Permit (2) City of Tigard
11111 COMMUNITY DEVELOPMENT DEPARTMENT
IIGAIZD Building Permit Review — Residential
Building Permit #: 1"`t1 - tC&- lit-4L-
Site Address: itidi ' Sw• Qy1,,1- GAG.
Project Name: l{tt r S _ '4 11 P V,I. Lot #: 2
(New dwelling= subdivision name;Addiiion or Alteration=last name of owner)
Planning Review Y�S� �llt s ,?yvd J l(
Pro sal: LIti,r 1" a•lat .
Lit Verify address/suite#active in Accela. In River Tyeecrrace: 1.4'Y No 0 Yes,River Terrace Review Addendum
Site t an Elements: (1=i ..sion Control
L copies of site plan on 8-1/2"x 11"or 11 x 17"paper C ' - ained trees with drip line and tree protection measures
flip wn to scale(standard architect or engineer scale) • !g ••tprint of new structure(including decks)and FEE
UP
1 arrow P _ •ty locations&easements(required for new and additions)
}im�address,project or subdivision name and lot number t%Sidewalk/driveway approach
lld plicant information (name and phone number) �' ation of wells/septic systems
allot dimensions and building setback dimensions u S t tree size,type and location
LICkquare footage of buildings to be demolished let names
II ' :sting structures on site [ Comer elevations(2'contours if more than 4'diff tial)
fl •t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? LeYes ❑No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑ No
(1 Clean Water Services—Service Provider Letter/(lot platted prior to 9/10/1995): (->Ay04146)c,,A 4
3equired: 0 Yes,applicant was notified 10•No Received: 0 Yes 0 No
ka4 t/tP
Public Facilitiea'Improvement(PFI) Permit
quired: 5 Yes,applicant was notified 0 No Applie For. �7 Yes 0 No,stop intake )F2. 2. 6-0(4
Iv and Use Case#: CUA�l 5.,ON) 16Zoning: a'
ere, >equired Setbacks: Front Is Rear. i S Side: S Street Side: (U Garage: to
Building Height: Max.Height: 35 Actual Height ? 1
andscape 4rea: 2.012 L% ot Coverage Max: eo %
Entrance l2'$et back no more than 8'front street-facing wall lr'l, Parallel to street or offset 45 degrees or less
Windows Li? '/um 12%of area of all street-facing facades 1 -
Garage LR�Garawdoor is behind widest street-facing wall 0 Yes ii4o,one of the following is met:
Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
1 0 Door extends no more than 5'from�wd there is a 12 sq ft.window above garage on 2nd floor.
f Garage door width is 0 12'or less ttd'S0%or less of facade 0 60%or less and includes 7 of following:
❑ Covered porch 0 Recessed entrance 0 Wall offset 0 1'Roof cave 0 Roof offset
❑ Fire shingles 0 Lap Siding 0 Roof pitch 0 Gable,hip,or gambrel roof 0 Dormer
O Accent siding 91 Window trim 0 Wmdow recess 0 Wmdow projection 0 Balcony
��isual Clearance [ Urban Forestry�P n
[ ' Sensitive Lands: 0 Yes L7 No Type:
VConditions met prior to iss ante of bull ermit
o3 .: Co4,11-0,,,,c k.o. 14, (.4.1- 0 Is. 1 giii fAts.,ii- irifvtil"ei.
lig Approved By Planning: Date: �I-IS•..1 K
Revisions (after Building Submittal only) Reviewer Date
awasarm Approved 0 Not Approved o i€- A-_ 20
Revision 2: 0 Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
L•\BuildingTonns\BldgPennitRvw_RES 022819.docx
Building Permit Submittal
Original Submittal Date: 4\t5t\Ct
Site Plans: # 3
Building Plans: # =
Building Permit#: ["Enter building permit#above.
Workflow Routing: Planning Q'Engineering B./Permit Coordinator DrBuilding
Workflow Sign-off: a Sign-off for Planning(include notes from planning review)
Route Application Documents: Er-Engineering (1)copy of permit application, (1)site plan, (1)building plan and
original plan review routing form.
Q Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: _, .� Date: \-\W�l Int
Engineering Review
llope at building pad: a o
lam'"C:anditions"Met"prior to issuance of building permit
2 `-Easements (encroachments)per engineering conditions of approval and plat
2-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes Q'No
Assess Water Quantity Fee in-lieu: 0 Yes [J44o
LIDA Facility on lot ❑ Yes Ca'1 to
Lfj Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
12--Approved by Engineering, 14.w ,',siA*,2. Date: `l-('j-i ci
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
ZirConditions "Met"prior to issuance of building permit
0 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:
OiLSDC Fees Entered: Wash Co Trans Dev Tax: c¢t'yes 0 N/A
Tigard Trans SDC: Yes 0 N/A
Parks SDC: diiiCYes 0 N/A
LIDA 0 Yes Q'.N/A
c&LOK to Issue Permit
Approved by Permit Coordinator: Date: Ll I { I t
I:\BuildinglFormslBIdgPennitRvw_RES_0228I9.docx