Permit City of Tigard
COMM:NI-1Y DEVELOPMENT DEPARTMENT
11111
: a
Building Permit Review — Residential
i it,AKD
Building Permit #: s_ (-1
1 .—OK07
- '
Site Address: .- C ri 106=f svi• Tt.1 AN kt L
Project Name:
S ,,"tr 'wk. Lot #: --7-
Planning Review
PTO 9 •z al: ljt-i,j :S l . fl. t+ .77,13qc-A,
N ,' A co s'CZ) .S/76-- /0( if-A/
PE Verify address/suite# active in Accela. le In River Terrace Go El Yes, Riper Terraa Review Agidessdiair KN
SityPlan Elements: Offinsion Contml
133 copies of site plan on 8-1/2"x 11"or 11 s I"'"pallet lUtetained trees with drip line and tree protection measures
-it to scale(standard architect or engineer de)
..... orth arrow
Vita Ilitlfyotpriiir of new structure(including decks)and.FFE
illvqpiliry.locations&easements(required for new and additions)
IffSi address,project or subdivision name and lot number Voidewalk/drivemay approach
10,- .plicant information (name and phone number) Sri, . anon of wells/septic systems
-",
'Lot dimensions and building setback dimensions •et tree size,type and location
ltuare footage of buildings to he demolished t. pet names
• 'sting structures on site ter frrier elevations(2'contours if more than 4'diffe..:m.6-31)
t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? gates 0No
Tpervioua area(applicable if R-7,R-12,R-25&R-40) If yes,is a norm water quality facility shown? ElVeitiNo
prClean Water Services-Se,vice Provider•Let 41ot platted prior to 9/10/1995):
)(equired: 0 Yes,applicant was notified Z. No Received: 0 Yes 0 No
Ig Water Meter Vision-lInit Worksheet-Addilidris,Remodels and ADUs
Required 0 Yes,applicant was notified E. No Received: 0 Yes EVN-
o
Of SDC Exemption for ADU applied for C Yes C No Received: 0 Yes 0 No
CRPublic Facilities Improvement (PIT Permit:
etthed: 0 Yes,applicant was notified C No Ayplied For: 0 Yes 0 No,snip intake
a :.and Use Case#: (..t.inuo -ii 6 4/VW 2.1V-Ginat a-9 '
ll'eZoning: ,,. -
lOryrtquired Setbacks: Front_..2,11 Rear. IS Side:_-.)__,_, Street Side jk Garage: 2,0
Ofr Building Height: Max. Height; 0 Actual Height: I
PP-Landscape›rea: % 06,Lot Coverage May
Entrance It'tKet back no more than 8'from street-lacing wall 10 Parallel to street or offset 45 degrees in less
Windows 2ls1inimum 12%of area of all street-facing facades I-7,fi
/
Garage rg Ga .,c door is behind widest street-facing wall C Yes G No,one of the following is mot:
i1
Of Door extends no more than 5'front wall and there is a covered porch extending beyond garage.
,...... 0 Door extends no more than 5 from and there is a 12 sq ft.window above garage on 204 floor.
Garage door width is 0 12'or less tff' 50%or less of facade 0 60%or less and includes 7 of folkming
0 Covered porch 0 Recessed entrance 0 Wall offset 0 1.Roof cave D Roof offset
0 Fire shingles 0 Lap Siding 0 Roof pitch 0 Gable,hip,or gambrel roof 0 Dormer
0 Accent siding 111% Window trim 0 Window recess 0 Window projection 0 Balcony
"Visual Clearance 0: Urban Forestry Plan
[ .Sensitive Lands: 0 Yes 0 No Type:
lIrEl Conditions met prior to issuance of building permit
Noyin
ID' Approved By Planning Le- ft. ... Date: 2..-Z.1--Zi 2.0.
.,
Revisions(after Building Submittal only) Reel Date
Revision 1: Er Approved 0 Not Approved ArfjYvb Ze/L 41/1'2-0
Revision 2: 0 Approved 0 Not Approved
1:13inkhngTomiesBl4l'ermitRvw_RES_12.2419.dota
Building Permit Submittal /
Original Submittal Date; ? 420
Site Plans;
Building Plans:
Building Permit#: •Iff-Enter building permit# above.
Workflow Routing: Er Planning PC—Engineering if-Permit Coordinator CYfiuilding
Workflow Sign-ofT: 1:7-Sign-off for Planning(include notes from planning review)
Rowe Application Documents: kfr Engineering: (1)copy of permit application,(1)site plan,(1) building plan and
original plan review routing form,
)J.-Building original permit application,sue plans,budding plans,engineer and
beam calculations and trust details,if applicable,etc,
Notes:
By Permit Technician: Date: „",q )__-2
Engineering Review
erSlope at building pad:
Conditions"Met"prior to issuance of building permit
EY Easements (encroachments) per engineering conditions of approval and plat
DrWater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes
Asacas Water Quantity Fee in-lieu: U Yes
LIDA Facility on lot: 17 Yes IfirNo:
iVlinal Plat Recorded:
NOT Approved by Engineering: Date:
Notes:
2/Approved by Engineering: Date: ..:4›
Revisions (after w • ng Submittal only)
t
Revision 1: Ir Appmved 0 Not Approved
-A—g- te
Revision 2: Approved 0 Not Approved
Permit Coordinator Review
CI Conditions"Met"prior to issuance of building permit
0 Approved,NOT Released: Date:
Notes:
Revisions(after Building Submittal only)
Revision Notice I: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
0,5DC Exemption: D Rvccivai 0 Does not apply
SDC Fees Entered: Wash Co Trans Der Tax: geYes 0 N/A
Tigard Trans SDC: 0/yes 0 N/A
Parks SDC: IV Yes 0 XA
LIDA 0 Yes N/A
Virj K to Issue Permit
keDater3 /9'67
Approved by Permit Coordinator:
AU 441x
CITY OF TIGARD MASTER PERMIT
2 ' COMMUNITY DEVELOPMENT Permit#: MST2020-00073
Ti G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 /(F 11 Date Issued: Mar 17 2020 12:00AM
Parcel: 1 S134BD12400
Jurisdiction: Tigard
Site address: 10854 SW TEAL CREST PL
Subdivision: SUMMERBROOK SUBDIVISION Lot: 7
Project: Summerbrook, Lot 7
Project Description: New SF. 8/15/2020: REPRINT to add irrigation backflow.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 4 First: 2081 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 16 Bathrooms: 3 Second: 0 sf Garage: 581 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2081 sf Value: $284,613.59 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 LaundryTrays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 1
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywall-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders 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: 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 2081
Owner: Contractor:
WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions)
1111 N POST OAK RD 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175
HOUSTON,TX 77055 BEAVERTON,OR 97006
PHONE: 503-213-4415 PHONE: 503-213-4415
FAX:
Total Fees: $35,563.53
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 throug O, R 952 000J0)90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987_ 87 or 1.800.332.2344. /
Issued By: ('/'! Cl✓� Permittee Signature: l9 N C/ 7 �L C �O"V
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.
Plum bins Permit Application
Building Fixtures 1:0k IH I I( 1: 1 Sr. 0\1.%
1 Received
City of Tigard RemBy ells eonitt N 20 0007.1
i•• 13125 SW Hall Blvd.,Tigard,OR 97223 / i �''7ST�U
I Phone 503.718.2439 Fax: 503.598.1960 t,_ Plan Rav ew
pgMiy; Other Permit No
f 1, A14.i Inspection Line: 503.639.4175 Dale Readydity. filth Sc,® Page 2 for
Internet: www.tigard-or.gov Notified'Method: Supplemental Information
TYPE OF WORK . I I FEE* SCHEDULE _
ID New construction 0 Demolition Far specialInfornrafion we checklist.
RECEIe , alp QtSf I Ea I Total
❑Addition/alteration/replacement ❑Other: ,L+ll FLU(`/flr�. `V/ ?-family dwellings(includes 100 fl.for each lrtiliiycomk al
ion)
CATEGORY OF CONSTRUCTION (1)bath 312.70
ID 2-family dwelling ❑Cornrtler L1industrin U G 0 5 202 3SFR(2)bath 437.78
0 Accessory building El Multi-familySFR(3)bath 1 500.32 500.32
CITY OF TIGAF[Eh.,additional bathitilchen 25.02
❑Master builder 0 Other BUILDING DI VLSI pTinIdCT( sq.ft) Paget
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:10854 SW Teal Crest Place Catch basin or area drain 18.76
City/State/ZLP:Tigard/OR/97223 T)rywe0,leach line,or trench drain 18.76
Footing drain(no.linear ft.:230) Page 2 87.55
Suire/bldgiapt.no.: Project name:Summerbrook Manufactured home utilities
50.03
Cross street/directions to job site:SW 121'Ave and SW Summerbrook Lane Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: 1 Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:__) Page 2
Subdivision:Summerbrook Lot no.:7 Fixture or item: _
Tax map/parcel no.: Backtlow preventer 1 31.27( 31.27
DESCRIPTION OF WORK Backwater valve 12.51
New Single Family Home 2081 sgfl 4 bedroom,3 bath with 581 sqft 3 ear Clothes washer ) 25.02 25.02
Dishwasher 1 25.02 25.02
tune-
Drinking fountain 25.02
Ejectors/sump 25.02
IN PROPERTY oWNER 0 TENANT Expansion tank
12.51
Name:David Weekley Homes Fixture/sewer cap 25.02
Address:1905 N'W 169th Plate Suite 102 Flow drain/floor sink/hub 25.02
Garbage disposal 1 25.02 25.02
City/State/ZIP:Beaverton,OR 97006 Hose Lib 2 25.02 50.04
Phone:(503)2134415 Fan:( ) Ice maker 1 12.51 12.51
' ® APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name:David Weekley Homes Medical gas(value:S_) Page 2
Contact name:Michele Sehledkr Primer 12.51
Roof chain(commercial) 12.51
Address:1905 NW 169"Plan.Suite 102 Smk/basim/lavat
QY 4 25.02 100.08
City/State/ZIP:Beaverton/OR197006 Solar units(potable water) 62.54
Phone:(503)213-4415 Fax::( ) Tub/shower/shower pan ! 2 12.51 25.02
E-mail:mschiedler@dwhomes-com Urinal 25.02
CO_WTRACTOR Water closet 2 25.02 75.06
Water heater I 37.52 37_52
Business name:Malmedal Plumbing _ Water
piping/DWV 56.29
Address:PO Box 207 Other. 25 02
City/State/ZIP:Banks/OR/97106 Subtotal 31. 27
Phone:(503)324-0759 Fax:( ) Minimum permit fee. 572.50 :
CCB Lic.:102535 Plumbing Lic.no.:34-276PB Plan review (25%of permit fee)- - State surcharge(12%of permit fee) j,-7,t
Authorized signature: TOTAL.PERMIT FEE
,n /� r ��,f,r I q5. t72
Print name: caw!(f`t( �,UY lt, Date: 7242 This permit app5ealion tapir's xa permk b not obtained within ISO days
f!1✓ after it ha beta accepted as complete.
*Fee methodology set by Tri-County Building Industry Soma Board.
1:1BuilangPermitaLMU-PcmitApp do HYP1A9 4'461611 IA/pVCOMNWLbl
CITY OF TIGARD MASTER PERMIT
,II ` .1 COMMUNITY DEVELOPMENT Permit*: MST2020-00073
Date Issued: 03/17/2020
TIGAAL1 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S134BD12400
Jurisdiction: Tigard
Site address: 10854 SW TEAL CREST PL
Subdivision: SUMMERBROOK SUBDIVISION Lot: 7
Project: Summerbrook, Lot 7
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms. 4 First: 2081 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 16 Bathrooms: 3 Second: 0 sf Garage: 581 sf Front: 20 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors:
Total: 2081 sf Value: $284,613.59 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain 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: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<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: 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 8 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 2081
Owner: Contractor:
WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions)
1111 N POST OAK RD 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175
HOUSTON,TX 77055 BEAVERTON,OR 97006
PHONE: 503-213-4415 PHONE: 503-213-4415
FAX:
Total Fees: $35,528.51
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 y u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 9 1-00 Yo ay obtain a oft rules or direct questions to OUNC by calling 501.2 .1987 or 1.800.332.2344.
Issued By: Permittee Signature: '' -`y-' ~`Il
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.
Building Permit Application
Residential RECEIVED FOR OFFICE USEA ONLY /�
Received At) /�• yg� )�) li�f/�CJ' 73
NI 4- City of Tigard Date By: /' ®t6 SKr )-0
13125 SW Hall Blvd.,Tigard,OR 97223 EB 2 7 2020 Plan Review 2 J}� �,. r t/
Phone: 503.718.2439 Fax: 503.598.I9&0 Date/By: 3 2 ,x0 77I+ 4 VW
T I GARD inspection Line: 503.639.4175 Date Ready.By t See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGRRD Notitied,'Meth,•: I� /� �� Supplemental Information
BUILDING DIVISION
TYPE OF WORK RE UIRED DATA:1-AND 2-FAMILY DWELLING
Ei New construction ■ •_molifion Permit fees*are based on the value of the work performed. .
Indicate the value(rounded to the nearest dollar)of all
■ Addition/alteration/replacement El • equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION
Valuation: �ii retn ZSy (9 t3
El I-and 2-family dwelling 0 CommercialiindustrialNumber of bedrooms: 4
0 Accessory building 0 Multi-family
■ Master builder ■ Number of bathrooms: 3
. SITE INFORMATION t LOCATION Total number of floors: 1 1—Q42 -
Job site address: .54 SW Teal Crest Place New dwelling area: 2081 square feet 2(A '
• Garage/carport area: 581 square feet
Suite/bldg./apt.no.: Project name:Summerbrook Covered porch area: 60 square feet
Cross street/directions to job site:SW 121e Ave and SW Summerbrook Lane Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Summerbrook I Lot no.:7 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 Single Family Home to be built-2081 SQFT 4 Bedroom,3 bath with 581 SQ Valuation: $
FT 3 car garage, Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:David Weekley Homes Type of construction:
Address: 1905 NW 169"Place Suite 102 Occupancy groups:
City/State/ZIP:Beaverton,OR 97006 Existing:
Phone:(503)213-4415 Fax:( ) New:
❑ APPLICANT tP CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:David Weekley Homes
Structural plan review fee(or deposit):
Contact name:Michele Schiedler
FLS plan review fee(if applicable):
Address:1905 NW 169'Place,Suite 102
Total fees due upon application:
City/State/ZIP:Beaverton/OR/97006
Amount received:
Phone:(503)213-4415 Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:mschiedler@dwhomes.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:David Weekley Homes Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 1905 NW 169"Place,Suite 102 Solar Installation Specialty Code checklist.
City/State/ZIP:Beaver R/97006 Permit Fee(includes plan review $I80.00
and administrative fees):
Phone:(503)213-4415 Fax:( ) State surcharge(12%of permit fee): $21.60
t
CCB lie.:213653 Total fee due upon application: $201.60
Authorized signaturd: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Michele ler Date:2/26/20 *Fee methodology set by Tri-County Building Indust),
Service Board.
I:\Building\Pennits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(1 UO2/COM/WEB)
Building Permit Application Checklist
One-and Two-Family Dwelling FOR OFFICE USE ONLY�,7 g
City of Tigard Received
Ey
•
't 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
Associated pemvts:
Phone: 503.718.2439 Fax: 503.598.1960
TIGARD
24-Hour Inspection Line: 503.639.4175 ® Electrical ® PlumbingPermit No.:
® Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW lies No N/A
I Land use actions completed. See jurisdiction criteria for concurrent reviews. ® D ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ® 0 0
3 Verification of approved plat/lot. ® 0 ❑
4 Fire district approval required. Name of district: • 0 0 ❑
5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 ❑
6 Sewer permit. 0 El ❑
7 Water district approval. ❑ 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. ® 0 ❑
9 Erosion control ®plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ® ❑ ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ® ❑ ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ® ❑ ❑
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ® 0 ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ® 0 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. ® ❑ ❑
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- �/ 0 0
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 ® ❑ 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ 0 El
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 ® 0 0
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 CO 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 ® ❑ ❑
architect licensed in Ore_on and shall be shown to be a.•licable to the .ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans arc required for Item 11 above. Site plans must he 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. ® ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ® 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ 0 El
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.
1:1Building\Permits\BUP-RESPeimitApp.doc 02/24/2011 440-46 13T(11/02/COM/WEB)
Mechanical Permit ApplicatiRECEl 1/ED FOR OFFICE USE ONLY
City Of Tigard Received
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 FEB 2 Date/By:
2020 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 TIGARD
Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: huts: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION 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*
® I-and 2-family dwelling ❑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:
Air conditioning 46.75
Job site address: 10854 SW Teal Crest Place Furnace 100,000 BTU(ducts/vents) I 46.75
City/State/ZIP:Tigard/OR/97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt. no.: Project name:Summerbrook Duct work 23.32
Cross street/directions to job site:SW 1219t Ave and Summerbrook Lane Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision:Summerbrook Lot no.:7
Other 23.32
Other fuel appliances:
Tax map/parcel no.:TBD Water heater 1 23.32
DESCRIPTION OF WORK Gas fireplace/insert 1 33.39
Flue vent for water heater or gas
New single family home to be built-2081 sqft,4 bedroom 3 bath home with fireplace 23.32
581 sqft 3 car garage Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/tlue/vent 23.32
el PROPERTY OWNER ElTENANT Other. 23.32
Environmental exhaust and ventilation:
Name: David Weekley Homes Range hood/other kitchen
equipment 1 33.39
Address:1905 NW 169th Place,Suite 102 Clothes dryer exhaust 1 33.39
City/State/ZIP:Beaverton/OR/97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) >Y' 23.32
Phone:(503)213-4415 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ® CONTACT PERSON Other 23.32
Fuel piping:
Business name: David Weekley Homes
$14.15 for first four;$4.03 for each additional
Contact name:Michele Schiedler Furnace,etc.
Address:1905 NW 169th Place,Suite 102 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Beaverton/OR/97006 Water heatet
Phone:(503)213-4415 Fax::( ) Fireplace I
Range
E-mail:mschicdlcr dwhomes.com Barbecue
�h Clothes dryer
CONTRACTOR �,�, ,� �' ty (gas)
Business name:David Weekley Homes Other.
MECHANICAL PERMIT FEES*
Address:1905 NW 169th Place Suite 102 Subtotal
City/State/ZIP:Beaverton/OR/97006 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)213-4415 Fax:( ) State surcharge(12%of pennit fee)
CCB lie.:213653 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
/ days after it has been accepted as complete.
Authorized signature: / V * Fee methodology set by in-County Building Industry Service Board
Print name:Ken Puttman Date:
TrBuil,dnguPernts.MEC_PennitApp_0401 odor 440461 TT(I I/02,COM,'W EB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
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$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Pemuls\MEC_PermitApp_040113.doc 2
Electrical Permit ApplicatieECEIVED FOR OFFICE USE ONLY
City11111 ofTigard FEB 2 7 2020 Received Permit":
g Date/By:
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
L Phone: 503.718.2439 Fax: 503.5�R!49ii1(OFTIGARD Date/By: Related Permit m
Inspection Line: 503.639.4175 w+�s�s �t i Ready Uate/By runs 63 See Page 2 for
11(i All[) ' 1 11 kRi,_ rat NotifiedMethod: Supplemental Information
Internet: www.ligard-or.gov '3utur PP
�x xY`t ' ,V4Uter""...,tiLr:n v!.J*0F148tiSi*IC. . -.: �r:, .g ,.. ✓..,.. .>,k *A�+t�s...�1EArr1FeN � e, ,.,.
mrx<.
tEl New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition'z �+ ❑Other: (,, where die available fault current 0 Marinas and boatyards.
tH X >,Viti. +fdl�$i' .r tl;;�)8C ',$.UCTIQN exceeds 10,000 amps at 150 volts or 0 Floating buildings
E I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,(100 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
, , v
#,*.� "r HF.•e-,;, :JOB* tN,F,41tMA` S1N t1,1VA LQCA'C10N . 0 Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#:68020007 Job site address: 10854 SW Teal Crest Place t00HP or more. ❑"A"."E "I-_2 ^I-3"
0 Six or more residential units. occupancy.
City/State/ZIP:Tigard/OR/97223 ❑Health-care facilities. ❑Recreational vehicle parks.
_
Suite/bldg./apt.#: Project name:Summberbrook 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:SW 121st Ave and Summerbrook Lane v; A *r fi riiin r r e-Aypak,r ,7..
Description I Qty. 1 Each I 'totel I •
New residential single-or multi-family dwelling unit.
Subdivision:Summerbrook Lot#:7 Includes attached garage.
1,000 sq.ft.or less 1 168.54 168.54 4
Tax map/parcel#:TBD Ea.add'l 500 sq.II.or portion 3 33.92 107.76 1
,..lnt-`r, ytr<g„-�""' ,. a 6 . §00 ;:+?.:F'x:V. : 'r:°S .., .,,..;. ,. •r,.`, ; Limited energy,residential 75.00 2
New single family home to be build-2081 sqft,4 bedroom 3 bath home with (with above sq.ft.)
Limited energy,multi-family 75.00 2
581 sqft 3 car garage residential(with above sq.II.)
Renewable Energy ❑ See Page 2
...." ,P: $2'.34WNE1t - ..n," ' '$A141- - - Services or feeders installation,alteration,and/or relocation
Name: David Weekley Homes 200 amps or less 100.70 2
Address: 1905 NW 169th Place Suite 102 201 amp to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Beaverton/OR/97006 601 amps to 1,000 amps 301.04
Phone:(503)213-4415 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
t„ 2>�wpyyxx ,9�r';` yy,, a L�.�,y�y�t�ss ra r, ... Branch circuits new,alteration,or extension,per panel
y W.,} N xx i/ i3 °S"4 $ M�. f4 is, €-,�sF^. n VR�1 3'�M mosoM ...t.4„YN.'..
-� - - �+ � A.Fee for branch circuits wirlr
Business name: David Weekley Homes above service or feeder fee, 7.42
each branch circuit
Contact name: Michele Schiedler B.Fee for branch circuits withom
service or feeder fee,first 56.18 2
Address: 1905 NW 169th Place Suite 102 branch circuit
City/State/ZIP:Beaverton/OR/97006 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)213-4415 Fax: :( ) Each manufactured or modular 67 84 2
dwelling,service and+'or feeder
Email:mschiedler@dwhomes.com Reconnect only 67.84 2
air., ,9ZF .53 w s„''4W*4;;I9`9.HACT,OR,," . ;;.A Pump or irrigation circle 67.84 2
Business name:Garner Electric Sign or outline lighting 67.84 2
^O Bad,
(A 1 Signal circuit(s)or lextension. 0 See Page 2 2
Address: C-{f panel,alteration,or extension.
City/State/ZIP: tii (L O O2_ g4_1-7.� Each additional inspection over allowable in any of the above
, t Additional inspection(1 hr min) 66.25/hr
Phone: 56, to IR -1„t Z Fax:( ) Investigation(I hr min) 90.00/hr
Email: �/�/'� /7 rrt s� r /�,.� Induvinalplant(1hrmin) 7818/hr
1 f lA G fy f l.Et-.s { •`L4m Inspections far which no fee is
t'`Gy c s rlieail listed ' ,.n,21 90.00/hr
CCB Lie.:it c..33 11 Elecn-ica)Lic.:3 — Supry tc.:3'�'1--5 P ,yy �"„t S .� n r,,
+CY! 4� py'a.,„yYy�` gam,:, d` pttk < i. J ',:5.1
,.I6 iNhti`v..L,AYk���`�V ... S�IJ L.'.')✓I�V�.M.'S.1.`a f...-i.-.i
Suprv.Electrician signature,required: Subtotal:
Print name: a'!P-S Ga.,rr J,,y a e: L up-ZQ 0 Plan Review Required(25%of permit fee):
8--f-urtztiv
State surcharge(I2°/u of permit fee):
Authorized signature: TOTAL PERRIIT FF..E:
,^ 1{� �� r This permit application expires if a permit is not obtained within 180
Print name: g �' . cis, Date:2-.icy_"Z Q days after it has been accepted as complete.
4 Number of inspections allowed per permit.
].Building Penoits•ELC-PermiiApp_ELR_ERE. net.0617201/ 440-16151i1I-OS'COMWES
V
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
It.SIDENTIAL WORK ONLY:
Description I OD. Each J 'Total
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: s kva or less 100 70
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva2
Is] Garage Door Opener* 552 26
>100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
® Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
El Other: Each additional inspection is 66.25,'hr 1
charged at an hourly(I hr min)
Inspections for which no fee is 90.00t hr
specifically listed( t hr nin)
` ,.t �ECG R1[k ,ERNllT FEES
1►,rw,� Dye
•
� ?• t!,+-1� +,, .+ , 5�. ..r Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00
(SEE OAR 918-309-0000) • Number of inspections allowed p rpermit
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
C Data Telecommunication Installation
Fire Alarm Installation
C HVAC
C Instrumentation
Intercom and Paging Systems
• Landscape Irrigation Control*
❑ Medical
(1 Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I'MMuilding PeraitsELC-PennitApp ELR_ERE doe Res 0647:2015
Plumbing Permit Application
Building Fixtures ION OW( l._ 1 ,51.. ONIA
L. j Received
City of Tigard Date/By: PermitNo.:
.•■ 13125 S W Hall Blvd.,Tigard,OR 97223 Plan Review
I Phone: 503.718.2439 Fax: 503.598.196 Other Permit No.:
Date/13y.
Tit;t ti A R D Inspection Line: 503.639.4175 Date Ready/By: tuns $3 See Page 2 for
Internet: www.tigard-ocgov Notified/Method: Supplemental Information
TYPE OF WORK _ I FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist
• Description I Qly. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100It.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
' El 1-and 2-family dwelling 0 Commercialinduslrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 1 500.32 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) 1 Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:10854 SW Teal Crest Place Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard/OR/97223
Footing drain(no.linear ft.:230) Page 2 87.55
Suite/bldg.apt.no.: Project name:S um merb rook Manufactured home utilities 50.03
Cross street/directions to job site:SW 121't Ave and SW Summerbrook Lane Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear II.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Summerbrook I Lot no.:7 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 31.27
. DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer I 25.02 25.02
New Single Family Home 2081 sgft 4 bedroom,3 bath with 581 sgft 3 car Dishwasher 1 25.02 25.02
garage. Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:David Weekley Homes Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:1905 NW 169th Place Suite 102
Garbage disposal 1 25.02 25.02
City/Store/ZIP:Beaverton,OR 97006 Hose bib 2 25.02 50.04
Phone:(503)213-4415 I Fax:( ) Ice maker I 12.51 12.51
". APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name:David Weekley Homes Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Michele Schiedler
Roof drain(commercial) 12.51
Address:1905 NW 169th Place,Suite 102 Sink/basin/lavatory 4 25.02 100.08
City/State/ZIP:Beaverton/OR/97006 Solar units(potable water) 62.54
Phone:(503)2134415 Fax:•:( ) Tub/shower/shower pan 2 12.51 25.02
E-mail:mschiedler@dwhomes.com Urinal 25.02
CONTRACTOR
Water closet 2 25.02 75.06
Water heater l 37.52 37.52
Business name:Malmedal Plumbing Water piping DWV 56.29
Address:PO Box 207 Other. 25.02
City/State/ZIP:Banks/OR/97106 Subtotal
Phone:(503)324-0759 Fax:( ) Minimum permit fee: $72.50
CCB Lie.:102535 Plumbing Lie.no.:34-276PB
Plan review (25%of permit fee)
1 _ Q State surcharge(12%of permit fee)
Authorized signature: )'� ` // TOTAL PERMIT FEE
Print name: ea jet kit ,( .L Date: 2.41.7r This permit application expires if a permit is not obtained within 180 days
` jjj after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
LU3uildinglt'amiu\PLMU-0mnitApp.duc I O/O1N9 4464616T(10/02/COM/WE6)
City of Tigard
IN
COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 G A R D Building Permit Review — Residential
Building Permit #: _ 6s1/(j7){ lei /��
Site Address: 1 Q gs y S'vi Tfo,l Crttt- 'Otto-
Project Name: ,cu v-ttf-bra-dk Lot #: -7-
Planning Review
Pro osa1: N SF ' FLA 1+11)-,4
74 Verify address/suite# active in Accela. kq In River Terrace: a"No El Yes,River Terrace Review Addendum
Sit 'lan Elements: 2Cosion Control
lP 3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper ak tained trees with drip line and tree protection measures
awn to scale(standard architect or engineer scale) otprint of new structure(including decks)and FFE
�orth arrow patty locations&easements(required for new and additions)
Itd Si address,project or subdivision name and lot number �}.grdewalk/driveway approach
plicant information(name and phone number) jk..ation of wells/septic systems
Lot dimensions and building setback dimensions . -et tree size,type and location
t• are footage of buildings to be demolished �IP t names
7 sting structures on site I!d'Corner elevations(2'contours if more than 4'difffferal)
IR .t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? L''Yes CI No
ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑ No
Lid' Clean Water Services—Service Provider Letttt of platted prior to 9/10/1995): { �n
equired: ❑ Yes,applicant was notified id' No Received: ❑ Yes ❑ No �( `A Y
E Water Meter tore Unit Worksheet—Addi ' ns,Remodels and ADUs / wA
Required: 0 Yes,applicant was notified NJ No Received: ❑ Yes T'No
id SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes 0 No
Public Facilities Improvement(PFI) Permit:
quired: ❑ Yes,applicant was notified i ❑ No A plied For: �j❑ Yes ❑ No,stop intake
RLand Use Case#: C,UP2AIf—0-(11(37 a2l,)t —GdC61 [ Zoning: R`4.5
uired Setbacks: Front: 9.A Rear: IS Side: S Street Side: Garage: 20
Lld" Building Height: Max. Height: . 0 Actual Height:
1a'Landscape urea: % g`}Lot Coverage Marl
Entrance et back no more than 8' from street-facing wall Parallel to street or offset 45 degrees or less
Windows nimum 12%of area of all street-facing facades 1-447
Garage Garav door is behind widest street-facing wall ❑ Yes No,one of the following is met:
Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
� . ❑ Door extends no more than 5'from and there is a 12 sq ft.window above garage on tad floor.
l Garage door width is ❑ 12'or less L'1 50%or less of facade ❑ 60%or less and includes 7 of following
❑ Covered porch 0 Recessed entrance ❑ Wall offset ❑ 1'Roof eave 0 Roof offset
❑ Fire shingles 0 Lap Siding 0 Roof pitch 0 Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding Window trim ❑ Window recess ElWindow projection CIBalcony
Vt./Visual Clearance Urban Forestry Plan
a/Sensitive Lands: ❑ Yes ❑ No Type:
0 Conditions met prior to issuance of building permit
No s:
Approved By Planning: :. Date: 2.2,1-^Ze1,d
Revisions (after Building Submittal only) Cope_
Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:Building\Fonns\BldgPern itRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: ,-a 2 7 .
Site Plans: # 7
Building Plans: # 3
Building Permit#: erEnter building permit#above.
Workflow Routing: Z-Planning engineering ' IJ Permit Coordinator Building
Workflow Sign-off: n—Sign-off for Planning(include notes from planning review)
Route Application Documents: ,e"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: r Date: 2- /
Engineering Review
79
Slope at building pad: � .�
I�" Conditions "Met"prior to issuance of building permit
Q}'Easements (encroachments)per engineering conditions of approval and plat
PrWater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes �Io
Assess Water Quantity Fee in-lieu: CI Yes M/„o
�
LIDA Facility on lot: ❑ Yes �' No
1;2/Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
nte Approved by Engineering: Date: 3 2C,
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ 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:
ElSDC Exemption: ❑ Received 0 Does not apply
DC Fees Entered: Wash Co Trans Dev Tax: RY-Yes ❑ N/A
Tigard Trans SDC: 1=17 es ❑ N/A
Parks SDC: [ Yes 0 XA
LIDA ❑ Yes N/A
OK to Issue Permit
1.3 fiA9
Approved by Permit Coordinator: ktrDate:3
I:'Building\Forms\BldgPermitRvw_RES_122419.docx