Permit (44) CITY OF TIGARD MASTER PERMIT
N.; .
tr •_,, COMMUNITY DEVELOPMENT Permit#: MST2016-00289
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 08/15/2016
TEa,h.Rla 9
Parcel: 2S 111 AA07500
Jurisdiction: Tigard
Site address: 8952 SW INEZ ST
Subdivision: GREENSWARD PARK NO.4 Lot:
Project: Greensward South, Lot 2
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1453 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 26 Bathrooms: 3 Second: 1483 sf Garage: 648 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
Total: 2936 sf Value: $371,668.55 Rear: 20
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0
Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 5 201-400 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
p
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 2936
Owner: Contractor:
GP4 LLC FOUR D CONSTRUCTION Required Items and Reports(Conditions)
PO BOX 1577 PO BOX 1577 1 Ersn Cntrl 503-639-4175
BEAVERTON,OR 97075 BEAVERTON,OR 97075
PHONE: PHONE: 503-720-7445
FAX: 503-590-1751
Total Fees: $30,325.17
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. ATT . regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-00 010 through OA 9 -001, �0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issue By: K_ • � h /j 4 ( Permittee Signature: -Pt - i C�Gi/k�
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 FOR OFFICE: I;SF ON Ll
City of Tigard Received /t Permit No.:
13125 SW Hall Blvd.,Tigard,OR 9X23 Date/By: (p 3o lit or"
" in, I��j�,/ !
■ t 5`' Plan Review.?-'3 --i/ P -_0 C
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Ca -�'� Other Permit:�l(
Inspection Line: 503.639.4175 ;',. Date Ready/By: orris: !a See Page 2 fpr
Millthil Internet: www.tigard-or.gov Notified/Method:= 15" r4I ft, /` Supplemental Information
TYPE OF WORk REQUIRED DATA:1-AND 2-FAMILY DWELLING
, 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
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ 3/1 , 6 y-
1-and 2-family dwelling 0 Commercial/industrial
0 Accessory building ❑Multi-family Number of bedrooms:
o Master builder 0 Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: a v , Li-
job site address: S q 5 2 S i yij r'I1/41 E v New dwelling area: cl..9 3( square feet
City/State/ZIP: 'r 1 kt,.fsiiLD ( C17 22 q Garage/carport area: 6 Lf? square feet
Suite/bldg./apt.no.: Project name: ( /vt�.l(4/4 jBOkr kill, Covered porch area 3,.. square feet I O 3
Cross street/directions to job site: 1,-,,,,,,c_ Z.. s `�' , , c f C :t 1-1,4. Deck area: 3 S 0 square feet I J
Other structure area: j 8v 4 square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 6 mak/s a e_ , ,,,,, Lot no.: f Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
��'� Res Valuation: S
i ate S t d 4 t_.t P I �' t�i(.it e f D (.e"
F Existing building area square feet
New building area: square feet
INF PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: ly'`L : Sc, ° Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
pit APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer tofee schedule)
Business name: 3 Ct:fv�C"1 lit
_ L ��IStructural plan review fee(or deposit):
Contact name: t if) 0 El4AiLeec\l',4.1.-
FLS plan review fee(if applicable):
Address: no. c:x iS A
City/State/ZIP: 'i Total fees due upon application:
v'e kJ O_, t-.7 67 cS
Phone: C Fax:: ;, 5.f/c/ 7 Amount received:
( ) �) t PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: Coax p c'..C:F.)S j-- t.A.5.3 ,e z il,
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection details
p and fire department access,along with the 2010 Oregon
Address: ,p,clc'.,.' `* L. Solar Installation Specialty Code checklist.
City/State/ZIP: c 9 f' Permit Fee(includes planreview $180 00
h and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: J I Ca3 7Total fee due upon application: $201.60
Authorized signature: 4j,_ This permit application expires if a permit is not obtained
e within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name: ' j 1 ) =.At i Date:6.-3 0 . /G. Service Board
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application 1 oiz OFirl( E I SE 0\11
City of Tigard . Received
Date/B :
Plan Review Permit No.:
i al 13125 SW Hall Blvd.,Tigard,OR 97223 y "� i� O LC /
• Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit:
T t c;A HD Inspection Line: 503.639.4175 Date Ready/By: kris- 0 See Page 2 for
Internet: www.tigard-or.gov =Notified/Method: Supplemental Information
TYPE OF WORK '. COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
New construction 0 Addition/alteratidn/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
. Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
AZI 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special informarton use checklist
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
C/.
Air conditioning i 46.75
Job site address: S l 52 S,W . G Z.. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ^" 1 ,i . 9 .7'2_2-Li Furnace 100,000+BTU(ducts/vents) 54.91
I Heat pump 61.06
Suite/bldg./apt.no.: 1 Project name: Duct work 23.32
Cross street/directions to job site: 32 = , s v/, CI 0 . i 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: ,fa.L. , c Aix0 pi�yilr, .,x.t.i._t , Lot no.:
��
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
' t-ii t - , fireplace 23.32
ti=t„-€..�.= �tF�t:.i... �"l� �C�.�IYIt:'t�C
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
V PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:, Range hood/other kitchen
equipment 33.39
Address: ,; 05 Clothes dryer exhaust 33.39
City/State/ZIP: ,-11,
Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
St APPLICANT 0 CONTACT PERSON Other: 23.32
Business name: ..)',:,,$1-
. .7 Fuel piping:
t:.A.i.iL .? '$r E:.s t ,F-u c-ric_n i,`-r $14.15 for first four;$4.03 for each additional
Contact name: o.+1,00 t c--iP`lIbbl T-° Furnace,etc.
Address: _ Gas heat pump
s�� t Wall/suspended/unit heater
City/State/ZIP: t\' c:42.... t-t'7 c/s Water heater
Phone:(.5 ) `"7).C.- 7 4 s Fax::(5.-3)S'et - i75 i Fireplace
Range
E-mail: FuLi(,i „ b C. ,( S-r&` iviS F .(.a.;1,,y, Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name:
' a:h i 4lc if
N°'t` MECHANICAL PERMIT FEES*
Address: 171c 0. 3,..,s 93 T Subtotal
City/State/ZIP: � c iyt: t )t>_, i.V--. (It-1 C R Minimum permit fee($90.00)C.'
) ��t 1 Plan review(25%of permit fee)
(
Phone: x"51 i C Li t,.i, Fax:(......,3 ) G 50, a j t cit State surcharge(12%of permit fee)
CCB lic.: i'7 6c, tyTOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Litt_e_...,
Leiel7 days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: 40r' :L... ,H :i u - Date: 6.—go —/t,
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
e">
Electrical Permit Application HA( 1,u1( 1.. 10sF 0:11.1
City of Tigard d Received
Dates V 1 Jy
4 '13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review lin
Phone: 503.718.2439 Fax: 503.598.1960 . '' Dates : Related Permit#:
Inspection Line: 503.639.4175 , Ready Date/By: Juris: Fii See Page 2 for
1",,RSD Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
fi
1-and 2-family dwelling 0 Commercial/industrial El building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
�:/ ❑Addition of new motor load of system.
Job#: Job site address: '�jq 52 S t W. TN E-7.-- IOOHP or more. ❑"A","E">"I-2">"l-3",
o Six or more residential units. occupancy.
City/State/ZIP: ._i 1, 1�I ('t'j 2 t.'-
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 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: ', 7, &" 5 a cic II .... FEE SCHEDULE
Description I Qty. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: A.0 r ;, „Sc.,,,,,tli, Lot#: 2.--- Includes attached garage.
1,000 sq.ft.or less ' 168.54 4
Tax map/parcel#:
Ea.add'1500 sq.ft.or portion t j 33.92 1
DESCRIPTION OF WORK Limited energy,residential , 75.00 2
(with above sq.ft.)
A/6W Sit" C:=t,..0. ii 'g t..5 i' 4 Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
('PROPERTY OWNER 0 TENANT Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: t--,. 201 amps to 400 amps 133.56 2
„. 401 amps to 600 amps 200.34 2
City/State/ZIP: f. 601 amps to 1,000 amps 301.04 2
Phone:( ) 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 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
isf
APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Cod 14,, 0p c ilk I ick,,' above service or feeder fee,
7.42 2
each branch circuit
Contact name: DNA;D 1Ai4iNgua 1.” ' B.Fee for branch circuits without
Address: ? r service or feeder fee,first 56.18 2
t,.,.r '-&-,,,4 i S`1 1 branch circuit
City/State/ZIP: ,PiEach add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:Ko'3 ) ` 2 c,:--- 2 s1 4-1 Fax: :(5Z!4),'59O• 4.75 i Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email: i-64(47—D C.n i.251'
Ci`. M'i6oLi,t 0 Wt.
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: E.j,,, t.:,74,..-1.4Sign or outline lighting 67.84 2
� Signal circuit(s)or limited-energy
Address:
C.45.-- r /: ) /e,)QA. panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: _ ra Each additional inspection over allowable in any of the above
' t#- (-”1 1 ^4` C Additional inspection(1 hr min) 66.25/hr
Phone:(5c-,.:i) Z 7 7 -,3 7L:-4(.3 Fax:( c; 3 ) 961 .7 I y Investigation(1 hr min) 66.25/hr
Industrial plant(1 hr min) 78.18/hr
Email: c 7'
L e" "
La iry tL kms,f' Co_ L;itinN.14,,,,, I (..C1it. 'i. Inspections for which no fee is
CCB Lic.: 1 f' ' Electrical Lie.: f' Suprv.Lie.: 5- 26,2 specifically listed(%2 hr min) 90.00/hr
a.....4...._ ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:r ' s«.Gt. Subtotal:
Print name:g Date: 6..30 /,(, 0 Plan Review Required(25%of permit fee):
�'p l t 1 /VI.c. 1r -l1`W State surcharge(12%of permit fee):
�� TOTAL PERMIT FEE:
Authorized signature:
/_� This permit application expires if a permit is not obtained within 180
Print name: :DINL:t 0 , Dz ert t-f�.. Date: 6--S6 f 7 days after it has been accepted as complete.
Number of inspections allowed per permit.
1:\Building\Permits\ELC PermitApp ELR ERE.doc Rev 04/21/2014 440-4615T(11/05/COM/WEB
Plumbing Permit Application
9
Building Fixtures FOR OFFICE USE Ovl,v
• El
City of Tigard i, Received M
Date/By: Permit No.: S-r- -064,1?-123125 SW Hall Blvd.,Tigard,Olt 9 X223 Plan Review LTi
Phone: 503.718.2439 Fax: 503.598.1960Date/By: Other Permit No.:
Inspection Line: 503.639.4175 Date Ready/By: loris: ® See Page 2 for
Internet: www.tigard-or.gov v o`
Notified/Method: � Supplemental Information
TYPE OF WORK ., FEE* SCHEDULE
New construction 0 Demolition For special information use checklist.
Description Qty. Ea. Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
p[.1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath
I 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: (8 S",,5 5,w, IN E-L- Catch basin or area drain 18.76
City/State/ZIP: Cu. Drywell,leach line,or trench drain 18.76
i W , �7�` I " Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Iti A? 4�1%, t::iCs •i- 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:(„1` A75,,,,,,,,i.„( iyi9 ;„ `',, t.s...t,,,,.. Lot no.:
'2../. Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
r Clothes washer 25.02
✓art45,071/4/04.t:. ivi t it t A=C Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
lit PROPERTY OWNER 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: a LILA:,+.4,...,
t� Floor drain/floor sink/hub 25.02
Address: '_,.,„,.it.= i " Garbage disposal 25.02
City/State/ZIP: ''{ Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
Iti APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: 12,_ 6aA5 ra p Medical gas(value:$ ) Page 2
,i Primer 12.51
Contact name: )t* i t:1 t: i4 Cel-r--
_ Roof drain(commercial) 12.51
Address: 1), (1
7 d Sink/basin/lavatory 25.02
City/State/ZIP: 1B Epic-v.%Toott. tic& c'j 7 0/ S Solar units(potable water) 62.54
Phone:(Si," ) 7 2 c,__ 7 tj Li S Fax: :(5,--.?,) 9,0, .. I' Tub/shower/shower pan 12.51
E-mail: (774L4,0„,„ .0 ? ;
IIsCity of Tigard
p COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c n K n Building Permit Review — Residential
Building Permit #: /f'10/6__cx ”
Site Address: $9 Sr). Su 1;- e r—
Project Name: C,-ce-,,..) s ,,,I - d_
Pa AL ':,M,///If 50,�`ETI Lot #: —2.
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: N e,,,) 2
Verify site address/suite# exists and active in permit system.
ARiver Terrace Neighborhood: ,rNo ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
EN3'Three(3)copies of site plan
�ite plan must be on 8-1/2"x 11"or 11 x 17"paper �snng structures on site
rint of
, rawn to scale (standard architect or engineer scale) floor 1 vationsw structure(including decks)with finished
Afic orth arrow
, LUtility locations(required for new,may apply for additions)
Site address,project or subdivision name and lot number E�,//
,LJocation of wells/septic systems
g-Applicant information (name and phone number) ( rosion control(including drainage-way protection,silt fence
k4Lot dimensions and building setback dimensions design,location of catch basin,etc.)
tot area,building coverage area,percentage of coverage and ,Street names
impervious area (applicable if R-7,R-12,R-25&R-40)
I�I roperty corner elevations (2 foot contour lines if more than �treet tree size,type and location
4 foot differential) Existing trees to be retained with drip line,and tree
protection measures
Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified
,.5?"-No Received: ❑ Yes ❑ No
.Public Facilities Improvement (PFI) Permit:
Required: Xe Yes,applicant was notified ❑ No Applied For:
N'Yes ❑ No,stop intake
.'Land Use Case #: ,,s w[3 a U 14 -- Oov I O
-ka—Zoning: —LI- `S
Setbacks: Front o2 0 Rear
Landscape Requirement: pi A. % S Side s Street Side Garage o20
'Lot Coverage Maximum: Ni/A. cyo
Er-Building Height: Maximum Height 3
[kr Visual Clearance Actual Height
Easements
kr-Sensitive Lands: ❑ Yes 1 No
Type
X.Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning:
/1.vli Date: & -30 --/k7
Revisions (after Building Submittal only)
Revision 1: Elpp d ❑ Not Approved
A roveReviewer Date
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Fonns\BldgPennitRvw_RES_012116.docx
Building Permit Submittal
Original Submittal Date: / a/i
Site Plans: #
Building Plans: # 3
Building Permit#: er building permit#above.
Workflow Routing: arming ngineering nt-t-Coordinator madding
Workflow Sign-off:
i off for Planning(include notes from planning review)
Route Application Documents: gineering: (1) copy of permit application, (1) site plan, (1) building plan and
ori 'nal plan review routing form.
uilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: - ?, /- - ' � Date: 7//)-fry.
Engineering Review
A7eSlope at building pad: A X
Conditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat
FA Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
Date:
C] NOT Approved by Engineering:
Notes:
i
Approved by Engineering: �`�/" .21' Date: 7—/4/-44-
Revisions (after Building Submittal only)
Reviewer Date
Revision 1: ❑ Approved E 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:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
Ii ..-`10C Fees Entered: Wash Co Trans Dev Tax: r-Yes ❑ N/A
Tigard Trans SDC: C. es ❑ N/A
Parks SDC: ralYes ❑ N/A
7OK to Issue Permit /-7 /
Approved by Permit Coordinator:
I Date:
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