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Permit
.PlumlbingPermit Application BuildingFixtures ity � RECEIVE UM (411( I I �C 0v1 4 �{ AUGf Tiga 06 202f D2el //5,2.) 4 ) Peaitxyy$.rze I`'1—t 9335 13125 SW Hail Blvd-,Tigard,OR 97223 7 Phone: 503.718,2439 Fax 503.598.1960 DaioBy: P rmin� i I", , rI) Inspection Line: S03.639.4175 CITY OFTIGAR' Iamea Internet: www.tigard-or.gov a a tea: J is See raja 2 for TYPE Otf-wok L formattoo iTEE+'. SC#I18Dtytn" 21 New construction 9Demolition For special hijorma@dnuttchoel-Irrr 0Additiodatterstionheplacement ❑Omer Dosut}nion I Oft J Ea. I Total New 1-2-family dwellings(includes 100 ft.for cad utility connection) CATEGORY OF CONsraucrtoN 8FR(1)bath 312.70 121 1-and 2-family dwelling 0 Commercial/Industrial SFR(2)bath SFR(3)bath 50032 ❑Accessory budding ❑Multi-family 50032 Ell 0 Master builder 0 Other: Each additional btuivlcitctt) ■ 25.02 2- ) � JOB SITE INFORMATION AND LOCATION Steire sprinkler Wfca ( s9•R) Page 2 Site utilities: Job site address: : r, 0 $n,/ 57p:af 7 I=L cti'/'��( (_ ��1, Catch basin or drain 18.76 City/StateJZTP:Tigard OR a (! Drywoll leach titer or trench drain18,74 Suite/bldg./apt no.: Project Warne: ."2 Uf�r�J Q` - Footing drain(no.linear ft.:r_) Page 2 Mandtctured home tt him 50.03 Cross street/directions to job site: C , aamManhoks s 18 76 Rain drain Spector 18.76 Sanitary sewer(no,linear ft.:,•--) page 2 Storm sewer(no.linear R:._ __) _ Page 2 MIS Water service(no.linear ft.:•,) Page 2 Subdivision: Lot no.: Fixture or item: Tax neap/parcel no.: mow 1C'COkr 31.27 DESCRIPTION OF WORK.:. Baokwatu valve 12.51 / _1� )/ r ;: i.:•_., ...... -.;:: ..r::_:. Clothes washer l tuo i f .7_V a c/4 l�V cl ii ;iii--�,(, Dishwasher 25.02 25.02 hr,r g n. Al:'. 25.02 Ejectors/sump 25.02 PROPERTY OWNER .. • Expansion tank 12.51 Name:Westwood Homes LWFixtuttlsawa cap 25.02 Address: 12700 NW Cornell Road Floor drain/Poor sink/hub 25.02 City/State/ZIP:Portland OR 97229 floc disposal 25.02 - o Base bib 25.02 .111 Phone: Fax:(503)342-2403 Ice maker 12.51 '? APPLUCA „;.IQ ,CONTACT PERSON..'';: , Intewepmr/gicaseh'P _ 25.02 ME Business Warne: '" ' Medical gas(value:$._ ) Paget Contact name: • " Primer12.51 Address: Roof drain(c maae1a►) II 12.51 Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 4 Phone: Fax::( ) Tub/shower/shower pan 12.512.5 E-mail Urinal 25.OZ CONTRACTOR. Water closet25.02 Business name:HMI Mechanicalanical 37.52 Waterpiping/DWV _ 5629 Address:5757 SE Willow Lane Other iau1 ,cat-37 YVII City/State/ZIP:Mitwsulde OR 97267 Subtotal tobd Phone:(SO3)975-9787 Fax:(503)659.2979 Minimum permit fee: $72.50 CC?Lie.:I78122 Plumbing Lic.no4764/(1 Plan review (25%ofpermit fee) Authorized signature: ,,may , tt surcharge(12%ofpermit FEE 3.O w L Print name:Dew • ague Data TL6 prrmtt appticaatloaTOTAL PERMIT .2...r. G.3 1j/? �"""'•""�•�' ai{4rNwain'���k is sat obtained width,In gays "Fee medlodoloiy re by 7ri-County Bending�m Industry Service Board I:tautldirisWer tit ,lAU-P inhhAPPdoc 10A1N9 4+0-46t6710vvCOMnv&s3 CITY OF TIGARD MASTER PERMIT 1114 •.. COMMUNITY DEVELOPMENT Permit#: MST2019-00335 T I G A R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/13/2020 Parcel: 2S110BC13000 Jurisdiction: Tigard Site address: 12045 SW ASPEN RIDGE DR Subdivision: ESTATES AT ASPEN RIDGE Lot: 5 Project: Estates at Aspen Ridge, Lot 5 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 5 First: 1953 sf Basement: 620 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 4 Second: 1166 sf Garage: 807 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors. Yes Total: 3739 sf Value: $503,051.85 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain 0 Storm Sewer: 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: 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: 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 Ecompasing: Y Other: N Other Description: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 3739 Owner: Contractor: WESTWOOD HOMES LLC WESTWOOD HOMES LLC Required Items and Reports(Conditions) 12700 NW CORNELL RD 12700 NW CORNELL RD 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97229 PORTLAND,OR 97229 PHONE: 503-713-6294 PHONE: 503-330-2215 FAX: 503-342-2403 Total Fees: $37,761.18 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/6 on law requires f u to folio the rules adopted by the Oregon Utility Notification Center. Those rujes"are-,set forth in OAR 952-001-0010 thro h R 952-0 090. Y may obta' co of the rules or direct questions to OUNC by calling 5 32.1987 or 1.800.33 .2344. Issued By: 74 r Permittee Signature: Call 503.63 . 175 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. e- Approved plans are required on the job site at the time of each inspection. f Building Permit Application r i r...;.. Residential 1 0 R of i i('I: l SF ONLY City of Tigard A ll u 1 2019 Received 13125 SW Hall Blvd.,Tigard,OR 97223 t r.,, pl te/By: `7 I? r '"1* "' c0^co 33s' g t.... +,-t rn° r a,,„,. Plan Review a I �^j ...,/",r Phone: 503.718.2439 Fax: 503.598.1960 11 '�t,l� sin§tli,: Date/By: K T I G A R D Inspection Line: 503.639.4175 ate Ready/By: / Ions: H See Page 2 for Internet: www.tigard-or.gov Notified/met l ` Supplemental Information 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 ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ 5 I 051 ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder El Other: Number of bathrooms: Li UJ JOB SITE INFORMATION AND LOCATION. Total number of floors: ' -.3 / 4‘49 Job site address: 12 0(,,5 S 14 As t `. na1� Dr. New dwelling area: 3 7 3' t square feet 1/(if(40i City/State/ZIP: 7-74 r C .2( C 172.2 .( Garage/carport area: !II4 - 81quare feet /CJ 3 Suite/bldg./apt.no.: �j Project name:L5. q7L- 4.'"" G t Covered porch area: 1► .. square feet (a.,,Z) Cross street/directions to job site: eiC 'I Deck area: 2 CO square feet Oth c r quare feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot no.:...,5 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.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. New SFR p jGw�. 3-73 i Valuation: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:Same as applicant Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: ® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name:Westwood Homes LLC (Please refertojeeschedufe� t 1 V1 rC r� Structural plan review fee(or deposit): Contact name:. U 1 FLS plan review fee(if applicable): Address: 12700 NW Cornell Rd Total fees due upon application: City/State/ZIP:Portland,OR,97229 Phone:50 ---1'3"0 2/`► Fax: :( ) Amount received: E-mail: 4/U s(/Vje ji(//GJ,S�'�vQ?)of h Cryy\Q. [...LC,C r/m PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name: V /1ShVs,/ C Y S L IX Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: /27 0 0 (/IV a(l'l� (may Solar Installation Specialty Code checklist. ty PO �n of ©a- 7 ZZ ' Permit Fee(includes plan review $180.00 City/State/ZIP: and administrative fees): Phone:6w3) 71,3-- z q t/ Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:195597 Total fee due upon application: $201.60 Authorized signature: a...,W\c,z:uA7r./ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. / ��// *Fee methodology set by Tri-County Building Industry Print name: u swi I Date: 13/ �� / Service Board. I:\Buildin \Permits\BUP-RESPermi��02/24/2011 440-4613T 11/02/COM! B g PP ( �'E ) Mechanical Permit Applicatio " r ; --R 1\. " FOR OFFICE LSE ONL_v City of Tigard Received Permit No.: yy Date/By: 13125 SW Hall Blvd.,Tigard,OR 97223AUG i ,� 01 Plan Review = Phone: 503.718.2439 Fax: 503.598.1960 Other Permit: Date/By: 1"I ,A is D Inspection Line: 503.639.4175 V i i,'i - i i..7:, Date Ready/By: Juris. H See Page 2 for Internet: www.tigard-or.gov ;-.,t ttd p'stt,Rr, ?"t?i Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST - Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: A Air conditioning 1 46.75 46.75 Job site address: I Z t j i/,/ �,!�€ii "Yp� cr.� , Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75 City/State/ZIP: 0 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 1 23.32 23.32 Cross street/directions to job site: 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 1 23.32 23.32 Other: 23.32 Subdivision: Lot no.:5 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 fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Oth ® PROPERTY OWNER ❑ TENANTS' 23.32 Environmental exhaust and ventilation: Name:Westwood Homes LLC Range hood/other kitchen Address: 12700 NW Cornell Road equipment 1 33.39 33.39 Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP:Portland Oregon 97229 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 4 23.32 93.28 Phone:(503)713-6294 Fax:( ) Attic/crawlspace fans 23.32 ® APPLICANT ❑ CONTACT PERSON Other: 23.32 Fuel piping: Business name:Westwood Homes LLC $14.15 for first four;$4.03 for each additional Contact name:Allison May Furnace,etc. 1 14.15 Address: 12700 NW Cornell Road Gas heat pump Wall/suspended/unit heater City/State/ZIP:Portland Oregon 97229 Water heater 1 4.03 Phone:(503)713-6294 Fax::( ) • Fireplace 1 4.03 Range 1 4.03 E-mail:allison@westwoodhomeslic.com Barbecue CONTRACTOR Clothes dryer(gas) Business name:Performance Insulation&Energy Services Other: MECHANICAL PERMIT FEES* Address: 12700 sw hall blvd Subtotal 326.44 City/State/ZIP:Tigard Oregon 97223 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)598-8001 Fax:(503)598-8002 State surcharge(12%of pernut fee) CCB lic.:199448 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:Allison May Date: (pI/?)/�tq I:\Building\Permits\MEC_PermitApp_040113.doc 440-617T(11/02/COM/WEB) Electrical Permit Application AUGFOR OFFICE USE ONLY H g Received City of TigardIII b 2 G Permit#: Date/B w 13125 SW Hall Blvd.,Tigard,OR 97223 i Plan Review Phone: 503.718.2439 Fax: 503.598.1960 ' ',Jr l '"'7' Date/B : Related Permit#: Inspection Line: 503.639.4175 @ 111 -E t q -� 9y,.,� Ready Date/By: lurk See Page 2 for T I G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ®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 0 Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. El1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑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: i 2,0 L.f S SW lit^spell 100HP or more. ❑"A","E","1-2","1-3", City/State/ZIP: /24 /� ❑Six or more residential units. occupancy. a/l �r•❑Health-care facilities. El al vehicle parks. Suite/bldg./apt.#: Project name: Vi auu%.e5.� VV ❑Hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Lot#: 5 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 (with above sq.ft.) New SFR 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 ® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name:Westwood Homes LLC 200 amps or less 100.70 2 Address: 12700 NW Cornell Rd 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Portland,OR 97229 601 amps to 1,000 amps 301.04 2 Phone:(971)678-5018 Fax:( ) Over 1,000 amps or volts 552.26 2 (A S(11't 1m9s4 Ivo°c(how S LU.C' awl Temporary services or feeders installation,alteration,and/or Email: r 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 ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name:Same as Owner 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:( ) Fax: :( ) 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:Ross Electric Inc Sign or outline lighting 67.84 2 th Signal circuit(s)or limited-energy ❑ See Page 2 2 Address:2870 SE 75 Ave#203 panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP:Hillsboro,OR 97123 Additional inspection(1 hr min) 66.25/hr Phone:(503)642-2800 Fax:( ) Investigation(1 hr min) 90.00/hr Email:RossElectric@comcast.net Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 157891 Electrical Lic.: 34-436C Suprv.Lic.: 42325 specifically listed('/2 hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Stephen Ross Date: ❑Plan Review Required(25%of permit fee): r State surcharge(12%of permit fee): Authorized signature:,,, i L'►- TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: ,. Dater Jl cl i 4f days after it has been accepted as complete. ( * Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Plumbing Permit Application Building Fixtures H ,1,� FOR OFFICE USE ONLY • City of Tigard AUG G 1 5 2019 RDa1eyed Permit No.: IIIINI 13125 SW Hall Blvd.,Tigard,OR 97223 t 1lJ ll Plan Review C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑Demolition For special information use checklist Description I Qty. I Ea. Total ❑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 El1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 1 ZQI�S SW A S f'o , rlaty a Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard OR Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: • Project name:£ 7 C4 Manufactured home utilities 50.03 Cross street/directions to job site: ' / y) i� Manholes 18.76 I yil s a• /J Rain drain connector • 18.76 l--r . Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water Service(no.linear ft.:_) Page 2 Subdivision: Lot no.: 5 Fixture or item: Tax map/parcel no.: Backflow preventer ' 31.27 Backwater valve 12.51 DESCRIPTION OF WORK Clothes washer 1 25.02 new SFR Dishwasher ` 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name:Westwood Homes LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 12700 NW Cornell Road Garbage disposal ( 25.02 City/State/ZIP:Portland OR 97229 Hose bib L 25.02 Phone: Fax:(503)342-2403 Ice maker ' 12.51 123 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: WQ t �-w00d fiOYNQ S z.. 1 Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: . RL / J Roof drain(commercial) 12.51 Address: j 21 NV U� ! w Co (/\Q I i' Sink/basin/lavatory [Tn 25.02 City/State/ZIP: 17O( -(af' d cg g72Z 7 Solar units(potable water) 62.54 Phone: 3.-11!3--fo241.1 Fax::( ) I , Tub/shower/shower pan 1--. 12.51 E-mail 4/ `sar�WeS�W D D�/ ! QS ls•-C ei ant. Urinal 25.02 Water closet 14 25.02 CONTRACTOR Water heater ( 37.52 Business name:H&H Mechanical Water piping/DWV 56.29 Address:5757 SE Willow Lane Other: 25.02 City/State/ZIP:Milwaukie OR 97267 Subtotal Phone:(503)975-9787 Fax:(503)659-2979 l//f� Minimum permit fee: $72.50 CCB Lic.:178122 Plumbing Lic.no r L v/ Plan review (25%of permit fee) I/ State surcharge(12%of permit fee) Authorized signature: ,ter, -.-, , TOTAL PERMIT FEE Print name:Dusti a ue Date: / This permit application expires if a permit is not obtained within 180 days g if/ i after it has been accepted as complete. ` *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(l0/02/COM/WEB) 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 tii Transmittal Letter 11111 TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: /9-1 tAlgel' , DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED SEP122019 FROM: A 1. Li (J171 /1/1) (4./) CITY OF TIGARD COMPANY: VUOS-1-1it/Q add 01/K0 S t--C. BUILDING DIVISION PHONE: ,0-'�j 3- 2 qy By: RE: 10 LC SA) 45ftw / / 4( . irtST 201 q-CX3 33S (Site Address) (Permit Number)��5 (Project name or subdivision name a_d lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. X i- Revisions: ` (/SS €i I F\Qe.v/�7 Cross section(s) and details. Wall bracing and/or lateral ana ysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: FOR O FICE USE ONLY Routed to Permit Tec cian: Date: �t/((� (�} Initials:y1-'6- Fees Due: 1 El No Fee Descripti n: Amount Due: $ c,r-, t` $ Special Instructions: Reprint Permit(per PE): ❑ Yes E o�� ❑ Done/ Applicant Notified: �__._ Date: ,z11&//� Gj Initials: 91 I:\Building\Forms\TransmittalLetter-Revisions 061316.doc City of Tigard I/ ~ COMMUNITY DEVELOPMENT DEPARTMENT ,. ■ T I G A R D Building Permit Review - Residential Building Permit #: ��.oi -(4c3,c' Site Address: 1 ZM Sr.✓ Avti, gull, on Project Name: Ls J' �Qt, fix Lot #: a (New dwelling=subdivision name;fix or Alteration=last name of owner) Planning Review'' (` Pr. .osal: IVu &tivtt ct,i7i ei. _ ' ;I, Verify address/suite#active in Accela. oar In River Terra -: Lid' No ❑ Yes,River Terrace Review Addendum Site Ian Elements: L•I •sion Control copies of site plan on 8-1/2"x 11"or 11 x 17"paper I/ 'e : ed trees with drip line and tree protection measures yawn to scale(standard architect or engineer scale) U. yotprint of new structure(including decks)and FFE ©/N th arrow awn locations&easements(required for new and additions) address,project or subdivision name and lot number Sidewalk/driveway approach rllaplicant information(name and phone number) 'i :cation of wells/septic systems [ot dimensions and building setback dimensions ` eet tree size,type and location Euare footage of buildings to be demolished '_S,� et names xisting structures on site li Corner elevations(2'contours if more than 4'diffee ntial) Jot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 12 ;. ❑No pervious area(applicable if R-7,R-12,R-25&R-40)iIf yes,is a storm water quality facility shown? i -' ❑Nolean Water Services—Service Provider Lette of platted prior to 9/10/1995): �gwired: ❑ Yes,applicant was notified lld No Received: ❑ Yes ❑ No 4tr v►IA [ ' Public Facilities Improvement(PH) Permit: 1 - equired: ❑ Yes,applicant was notified I/ nd Use Case#: SUO f�O(fl 1D E/J No Applied For: [ /yes ❑ No,stop intake Zoning: VI.5 E "Required Setbacks: Front: Rear: I S Side: Street Side: 1L' Garage: 24 Lam" Building Height: Max. Height: Actual Height: 2-S.S OLandscape Area: % of Coverage Max: 0/0 Entrance LE"' t back no more than 8'from street-facing wall Lam'Parallel to street or offset 45 degrees or less Windows �ud ni urn 12%of area of all street-facing facades Ito/ Garage ( Garadoor is behind widest street-facing wall ❑ Yes Lid'No,one of the following is met: C+7 Door extends no more than 5'from wall and there is a covered porch extending beyond garage. it ❑ Door extends no more than 5'from wa]Yand 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 -Window trim ❑ Window recess ❑ Window projection ❑ Balcony f isual Clearance I.PW/Urban Forestry pan Sensitive Lands: ❑ Yes IV No Type: rf onditions met prior to iss anc of building permit o s: Ste If,1,0.01 . ,- Yh)" ntoi4urt„"1. 014mit rL, 5 a r6I,-- R., La c-{. Approved By Planning: Date: NJ__1 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\BldgPernutRvw_RES 022819.docx Building Permit Submittal Original Submittal Date: YZ'c72' Site Plans: # Building Plans: Building Permit#: —7-Enter building permit#above. Workflow Routing: ;E_.Planning EngineeringPermit Coordinator �jBnilding 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 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: Date: ,i En veering Review ,..,, Slope at building pad: CP/Conditions "Met"prior to issuance of building permit t,/Easements (encroachments)per engineering conditions of approval and plat LV Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes El No Assess Water Quantity Fee in-lieu: ❑ es El No LIDA Facility on lot: ('Yes El No El Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: LN ApprovedbyEngineering: Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: El Approved El Not Approved Revision 3: ❑ Approved El Not Approved Permit Coordinator Review El 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: LIYSDC Fees Entered: Wash Co Trans Dev Tax: R" es ❑ N/A Tigard Trans SDC: Iffy ElN/A Parks SDC: El LIDA El N/A L`7 OK to Issue Permit Approved by Permit Coordinator: Date: I:\Building\Forms\BldgPermitRvw_RES_022819.docx