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Permit (95)
CITY OF TIGARD MASTER PERMIT "r� .. . COMMUNITY DEVELOPMENT ,,, Permit#: MST2017-00363 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 *: Date Issued: 11/09/2017 �� Parcel: 1 S 125DA05800 Site address: 6730 SW ALFRED ST Jurisdiction: Tigard Subdivision: KINGS VIEW Lot: 44 Project: TOWER Project Description: New SF. 1/16/2018: PRIOR TO FINAL OCCUPANCY, SANITARY SEWER MUST BE MOVED FROM UNDER NEW HOME AND PLACED IN A DEDICATED EASEMENT FOR SERVICE TO BUILDING Floor Areas Required Setbacks Stories: 2 Bedrooms: 4 First: 2043 sf Basement: 0Requireda Height: 26 sf Left 5 Parking Spaces: 0 9 Bathrooms: 3 Second: 1425 sf Garage: 601 sf Front: 20 Dwelling Units: 1 Smoke Third: 0 sf Right: 5 Detectors: Yes Total: 3468 sf Value: $428,966.49 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Urinals: 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 Bckflw Prevntr: 0 Backwater Vafue: 1 Drywall-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 2 Furn<100K: 1 Vents: 0 Woodstoves: 0 = 0 Gas Outlets: 4 Furn> ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders 1000 sf or less: 1 Branch Circuits 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 7 201-400 amp: 0 201-400 amp: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 p W/O Svc/Fdr: 0 P 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 Other: N Other Description: All Ecompasing: Y BUILDING INFO Class of Work: Type of Use: NEW Type of Constr: Occupancy Group: Square Feet: SF VB R-3 3468 Owner: Contractor: TOWER,DUSTIN D OWNER Required Items and Reports(Conditions) 6720 SW ALFRED ST DUSTIN TOWER 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 6720 SW ALFRED STREET TIGARD,OR 97223 PHONE: PHONE: 503-740-8445 FAX: Total Fees: $11,462.44 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 OAR 952-001-0010 through OAR 952-001-0090. You" m/av obtain a •• .• e rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. le Issued By: �i� � < � / , Permittee Signature: X503.639.4175 by 7:00 a.m.for the next available inspection date. r 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. ' Mechanical Permit Application FOR MIA( I (SSI.ONl.' City of Tigard 1 � '41'1i it ■ Permit No.: /a 13125 SW Hall Blvd.,Ti k'�" "�i < II Tigard,OR 97223 a l i sDaIan Review Phone: 503.718.2439 Fax: 503.598.1960 Other Permit: Inspection Line: 503.639.4175 Date/Rea TIGAKI> I 1 Internet: www.ti and-or. ov ,, , 1, Date Ready/By: loris: ® See Page g g ! (, ; �, ('Id i yNotified/Method: Supplemental Information TYPE OF woiu ,�1 Y OF l ft Akb COMMERCIAL FEE* SCHEDULE= CHECKLISTUSE t�New construction r l° .,, . 1 n ' Mechanical permit fees*are based on the value of the work ❑Addition/alteratip epta(¢ ,t,. g;5 . .r.. performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF:CONSTRUCTION ., Value $ RESIDENTIAL EQUIPMENT/SYSTEMS FEES*`. LrJ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATI Heating/cooling: Job site address: 7j I` S+ Air conditioning . 46.75 J 3 S C� jig i '°- Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP; r t o r rO2 97 .Z Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: J Project name: Heat pump 61.06 TDw e.r" a eS Duct work 23.32 Cross street/directions to job site: Hydronic hot water system / 23.32 a 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 i Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF:WORK ;,,,e, '.T ' Gas fireplace/insert 3339 `� r Flue vent for water heater or gas �1I I —a-44-4--iii LA/;4,S-4 re_0Gt.tx fireplace 23.32 t,{airi vi L G,o,-i- cti- v 5 S- rn ---fro �n,.�/ ( Log lighter(gas) 23.32 S [ /� Wood/pellet stove 33.39 Wood fireplace/insert � 23.32 ,,..33 1 e\ Chimney/liner/flue/vent 23.32 V Fir I'IZRPERT*i;OWNER •" TENANT' Other: 23.32 Environmental exhaust and ventilation: Name: t),u 1„,,^ Bow,, Range hood/other kitchen Address: G 7 2 U S t� A I F� S4- equipment 33.39 �CClothes dryer exhaust 33.39 City/State/ZIP:-1--.... 4 r , ®R 9 7 22-3 Single-duct exhaust(bathrooms, Phone: So toilet compartments,utility rooms) 23.32 ( j ) r 4� g'i14 g Fax:( ) Attic/Crawlspaoe fans 23.32 0"'APPLICANT r,., '..". 8...' �:, CONTACT fERSOIy,;:' Other 23.32 1 Business name: Fuel piping: "1 $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump City/State/ZIP: Wall/suspended/unit heater Water heater Phone:( ) Fax::( ) Fireplace ^} ageE-mail: 0G",St ``JiLe w"P (- y\i41'�✓�) ;?VUBarbecue ue CONTRACTOR Clothes dryer(gas) Business name: ,, rPr,h_I, Other: Address: MECHANICAL PERMIT FEES* Subtotal 416,cr,*i i City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State of 12%surcharge g ( permit fee) jY () 6j CCB lie.: TOTAL PERMIT FEE 11 This permit application expires if a permit is not obtained within in 180 days after it bas been accepted as complete. Authorized signature: f4^�"'.....--_ * Fee methodology set by Tri-County Building Industry Service Board Print name: Dog{-..A. 1-01...../L f— Date:to/2%i 7 1:\Building\Permits\MEC_PermitApp_040113.doc 440-46177'(I 1/02/COM/WEB) CITY OF TIGARD MASTER PERMIT 71 *. COMMUNITY DEVELOPMENT Permit#: MST2017 00363 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/09/2017 [GA9 Parcel: 1 S 125 DA05800 Jurisdiction: Tigard Site address: 6730 SW ALFRED ST Subdivision: KINGS VIEW Lot: 44 Project: TOWER Project Description: New SF. DEMO CREDITS TO BE APPLIED FROM BUP2017-00271. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 2043 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 3 Second: 1425 sf Garage: 601 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3468 sf Value: $428,966.49 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 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: 4 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: 7 201-400 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 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 3468 Owner: Contractor: TOWER,DUSTIN D OWNER Required Items and Reports(Conditions) 6720 SW ALFRED ST DUSTIN TOWER 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 6720 SW ALFRED STREET TIGARD,OR 97223 PHONE: PHONE: 503-740-8445 FAX: Total Fees: $11,410.20 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 OAR 952-001-0010 through OAR 952-001-0090. Y•- -• •• - op • •- les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: `j' --�� c = Permittee Signature: e�✓--. Call M.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 . i_'�+ ,f -. Foil oFF1CF: IASL o\l.l City of Tigard '1,,,' ' - ./Received ±� `J g Date/By: /d/4 17— Permit No.1v -Aji7 '' -3,3 III 11111 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review O'''' Other Permit: to 1 + ■ Phone: 503.718.2439 Fax: 503.598.1960 st Date/By: 3 7 G l /'� . T 1 G A K D Inspection Line: 503.639.4175 -t 1( 1 Date Ready/By: lure ® See Page 2 for Internet: www.tigard-or.gov Notified/Method:lQ O,/4 4,, I Supplemental Information TYPE OF wittIALDING DIVISION 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. ®'1-and 2-family dwelling ❑Commercial/industrial Valuation: $ `?— El Accessory building 0 Multi-family Number of bedrooms:y. 4tae r6 6 0 Master builder 0 Other: Number of bathrooms:, 9 v (,7 3) JOB SITE INFORMATION AND LOCATION Total number of floors: (.}0 69 Job site address: vJ A \c r c ek S \- New dwelling area: 3 Li 6 Z5 square feet City/State/ZIP: Ti r A r Q ta. 1 7 z Z,3— Garage/carport area: G 0 square feet Suite/bldg./apt.no.: `I Project name: 7'0,�e f" (Z,a S. Covered porch area: 3)a square feet j(1,as- Cross street/directions to job site: Deck area: square feet a©li 3 3 +"Yl Other structure area: square feet i s ,, s, ' QUIRED DATA:COMMERCIAL.-USE CHECKLIST Subdivision: Lot no.: /' Permit fees*are based on the value of the work performed. ll Tax map/parcel no.: i.)671161 / 2/1/7 46 z7' /7 - : 0, 7/ equipment, pIndicate the value materials,(rolabord, to the nearest and the profit)of of equipment, labor,overhead,and the for the ,, / DESCRIPTION OF WORK work indicated on this application. i V s, 62 --4 %.7S /'4'y / a,#<,. Valuation: $ c21) a eX/S T//✓eT' .S7--- ti.t "7 n/ Existing building area: square feet 1?774 . 7763 t9A1 /e)ej i./C.. J'�L 7`�- New building area: square feet E PROPERTY OWNER 0 TENANT Number of stories: Name: Dtsgi-i,e-N —cc vss e.: Type of construction: Address: ,7 7 0 - Al c r e c t 3 Occupancy groups: City/State/ZIP: -1—;ct c-c j , CoI, ) 7 2 e 3 Existing: Phone:($03) 7 L/O — 6.j y 5`' Fax:( ) New: 0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: _ Structural plan review fee(or deposit): Contact name: 0,1/4.)0.i T FLS plan review fee(if applicable): Address: 67 z 0 Su„, Ai(r t S.f City/State/ZIP: Total fees dune-leo' application: t o ,.r 1 t , "1.1223 Phone:(so:„? ) -pis Q iiq s— Fax::( ) count received: E-mail: PHOTOVOLTA,t'ALAR PANEL SYSTEM FEES* 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 �f/�fe>� and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty 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 lic.: / p Total fee due upon application: $201.60 Gi Authorized signature: _ �' , 1 `_ This permit application expires if a permit is not obtained V within 180 days after it has been accepted as complete. r Date: *Fee methodology set by Tri-County Building Industry Print name: �t,�� r\ p l 2 i— to t�f 1 Service Board. I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) t Building Permit Application Checklist One- and Two-Family Dwelling roil orrlcl: LSI. o\L\ City of Tigard d Received g Date/By: Permit No.: IN 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: 2 Phone: 503.718.2439 Fax: 503.598.1960 TIGARD 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 'es 10 "/n 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ■ ■ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 ❑ 0 3 Verification of approved plat/lot. ❑ 0 ❑ 4 Fire district approval required. Name of district: . ❑ 0 0 5 Septic system permit or authorization for remodel. Existing system capacity 0 0 0 6 Sewer permit. ❑ 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 r basin protection,etc. 3 p. 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 ❑ 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 ❑ 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 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 Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. f 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- ) on- 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 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 ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. `).• 20 Manufactured floor/roof truss design details. ❑ 0 ❑ 1 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ 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 licable to the ro'ect under review. 2 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 ❑ 5 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ 0 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ 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 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,kI:\ 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. Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) I • Mechanical Permit Application FOR OFFICE I;SE O1l.\ Cityed of Tigard ce By: w g �' s I�te/By: Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 ! , li,.r r ,'PIa Plan Review ® Phone: 503.718.2439 Fax: 503.598.1960 Other Permit: Date/By: TI G A R D Inspection Line: 503.639.4175 Date Ready/By: lug. H See Page 2 for Internet: www.tigard-or.gov j 1 ` ,, 12,1' Notified/Method: Supplemental Information TYPE OF WORii �l Y O t �it; it COMMERCIAL FEE* SCHEDULE USE CHECKLIST ,, x r 1 =, ;( . Mechanical permit fees*are based on the value of the work d New construction 0 Addition/alteraticjri rep 4 Litt c -- 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* and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning . 46.75 Job site address: C 710 S\AJ A 1 F,,. S T t Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:I--;r,o r J . C)i 7 -13 Furnace 100,000+BTU(ducts/vents) 54.91 • J 1 Heat pump 61.06 Suite/bldg./apt.no.: Project name: -roc,GI— Q e$, 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 Other: 23.32 Subdivision: Lot no.: 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 fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 . , Other: 23.32 ge PROPERTY OWNER '=` '71:::1 TENANT Environmental exhaust and ventilation: Name: O,s..t, -1-0,,,,e, Range hood/other kitchen equipment 33.39 Address: .-7 2 C7 „,,,i A I Fes.,) S.A.. Clothes dryer exhaust 33.39 City/State/ZIP:--c-,,,c,a,.....Q , c) , 72_2-9 3 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(So3 ) -7 c(� 7(4,4 S Fax:( ) Attic/crawlspace fans 23.32 ' ,..= Other: 23.32 ❑``"APPLICANT � CONTACT�;1*ERSi31�Jr Fuel piping: Business name: $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) Other: Business name: 0)u/wt. MECHANICAL PERMIT FEES* Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lic.: 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: D054-.-A- `0 we l Date: 10/Z,/,- I:\Building\Permits\MEC_PerniltApp_040113.doc 440-4617T(11/02/COM/WEB) 4 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial& Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040113.doc 2 L Electrical Permit Application l OR 0111( 1. t s►:0y,.1 City of Tigard 0 t---,, , r ,';11,-eceived €its t' ate/B . s III • 13125 SW Hall Blvd.,Tigard,OR 97223 r" a t Plan Review 01 C Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: Inspection Line: 503.639.4175 a Ready Date/By: Juris: RI See Page 2 for I IGARD Ut, ,6 11 1 i Supplemental www.tigard-or.gov Notified Method: Su lemental Information TYPE OF WO I PLAN REVIEW 11 r. `" "" Please check all that apply(submit 2 sets of plans w/items checked): New construction ❑Addition/altera 'I l ilac ler .t fl i - �` £ , '.1.-')."-"' 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Other: L `') t J t' where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 1-and 2-family dwelling ❑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 1o17 b 5 s1 • ' 5� ❑100Addition of new motor load of system. Job#: Job site address: W IY91 l oo11P or more. ❑"A">"E">"1-2">"1-3"> ❑Six or more residential units. occupancy. City/State/ZIP: BOG 6112, °\1 0 Recreational vehicle parks. tY � `J\� 0Health-care facilities. 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: FEE SCHEDULE Description I Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) PROPERTY OWNER 0 TENANT PROPERTY Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: n,,,,,+i a T}tAi ef 200 amps or less 100.70 2 Address: Lo1 ZO sw A 1.ltd ,st201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: I ira OZ C11./23 601 amps to 1,000 amps 301.04 2 Phone:(5 ) 1( -lcu4 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:v_ v V Date: (Q121(7 401 amps to 599 amps 168.54 2 0 APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address: branch circuit City/State/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed('/z hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): l State surcharge(12%of permit fee): a—.J TOTAL PERMIT FEE: Authorized signature: This permit application expires if a permit is not obtained within 180 Print name: c.+:.;{-o ` 00.,.."¢.r Date: to/-z_// 7 days after it has been accepted as complete. [ * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB 4 Electrical Permit Application—City of Tigard a Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. I Each I Total I Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(%hr min) ELECTRICAL PERMIT FEES .. x..K. COMMERCIAL WORK ONLY; Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls TI Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 ,Plumbing Permit Application Building Fixtures 4 1 FX yv 1 ceived City of Tigard i x c , /By: Permit No.: ins-.tom 7.0.00123 II 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review IC Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: T I G A R D Inspection Line: 503.639.4175 :)01 Date Ready/By: Juris: See Page 2 for Internet: www.ti and-or. ov Notified/Method: Supplemental information TYPE OF WORK CITY OF TIGARD FEE* SCHEDULE For special information use checklist. New construction � � .. .r } _1,a Ila 11--,. i Description Qty. Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY Cr"CF)NS17tUCTION SFR(1)bath 312.70 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family 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: 6 7 Z C) S tJ A lF r e4 S-k- Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: `�o r.� ' 002._,002._,, ci 7 Z Z. Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: �`p,, t-,eeeS. 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: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 rDESCRIPTION OF.WORK "t,..?..vBackwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 121.PROPERTY .,13::„. -t- t 0 TENANT f Expansion tank 12.51 Fixture/sewer cap 25.02 Name: `,.., i Cq nJ tr Floor drain/floor sink/hub 25.02 Address: E 7Z C 5 v._1 A l C,--e-ct S 4- Garbage disposal 25.02 City/State/ZIP:'T c„e 1 ()e. 9 7 Z Z-3 Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 0 APPLI ,-v " ;❑ CONTACT PERSON" 3Interceptor/grease trap 25.02 : . Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: 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 Water closet 25.02 CO CTQR-: Water heater 37.52 Business name: k/,tity, Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature'"`-. TOTAL PERMIT FEE Print name: ii r Date: �O�Z//7 This permit application expires if a permit is not obtained within 180 days V 5 ,` \ d✓ C l after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) 4 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee tea) Total Square Footage: Permit Fee: Footing drain-1st 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for � 1ot>ii each additional$100.00 or fraction thereof,to Other Inspections or Fees and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to Pfees*. accurately report fixtures could result in increased sewer 1; Plan Review for Plumbing Installations Quantity by Fixttti'e Type Plan review is required for any of the following. Fixture Type for #tePlacel Please check all that apply. Work Performed: Capped Added Relocate ❑ Anynew commercial buildingwith water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918-780-0040. Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: -Commercial 0 Any multipurpose fire sprinkler system. Domestic 0 Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" Isometric or Riser Diagram 4„ 0 Isometric or riser diagram is required for new buildings -Car Wash Drain • Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) • Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building,electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants,exempt from licensing under ORS 701.010 (7), need not submit this statement.This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. /or I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. DVS ; ✓% �© J c.r Print Name of Permit Applicant /zcO7 Signature of Permit Applicant Date Permit#: /4757,11/7—CKR36,1 Address: 6730 >W it/6W 111 ydE ' Issued by: ----� Date: /i/V1 7 lr� This Copy for Permit Offices 4 Branden Taggart From: Oscar Contreras Sent: Tuesday, October 17, 2017 8:42 AM To: Branden Taggart Cc: #Building Permit Technicians Subject: RE: Dustin Tower demo permit: MST2017-00363 Hi Branden, I've created '6730 SW Alfred St.'for the new house. I'll send out the new address notification to the local agencies once they've paid their fees. Oscar From: Branden Taggart Sent:Thursday, October 12, 2017 10:22 AM To: Oscar Contreras<OscarC@tigard-or.gov> Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: Dustin Tower demo permit: MST2017-00363 Importance: High Hi Oscar, I need to assign the new address to the home being built, and we will use the 6720 SW Alfred St. address for the existing garage apartment. Is there any way we can have you create the new address as soon as possible so that we can begin plan review? Thank you, Branden Taggart q City of Tigard le Permit Technician Community Development TIGARD 13125 SW Hall Blvd Tigard,OR 97223 (503)718-2449 brandent.4tigard-or,gov From: Dustin Tower [mailto:dustin@towerconcrete.net] Sent:Tuesday, October 10, 2017 10:25 AM To: Branden Taggart<brandent@tigard-or.gov>; Oscar Contreras<OscarC@tigard-or.gov> Subject: Re: Dustin Tower demo permit: MST2017-00363 Hi Attached is the form for the address change application. Thank You, Dustin Tower 1 503-740-8445 From: Branden Taggart<brandentCa�tigard-or.gov> To: 'Dustin Tower' <dustin(a�towerconcrete.net> Cc: #Building Permit Technicians <TigardBuildingPermitsatigard-or.gov> Sent: Monday, October 9, 2017 10:45 AM Subject: RE: Dustin Tower demo permit: MST2017-00363 Hello Dustin, Regarding the addressing for your property, we will need to have you complete the address form to assign a new address to your building permit, and return it to us for processing. We are going to keep the original address for the apartment. I have added the $50.00 address fee to your permit (MST2017-00363) for you to pay online, and I have included the link below to the address form: http://www.tigard-or.gov/help me to/forms.php#revize document center rz280 To pay the fees online, you can go to our website: https://aca.accela.com/tigard/. From there, click on the Building tab, enter the permit number (MST2017-00363) in the Record Number field, and click Search. Next, you will see the Payments section. Click on the arrow on the right of Payments to select Fees. You will then see a breakdown of the permit fees, and you can click on the Pay Fees link to complete the transaction. Once you pay online, please notify us at tigardbuildingpermits@tigard-or.gov. If you have any questions about this process, please let me know. Thank you, 13randen Taggart 11111 9 City of Tigard ( a Vi Permit Technician Community Development 13125 SW Hall Blvd Tigard„OR 97223 (503)718-2449- b ran d ent@tigaf d-o r.gov From: Dustin Tower [mailto:dustinna,towerconcrete.net] Sent: Thursday, October 05, 2017 8:25 PM To: Branden Taggart <brandentta'�,tigard-or.gov> Subject: Dustin Tower demo permit Hi Branden please email me what you need for address change Thank you, Dustin Tower 503 740 8445 Dustin(u)towerconcrete.net 2 ° . , DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule." 3 City of Tigard liliii . q COMMUNITY DEVELOPMENT DEPARTMENT T1cAUD Building Permit Review — Residential Building Permit #: r)95 ' 7— -a, - Site Address: () --a) 4/ ',0--- Project Name: i,t Wil-- Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: tev 7r--R IO Verify site address/suite#exists and activ in permit system. IA l'Over Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached Sit Plan Elements: V ree(3)copies of site plan i___Yistin_g structures on site �rawnS'te plan must be on 8-1/2"x 11"or 11 x 17"paperFootprint of new structure(including decks)with finished to scale(standard architect or engineer scale) or elevations V arrow .tility locations&easements(required for new and additions) Ze address,project or subdivision name and lot number !I Sidewalk/driveway approach pplicant information(name and phone number)/1 11 cation of wells/septic systems .t dimensions and building setback dimensions V Existing trees to be retained with drip line,and tree II Square footage of buildings to be demolished protection measures i • A t area,building coverage area,percentage of coverage and 0;.1 eet tree size,type and location /Anpervious area(applicable if R-7,R-12,R-25&R-40) M Street names Vil Property corner elevations (2 foot contour lines if more than >1,000 sf of impervious area created or replaced? d s ❑No 4 foot differential) If yes,is a storm water quality facility shown? Yes CI No 1\Ac'Clean Water Services—Service Provider Lette (lot platted prior to 9/10/1995): ' Required: ❑ Yes,applicant was notified t No Received: ❑ Yes ❑ No Public Facilities Improvement (PH) Permit: Required: CIYes,applicant was notified VJ No Applied For: ❑ Yes ❑ No,stop intake JI�! and Use Case#: rd oning: g_LI.`� i Required Setbacks: Front ,QO Rear [c' Side "'-' Street Side Garage 0 1Candscape Requirement: 0/0 ie'of Coverage Maximum: F Building Height: Maximum Height s 0Actual Height cQ Tisual Clearance Wensitive Lands: ❑ Yes ❑ No Type rban Forestry Plan �,onditions "Met"prior to issuance of building permit Notes: Approved By Planning: ----_� ' ������,r Date: a Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Fonns\BldgPermitRvw_RES_061417.docx Building Permit Submittal Original Submittal Date: 0//7 Site Plans: # Building Plans: # Building Permit#: is building permit#above. Workflow Routing: manning Ki''gngineering ertnit Coordinator R»+lrli g Workflow Sign-off: I Sign-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 plan review routing form. cAg4JPtf^ fr .4 !WI-wilding: original permit application,site plans,building plans, engineer and tc.+/17, beam calculations and trust details,if applicable,etc. Notes: 'f L1i •:i/ iW ) "". _-3 [A . 1.4 l7 /7 / By Permit Technician: v �. Date: to/51i 7 En ineering Review [ope at building pad: 2. S/v �y s �� Vie CJekYl.0 'ct ^�onditions "Met"prior to issuance of builpermit LSsements (encroachments) per engineering conditions of approval and plat L+d 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 0 No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: 441111 ,-- Date: /09// Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ 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: -0-4C Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A Tigard Trans SDC: Yes ❑ N/A Parks SDC: 'Yes ❑ N/A LIDA ?gi2Ves 111 N/A OK to Issue Permit 1 Approvedby Permit Coordinator: Date: /a/ �� I� I I:\Building\Forms\B1dgPennitRvw_RES_061417.docx FOR OFFICE USE ONLY—SITE ADDRESS: c2?U6) k 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. Mil City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or. ov TO: /f/(��(S07.1 DATE REC ED: DEPT: BUILDING DIVISION EC I '. FROM: bUS4 i I O t„)er AUG 8 2018 COMPANY: CITY OF f1CakRi', PHONE: So3 i-{t-{c RE: 6 7 3 C St,,} A t c r- J S 4 -' MsT 2 01'7 —o CYR C3 (Site Address) / , _ } (Permit Number) r (Project name or subdivision name and lot �, .e) Ir I // ic /y ? �_�_.. ATTACHED ARE THE FOLLOWING ' M : 7 0J Sl i//p� 8: Copies: Description: �� Copies: Description: I Additional set(s) of plans.' Revisions: Cross section(s) and deta. .. Wall bracing and/or lateral analysis. 10. F1oo roof framing Basement and retaining walls. Beam calcu ations. Engineer's calculations. Other(explain): REMARKS: 4 `�r :.55 bro.L),,-1 Fr0 cam,re.v-- 'r.SS Gov tiP` r` tr-J z ust 11 FOR FFICE USE ONLY Routed to P• i 'echnician: Date: '0 1, / I Q. Initials: it'� Fees Due. C -s ❑ No Fee Descri tion. Amount Due: $ oa t/1-- eu,,,, ,,,..,\N„.,__) stic—, Special Instructions: Reprint Permit(per PE): ❑Yes qV ❑ Done Applicant Notified: ry-- Date: ii ( S (f ( Initials: I:1 Building\Forms\Transmitta(Letter-Revisions_061316.doc