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Permit (13)
City of Tigard • INII COMMUNITY DEVELOPMENT DEPARTMENT ■ TIGARD Building Permit Review — Residential Building Permit #: nir Pi -a-()ifi4 Site Address: 86$I W Grrequitir4 LsAA,L I Project Name: Griutisi,,,�,-d ekrk ,fli.Z ekr�-i D, Lot #: Z, (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review /I/t8/1'i: ie ,--,,/ 5,A /)L Pro osalg Ntv At\AGLA SP P . Pta, #- 1151 CO zv. re lur-41.-x•2.1 -6,� �,�i e/,, LK Verify address/suite#active in Accela. Veln River Terrace: IE No ❑ Yes,River Terrace Review Addendum Siit5/Plan Elements: gEr Sion Control L_u,"3/opies of site plan on 8-1/2"x 11"or 11 x 17"paper ained trees with drip line and tree protection measures L�'D awn to scale(standard architect or engineer scale) f2F tprint of new structure(including decks)and FFk rth arrow C ty locations&easements(required for new and additions) UK - address,project or subdivision name and lot number , idewalk/driveway approach �' •ilicant information(name and phone number) A • ation of wells/septic systems leo .t dimensions and building setback dimensions tree size,type and location A square footage of buildings to be demolished LA'S et names xisting structures on site L7 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? L_,1 ❑No ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? IRV'es ❑No Er Clean Water Services—Service Provider Letter(lof platted prior to 9/10/1995): yeLlgained: ❑ Yes,applicant was notified Ind No Received: ❑ Yes ❑ No EV Public Facilities Improvement(PFI) Permit: Re aired: ❑ Yes,applicant was notified L� No Applie For: ❑ Yes ❑ No,stop intake L5' and Use Case#: I Fly rf 0 O o3 Ud Coning: PQ,-y.S '43uilding equired Setbacks: Front: 1,0 Rear: 15 Side: S Street Side: ill- Garage: 1.6 Height: Max. Height: 30 Actual Height: 14 (Landscape a: % tLIALot Coverage Max , Entrance back no more than 8'from street-facing wall IP Parallel to street or offset 45 degrees or less Windowsct um 12%of area of all street-facing facades 31..V. Garage V Garage door is behind widest street-facing wall es f +,one of the following is met: ❑ Door extends no more than 5'from wall and there is a overed porch extending beyond garage. Door extends no more than 5'from�wa d there is a 12 sq ft.window above garage on 2nd floor. Lvl Garage door width is ❑ 12'or less Ly 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 ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding indow trim ❑ Window recess ❑ Window projection ❑ Balcony Clearance Urban Forestry Pan iyisual nsitiLands: 1=1 Yes [t No Type: ditions met prior to issuance of building permit No s: Approved By Planning: .2n-9--- l Date: [(H4-11-11 I' Revisions (after Building Submittal only) ewer Date Revision 1: 71 Approved ❑ Not Approved :li /'_. Align— Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPennitRvw_RES_022819.docx 6 Building Permit Submittal Original Submittal Date: 4,?3/!'f Site Plans: # Building Plans: # 47 BuildingPermit #: ❑ ter building permit#above. Workflow Routing: nPlanning Cr.E?igineering rmit Coordinator 3—Betiding Workflow Sign-off: [Sign-off for Planning(include notes from planning review) Route Application Documents: gineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. ding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: m/ /5 Engineering Review [?1 Slope at building pad: '3 e, El Conditions "Met"prior to issuance of building permit ❑'Easements (encroachments)per engineering conditions of approval and plat CM-Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 13' No Assess Water Quantity Fee in-lieu: ❑ Yes a No LIDA Facility on lot: ❑ Yes Er'No IZT Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: 12r Approved by Engineering: 6 ti*.tc, &j Date: 10 • Zg• Zd i 1 Revisions (after Building Submittal only) Reviewer Date Revision 1: Approved 1117T Not Approved /-fry.6.21 ,�,,. C 1121)/U'i? Revision 2: ❑ Approved 111 Not Approved JJ 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: SDC Fees Entered: Wash Co Trans Dev Tax: yes ❑ N/A Tigard Trans SDC: EtXs ❑ N/A Parks SDC: ir Yes �❑ 1,1,/A. `v LIDA ElYes L�1'N/A i i/2-.0 p OK to Issue Permit • Approved by Permit Coordinator: , ' Date:l0 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 : _ N Transmittal smlttal Letter r G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: G/// �-a,\J DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: TE4 qa-T NOV 18 2019 CITY OF TIGARD COMPANY: 5c1. -nc_E nome-5 BUILDING DIVISION PHONE: So 3- .-79-3.7._7 7 By:8-1) RE: g61( SEA) 4-41Y/5/44",-.1 orl—00443- (Site Address) (Permit Number) 5 ry 7,hi( IG'). . l ?",01.. (Project name or subdivisiaryhame and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s)of plans. / Revisions: 5 is Pi..44.0 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: MOY1D ,CbcewD-'7G0 A,S f-G & in/ESC jp )4-ti pm) rzooL to co- -K- E 4c-r o t./P4- F-4-au-cp 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 it provides helps the review process and response to your project. 11111 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT = N Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • wward-or_gov TO: G//7 0 \/ DATE RECEIVED: DEPT: BUILDING DIVISION RECVED FROM: �G4J 7c (L7 N 18 2019 ITY OF TIGARD COMPANY: 5101t.;-rIcE caGTn i Ny =UILDING DIVISION BY: PHONE: 5"0 3 —a-7,.7 7 RE: kt'S 6r-16/5A-wed A. it(S7720l9—004‘12— (Site Address) /� (Permit Number) ( Y)S 647 AM" At rje ! roject name or subdivisio ame and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: • Additional set(s) of plans. / C/ Revisions: 51 iE pz_AdO Cross section(s) and details. ► " Wall bracing and/or lateral analysis. Floor/roof framing. P. y\\\rf Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: molrL`'D rowv iI-'/rte ), n t l J S( 75 LL.Da.) ;wl 7-6 00-r-- EA or 444-- F-4L11,1 F R O FICE USE ONLY Routed to Permit Tec • cian: Date: 1( 7 (1 Initials: Fees Due: 'Yes • No Fee Des ripti n: Amount Due: $ Ot) 1/2— 044,‘. rt f .ALJ $ �j • $ Special Ins ruc 'ons: Reprint Permit(per PE): [' Yes \ ❑ Done Applicant Notified: 64e -- Date: `/; Zdit y Initials: t;/ / I:\Building\Forms\TransmittalLetter-Revisions_061316.doc CITY OF TIGARD MASTER PERMIT I. COMMUNITY DEVELOPMENT Permit#: MST2019-00412 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/07/2019 T t(_ A R[7 9 Parcel: 2S 111 AA07400 Jurisdiction: Tigard Site address: 8681 SW GREENSWARD LN Subdivision: GREENSWARD PARK Lot: Project: Greensward Park No. 2, Lot 2 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 4 First: 2288 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 18 Bathrooms: 3 Second: 0 sf Garage: 464 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2288 sf Value: $308,696.74 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains. 0 Tubs/Showers: 3 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: 4 201-400 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 2288 Owner: Contractor: SOLSTICE CUSTOM HOMES Required Items and Reports(Conditions) 5740 SW ARROWWOOD LN 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97225 PHONE: PHONE: 503-709-2277 FAX: 503-297-0104 Total Fees: $33,365.37 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 y obtain a c;"o,, e rules or direct questions to OUNC by calling 503.2 mi,987 or 1.800.332.2344. Issued By: / ' i Permittee Signature: ,� Call 503.639.4175 by 7:00 a.m.for the next available inspec •n 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 ' Residential FOR OI 1 l( l: l Sl. O\I.1 IN City of Tigard Received ` l �, Permit No.: r.-�n __ Plan B : C. Y I , • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review / Other Permit: c C Phone: 503.718.2439 Fax: 503.598.196000 2 3 2019 Date/B : ca�� 5'. TI G A R D Inspection Line: 503.639.4175 Date Ready/By: gl See Page 2 for Internet: www.tigard-or.gov CITY O 3 1 Notified Method: EN Supplemental Information X,§ o I'V4va Li90ri - TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING New construction ['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,and6he profit or the CATEGORY OF CONSTRUCTION work indicated on this application. 30 ( (4,9 Ei]/j-and 2-family dwelling ❑Commercial/industrial Valuation: $ D Li❑Accessory building 0 Multi-family Number of bedrooms: x ❑Master builder 0 Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: / 1 • 7' ��j Job site address: jf't ffl 5%) C?t1&l-x,,51,0 -p �f New dwelling area`-i L, s J square feet City/State/ZIP: --1/ oR of ZZ 4 Garage/carport area: Ill square feet Suite/bldg./apt.no.: Project name: Covered=area: . /Z. square feet Cross street/directions to job site: /4 A_ t_ To 6-ia.---e.-Nt9,440 LA. Deck area: /V1 p��square feet ittentinfit warit,. ` i j ' v 44.4, et Other structure area: / square feet li y'-F • [�, - , j REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:/74,04„Ez_ 1 Gree rUS D P' Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: N(7. ). i74t777/Urtl 2-5/0144 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. NC: '7e 74a-> D �)N4L(: ��1n'l1C �� Valuation: $ Existing building area: square feet New building area: square feet PROPERTY OWNER 0 TENANT Number of stories: Name: 5 t15 TI Ll= cis1 r7TLYt"1 /4„c,vices. Type of construction: Address: 61140 Si,t) 412.4wa;&oD Occupancy groups: City/State/ZIP: 104:rt, ? al, 6)77 Z5 Existing: Phone:(5;' ) 70 n-,z„q"?7 Fax:( ) New: reAPPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: 5/(�iri►C A-5 �vttlL� (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: Amount received: Phone:( ) Fax: :( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. �,+ Submit two(2)sets of roof plan with connection details Business name: E D"v1�L/�- and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: /C3 4,„3 3 //t.`OZ' Total fee due upon application: $201.60 Authorized signature: li/dAsiy/77 )k %' cJ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: �p� Date: *Fee methodology set by Tri-County Building Industry �t�t+"/ /0'23 Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02(((/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Received I g Date/B : Penuit No 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: 1 Phone: 503.718.2439 Fax: 503.598.1960 I I _ li i 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. M ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 12/- ❑ ❑ 3 Verification of approved plat/lot. a ❑ ❑ 4 Fire district approval required. Name of district: . [j. ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ p ❑ 6 Sewer permit. 0 ❑ ❑ 7 Water district approval. E' ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. [j' 0 ❑ 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ 0 ❑ 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 ❑ 0 ❑ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator,lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0 ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ 0 ❑ 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- 0 0 ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ 0 systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 0 ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 ❑ architect licensed in Ore.on and shall be shown to be a..licable to the sro'ect under review. .JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 El ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 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(1 1/02/COM/WEB) Mechanical Permit Application FOR OFFICE USE ONLY City of Ti and �,. Received Permit No.:g Date/By: �t ) Ill ill 13125 SW Hall Blvd.,Tigard,OR 9722C 9 Plan Review i = Phone: 503.718.2439 Fax: 503.598.1960 Date/By: TI GA R D Inspection Line: 503.639.4175 Q CT 2 3 2019 Date Ready/By: Juris: Ed See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* land 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: y Air conditioning C 46.75 Job site address: fjf'j 5.`t. /'/7 le %'„ Furnace 100,000 BTU(ducts/vents) f 46.75 City/State/ZIP: 'l/.7 'a,„. et7Z Z Furnace 100,000+BTU(ducts/vents) 54.91 �/ Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or P/4---4- Th 1/,.e..imlivoy j 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 Oth Subdivision: Lot no.: er' 23.32 Other fuel appliances: Tax map/parcel no.: Water heater / 23.32 DESCRIPTION OF WORK Gas fireplace/insert / 33.39 Flue vent for water heater or gas Nj LA-) 5%/vif f.L I rt/1%'/L.y fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 1 23.32 Chimney/liner/flue/vent 23.32 Oth EkPROPERTY OWNER ❑ TENANTS' 23.32 Environmental exhaust and ventilation: Name: til-, /j(..t-; (y2`:/0A, /4ti.:-,1 e.--s Range hood/other kitchen Address: �" t 1 v equipment j 33.39 `�T y D 5t fl1t)t t_. is Clothes dryer exhaust { 33.39 City/State/ZIP: p "L, D Q‘2, (4777-.5 Single-duct exhaust(bathrooms, L j 1 T 23.32 Phone:(fie;y) -7;'('''. 7"l"`7 Fax:( ) Attic/crawlspace fans 23.32 lia4PPLICANT 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name: 5 ct U' GLS Lv),`/'`L $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. 1 Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace 1 Range t E-mail: Barbecue 171..4:,-'1,';',,,'4,14.,r"-;,f. , " x"CONTRACTOR Clothes dryer(gas) Other: Business name: G e—A7J7//��,'�"- A e MECHANICAL PERMIT FEES* Address: wq 9 56- 3-vi(L EN Subtotal City/State/ZIP: (L �/ Al 0 tg C 701 c Minimum permit fee($90.00) / / Plan review(25%of permit fee) Phone:( 0`1) Fax:( ) State surcharge(12%of permit fee) CCB lic.: 1 7 E^. L I D= TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: �� * Fee methodology set by Tri-County Building Industry Service Board Print name:4.144/l pt- gyC / Date:/0,z 3.1 BGa} I:\ uilding\Permits\MEC_PermitApp_040113.doc 440-46171(11/02/C((OM/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. I:\Building\Permits\MEC_PermitApp_040113.doc 2 RECEIVED Electrical Permit Application oi 1 l( I' 1 'NI:011 't 2 City of Tigard OCT 8 2019 D3tda: 112LiPPRinglaiMPI Iii ® 13125 SW 11311 Blvd.,Tigard,OR 97223, ' I Phone: 503.718.2439 Related Permit N: ., , . Entail: TigardBuildingfemtirsOTigaid-o40'01NG _ h.h: El Ste Page 2 Mr ,,ITY OF TnIGIvAisRiDot, ti:,,,:7:11yRzi:i:ny, itc'A''') Inspection line: 503.639.4175 Internet: wsvw.tigattl-or.gov Notified/Method: Supplemental Information , .7,,,,'.,-:.,..,:i7.5, :i:-.,1,-.k.'::-;.17.10:pro-kv.,-,- il,:f,:::-];-%,-,,sig.!:f.-,',-::--•,' ':':.-A,11-11-t '''',- .1-'1:1-V.L514A,'INil,i'Milkt.W.0.'-':',,r4;-•:-,1,;,-;0:;: W.4-6w construction D Addilion/alleration/replacement Please check all(MI apply(submit 2 sets of Mans wiitems checked): 0 Service or revicr400 tamps or more 0 fluilding over three stork,. 0 Demolition 0 Other: where the available fault current LI Marinas and boat)ards etttgbct1Vit;.dt;0644Mu,Oicig.•'.;.z• '...:,,..--' 1- ,....- ; excccds 10,000 amps at ISO volts or 0 Floating buildings. less to ground,or exceeds 14, la-I:and 2-family dwelling 0 Commercial/industrial 0 Accessory building 000 0 Conunercialque agrkultum I amps rot ati other trutallotons. buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 imtillalkm of ISO KVA or 4.013.-SiTt:'iPirOrkMATION',AND tOOATION.•":.:. '' ' 0 EmrtscncY xYricm brgcr st paratety deal ed , °Addition°(rew nailer load of 1)1 kill. Job#: Job site address: g61 .51A) Cir.ellipix?„-j tpi 1001IP or mum .-----. i .6" 0 Six or MOM tesideatial units occupancy, Cily/State/ZIP: /la,of ox, 0(7474 LI north-care factlilks. 0 Recreational vehicle parks / Suite/bldg./apt.11: 1 Project name: 011szardous locatiors. 0 Supply voltage fur mete than 0 Service or feeder 600 amps or more. 600 volt'no rni2aL Cross street/direclions to job site: /14.6t.. 77.3 0 6-civsu4itp Li,...) . .: ,.--, .. . .: - pEE sc,ii.EgOtE::;.'. .. eticriptrao I Ory. J Each I Total T• New residential single-or muld-fandly dwelling milt. Subdivision: Lot#: Includes attached garage. 1,000 sq.11.or less 168.54 4 Tax map/parcel II: Ea.add'I 500 sq.It.or pot lion 33.92 1 : ''••." '' ,-...'.:"::--.':.•-'..• ':.: .1) SeRftriON....1;14F.WQRR'-'''‘,',"';'''•;'''...', ' .*:' '.';: .: limited energy,residential 75.00 2 (with above sq.ft.) United energy,multi-family 75.00 2 residential(velth above sq.il.) Renewable Energy 0 See Page 2 8214kOPF.II,TY OWNER " ] = ' . "',.: 0 TENANT ':' : ..,-.:.' Services or feeders Installation alteration,and/or relocation Name: 5 a.6 Ti Li',...--- ciArgom hbool 6--S ... 200 amps or less 100.70 2 201 amps to 440 amps 133.56 2 Address:51q17 S(.4) 412.11,1V)&10D0i) 1-0 401 amps to 600 amps 200.34 2 City/State/ZIP: Top_r4,4* Og, •."•-)7,?..,5 601 amps Co 1,000 amps 301.04 2 / Phone:(90-7) -7f>,.... r7 7 Over 1,000 amps Of volts 552.26 2 Email: 4j,34j,3 -7444y' 7Temporary services or feeders installation,alteration,and/or ge_4/nittz...,cot--i relocation . Owner fastellration: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: Dale: 401 amps lo599 amps 168.51 2 .,:,-- -'i •.- :.••:,,:_0,.:0510,...A.,:r. 4,trigten,,, .;.:, A.Braan:hrocribrranculctlisc-irtunesivu,:lilt/ration,or extension,per panel Business name: 5A-ria iel- • AA/a ai - above service in feeder fee, 7A2 2 each branch circuit • Contact name: 13.Pee far branch circuits stdihour - service or feeder Ice,first Address: branch circuit 56.18 2 City/State/ZIP: Each edti'l branch circuit ' 7.42 2 - Miscellaneous(service or feeder not included) Phone:( ) Each manufactured or modular 67.84 2 dwelling.Se:Nice and/or feeder Entail: Reconnect only 67.84 2 CONTRACTOR. -.. •- -. • : . . ..: ' : ' Pump or Irrigation circle 67.84 2 _...___. Business name: L,-_--.,1,,Ift.--,-- / -g46.. g.otf/0 sign or outline light ing 67.84 2 Address: 414E4 Ate- /ii5±. 41..,g1 50 trc- E panel,attention,or extension.Signal circuit(s)of limited-energy 0 See Page 2 2 City/State/ZIP: roAt,t),, Each additional Inspection over allowable In any of the above cel , 01( ei72,500 Additional inspection(I hr min) 66.25/hr Phone:(90) (432_ ,.- 0-015- Investigation(I iambs) 90.00/hr Industrial plant(I hr min) 78.18/hr Email: /1- El/reel ar-r/b/cP_D0/1't t 0 it b...2-- Inspections for whichfee no is 90.00/hr CCB Lie.: le) --1 Electrical Lie.:C‘,3q Suprv.Lie.: .5-7.‘2.5. specincally listed CA hr min) ELECTRICAL PEIIMiT FEES Suprv.Electrician signature,required: Subtotal: Print nome: j Date:,'o.4%/9 0 Plan Review Required(25%of peonit fee): State surcharge(12%of penult fee): Authorized signature: TOTA I PERM IT FEE: - This permit application expires If a permit Is not°Mallard within 180 Print name: / O -, 7"O 4/,...01.,eile jar 12., 17.7ate:/1,•----7,7(.77--/C.7 - days after II has been accepted as complete. , Number of inspections allowed per permit. IADoili;:tanm.k.al.0 PertAApp_EIJI_ERFix Re/18'260317 4 in4ria2(11X,PCONSAVell Electrical Permit Application Folz orFict: t si: a\1,1 City of Tigard Received �� i Date/B 71 - 13125 SW Hall Blvd.,Tigard,OR 97223 +*�� +t: F Plan Review Phone: 503.718.2439 Date/B : Related Permit#: Email: TigardBuildingPermits@Tigard-or.gov ± r T 9 "J 20't Ready Date/By: Juris: RI See Page 2 for T I G A R D Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK „ r, .r r` i ). ''` :. PLAN REVIEW Rw construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition 0 Other0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ©T and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural 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 derived }} ❑Addition of new motor load of system. Job#: Job site address: 6�/ 5(/l) 6yv.Q2yt5 ' ✓I Glr 100 HP or more. ❑"A","E","1-2","1-3", City/State/ZIP: ./ `` 01722-V- ❑Six or more residential units. occupancy. //jar"( "r Recreational vehicle parks. J 0Health-care facilities. 0 Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: //46L, O ,2 N541, P L) FEE SCHEDULE �'lI`„ Description I Qty. I Each I Total 1 New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 (PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: 5 Ctr/1-0. GL 4370/ PIDMES200 amps or less 100.70 2 Address: :5•-1 cv t.�DG) (_/u 201 amps to 400 amps 133.56 2 ! 401 amps to 600 amps 200.34 2 City/State/ZIP: n �0F�f �/ OV n` zZ 601 amps to 1,000 amps 301.04 2 Phone:(505) '7 D7 -g),7 7 Over 1,000 amps or volts 552.26 2 '` P � Temporary services or feeders installation,alteration,and/or /tpc, Email: �/?n4f1 , cok-7 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 (APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: ,4 yyl rr As 0014 L above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: /6,1 IL� /%66--crkJ G 420th' Sign or outline lighting 67.84 2 Address: } Signal circuit(s)or limited-energy �y� �y 0 See Page 2 2 i �- (� l V�%I 5(,( � (G panel,alteration,or extension. City/State/ZIP: r/�Atz ,�(�%� 0� G� Z Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(9o.3) y3L , gii-Lic Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email: M A_)((✓ 6,/7t2.,✓ '/LIC:r`��X t Ufrx Inspections for which no fee is 90.00/hr CCB Lic.: 2 ej/2,,-7e../ Electrical Lic.:c 631/ Suprv.Lic.: specifically listed(%hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. I Each I Total I * Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 n A• udio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: n B• urglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 n Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 n Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: n Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('h hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES SubtotalEnteron Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls n Clock Systems n Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC n Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical n Nurse Calls 7 Outdoor Landscape Lighting* n Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of TigardE E: R 5iew ived Permit No.: yb iii 13125 SW Hall Blvd.,Tigard,OR 97223 Plan D /By: �'� E �)'LI� = Phone: 503.718.2439 Fax: 503.598.1960 2 � Other Permit No.: T I GARD Inspection Line: 503.639.4175 U Date/By: Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov ,o„^t Notified/Method: Supplemental Information • TYPE OF WORK FEE*V.New construction 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 SFR(1)bath i 312.70 ®1-and 2-family dwelling Elm Comercial/industrial SFR(2)bath 437.78 ❑Accessory building ❑Multi-family SFR(3)bath 1 500.32 Each additional bath/kitchen / 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Catch basin or area drain 18.76 Job site address: 5,81 51)) 6„,ee445 � City/State/ZIP: 1t�j t,,,c+ 4/1 Z7 l/i Drywell,leach line,or trench drain 18.76 f l Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name:4y2Ct icri,vi104,44„,4) 2._ Manufactured home utilities 50.03 Cross street/directions to job site: ( i(!aA) - Manholes 18.76 H 4d.(- T 4 1(✓1u 5 ti)14/2-p LAO Rain drain connector / 18.76 Sanitary sewer(no.linear ft.:J!) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.:." ---) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer j 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer j 25.02 Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 10'1-PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name:y ,i'Ttz- C L >4 iit,,_ 0004 Floor drain/floor sink/hub 25.02 Address: tj 1 D (/J '171-UL�,,L;i',',? LA) - Garbage disposal 1 25.02 City/State/ZIP: f, '(i 4)) C'Jif- 0-72z-5 Hose bib rL- 25.02 Phone:(51. )70,.)-�.,z 7 7 Fax:( ) Ice maker / 12.51 [j APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: t fi Medical gas(value:$ ) Page 2 t: A-5 et),,,,E12 Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 5 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 2- 12.51 E-mail: Urinal 25.02 CONTRACTOR Water closet 5 25.02 61X0/40. Water heater / 37.52 Business name: ..-.;--,.t%4L, ty5 00 At W4 j Ai pLwmq///J4 Water piping/DWV 56.29 Address: l co 0 t.. J J Are /Q / Other: 25.02 City/State/ZIP: � GCs �- h ) C9 771 2_3 Subtotal Phone:( ) (9t�i Oq �L( 3 Fax:( ) Minimum permit fee: $72.50 CCB Lic.: q Z 66-c) J Plumbing Lic.no.: 3y , j�� Plan review (25%of permit fee) �I ' � � �i �/y� J State surcharge(12%of permit fee) Authorized signature; 4i % C TOTAL PERMIT FEE J l /,p,--?7, This permit application expires if a permit is not obtained within 180 days Print name: (� _ Date: after it has been accepted as complete. *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) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-1"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Ins ections or Fees Qty' Fee(ea) Total each additional$100.00 or fraction thereof,to P and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge 1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. Jacuzzi Whirlpool Car Wash: -Each Stall El New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial 0 Any multipurpose fire sprinkler system. Domestic 0 Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram 4» 0 Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -lav/Bar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 City of Tigard r COMMUNITY DEVELOPMENT DEPARTMENT ■ . TIGARD Building Permit Review — Residential c Building Permit #: ,/ y/ iei—a-01 ,1 Site Address: 3&81 S J GrriNtA,, t Lfik AA, Project Name: GrtINswtrA ekrk Mi.Z P.r-1-itim Lot #: Z (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review II tt }�, COPro osal: NtIJ At\IGLa Sfi : Pta% It- 1251 C �/ w Verify address/suite#active in Accela. River Terrace: L" No ❑ Yes,River Terrace Review Addendum Siite,Plan Elements: IE ,sion Control [ 3/opies of site plan on 8-1/2"x 11"or 11 x 17"paper L1, 'ped trees with drip line and tree protection measures awn to scale(standard architect or engineer scale) Ilt' tprint of new structure(including decks)and FFE rth arrow 'ty locations&easements(required for new and additions) address,project or subdivision name and lot number idewalk/driveway approach 6' 'slicant information(name and phone number) 4 • ation of wells/septic systems Lt, e t dimensions and building setback dimensionsilVtreet tree size,type and location Fe.quare footage of buildings to be demolished �n et names xisting structures on site [ Comer elevations(2'contours if more than 4'differential)_ L -ot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? L'_7,Y ❑No ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? [ 'Yes ❑No Cl Clean Water Services—Service Provider Letter of platted prior to 9/10/1995): quired: ❑ Yes,applicant was notified Lrd No Received: ❑ Yes ❑ No L1 Public Facilities Improvement(PFI)Permit: Re aired: ❑ Yes,applicant was notified C�7"No Appliiee For: ❑ Yes ❑ No,stop intake '.L'J' and Use Case#: ����-0003 l� Zoning: 12'14•S equired Setbacks: Front: 7,0 Rear: 15 Side: S Street Side: g"r Garage: 24 E Building Height: Max. Height: 30 Actual Height: 10 kfrLandscape a: % tELALot Coverage M�ax:/ 0/0 Entrance back no more than 8'from street-facing wall L5'Parallel to street or offset 45 degrees or less Windows um 12%of area of all street-facing facades 311,.. Garage V Garage door is behind widest street-facing wall es i''''re,one of the following is met: ❑ Door extends no more than 5'from wall and there is a overed porch extending beyond garage. Door extends no more than 5'from�w d there is a 12 sq ft.window above garage on 2nd floor. [ Garage door width is ❑ 12'or less [ 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 ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding endow trim ❑ Window recess ❑ Window projection ❑ Balcony 'sual Clearance rban Forestry pan Sensitive Lands: ❑ Yes [ No Type: C ditions met prior to issuance of building permit No s: )) ���� Approved By Planning: sA, co,,,,1L- Date: k)-L3-1q $ 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: tegolVief Site Plans: # Building Plans: # Building Permit#: L`i<ter building permit#above. Workflow Routing: LPlanning -E1i'meering C '-rmit Coordinator 13-1311ilding Workflow Sign-off: 1-Sign-off for Planning(include notes from planning review) Route Application Documents: --1?igineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. C3-wilding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: - • Date: 1 y Engineering Review Cr Slope at building pad: 3 90 Cr Conditions "Met"prior to issuance of building permit 0'Easements (encroachments) per engineering conditions of approval and plat a-Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Er No Assess Water Quantity Fee in-lieu: ❑ Yes C3' No LIDA Facility on lot: ❑ Yes 'No ET Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: 1j n.ao �j Date: lo • Zg• Zd t`� 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: SDC Fees Entered: Wash Co Trans Dev Tax: Eyes ❑ N/A Tigard Trans SDC: ❑ N/A It Parks SDC: id Yes ❑ NJA LIDA ❑ Yes L'1�'N/A OK to Issue Permit Approved by Permit Coordinator: /j��ate:lb/3-15ie( I:\Building\Forms\BldgPermitRvw_RES_022819.docx