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03-March (2) ili.,..., k. CITY OF TIGARD MASTER PERMIT ill''. COMMUNITY DEVELOPMENT Permit#: MST2015-00287 13125 SW Hall Blvd.,Ti Date Issued: 03/08/2017 TfCa1R. and OR 97223 503.718.2439 9 Parcel: 2S112CB00500 Jurisdiction: TIGARD Site address: 8245 SW NORFOLK LN Subdivision: HOGGAN'S PARK Lot: 6 Project: Hoggans Park, Lot 8 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 6 First: 1221 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1663 sf Garage: 606 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2884 sf Value: $354,716.13 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 Storm Sewer: 100 Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 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: 4 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 ng: Y Eco Other: N Other Description: mpasa BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2884 Owner: Contractor: WESTWOOD HOMES LLC WESTWOOD HOMES LLC Required Items and Reports(Conditions) 12700 NW CORNELL RD 12700 NW CORNELL RD 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97229 PORTLAND,OR 97229 2 A geotechnical report is required before the footing PHONE: PHONE: 503-330-2215 FAX: 503-342-2403 Total Fees: $24,307.43 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 ••"- 952-001-0010 952-001-0010 thro 952-001-0090. Y in a co Frrples o direct questions to OUNC by calling 503.232.1987 or 1.:.,.332.23 Issued By: -,7"4,00&...... Permittee Si nature: -%' 9 Ai Ca .4175 by 7:00 a.m.for the next available inspection date. dir 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. 1 Building Permit ApplicatiORECEIVE LsIQ QS /T Residential DEC 2 3 2015 IOk 0141('1 t'SI O�NLv City of Tigard Received III13125 SW Hall Blvd.,Tigard,OR 97 = Date/B : /02A2 y jar Permit No OF TlGARDPlan ..ird." �ls " ol.�d� �7 Phone: 503.7182439 Fax: 503. y• ti,, DateB Review �y Other Perm, d� ��_e I 1 G;1Rp Inspection Line: 503.639.4175 � �iNG DIVISION Date Ready/By: - Internet: Line:www.tigard-or.gov S See Page 2 film Notified/Method:/pZ,�",/,0 Supplemental Information E-I,1/L- Ai9-,7— 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. 0 Addition/alteration/replacement 0 Other: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® 1-and 2-family dwellingValuation: G ❑Commercial/industrial I /i ❑Accessory building Number of bedrooms: 9 ❑Multi-family o Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: L. Job site address: r,y ,I lidwelling Z „ square feet 31.9 7 -� ��"�r �� ��/'/k ��.rl�t.�", New area: V z7 31.9 City/State/ZIP: 7" 4,a i , ,.1 E' ( L( Garage/carport area: Fr square feet Suite/bldg./apt.no.:/ Project name: _ Covered porch area: 4. )4\s square feet / CaCross street/directions to job site: 'h Deck area: square feet'clA.) Other structure area: — square feet ? REQUIRED DATA:COMMERCIAL=USE CHECKLIST Subdivision:ifc-rte e v 4 4 PC i'i I Lot no.: ,./; Permit fees*are based on the value of the work performed. Tax map/parcel tSo.: 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. New Single Family Construction Valuation: g Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:Westwood Homes LLC Type of construction: Address:12700 NW Cornell Rd Occupancy groups: City/State/ZIP:Portland,OR 97229 _ Existing: Phone:(971)678-5018 Fax:( ) �� New _ ' `- ■ CONTACT PERSON BUIL")I ING PERMIT FEES* Business name:Westwood Homes LLC (Please refer to fee schedule) Contact name:Matt Fricke Structural plan review fee(or deposit): Address: 12700 NW Cornell Rd FLS plan review fee(if applicable): City/State/ZIP:Portland,OR 97229 Total fees due upon application: Phone:(971)678-5018 Fax::( ) Amount received: E-mail:Matt@Westwoodhomesllc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name:Westwood Homes LLC Submit two(2)sets of roof plan with connection details Address:12700 NE Cornell Rd and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP:Portland,OR 97229 Permit Fee(includes plan review Phone:(971)678-5018 Fax:( ) and administrative fees): $180.00 State surcharge(12%of permit fee): $21.60 CCB lic.:195597 ,,,20, Total fee due upon application: $201.60 Authorized'signature: ' This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Matt Fricke Dater *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\PermitsgBUP-RESPermitApp.doc 02/24/2011 440-4613T 11/02/COM/WEB) r 'Mechanical Permit Applic E'VE FOR OFFICE USE ONLY City of Tigard �� t""" "' Received . DDate/By: �� y: Permit N - , �q/�Q �iQ� 7 - 13125 SW Hall Blvd.,Tigard,OR 97223 3 2015 Plan Review V Phone: 503.718.2439 Fax: 503.598.19 lE C Date/By: Other Permit: T I G A R D Inspection Line: 503.639.4175 Date Read B 7uris: Internet: www.tigard-or.govTIGARD Ready/By: Supplemental See Page 2 nr CITY OF Notified/Method: Information BUILDING DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE— USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: t. �. ., Air conditioning t 46.75 Job site address: Z.f j 4/ 1 G;)� Furnace 100,000 BTU(ducts/vents) j 46.75 City/State/ZIP:Tigard OR Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: 1 Project name: Duct work 23.32 Cross street/directions to job site: 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-• i-*n.? f,r' 4 �'" I Lot no.: Other: 23.32 e.r Other fuel appliances: Tax map/parcel n Water heater I 23.32 DESCRIPTION OF WORK Gas fireplace/insert I 33.39 Flue vent for water heater or gas new SFR fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 El PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name:Westwood Homes LLC Range hood/other kitchen — equipment I 33.39 Address: 12700 NW Cornell Road Clothes dryer exhaust I 33.39 City/State/ZIP:Portland OR 97229 Single-duct exhaust(bathrooms, (� �/ Ci,_.1-, toilet compartments,utility rooms) f 23.32 Phone: 71Y" _5C)C g Fax:(5031342-2403 lttrs/Era`al El APPLICANT 0 CONTACT PERSON Other: 23.32 Business name:Westwood Homes LLC Fuel piping: �w $14.15 for first four;$4.03 for each additional Contact name:./1101-t nF I tee, Furnace,etc. Address: 12700 NW Cornell Road Gas heat pump Wall/suspended/unit heater City/State/ZIP:Portland OR 97229 Water heater Phone: it -.6;5r Chis I Fax::(503-)342-2403 Fireplace Range E-mail:Ws a?westwoodhomesllc.com Barbecue CONTRACTOR Clothes dryer(gas) Business name:Central Air Other: MECHANICAL PERMIT FEES* Address:PO Box 433 Subtotal City/State/ZIP:Clackamas,OR 97015 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)656-1908 Fax:(503)650-3898 State surcharge(12%of permit fee) CCB lic.: 178624 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: ( * Fee methodology set by Tri-County Building Industry Service Board Print name:Jon Montgo Date: i:\Building\Permits\MEC_PermitApp_04o113.doc 440-4617T(I 1/02/COM/wEB) . ' Electrical Permit Applicata CEIVE horn ohhlch t SE()Nl.1 City of Tigard Received :1. • 13125 SW Hall Blvd.,Tigard,OR 97213 EC 2 3 O 5 PlateB Permit#:/Yjrj� ` �P��7 111 Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Date/B : Related Permit#: T 1 v A RD N Inspection Line: 503.639.4175 CIIT OF 1 I GA�Ip D Ready Date/By: Jars: Internet: www.tigard-or.govla BUILDING DIVISION See Page 2 for otified/Methoa: Supplemental Information TYPE OF WORK PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): J 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Other: CATEGORY OF CONSTRUCTION where the available fault current 0 Marinas and boatyards. exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory 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: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: I Job site address r` Y'j ❑Addition of new motor load of system. C j"i 1 /1,91`(6. f c:1?k' 100HP or more. ❑«A» «E» «1 Z»«1 3» City/State/ZIP: --t- 2 G'%' 4 i e 0 Six or more residential units, occupancy. / 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: I Project name: 0 Hazardous locations. 0 Supply voltage for more than Cross street/directions to job Site: ❑Service or feeder 600 amps or more. 600 volts nominal. FEE SCHEDULE Description I Qty. I Each I Total Subdivision: � / New residential single-or multi-fanul dwelling unit. tie. YG irk I Lot#: Y Includes attached garage. Tax map/parcel#: \s*"J/ 1,000 sq.ft.or less I 1 168.54 4 DESCRIPTION OF WORK Ea.add'1500 sq.ft.or portion33.92 1 Limited energy,residential New SFR (with above sq.ft.) 75.00 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 ig PROPERTY OWNER I : 0 TENANT, Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation Name:Westwood Homes LLC 200 amps or less 100.70 2 Address:12700 NW Cornell Rd 201 amps to 400 amps 133.56 2 City/State/ZIP:Portland,OR 97229 401 amps to 600 amps 200.34 2 I 601 amps to 1,000 amps 301.04 2 Phone:(971)678-5018 Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 ampsto 400 amps j 59.36 1 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 1 2 APPLICANT I 0 CONTACT PERSON Branch circuits—new,alteration,or extension, er panel Business name:Same as Owner A Fee for branch feeds fee, above service or feeder fee, Contact name: each branch circuit 7.42 2 B.Fee for branch circuits without h,Iirtlt _ __ — _ 56.18 2 branch circuit City/State/ZIP: Each add'l branch circuit 7.42 2 Phone: Miscellaneous(service or feeder not included) ( ) I Fax::( ) Each manufactured or modular Email: dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Ross Electric Inc Sign or outline lighting 67.84 2 Address:2870 SE 75th Ave#203 Signal circuit(s)or limited-energy 2 e panel,alteration,or extension. 0 See Page 2 City/State/ZIP:Hillsboro,OR 97123 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)642-2800 I Fax:( ) Investigation(1 hr min) 90.00/hr Email:RossElectric@comcast.net Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.: 157891 I Electrical Lic.: 34-436C I Suprv.Lic.: 42325 specifically listed('/2 hr min) 90.00/hr Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES Subtotal: (...Print name: Stephen Ross I Date: 0 Plan Review Required(25%of permit fee): y State surcharge(12%of permit fee): I Authorized signature: i�� C , i TOTAL PERMIT FEE: U( I Print name: �, I This permit application expires if a permit is not obtained within 180 Date: !�-" .-r.:1.c) I days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PetmitApp_ELR_ERE.doc Rev 06/17/2015 440.4615T(11/05/COM/WEB . ' 'Plumbing Permit Applica . Building Fixtures 1LGEIVL FOR OFFICE tISE ONI.Y City Of Tigard DEC 2 3 2015 Da eBed Permit No � 9W.5.-041Z,Y7 r 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review _ Phone: 503.718.2439 Fax: 5030TP'6OF TIGAAD Other Permit No.: Date/By: Inspection Line: 503.639.4175 BUILDING DIVISION Ready/By: g T I G A R D Internet: www.tigard-or.gov Date Read/B : Juris: H See Page 2 for Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction 0 Demolition For special information use checklist Description Qty. Ea. 1 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 ® 1-and 2-family dwellingSFR(2)bath 437.78 0 Commercial/industrial ❑Accessory building 0 Multi-family SFR(3)bath ' 500.32 Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: "'�'� / / Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard OR 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: 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:WL.,:-. 0 i;; 1' l e,'(/7 J Lot no.: 7 Fixture or item: Tax map/parcel no.: Backflow preventer ° 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer ( 25.02 new SFR Dishwasher it 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 C1 PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name:Westwood Homes LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 12700 NW Cornell Road Garbage disposal 25.02 City/State/ZIP:Portland OR 97229 Hose bib ' . 25.02 Phone: I l f^ 611®colt f Fax:(503)342-2403 Ice maker 12.51 El APPLW N'T U CONTACT PERSON Interceptor/grease trap A25.02 Business name: lAkittijati HMI e.) a( Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:1l1# Ft":C.ke, Address: j Roof drain(commercial) 12.51 O�4r Sink/basin/lavatory 1. 25.02 City/Statte/ZIP: Solar units(potable water) 62.54 Phone:l71f )6.K-- l,5 Fax::( ) Tub/shower/shower pan 12.51 E-maill Itq q westwoodhomesllc.com Urinal 25.02 Water closet r 25.02 CONTRACTOR Water heater 37.52 Business name:H&H Mechanical Water piping/DWV 56.29 Address:5757 SE Willow Lane Other: 25.02 City/State/ZIP:Milwaukie OR 97267 Subtotal Phone:(503)975-9787 Fax:(503)659-2979 Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.:178122 Plumbing Lic.no.:„pe q,�f �' / State surcharge(12%of permit fee) Authorized signature: s--. .. f.✓ - /2" TOTAL PERMIT FEE Print name:Dusti ague / Date: 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. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) City of Tigard i r COMMUNITY DEVELOPMENT DEPARTMENT III T I G A R D Building Permit Review - Residential Building Permit #: Af.rj /,S -- e).,-Z6/9 ? Site Address: & c „3 .. Project Name: c c / . ' r!S �r� Lot #: (New dvril g subdivision name;Addition or Alteration=last name of owner) Planning Review `` Proposal: /.1e j , 'I/Verify site address/suite# exists and active in permit systt . ever Terrace Neighborhood: ❑ Yes L✓J No SPlan Elements: ligl ree(3) copies of site plan .sting structures on site :'e plan must be on 8-1/2”x 11"or 11 x 17"paper Fw• ootprint of new structure(including decks)with finished FJ. Prawn to scale(standard architect or engineer scale) fl..r elevations rF .rth arrow f/. tility locations (required for new,may apply for additions) . e address,project or subdivision name and lot number (.cation of wells/septic systems V splicant information (name and phone number) 7 Erosion control(including drainage-way protection,silt fence •t dimensions and building setback dimensions d tgn,location of catch basin,etc.) Z Lot area,building coverage area,percentage of coverage and �jeet names j,�,npervious area(applicable if R-7,R-12,R-25&R-40) LJ�Street tree size,type and location ,['Yoperty corner elevations(2 foot contour lines if more than l fisting trees to be retained with drip line,and tree 4 foot differential) protection measures OClean Water Services—Service Provider Lettee((lot platted prior to 9/10/1995): /Required: ❑ Yes,applicant was notified Lld No Received: ❑ Yes E No Lld Public FaciImprovement (PFI) Permit: equired: 11A Yes,applicant was notified El No Applied For: [Xes ❑ No,stop intake and Use Case#: j — -. ., :,�.0, n _ a. . A ,Setbacks: Front //5- Rear plc' Side s Street Side Jv Garage ) �/andscape Requirement: G� �/ of Coverage Maximum: _ °% Building Height: Maximum Height 5 Actual Height Q4� tal tsual Clearance 132 Easements ensitive Lands: ❑ Yes IgNo Type Urban Forestry Plan ❑ Conditions "Met"prior to issuance of building permit _� Notes: a/1 1L/G1r/c. rhtiv-r., In'/ i .vith- 7T; u'Ji2 ,t-iL' / a� ,_dam `� Approved By Planning: --.-�.-�- ..� +A,_ z Date: Q /gRevisions g1Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPennitRvw RES 070915.docx Building Permit Submittal Original Submittal Date: /..,27).3/—s Site Plans: # ..� Building Plans: # Building Permit#: 0--"Enter building permit#above. �� Workflow Routing: E Planning CtEngineering L� Permit Coordinator C' uilding Workflow Sign-off: g--Sign-off for Planning(include notes from planning review) Route Application Documents: [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: ,p7,v By Permit Technician: c74 Date: /, ,2/2 //—s Engineering Review Slope at building pad: /Tp reSlope "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: ❑ Yes t No Assess Water Quantity Fee in-lieu: ❑ Yes No LIDA Facility on lot: ❑ Yes No ❑ NOT Approved by Engineering: Date: Notes: Appiived by Engineering: ,. , 4? Date: Jam,.z Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ N•t 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: SDC Fees Entered: Wash Co Trans Dev Tax: ,Yes ❑ N/A Tigard Trans SDC: ❑ Yes _C oN/A Parks SDC: Yes ❑ N/A ?' f OK to Issue Permit ' "/ , Y ( 1i 72A9/5- Approved by Permit Coordinator: Date: I:\Building\Fonns\BldgPennitRvw_RES 070915.docx