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Permit (12) ...t , ,r, 1 0 -2,,,v,, c-zir B1dildi g Permit Appl> Va, o I 0 Residential FOR OFFI(E ISF ONLY- n9 0115 City of Tigard Received / ul Date/B : L�� _±% Permit No.: ,1 LO(5— Cegdwg 13125 SW Hall Blvd.,Tigard,OR 9722,3 t IN ■ c Plan Review C Phone: 503.718.2439 Fax: i 5 9d t �� Date/B : j Other Permit:AL/P�/5-*Ce). Z/ T I ,A R D Inspection Line: 503.639:4t rr t I i sti xt ,,i,' Date Read /B Juris: Internet: www.ti and or v`t i "tJ9x e I'' Ready/By: Supplemental See Page 2 fnr g g� r�' Notified/Method: Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING 133 New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El 1-and 2-family dwelling 0 Commercial/industrial Valuation:3 8�)74g$--- ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: 0 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 Job site address: /)ySSt/j'i/ ..S W 6I -e,;broil At, New dwelling area: 3 1 8 square fee S-91S ?(, City/State/ZIP: 7/94 Yip 0t 97'2.2 3 Garage/carport area: 91.1 square feet Suite/bldg./apt.no.: Project name: l Covered porch area: uare feet 1 6 0 1 Cross street/directions to job site: $yrl E Set 11,4- 4 _ Deck area: S square feeKp Other structure area: square feet t) 4 REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: I S/ IT �/� CD,©0® Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the \ s(1 DESCRIPTION OF WORK work indicated on this application. Z ;�,,+ G1Li X Valuation: $ ` . Y�" Existing building area: square feet v New building area: square feet V PROPERTY OWNER 0 TENANT Number of stories: Name: El,�yp f,+rct s4 C l4 SS L /1s woes,L.C-- Type of construction: 1 Address: `'2 t:,0 it S,1,,,,) P,KA Si- , Occupancy groups: kn City/State/ZIP: Po' /k rtLd o K 7722^3 Existing: Phone:( 3 ) Lig 2 -44.5'7 Fax:( ) S4 4,14 New: IrrWAPPLICANT CONTACT PERSON BUILDING PERMIT FEES* v Business name: © J a Pi_T-E 2 L6_/ (l'lease refer ro fee schedule) Z Structural plan review fee(or deposit): Z Contact name: Address: — FLS plan review fee(if applicable): City/State/ZIP: Total fees due upon application: Phone:(;3 5('5'-'7L1i _L( Fax::( ) Amount received: 75z) E-mail: W PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* .\ CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name: S C.Ci',ICI( Pt yt I4 h Geih c VQ( C . I yck t?, Submit two(2)sets of roof plan with connection details t g and fire department access,along with the 2010 Oregon i Address: -�6O 9 l>J pl(/�t Cf-, Solar Installation Specialty Code checklist. City/State/ZIP: © i� (C Q fes' �y7 Z Permit Fee(includes plan review and administrative fees): $180.00 *Phone:(A 3 ) Le..cL-94 S 3 Fax:($. ) Sq tel.( State surcharge(12%of permit fee): $21.60 CCB lic.: 'S-70. y 6, Total fee due upon application: $201.60 Authorized signature: oe) This permit application expires if a permit is not obtained /// "'' � within 180 days after it has been accepted as complete. Print name: ( VG he r c'2Se-w Date: (Z.(Z.t f//c *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPennitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling Folz oFEICE usE oNi.l' City of Tigard Received Permit No.: Associat • 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: ■ Phone: 503.718.2439 Fax: 503.598.1960 ❑ Mechanical 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing 1 t G A R 17 Internet: www.tigard-or.gov 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 • 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district: . 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 0 6 Sewer permit. 0 0 0 7 Water district approval. 0 0 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0 building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 0 there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 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 0 floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 0 Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 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 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0 systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 0 0 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0 for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 0 architect licensed in Ore:on and shall be shown to be a.I licable to the iro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 0 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 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 0 0 and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 0 including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:ABuilding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB) t �sril i`�, Y�"'ol ,..,.. Electr cal Permit ApplicatiQ7t�` FOR OFFICE USE ONLY City of Tigard ReceivedB ® 146 c' 2 'fit, / Permit .114 v 13125 SW Hall Blvd.,Tigard,OR 972-3 " - ' �'"' Plan ✓ j��.j�S��g� Plan Review Phone: 503.718.2439 Fax: 503.598.1960Related Permit S: g t Inspection Line: 503.639.4175 t.� i t/(i,i� C i4 �.t DateB Ready Date/By: inns: 0 See Page 2 for T i G A R D Internet: www.tigard-or.gov g ,,,, iiiiv,i,, sh.>c°i;�`1 z Vit Notified'Method, Supplemental Information - W ; TYPE OFWORK. . Mechanical Permit Applic � t FOR OFFICE USE ONLY 1114City of Tigard Received /n / /(^ Date./By: 0G / �j - vl / Permit No.: � �,ey g96 4 13125 SW Hall Blvd.,Tigard,OR 97223 O OS 7 = Plan Review Phone: 503.713.2439 Fax: 503.598.1960' 4 `1 Date,Bv: Other Permit: T I G A R D Inspection Line: 503.639.4175 Date Ready'By: Juris: 10 See Pae 2 for Internet: www.tigard-or.gov � r_ Notified/Method: g Ole y Supplementallnformation TYPE atitAINGOif COM4IERCIAI,,,FEE*Y'SCHEDULE`=USE`CHECKLIST,) Mechanical permit fees*are based on the value of the work [ Alew 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*` ►2 1-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: i 1 1' S5 -t- /i L gi S`I,.. -v 4-fe'1 )ti y 7 Furnace 100,000 BTU(duets;vents) J 46.75 City/State/ZIP: 7 1,rt s C 0,2 9'7'?-2°3 Furnace 100.000+BTU(ducts;vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: Svc^ rj sei.-t. 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: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: / 9 '?mac C,,., C"t I OC' Water heater 23.32 DESCRIPTION OF'WORK Gas fireplace,/insert 33.39 1 Flue vent for water heater or gas ilV CA t4 p L->C fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ❑ PROPERTYr OWNER ❑ TENANT Other: 23.32 ` Environmental exhaust and ventilation: Name: L,:—.1,01,-,,,f c4_1N e_f}, .t 4. t"'t(o,,,,LtS LL[_, Range hood/other kitchen equipment 33,39 Address: —26 L, c 3 P HAL S , Clothes dryer exhaust 33.39 City/State/ZIP: pcv-t�a vl L"1 012 97 2-23 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(c`ji='3) Lit C2 ^91- c7 Fax:( ) See.0.-k•� Attic/crawlspace fans 23.32 0 APPLICANT 0 CONTACT PERSON >.r Other: 23.32 Business name: Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Furnace.etc. Address: Gas heat pump Wall/suspended%unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace Range E-mail: Barbecue CONTRACTOR Clothes dryer(gas) I Business name: Pai`Ihy1$ NQrtivt, Other: � 1 MECHANICAL PER IT FEES* Address: 1 G 30 3 Iv -E`' �� c —r— Subtotal City/State/ZIP: JptN d.,0 LxVt/Z. , L,3& 9 8116 2. Minimum permit fee(590.00) Plan review(25%of permit fee) Phone:(c03) 9 1 if 0 cS Fax:( ) State surcharge(12°/n of permit fee) CCB lie.: /q7 51/ q TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 ,(1):'(" 7—'1'r>.. days after it has been accepted as complete. Authorized signature: 2( i L * Fee methodology set by Tri-County Building Industry Service Board Print name: &Il C: e 7 e...,../2...g.-e4 Date: /1-/2`f 71- IaBuilding`Perm,tsMEC_PermitApp_040113.doc 440-4617T(I I'02 COM WEB) Plumbing Permit Appli w T il , Building Fixtures 5-la "" j YL' FOR OFFICE USE ONLY Citof Tigard 1Blvd t., '2+ 4 . qC Date/BReceivyd: /� �!/-) Permit No.:: 1/4�s f5'.. Oa-Q0 13125 SW Hall Blvd.,Tigard,OR149 22 - �" y' a y /S Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: �q lig Date/By: Inspection Line: 503.639Al 715 1 I�/014 (;L - T I G A R DDate Ready/By: loris: El See Page 2 for Internet: wwwtigatd of gov [ {' r)ANottfiedNethod: Supplemental Information TYPE lFe FEE* SCHEDULE ew construction ❑Demolition For special information use checklist. Description Qty. 1 Ea. Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION, SFR(1)bath 312.70 igj 1-and 2-family dwelling ❑Commercial/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: / f�cc -f- /f t-t '/ Si ). ti (j,e- y9 /24 Catch basin or area drain 18.76 City/State/ZIP: -7-10 4✓d o►2 ci 7•Z7.--) Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: ; e S4 Lj Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: ) S i 3 s cp b 9 ci o o Backflow preventer 31.27 - DESCRIPTION OF WORK ` Backwater valve 12.51 Clothes washer 25.02 "Luw d 4-10-P-y Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 [ CPROPERTY OWNER ❑ TENANT . Expansion tank 12.51 Name: L l Yc a'ct vt g S 1 L e i i t t s (�( Fixture/sewer cap 25.02 Address: J Floor drain/floor sink/hub 25.02 ��08 S � pi 5 b-, H 4 p ©1 7 2-2-3 Garbage disposal 25.02 City/State/ZIP: /State/ZIP: �jO`r ( Hose bib 25.02 - Phone:( 3) 4 5-Z-94-f Fax: ( ) v`'1/1.-t._( Ice maker 12.51 0`APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:S ) Page 2 Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 CONTRACTOR . Water closet 25.02 Water heater 37.52 Business name: De./44 0 k ht lj(„lb:, Water piping/DWV 56.29 Address: /9‘g0 5 -E__ !OS )E. Other: 25.02 City/State/ZIP: (t4PPy V',4 y 0 - Subtotal Phone:(S.O3) "j)ci-( (7%,3 Fax:( ) Minimum permit fee: $72.50 ! _ lel,6-6 Plan review (25%of permit fee) CCB Lic.: g[F � Plumbing Lic.no.: i" /� State surcharge(12%of permit fee) Authorized signature: x / 4, TOTAL PERMIT FEE Print name:/' QV c l j ej4 ce-4 Date: /21 Zt///S" 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 Service Board. 1:Building.Permits.PLv1U-PermitApp.doc 10 01.09 440-4616T(10 02,COxfWEB) RWEIVEri) Clean Water Services File Number . 2 4 201` ,x ; Clean\-�ateer Services 15-004146 • Lai(OFT1, ; i- nsitive Area Pre-Screening Site Assessment a 3'U1ILD1Ni 1. Jurisdiction: � ?rd 2. Property (, formation (example 1S234AB01400) 3. Owner Information Tax lot ID(i): Name: Ove Petersen 1S135CD09200,15135CD09100,1S135CD09000 Company: Scandinavian General,Cont4acting Address: 7608 SW Pine St. Site Address: City, State,Zip: Portland OR 97223 City,State,Zip: Tigard OR 97223 Phone/Fax: 503 515 9464,503 452 9457 Nearest Cross Street: SW Esau E-Mail: Iop8318@aol.com 4. Development Activity (check all that apply) 5. Applicant Information Addition to Single Family Residence(rooms.deck,garage) Name: Ove Petersen U Lot Line Adjustment ] Minor Land Partition Company: Residential Condominium ] Commercial Condominium Address: Residential Subdivision ❑ Commercial Subdivision Single Lot Commercial City, State,Zip: CJ 9 ] Multi Lot Commercial Other Phone/Fax: 503 515 9464,503 452 9457 one duplex to be built on each lot of record E-Mail: lop8318@aol.com 6. Will the project involve any off-site work? ❑Yes XI No ❑Unknown Location and description of off-site work 7. Additional comments or information that may be needed to understand your project This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form.the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete.and accurate. Print/Type Name Ove Petersen Print/Type Title ONLINE SUBMITTAL Date 12/21/2015 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,State,and federal law. Based an review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20,Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law. LJ This Service Provider Letter is not valid unless CWS approved site plan(s)are attached. Ej The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed by C i s -d "'—"' Date 12/22/15 2550 SW Hillsboro Highway • Hillsboro,Oregon 97123 • Phone.(503)681-5100 • Fax:(503)681-4439 • www.cleanwaterservices.org , City of Tigard I ipi COMMUNITY DEVELOPMENT DEPARTMENT T 1 G A R D Building Permit Review — Residential Building Permit #: H')�1 S - 009-go Site Address: VIS-5 f ► I q S \ S W 6 recn b y Project Name: E ro pecA,, C1 G Sit c f hnr tie„ Lot #: ( (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: .f.Q]vV F XVerify site address/suite#exists and active in permit system. —0 River Terrace Neighborhood: ❑ Yes /No Site Plan Elements: /Three (3) copies of site plan d' xisting structures on site // Site plan must be 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) Site address,project or subdivision name and lot number ---Bt cation of wells/septic systems (Inipplicant information(name and phone number) Xrosion control(including drainage-way protection,silt fence of dimensions and building setback dimensions ,_,,((design,location of catch basin,etc.) /Lot area,building coverage area,perc age of coverage and /Street names impervious area(applicable if R-7, 1 ,R-25&R-40) Street tree size,type and location /Property corner elevations (2 foot contour lines if more than �Fxisting trees to be retained with drip line,and tree 4 foot differential) protection measures .--.Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): I S—'QOQ 14(o Required: ❑ Yes,applicant was notified ❑ No Received: /Yes ❑ No —8-Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake Land Use Case #: LLA- P2-01S - 00001 , M L1c1q _ 00003 Zoning: R`1 'Z 7 Setbacks: f rarxt-- Rear 1 E Side 5 Street Side °( S Garage 10 ..,E/Landscape Requirement: 2,6 % 3s- F2-0,11- fear,* P y, Lot Coverage Maximum: 73-6- 1 v % S � 1 g'. 3c,ogo.h Building Height: Maximum Height SActual Height 3 $Visual Clearance yiEasements if—Sensitive Lands: ❑ Yes X No Type iii rban Forestry Plan l ❑ 1 onditions "Met"prior to issuance of building permit •otes: 0-2VY101 ‘1l wl co`ld:k-i\ (1 S A to-e- -cm h I f id /1/0 4-- /*wet Ar- c)4.. A,.( /a,-i-.s' Approved By Planning: Dater-6: 44�/ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Fonns\BldgPennitRvw REs 0709I5.docx i Building Permit Submittal Original Submittal Date: `�// Site Plans: #194 3 Building Plans: # 3 Building Permit#: El-Enter buildingpermit#above. ,1 �/ Workflow Routing: Er Planning Engineering X1'e !Jrmit Coordinator Building Workflow Sign-off: 2r Sign-off for Planning(include notes from planning review) Route Application Documents: ['J 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: !i,, _ 4,_.,...1_ Date: /a/:;*/i S---- Engineering Review Slope at building pad: 4 7, Conditions "Met"prior to issuance of building permit Easements (encroachments) per engineering conditions of approval and plat ❑ ''Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: X Yesif ❑ No Assess Water Quantity Fee in-lieu: A Yes ❑ No LIDA Facility on lot: ❑ Yes ❑ No NOT Approved by Engineering: 144 Date Notes: It,: llie-1.0 Approved by Engineering: Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved El Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: /2/3 Q‘-‘IQ I•( Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: SDC Fees Entered: Wash Co Trans Dev Tax: WYes ❑ N/A Tigard Trans SDC: ❑ Yes IP9N/A Parks SDC: EiPYes ❑ N/A El OK to Issue Permit Approved by Permit Coordinator: Date: I:\Building\Forms\BIdgPennitRvw_RES_070915.docx FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT '01 ` Transmittal Letter 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION EID ° , FROM: 6 JUN 8 1. 16 V COMPANY: L tl1 3 as-..., A\Z-ttka C_07:3/'• BUILDING t t 'v PHONE: 50 5 Sal 5-94/6 c/ B RE: //1/SC S �` 0/67 60 -2.t-,til'it/V N6 -ci oo P-96 (Site Address) (Permit Number) Edi o 4 , (Project name .r subdivision name and lot number ATTACHED ARE THE FOLLOWING ITEMS: Additional set(s) of plans. 5 Revisions: 3 Cross section(s) and details. Wall bracing and/or lateral analysis. 3,, Floor/roof framing. Basement and retaining walls. Beam calculations. a Engineer's calculations. Other(explain): REMARKS: io(a-, J f)io . /Ilei r' t l/77htS A/ , t4 LC QA/ Tepe//,-9 a77 Routed to Permit Technician: Date: Initials: Fees Due: ■ Yes ❑No Fee Descri ition: Amount Due: $ $ $ $ Special Instructions: Re.rint Permit ser PE : ❑ Yes ❑No ❑ Done A A. I licant Notified: Date: Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012