LN 1 Ersn Cntrl 503-639-4175 5740 SW ARROWWOOD LN PORTLAND,OR 97225 PORTLAND,OR 97225 PHONE: PHONE: 503-709-2277 FAX: 503-297-0104 Total Fees: $37,687.97 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 t• follow the ules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 95 •:1-009, "ou mayg btain a coy jlt a ulPs.nrdirect agestions to OUNC by calling 503.232.1987 or 1.800.332. 344. r Issued By: , Permittee Signature: ,..#9,....,-„,/, //' ' .,-_-_, /� 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. Bu. din Permit Application v. ` Residential I OR OF I'It 1 I I t)yl.l City TigardI ' L0 t i" Recivya �t �r., ,, ,f'-'_. Permit c i of /n5i,� 1 LA) t` . ,� 13125 SW Halt Blvd.,Tigard,OR 97223 t, Plan Review Ib 3* [ - a Other Permit: 44/ d�z i/ i 7 Phone: 503.718.2439 Fax 503.598.1960 230�) Date/By: orris: See Page 2 for 1 ,i (- Inspection Line. 503.639.4175 Date Ready/By: / 1 B 1 R D N.ified/Me�:`/ / L '7, I 1 Supplemental Information Internet: www.tigard or.gov ' +f 8�� � Ct�: :a7 nil i{�g' y ,1"ESiC TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING Permit fees*are based on the value of the work performed. New construction 0 Demolition Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead, ,profit forrthe th work indicated on this application. U CATEGORY OF CONSTRUCTION Valuation: ' ) 511-and 2-family dwelling 0 Commercial/industrial ) Number of bedrooms: 4/ ❑Accessory building 0 Multi-family , ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: 2-- LOU/ Job site address: J93 CI 5-,vJ _z-A✓✓.-2., New dwelling area: -383 3 square feet ill$ City/State/ZIP: 'fl &A-14-0 0 [Z 9 7225/ Garage/carport area: X36, square feet l(1,36 Suite/bldg./apt.no.: Project name: /C] square feet Cross street/directions to job site: Deck area: square feet A U B.LV D - 6.,g€N 1 )s&--o Li's/ - 9 0 1-* Other structure area: ----- square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: ' 0 * , Lot no.: 1 3 Permit fees*are based on the value of the work performed. - Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: 4 t L:,,,,, : L tom✓; t Viz_ equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. /14:-:--W /A/C t,.-(5 PIN iyt i C.V 65%IeivC.6 Valuation: $ Existing building area square feet New building area: square feet ,PROPERTY OWNER 0 TENANT Number of stories: Name: Type of construction: Address: ..SIPNl&- j:},S` ,i?6LOW' Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: XAPPLICANT 0 CONTACT.PERSON BUILDING PERMIT FEES* /GC' 645-roA,/, ,/,/0 (Pteserefer wiseschalute) Business name SCOL 5'/ --„ -S Structural plan review fee(or deposit): Contact name: D i 1 s. j 6,7- 14.ic}jZp 1pto)~ZT` FLS plan review fee(if applicable): Address: P.C's, Ex X i S 7 7 Total fees due upon application: City/State/ZIP: Brk ve R ro/ k 70-7 Amount received: Phone:003) -7 A0 .....-7 ti S Fax::(�,.13) .59i)-- J 7S — PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: F 6" Va D coioc/5 r e, 44,s $= i co ti Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name: - Submit two(2)sets of roof plan with connection details IA f3 L:li t..? and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. Permit Fee(includes plan review $180 City/State/ZIP: .00 /� and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: /y- 6 . Total fee due upon application: $201.60 Authorized signature: ',7d � This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. j � �� Date: *Fee methodology set by Tri-County Building Industry Print name: e ��-E�—/`� Service Board I:`Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) echanical Perm A t t lication i�t,Iz()I I I( 1 l `,I t)v I 1 Cityived ' I Date/By:ePermit No.: a q i„.7 ![IjL1`,• of Ti'Tip.: eC 13125 SW Hall '1 d,i igard.OR 97223 Plan Review Other Permit: k+ Phone: 503.718,', 39 .ax: 503.598.1960 OCT 2 3 201E, Date/By: Inspection Line: i 63t.-1175 Date Ready/By: Juris: ® See Page 2 for z ;t:t? ‘.1.-4-'i Supplemental Information Internet: tv��i.tiga gob a s w , b - Na#tfiedlMetttod: I i TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work %New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of a mechanical materials,equipment,labor,overhead,and profit. Q Demolition 0 Other: Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* Pi 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. 1 Total Heating/cooling: JOB SITE INFORMATION AND LOCATION Air conditioning j 46.75 Job site address '-'-'-'.-- CC C/7 _S $ . f/.C_-- Furnace 100,000 BTU(ducts/vents) / 46.75 City/State/ZIP: r)v 0' 7 2...z1 Furnace 100,000+BTU(ducts/vents) 54.91 t 0 Heat pump 61.05 u5 Suite/bldg./apt.no.: Project name: Ductwork 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or 14-A i-t-- 0 1--VD - 6ReErv4St,ARo LN — }'U r-i- hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 i lluetventfor any of ahoy ,"t 23.32 Other: 23.32 Subdivision: . J 12 Lot no.: Other fuel appliances: Tax map/parcel no.: at -r r i . 1-)(..:„.,L j) -3'I Water heater . [ 23.32 DESCRIPTION OF WORK Gas fireplace/insert / 33.39 Flue vent for water heater or gas fireplace 23.32 _ Log lighter(gas) 23,32 , ,i A &l cf IQ 0 t.-G P1 Nei I Ly P DQ--,xi�1 D i-% Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 a PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation: Name: Range hood/other kitchen equipment ( 33.39 Address: $AK C f� 13,1 E L OW Clothes dryer exhaust / 33.39 Ci /State/ZIP• Single-duct exhaust(bathrooms, 2/1t3 toilet compartments,utility rooms) ( 2332 , Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 g APPLICANT 0 CONTACT PERSON Other: 23.32 �//, � �_ Fuel piping: Business name: `�j�.ST/G �t L:`i�Ditl� i'`7C4is!' _j $14..15 for first four;$4.03 for each additional Contact name: t V'1 2 1)e 141.1--1"f')t)>f2.if- Furnace,etc. Gas heat pump Address: 12: e) , 2-)o`X r j.7 7 Wall/suspended/unit heater City/State/ZIP: 1.3.C-4.‘N/0,121--0 7 9 7 0 7 S Water heater ace Phone:(5 3) -2.,1.0 .- 7 y`t 5 Fax::(5113 5 ?c> 1-75 1 RangeFireplace 3 E-mail: F0(1132_0 co S `" -l+d�..S r0. cos Ail Barbecue t CONTRACTOR Clothes dryer(gas) Other. Business name: t e /'t'72.4:‘L. Iva._ t`, (,.,- MECHANICAL PERMIT FEES* Subtotal Address: P.o, i3e.)-?t 933Minimum permit fee($90.00) City/State/ZIP: e:L G m AS / Ca 0 t Plan review(25%of permit fee) Phone:(5;3) 6,5 .- / cj? ,r Fax:( ) 650-3 s 9i�`' State surcharge(12%of permit fee) CCB tic.: / 7 iG TOTAL PERMIT FEE This permit application expires if a permit is not obtained within days after it has been accepted as complete. Authorized signature * Fee methodology set by Tri-County Building Industry Service Bo Print name: 7)i Lt f 0 v DoiA)2, r.t.J`—Date: /9-7/6 -/l 1:\Buiidind+Pe*mi1stt EC PertoitApp 040113.doc 440-4617T(11/02/01RA WE8) Electrical Permit Application I (IR 4)1 r I/ i I .1 /,.1 , -a ti . ' a 4 5 Received City f Tigard 4 R. . Zi. Permit#: .:e.�. 1 t/ , a ��, ��s.� DateBy: �,,/ ,� ,r x � 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Related Permit#; Phone: 503.718.2439 Fax: 503.598.1960 k J C T 2 3 Z 019 Date/By: Ready Date/By: ./uric: ( BJ See Page 2 for Inspection Line: 503.639.4175 Su hrmental Information 1'' '=' Internet: www.ti and-or. ov f Notified/Method: t'P- TYPE OF WORK *\. PLAN REVIEW Please check all that apply(submit a sets of plans w/items checked): New construction ❑Addition/alteration/replacement 0 Service or feeder 400 amps or more ❑Building over three stories. Demolition 0 Other: where the available fault current ❑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. D Multi-family 0 Master builder 0 Other: ' , Mire Dame. Cl installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived Q Addition of new motor load of system. .Iola#: Job site address: e 9 U 5 V .> > Z..E-7 -- IOOIIP or more. 0"A",'•g,+,«1-2• •`I-3„ ` 7 ❑Six or more residential units. occupancy.' City/State/ZIP: 1(,A 1 0 O { - 7 Z-2'/ C]Health-care facilities. Q Recaeationai vehicle parks. 0 Hazardous locations. 0 Supply voltage for more tilt Suite/bidg.lapt #: Project name: Q Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SC.&n TLE. Description i Qty. I Bach 1 Total 1 4 1-1 LA- P)I V D '- Ca 'Z.E.LM:J%u A LA/ -- b r/4 New residential single-or multi-family dwelling unit. Subdivision: r - ' Lot#: Includes attached garage. ' "' 1,000 sq.ft.or less 168-54 Tax map/parcel#: -6611(.;:i .`(- t Lt) dl.IQ_1‹.. Ea.add'1500 sq.ft.or portion 33.92 DESCRIPTION OF WORK Limited energy,residential 75.00 : 7 (with above sq.ft.) I jE4 3 i!. 1/L s i- d; F=141-p.21%-y [ ES/De1't t Limited energy,mini-family 75.40 y{ : residential(with above sq.ft.) ti Renewable Energy I © See Page 2 Of PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less' 100.70 _ 201 amps to 400 amps 133.56 Address: "A I."� A5 se!r Z.())lA-» 401 amps to 600 amps 200.34 CityfState/ZiP: 601 amps to 1,000 amps 301.04 Fax:( ) Over 1,000 amps or volts 552.26 I Phone:( ) Temporary services or feeders installation,alteration,and/ Email. relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 Owner signature: Date: 401 amps to 599 amps 168.54 i Branch circuits-new,alteration.or extension, . r panel APPLICANT _ CONTACT PERSON A.Fee for butch circuits with i Business name: j�z�7-/ze- jS j cw7. .�C'6',1 CS above service or feeder fee, 7.42 each branch circuit Contact name: Nv f 0 L)-- A 12p?Csl2r B.Fee for branch circuits without service or feeder fee,first Address: P.0, e,ox 1 S-7.7 branch circuit 56.18 City/State/ZIP: , Yet?,roiO g.. 9. 767 e, Each add'l branch circuit 7.42 Miscellaneous(service or feeder not included) Phone:6d3)e7.20 .7 y V$ Fax: :(51,3 ).59O 1 .7 5 / Each manufactured or modular 67.84 dwelling,service and/or feeder Email: FO LI ca. D c.,,IS di "' M S . C:C+ii..itReconnect only 67.84 CONTRACTOR Pump or irrigation circle 67.84 Business name: 2,6.le' . .4,Gc.r- t..- `,Le Sign or outline lighting 67.84 Signal circuit(s)or limited-energy 0 See Page 2 Address: AtitallaW I r - panel,alteration,or extension. Each additional inspection over allowable in any of the all City/State/ZIP: ,, &..i T L, x/C? e.'J2., cI 72.2. O Additional inspection(1 hr min) 66.25/hr Picone:(5e3) Z 7 7 "" 3 789 ` Fax:(3 ) 9t / - 7,I// Investigation(1 hr min) 66.25/hr Industrial plant(1 hr min) 78.18/hr .Email: 1,.67- G- e-'t"F2,./C_6 g.ect f''61 C delta i i✓ , 64 44 Inspections for which no fee is 90.001 hr CCB Lie.:/ 7/Z7 V Electrical Lie.:C 6,39 Suprv.Lie.:5'76 L sj specifically listed(h hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required:`' ,� � ; „2�/ Subtotal: Print name: __,./.. .�7? 0 "iv ),4j! Date: el. -/ CI Plan Review Required(25%of permit fee): � � State surcharge(12%of permit fee): Authorized signature: j TOTAL PERMIT FEE � �/ This permit application expires if a permit is not obtained withh Print name: //)/iv/�7 - ,21-4_71‘;:X4 ate: .- J-' days after it has been accepted as complete. • Number of inspections allowed per permit. t:\Building'Pertnits\ELC PermitApp ELR ERE.doc Rev 04/21/201.4 440.46151(11/OS/COM/WEB Plumbing Permit Anplication Building Fixtures i t i iz til 1 t 1 , i , t i v i 1 ' Ci of Tigard $ Received Permit Na.: iya 13125 SW Hall Blvd.,Tigard,OR 97223 h„,. Plait Review La�� ( z Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Perattt No.: ins c tion Line: 503.639.4175 tt�� '' I See Page 2 for pe' U C Date Ready/Dy; hi< ;:ii Internet: www.tigard-or.gov Notified/Method: 1 I Supplemental Information TYPE OF WORK FEE* SCHEDULE rig New construction 0 Demolition For special information use checklist Description I Qty. 1 Ea. Total 0 Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connectio CATEGORY OF CONSTRUCTION SFR(1)bath ,qzz�x t i 312.70 i SYR ti.)bath 1 t 1-and 2-family dwelling 0 Commercial/industrral SFR(3)bath /.t' / 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site ad'lities: Catch basin or area drain 18.76 Job site address 0 e/0 eI . yit /i�'c=2 - : v , ..a' �„ I 18.76 I Drywell leach lire,or Muth drain City/State/71P: 11 es,c4F,D c R. c y7 L.L V Footing drain(no.linear ft.:) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 i4 a e BLVDCv12,EGivs ,Altip y,v. - 90 ,F-iI,,, Rain drain connector 18.76 y Sanitary sewer(no.linear ft.: ) 1 Page 2 I Storm sewer(no.%irseat It.:-_) ?g_2 ' Water service(no.linear Il.: ) 1 1 Page 2 I Subdivision: D `te t Lot no.: Fixture or item: Tax map/parcel no.: -�444eBackflow preventer 31.27 Backwater valve 12.51 DESCRIPTION OF WORK Clothes washer 25.02 Gs f „SIM„SIM -' i=',14i=',14 he,i Ly R E�i.D ENt _ Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 %PROPERTY OWNER 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: Floor drain/floor sink/hub 25.02 Address: 514 tile- AS 13 CLo kid sbagt(Sia 25.42 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 cgrAPPLICANT0 CONTACT PERSON Interceptor/grease hap 25.02 ' r Medical gas(value:$ ) Page 2 Business name: x-.L-ST7667 « %�, "/) ::� Primer 12.51 Contact name: /4 qr i'P 1Th&- jg A-g y P4.) -T" Roof drain(commercial) 12.51 Address: T 0, abx 1 S .7 7 Sink/basin/lavatory 25.02 City/State/ZIP: ,Z3&7.11/C-g.ro Il j C R f 7 o 7-S Solar units(potable water) 62.54 Phone:(5033 ) '7:A78.-7V5 Fax::(543)5-90..J 7 5/ Tub/shower/shower pan 12.51 Urinal 25.02 E-mail: 6 U P... p 66 h/S r A/i! A/ C.'C//7 Water closet 25.02 i CONTRACTOR 'Water Nuel i 31.52 Business name: --1-fit L lv/to(,L,c A f m?f\1.-:),/J Water piping/DWV 56.29 Address: /66/ /04 ,5,C, ,)1 lj l to I2 Rd. Other: 25.02 City/State/ZIP: iiiii4 G. i pd_ 5?7/12.3 Subtotal / Minimum permit fee: $72.50 Phone:(-543) 6, o 1.l/3 Fax:( ) Plan review (25%of permit fee) CCB Lie.: 7.2 6 e?:v' Plumbing Lie.no.:-?V--26e P6 State surcharge(12%of permit fee) Authorized signature../71 "->"_-.---7.__ J • 1 TOTAL PERMIT FEE r% /r This permit application expires d a permit is not obtained within 180 Print name: �-�v,� ��t✓--�--mate: /-�� / after it hes been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Boar I:Building\Permits4PLMU-PermitApp.doc 10/01/09 440.4616r(10/02/COMMBB) City of Tigard 1111 III COMMUNITY DEVELOPMENT DEPARTMENT i T I G A R D Building Permit Review — Residential Building Permit #: /17,51-, G9— Site Address: &1 0°1 6NA1 (ne 7.- Project Project Name: Irma Dell iu -A.G{dQ PAM Lot #: l (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review • -}� Proposal: I'ZVJ s J Al 'IT ' t`ft K.Verify address/suite#active in Accela. X In River Terrace: X No ❑ Yes,River Terrace Review Addendum Site Plan Elements: .:Zi •sion Control 1X3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper L 'etained trees with drip line and tree protection measures Drawn to scale(standard architect or engineer scale) XFootprint of new structure(including decks)and FFE North arrow AUtility locations&easements(required for new and additions) $Site address,project or subdivision name and lot number ASidewalk/driveway approach Applicant information(name and phone number) , cation of wells/septic systems of dimensions and building setback dimensions treet tree size,type and location /`Square footage of buildings to be demolished „ Street names ilki-Existing structures on site Corner elevations(2'contours if more than 4'differential) f jLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ee/ No impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Yt s No Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified 1FCNo Received: ❑ Yes Cl No Ne Public Facilities Improvement (PFI) Permit: ' A037,011-06°14 Required: ❑ Yes,applicant was notified IR'No Applied For: ❑ Yes ❑ No,stop intake 10. Land Use Case#: 946201D—1ID—OcotoJ UN1-7 14-0 003 j 1( Zoning: R"'4S . equired Setbacks: Front: '� Rear: 1S Side: S Street Side: NI Garage: "?...0 r � LYV Building Height: Max. Height: BO Actual Height: V 1s Landscape Area: % iktilikhot Coverage x: % l 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 11O j A-cei(./1'v9 -c L LL ,, Garage Garage door is behind widest street-facing wall IS Yes ❑ No,one of the following is met: FA1 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 do r width is ❑ 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following: spf" o re h ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset n p Fir s les El Lap Siding CI Roof pitch ❑ Gable,hip,or gambrel roof El Dormer *API ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection El Balcony Visual Clearance Urban Forestry Plan Sensitive Lands: ❑ Yes No Type: Conditions Vo rio CStJC issuance o lbuilA L • �_��1) e� -As LZ�/4 L UO "r Z.� U � 'T V Approved By Planning: � Date: 10"1.3'1°‘ 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_022819.docx Building Permit Submittal Original Submittal Date: Site Plans: # Building Plans: # 3 Building Permit#: , ,,�,.Enter building permit#above. Workflow Routing: L' nning LSI-engineeringICJ �rmtt Coordinator ding 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 ori anal 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: ‘r7 - Date: �d��..y�/7 Engineering Review 2'5lope at building pad: c'20 70277nditions "Met"prior to issuance of building permit l�/ sements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: El Yes eNo Assess Water Quantity Fee in-lieu: ❑ Yes eNo LIDA Facility on lot: ElYes L No Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: Date: /d/Z7%, Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved 0 Not Approved Revision 2: ❑ Approved 0 Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review 0 Conditions "Met"prior to issuance of building permit vE(Approved,NOT Released: ;14ir n /¢Pnt*+2..,Th/lto� "181 1 Date: 1e)/24111 Notes: tL-- Revisions (after Building Submittal only) 1 Revision Notice 1: Date Sent to Applicant: Pit ( Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: DC Fees Entered: Wash Co Trans Dev Tax: [�7)y es ❑ N/A Tigard Trans SDC: L�d'�Y ❑ N/A Parks SDC: L Yes 11,Z1/A/ LIDA CI C� A OK to Issue Permit Approved by Permit Coordinator: Date: 1 / -?7/11 1:\Building\Forms\B1dgPermitRvw_RES_022819.docx