Permit City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT V ® 1
II 0
_ . Request for Permit Action 9/QA,- , -
<(;A It I) 13125 SW Hall Blvd. •Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits @tigard-or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor ,K City Staff
Check(1)one
REFUND OR Name:
INVOICE TO: (Business or Individual) 0 1-6,,,e1, J
Mailing Address: ( . o (OU
City/State/Zip: C// Ll/ d P 9703
Phone No.: 50')3—
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
gi CANCEL/VOID PERMIT APPLICATION.
U ' FUND PERMIT FEES (attach copy of original receipt and provide explanation below).
►� INVOI—"' •R FEES DUE (attach case fee schedule and provide explanation below).
i E/REPLACE CO► 6"Ir -- • ` i •• not cancel permit).
Permit#: 1 o o`0/ 5-00 O g f (-o 2.tAni S-CC 5 S
Site Address or Parcel#: •• I of • 1
Project Name: 1 J■yA-t) I �
Subdivision Name: Lot#: o�
EXPLANATION: I
k/51-8-o1 c-o01 . wP._&-c., `Y-Co 105
Signature: rte Date: C l0 01/
Print Name: ( )CCk * kL
Thx/� py4 Awn/ 1-0.14.\
j
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
FOR OFFICE USE ONLY
Route to S s Admin: Date tiogimmanpm Route to Records: ��® B 117
Refund Processed: Date pf By tfiiir Invoice Processed: Date '/' f /S By -di.r%
Permit Canceled: Date 9/9/45 By ,l''' •arcel Tag Added: Date By
I:\Building\Forms\RegPermitAction_ 23'I4.doc
. .
Building Permit Application <�E�,EIv EP 0 �1' 9 .t om
Residential FOR OFFICE USE ONLY
MAY 21 2015
III City of Tigard DateBy .5-;:216 /5,. .:' _ pe mit Ngelfir y,=000,/
- • 13125 SW Hall Blvd.,Tigard,OR 9722'TY OF f[CARD Plan Review J 47Q -
Phone: 503.718.2439 Fax: 503.598.1 DateB : f\ (_, - a her Penr /6"-
TIGARD Inspection Line: 503.639.4175 BUILD[NG D[V[SIO1' Date Ready/By: . ,11 4 Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method cp/6/� 1r 'fT� Supplemental Information
' I ,,,�i ;--
TYPE OF WORK REQUIRED DATA: I-AND 2-FAMILY DWELLING
®New construction ❑ Demolition Permit lees*are based on the\aloe 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
CA'T'EGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling ❑Commercial/industrial Valuation: jfl ‘?/� `�/�J
❑Accessory building ❑Multi-family Number of bedrooms: 5
C�"�'
1 ❑Master builder ❑Other: Number of bathrooms: 2.5
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 15212. SW 1-1 IN,c„- ; . :c.; New dwelling area:-acr7 5 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: 433 square feet
Suite/bldg./apt.no.: Project name:Southview Heights Covered porch area: 142 square feet 1
Cross street/directions to job site:SW 122nd Ave&SW Beef Bend Rd Deck area: I te20 square feet (49
Other structure area: '3568 square feet 1p,
REQUIRED DATA:COMMERCIAL-USE CHECKLIST,..
Subdivision:Southview Heights Lot no.: 2. 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.
ness,single family residence Valuation: S
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Stone Bridge IIonics NW,LLC Type of construction:
Address:4230 Galewood St,Suite 100 Occupancy groups:
City/State/ZIP:Lake Oswego,OR 97035 Existing:
Phone:(503)387.7577 Fax:(503)387.7615 New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:same as above (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Deirdre Britt
FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
I Phone:( ) Fax::( )
Amount received:
E-mail:dbrittnstonebridl ehomesnw.com PHOTOVOLTAIC SOLAR P.,1,NEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:same as above Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specially 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.: 173318
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: r/pile. BP4-TT Date: GjM��J CJ *Fee methodology set by Tri-County Building Industry
f Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB)
I
RECEIVED
Electrical Permit Application FOR OFFICE USE ONLY
City of Ti and MAY 21 2015
Date/By.
'anl N 944/fjap/SAD /
1 M 13125 S W Hall Blvd.,Tigard,OR 97223 Man Review
X Phone: 503.718.2439 Fax: 503.59$)( Date/By: Other Par'mit:
I,,ITY OF TIGAR�
TIGARD Inspection Linc: 503.639.4175 Date Ready/fay: inns El See Page 2 for
Internet: www,tigard-or.gov BUILDING DIVISIOI 'nfilicd/Methnd: Supplemental Information
®New construction ❑Addition/alteration/replacement
Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 100 amps or store ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
_ , r/ sd''g s is ( } u, $ , =, exceeds 10,000 amps at 150 yobs or ❑Floating buildings.
less to grata),or exceeds 14,000 ❑Commercial-use agricultural
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building :amps for all other installations, buildings.
❑Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
�w xe* k ❑6nergency system. larger separately derived system.
y A SV t UiSiT llga r'6.° i s ° e ai ... t .,..
pp.,,aaQ , �„�,.�>�„ ��p ❑Add itiat of new motor load of ❑-A'',.'F„..1_Z••-I-3”,
Job no.: ,e7 s,J J Job site address:` 2, SW tAAVS VIEW' 1001IP of mote. occupancy.
. ['Six or more residential units. ❑Recreational vehicle parks,
City/State/ZIP:Tigard,OR 97224 ❑health-care facilities. ❑Supply voltage for more than
❑I hazardous locations, 600 volts nominal.
Suite/bldg./apt.no. I Project name:Southview Heights ❑Service or feeder 600 amps or more
g'2' .p 'rc, {;ref :
nd Description �,,a :M 9y s�i l ._
Cross street directions to job site:SW 122 Ave&SW Beef Bend Rd rmr •
New residential single-or multi-family dwelling unit.
Includes attached garage. _
Subdivision:Southview Heights I Lot no.: 7. 1,000 sq.ft.or less I 168.54 4
Ea,add'I 500 sq,ft,or portion ( 33.92 1
Tax map/parcel no.: Limited energy,residential
is gY. I
s: tl _,1:11 era ') ir:)=3 a ' ` ° " a ; (with above sq.1l.) ` 75.00 2 i's�..:a _u' '' , ,, .ms"n, Limited energy,mutt-family 75.00 2
new,single family residence residential(with above sq.ft.)
Renewable Energy ❑ See Page 2 •'
Services or feeders installation,alteration,and/or relocation
h j,..irx,"!,0 , , ''°.' 9.a„:. 1 ,,; : . E 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name:Stone Bridge Homes NW,LLC 401 amps to600 amps 200.34 2
Address:4230 Galewood St,Suite 100 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 55226 2
City/State/ZIP:Lake Oswego,OR 97035 Temporary services or feeders installation,alteration,and/or
Phone:(503)387.7577 I Fax:(503)387.7615 relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: _ Branch circuits—new,alteration,or extension,Per panel ,
' Y A Fee for branch circuits with
above service or feeder fee,
7,42 2
Business name:same as above each branch circuit
B.Fee for branch circuits without
Contact name:Deirdre Britt service or feeder tee,first 56.18 2
branch circuit
Address: Each add'I branch circuit 7.42 _ 2
Miscellaneous(service or feeder not included)
City/State/LIP: Each manufactured or modular
67.84 2
dwellingscrvice and/or feeder
Phone:( ) I Fax: ( ) Reconnect only 67.84 i 2
E-mail:dbritt(n)stonebridgehomesnw.com Pump or irrigation circle 67,84 2
€i-,. c. ; i "f' d Qg . ..'' -. , .. Sign or outline lighting 67.84 2
Business name:City Electric
is Signal circuit(s)or limited-energy Sec
panel,alteration,or esiension. Page 2 2_
Address:55568 SW Schaltenbrand Ln Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 6b,25/hr
City/State/ZIP:Sherwood,OR 97140 Investigation(I hr min) 66,25/hr
Phone:(971)404.1714 Pax:(503)625.3052 Industrial phut(I hr min) 78 1 R/Iii
--- -- Inspections for which no fee is
CCl3 Lic.: 42422 J Electrical Lie,: 26-289(' Suprv. I is: 35925 spectlically listed el:hr min) 90 on/hi
— ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal
Print name: Chuck Friesen Date: flan review(25':8.of permit Ice)
...__._._ _s State surcharge(12%of pernm fee):
Authorized signature: TOTAl,11:I2M11 ILL'
- - -- - - - I his permit ippliraunn empires ifs pernnl is nut obtained tvitbin ISO
Print Ilutnlc: I I)ttc tl.t,s atter it Ira'been au'epted as complete.
......... ,.. - Number nt inspccuons albou ei ye,perms;
1'liu;�dirn\VrnnirsiP b_(',_I'ermiVlpp IiI.5 11th due. Rev t'V2 t/211i .1-1•;.1::ISl1i ln)+/t"(Mt:w'1 li
1
. . „,,,,,...._ , _ ...._ .
v-n 1
Mechanical Permit Applicati `,CEIVEP FOR OFFICE USE ONLY
City of Tigard Received Permit No
I)atG13y_ /.C.5r02045!....WOt7
NI n 13125 SW I tall Blvd.,Tigard,OR 9722�AY 21'2015 Plan Review
ill ' Phone: 503.718,2439 Fax: 503,598.19 Dale/13y: Other Permit:
T(GARD Inspection Line: 503.639.4175 Dale Ready/By: luris: ® See Page 2 far
Internet: www.ttgard-or.gov CITY OF TIGARD Notilied/Method: Supplemental Information
T
`' COMMERCIAL FEE* SCHEDULE— USE Ch ECK'
Mechanical permit Ices*ate 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 al profit.
p — —
Value:e
g
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building l:or special information use clseckllst
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. L 'Total
I Iealing/wuling: -
,.,,I�.I� �' r /�,' Air conditioning 46.75
Job site address: 152-I2-SW tAIWG,S\tEtA {'AND` Furnace 100,000 BTU(ducts/vents) t 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/venls) 54.91
Heat pump 61.06
Suite/bldg./apt,no.: 1 Project name:Southview Heights Duct work 23.32
Cross street/directions to job site:SW 122"d Ave&SW Beef Bend Rd 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/ventfor any of above 23,32
Subdivision:Southview Heights I Lot no.: 2
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater _1 23.32
r � �- - l Jj ®., ,: t , Gas fireplace/insert t 33,39
-.. �a.--.n ,`£'t�ice ." 2 4.-,'''^ .., :Y6 ' P ...vf �- n
' Flue vent for water heater or gas
new,single family residence Fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
e ra g
' (11‘\'F.It ❑ '17\Ati"f Other:
Environmental exhaust and ventilation: 23.32
Name:Stone Bridge Homes NW,LLC Range hood/other kitchen
Address:4230 Calewood St,Suite 100 equipment __ t 33.39
�•Clothes dryer exhaust � : 33.39
City/State/ZIP: Lake Oswego,OR 97035 Single-duct exhaust(bathrooms, /.-�
toilet compartments,utility rooms) J 23.32
Phone:(503)387.7577 Fax:(503)387.7615 Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTAC l' PERSON
_Other: 23.32
�. -- Fuel piping:
Business name:same as above
-- '114.15 for first four;54.03 for each additional I
Contact name: Deirdre Britt Furnace,etc_
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater i
Phone:( ) Fax::( ) I-ircplace _
Rang_
F-mail-dbl.itt(ir)stonehridgchnmesnw.eonn Barbecue
CONfl(AcTOR Clothes dryer(gas)
Business name:('ontfort Zone Other:
NIECIIANICAL PERMIT FEES*
Address: 1032 NW Corporate Dr Subtotal
City/State/ZIP:Troutdale,OR 971160 Minimum penult fee($90.00)
Plan review(25%of permit fee)Phone:(503)667,5595 Fax:(503)491.8252 — __._
State ate surcharge(12%of permit fee)
CC13 lie.: 110091 TOTAL PERMIT'FEE
_.._—....._......._ this permit application expires if a permit is not obtained within IRO
1`�t k2_________---C ------^''�. days after it has been accepted as complete.
Atithoriietl signature: . I cc ntrlhtxlulogs sct by 7"1i-Comrly Ihnitling huhlary Service Itoaitl
Print name: David Ilcidsl rb 1,12ate:
I
1 'ii„Idv:,,eetems'•sii.c e..,m,or=p 0.1,,,,; I.. Tin-4.171(11:1,2/1')\pwf121
. CEIVED V 0 1 0 .
Plumbing Permit Application
Building Fixtures MAY 21 2015 FOR OFFICE USE ONLY
Rcccival ! f�
City of Tigard Pcrm;t Nn /�/�
.1 13125 SW Hall Blvd.,Tigard,OR 97�yTY OF TIGARG Ualr!0y: I�f'T��j�fJV l%�
DING DIVISIO" Klan Revrcw
Other Permit No.:
Phone: 503.718.2439 Fax: 5113. Date/By
Inspection Line: 503.639.4175 Date Ready/Hr tons RI See Page 2 for
II°AR'. Internet: www.tigard-or, ov
g Nolllicd!Ms.•thod: Supplemental hs forma lion
'TYPE OF WORK FEE'' SCHEDULE ltqf
fors e,(al to (IF1UIfl(111 use cliecklist
®New aul�Uuetion ❑Demolition P �
h,cription I Qty. I Ea. I 'Total
❑Addition/alteration/replacement ❑Other New 1-2-famm
ly dwellings(includes 100 ft.for each utility connection)
,,. ..;}4;s CELrLGOR 'pOF COtiSl LC11O t. SFR(I)bath 312.70
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath t 50032
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other.
Fire sprinkler( sq.R.) Page 2
Site utilities:
lob site address: 152-12 SW H AW S V IEvj Av E• Catch basin or area drain 18.76
-
Drywell,leach line,or trench drain 18.76
City/State/ZIP:'I'igard,OR 97224
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Southview Heights Manufactured home utilities 50.03
Cross street/directions to job site:SW 122"Ave&SW Beef Bend Rd Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear 11: ) Page 2
Storm sewer(no.linear II.:_) Page 2
Water service(no.linear It,:_) Page 2
Subdivision:Southview Heights I Lot no.: 2. Fixture or item:
Tax map/parcel no.: Back flow preventer 31.27
,,iz tl ai,,,,j,,',, :,,),`b a'},4-:::� , s � °,„ Backwater valve 12.51
„`"l` '� '` 3 ' ' Clothes washer 25.02
new,single family residence Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
•
13 i><0'.'4401,:,)4 !»s6A''i` v '4t '1 4:1,....,:, ?.. ,, Expansion tank 12.51
-
Name:Stone Bridge Homes NW,LLC
Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:4230 Galcwood St,Suite 100
Garbage disposal 25.02
City/State/ZIP:Lake Oswego,OR 97035 Hose bib 25.02
Phone:(503)387.7577 Fax:(503)387.7615 Ice maker 12.51
l a APPLIC N i' ❑ T. ' PERSON Interceptor/grease trap 25.02
Business name:same as above
Medical gas(value:$ ) Page 2
' Primer 12.51
Contact name:Deirdre Britt
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) l Fax::( ) m Tub/shower/shower pan 12.51
1.-mail:dbritta?stonebridgehomesnw.com Urinal 25.02
r;tom :
° . , e ` - Water closet 25.02
� mss,_. � . .�a . �_
> ..,,.; 4 water heater 37.52
Business name: Max Plumbing Water pipinfdDWV 56.2)
Address:PO Ilox 5597 Other: 25.02
City/State/ZIP: Beaverton,OR 97006 Subtotal
Phone (971)275.0198 Pax:( ) Mimi permit lee_ 1172)(l
_._
('(If I ie.: 194644 Plumbing I ie.no.: P111083
Plan review (254:,of permit Ice)
State surcharge(12'::,of permit lee)
A,nhorind sig»hunt t� rf /__ .-+tr"_"`'�"-'"'-"'"- TOTAL PERMITf FIT
I , l This permit application expires if a permil is not obtained within IRO<lays
Print n.,nlr:.lason Ilest'ner Date:
after it bas been accepted as cua,ple le.
"Pc,mclhudulugy sal by Ii-(uunly IrudJinr ludu;i, tics ncc nua,d.
:,ii,aalwarn■iii,.Ii 5III.I'ennli Opp doe lo:i;l,.: 44.•'iu:<,I(In;:nr{iiA.1/\P.Iil
•
City of Tigard
IIN1111 COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Residential
I It , \ I: I)
Building Permit #: MSTtI/s'- o'o I'/
Site Address: 1SSI2 sw HGry S V iew ok ve.
Project Name: S outtn v rev.' 14 ei Tints Lot #: 2
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: Nitta Single. crnmilk/a-- c s cUbelu..
Verify site address/suite# exists and active in permit system.
River Terrace Plan District: ❑ Yes )2r'No
Site Plan Elements:
Three (3)copies of site plan —Etxisting structures on site
'Site plan must}g on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
Drawn to scale(standard architect or engineer scale) floor elevations
/North arrow Utility locations(required for new,may apply for additions)
XSite address,project or subdivision name and lot number cation of wells/septic systems
/Applicant information(name and phone number) ,!/Erosion control(including drainage-way protection,silt fence
,Lot dimensions and building setback dimensions design,location of catch basin,etc.)
,'Lot area,building coverage area,percentage of coverage and Street names
impervious area(applicable if R-7,R-12,R-25&R-40) Street tree size,type and location
)2froperty corner elevations(2 foot contour lines if more than )"Existing trees to be retained with drip line,and tree
4 foot differential) protection measures
XClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: %Yes,applicant was notified ❑ No Received: CI Yes CI No
gPublic Facilities Improvement(PFI) Permit:
Required: ,] Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
❑ Land Use Case#: S U e 2(312 - 0003
, 7 Zoning: I/—'1
%Setbacks: Front t S Rear 1 , Side S. Street Side 1'0 Garage Zn
7 Landscape Requirement: Z0
Lot Coverage Maximum: 6'0 °/a
ABuilding Height: Maximum Height Actual Height IS
0 Visual Clearance h//f
XEasements
i2 Sensitive Lands: ❑ Yes No Type
7 Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: A'7Qvi rz,-,k_ Qjr, Date: .S/2/ / /S
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
l:\Building\Forms\BldgPermitRvw_RES_031015.docx
Building Permit Submittal
Original Submittal Date: -s/214�
Site Plans: #
Building Plans: #
Building Permit#: er Enter building permit#above.
Workflow Routing: Manning E --Engineering Permit Coordinator 'Building
Workflow Sign-off: Er Sign-off for Planning(include notes from planning review)
Route Application Documents: f Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
riginal 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: y j��. - Date: ....V.:26//_5"
Engineering Review
2. 5-10
+
Slope at building pad:
Conditions "Met"prior to issuance of building permit
,Er Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes Er No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Ycs ,r No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: g Date: 5/7- (..//
Revisions (after Building Submittal only) Reviewer ( Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: El 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:
to Issue Permit
Approved by Permit Coordinator: / Date: 7i c
I:\Building\Forms\BldgPermitRvw_RES_031015.docx
glID STONE �
� v .. 291839 RECEI
423o GALEWOOD ST. SUITE ioo � MAY 21 2015 DATE: 5/5/15
LAKE OSWEGO, OR 97035 `' ' PROPERTY: SOUTH VIEW
(503)387-7577 P► / CITYOFTIGARII CITY:
E: T1"=20'
A
�� BUILDING DIVISIOiN PLAN No.: 310
rw OPTION 4 ELEVATION
4119. �, *0°' , ^ � '4%-e*
VOiD
‘)%Pil C*- dr4A5- 0C#/
10 III. :• ;:e*.
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LOT 1 �� i 3,m
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•
CITY OF TIGARD - o", -
Approver by Planning
Date: s/2, / i s 3m5
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Initials: "v)
LECsEND I, '_ �►
STREET TREE: r, If �■��
ZELKOVA SERRATA 0, �ti
(` RED MATZE• •
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LOT COVERAGE BUILDING
LOT AREA: 5,150 SQ. FT. MAIN: 1,490 SQ. FT.
BUILDING AREA: 2,231 SQ. FT. UPPER: 1,555 SQ. FT. `�
PERCENTAGE: 35% GARAGE: 433 SQ. FT. S ��
PORCH: 142 SQ. FT.
NOTES:
ALL GRADE AND PROPERTY LINES ARE ESTIMATES OF CURRENT LOCATIONS. LOT "I
ALL DIMENSIONS AND SQUARE FOOTAGE ARE APPROXIMATE FIGURES. 5,150 5< PT.
ALL RETAINING WALL HEIGHTS AND LOCATIONS ARE ESTIMATES.
THEY MAY VARY AND BE SUBJECT TO CHANGE.