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Permit (109) CITY OF TIGARD MASTER PERMIT `ri 1' COMMUNITY DEVELOPMENT Permit#: MST2018-00107 Jr" c-A I:.C) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/11/2018 Parcel: 1 S 125DA02400 Site address: 6815 SW WALNUT TER Jurisdiction: Tigard Subdivision: KINGS VIEW Project: Wright Lot: 9 Project Description: Shortening garage by(1)FT to comply with 20 FT set back from street. BUILDING Floor Areas Stories: 0 Bedrooms: 0 Require_ d_ S- Re- ,d First: 0 sf Basement: 0 sf Left Parking Spaces: 0 Height 0 Bathrooms: 0 Dwelling Units: 0 Second: 0 sf Garage: 0 sf Third: 0 3f Front 20 Smoke Total: 0 Right 5 Detectors: sf Value: $3,750.00 Rear 15 PLUMBING Washing 0 Water Closets: 0 ach: 0 Laundry Trays: 0 0 Rain Drain: 0 Tubs/Showers: 0 Floor Drains: 0 Sewer Lines: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Garbage Disp: 0 Water Heaters: 0 SF Rain Storm Sewer: Footing Drain: 0 Water Lines: 0 Drains: 0 Ice Maker: 00 Hose Bib: 0 Bckflw Prevntr: 0 Catch Basins: 0 Drywell-Trench Drain: 0 Backwater Value: p Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel it pss Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Furn<100K: 0 Other Units: 0 Vents: 0 Woodstoves: 0 Furn>=100K: 0 Gas Outlets: 0 ELECTRICAL Residential Unit Service Feeder Temo Srvc/Feeders Branca h Cly 1000 sf or less: 0 0.200 amp: 0 Ea add'I 500 sf: 0 0.200 amp: 0 W/Svc or Fdr: 0 201-400 amp: 0 201-400 amp: 0 Mfd Home/Feeder/Svc: 0 401-600 W/O Svc/Fdr: 0 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 S Other: N System: N Garage Opener N Other Description: All Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Owner: VB R-3 Square Feet: ALT SF Contractor: 0 WRIGHT,GARO&CRYSTAL L OWNER 6815 SW WALNUT TER Required Items and Reports(Conditions) TIGARD,OR 97223 GARO WRIGHT 6815 SW WALNUT TERRACE TIGARD,OR 97223 PHONE: 503-347-8028 PHONE: 503-347-8028 FAX: Total Fees: $341.63 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable la . All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issu e, or if work is suspended days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificatio Center. Those r les are forth in OAR 952-001-0010 through OAR 952-001-0 0, You may obtai copy of the rules or direct questions to OUNC by calling 503 232=. 987 or 1.8 0 32. 34, more® the 180 i • Issued By: �/� - l � �� •-ermitteeSignature: Call 503.639.4175 by 7:00 a.m.for the next available inspection dat= This permit card shall be kept in a conspicuous place on the job site until complet on of th•project. Approved plans are required on the job site at the time of each inspec'.n. Building Permit Application Residential City of Tigard � ° FOR MEI( GSG oNl.1 JINa. 13125 SW Hall Blvd.,Tigard,OR 97223 Received C 1111 Date/B , Permit er Phone: 503.7182439 Fax: 503.598.1960 Plan Review41, Li — T I G A R D fia Inspection Line: 503.639.4175 Date/B : - Other Permit: Internet: www.tigard-or.gov Date Ready/By:' — Notified Method: pi/�j ® See Page 2 for ! 4, , Supplemental Information TYPE OF WORK /XI 0 New construction REQUIRED DATA:1-AND 2-FAMILY DWELLING r. 0 Demolition Permit fees*are based on the value of the work performed. Addition/alteration/replacement 0 Indicate the value(rounded to the nearest dollar)of all Other: equipment,materials,labor,overhead,and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION 6: 1-and 2-family dwelling 0 Commercial/industrial Valuation: ❑Accessory building $ .37S0 , 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Job site address: Total number of floors: r of City/State/ZIP: Q' t ' New dwelling area: CA. tI 0 square feet Suite/bldg./apt.no.: Z-'2" Garage/carport area: square feet Project name: RA Cross street/directions to job site: / 67Covered porch area: square feet s+ % Deck area: square feet Other structure area: square feet Subdivision: REQUIRED DATA:COMMERCIAL-USE CHECKLIST Tax map/parno.: Lot no.: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK �� tea work indicated on this a.plication. J - A P A Z 4-D '` Valuation: $ ", millilil Existing building area: square feet 4 PROPERTY OWNER New building area: square feet ❑ TENANT . Number of stories:r ,P Address: r � Type of construction: City/State/ZIP: ` . L, Occupancy groups: Phone:(�() ) 1t�_ C9Q t 1?....V IMEMiniminini IMIPIIIII1111111111 lit APPLICANT CONTACT PERSON Business name: BUILDING PERMIT FEES* Please re er to ee schedule Contact name: a ..0 w Structural plan review fee(or deposit): Address: .t 1111111111 t `J' •i I l FLS plan review fee(if applicable): 111111111 o A. 04, Total fees due upon application: 1111111111 Phone:(90.- „1 A U Amount received: � —G CLS�.� ; ��,� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: a CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Address: Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon City/State/ZIP: Solar Installation S#ecial Code checklist. Phone:( ) Permit Fee(includes plan review and administrative fees): $180.00 State surcharge(12%of permit fee): $21.60 Total fee due Authorized signature: upon application: $201.60 L Ale,I V�, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. A 1n *Feemethodology set by Tri-County Building Industry pp.doc I:\Building\Permits\BUP-REspermitqServicemBoard. 02/24/2011 440-4613T(11/02/COM/WEB) BuildingPermit A lication Checklist roll 01.1 lc.l I_SF oNl.1 g One— and Two—Family Dwelling Received permit No.: Date/By: City of Tigard Associated permits: ■ 13125 SW Hall Blvd.,Tigard,OR 97223 G Phone: 503.718.2439 Fax: 503.598.1960 24-Hour ❑ Elecerical 0 Plumbing ❑ Mechanical Inspection Line: 503.639.4175 ❑ Other: T I G A R D Internet: �,�,�,.tigard-or.gov A/A lits \o REQUIRED FOR PLAN REVIEW ��' THE FOLLOWING ITEMS ARE REQ ��■� 01111K11 I 1 Land use actions corn,leted. See'urisdiction criteria for concurrent reviews. 0 `7" 2 Zonin.... Flood slain,solar balance •oints,seismic soils desi t nation,historic district,etc. ��'� 3 Verification of a r o roved t. ■"■'�� 4 Fire district a e royal re uired. Name of demtrict: J 5 Se tic s stem ermit or authorization for remodel. Existin s stem ca•acit ■ MI 6 Sewer d ermit. ��"■l�� 78 Water district a royal. �� protection,silt fence design and location of catch- ■ 9 Erosion o ort. Must c• ori'1 rel uiired.tInclude drainage-way file to tioh a tfencod • 9 Erosion control ❑plan 0 permitq applicable local and state ■ ■ ■ basin Complete etc. full-size 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to building codes. Lateral design details and connections must be incorporated into the plans or on a separate sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if ■ ■ co, ri:ht violations exist. lding corner elevations(if ■ l 1 then is ore drawn 4-ft.elevation differential,plan must showd lcon our setbacknes at 2-ft.dimensions; );1 location of easements there is more and driveway;footprint of structure(including percentageofof location of wells/septic area;stems;utility xi ting tructuressondirection site;and indicator;lot area;building coverage area;p g �� surface draina:e. • 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ■ ■ ■ and location. �� 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water0 ■ furnace,ventilation fans, ,lumbin:fixtures,balconies and decks 30 inches above ade,etc. headers,joists,sub- 0 14 Crossflosection(s)and details. Show all framing-member sizes f construction. More than one cross sectd ion may be required to beams,acing such as floor arly portray or,wall coShow on,roo construction. Show details of all owall and nstruction�t thermal insulation,etc.fing,roof slope,ceiling height,siding material,footings ■ ■ and foundation,stairs,fireplace c 15 Elevation views. Provide elevations for new constructionminimum iniim is greater elevationso for fadd ti ns and ndg remodels. ■ Exterior elevations must reflect the actual grade ifthe change grade0 0 Full-sizea t addendums ath),a foundation d/o lateralevations with analysis plans.Must indicate details references are acce,and locations;for non- lal I 16 Wall bracing(prescriptiveP �� rescri•tive •ath anal sis I rovide s•ecifications and calculations to en�ineerin� standards. spacing,and bearing 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,sp g, ■ ■ ■ locations. Show attic ventilation. �� 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 ■ ❑ s stems,see item 22,"En_ineer's calculations." 19 Beam calculations. Provide two sets oofccalculations nusing current lint code design values for all beams and multiple joists U 0 over 10 feet lied• and/rr f bes d lis _ �� WM ate 20 Manufactured floor/roof truss desi n details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required III ■ forn foure or more a liances. �� 22 Engineer's calculations. When required or providbe a(t•licable to the ro ect under reviewt�ped by an engineer or ■ architect licensed in Ore ton and shall be shown to �� JURISDICTIONAL SPECIFICS `"�"�� 23 Three 3 site dans are re wired for Item 11 above. Site dans must be 8-1/2"x 11"or 11"x 17".uildin. I tans will not be accested. L,LII1 24 Two 2)sets each are re c uired for Items 16, 19,20 and 22 above. ■ 25 dans shall not coma t m et criteria outlined ilines or ta•e-ons. n the Permitirrored" &System Develo,m nt Fees document. uut 26 "Reversed"tocbale"iindicates . dans �� 27WI 8 "Drawneplan " eetsi standard,typor en approved project street tree plan(if applicable),and City of Tigard ■ 28 Site to include tree size,type and location per app p J ■ Street Tree List. Siteplan to include trees and tree protection measures as required y conditions ns of approval. nature as locations,iondriplines, ■ ■ II 29 ■ and protection measures must be drawn to scale and must m -Screening Site Assessment form is required for all 30 including Clean Water Services'covers vnon-imperviouse Area surface)and accessory structures to existing residential dwellings decks,patio (overP on a lot of record a',roved prior to Se•tember 9,1995. I:\Building\Petmits\BUP-RESPetmitApp. dot 02/24/2011 440-4613T(11/02/COM/WEB) imgO64.jpg Page lofl INCity of Tigard 4 COMMUNITY ■ DEVELOPMENT DEPARTMENT �;„ Building Permit Review — Residential Building Permit#: _ Site Address: G81.5" . sw tax Project Name: �^ �� T � (New tiling subdivision name;Addition or Alteration— Lot#: Planninglast name of owner) Review Proposal: Ewa', 4` '1- i ..". ,a`T G —/ ra•... a c 1 . + ( `'��b to de— Q.. 0 El 'fy site address/suite#exists and active)n u i truer Terrace N ^ permit system. Neighborhood: LU'No 0 Yes,See River Terrace Sit Elements: Review Addendum Attached (3)copies of site plan plan num b€on 8-1/2"x 11"or 11 x 17"paper •wig structures on site wn to scale(standard architect or engineer scale) ofnewstructure(mclu�$decks)with finished rth arrow floor elevations address,project or subdivision name and lot number s&easements .- (required for new and addition ,,••licant information(name and phone number) /driveway approach 't dimensions and building setback dimensions = • �••. •f wells/septic systems 'Sq e�Ctage of buildings to be demolished .tectiting trees s be retained with drip line,and tree building coverage + •rection measures impervious area if area,R-7,percentage of coverage and 7.,.:- _ gyp,�_ R-12,R-25&R-40) size, and location �""` -ct2mer elevations(2 foot contour ' t names 4 foot differential)era lines if more than > ; , >rnpervious area created or replaced? ❑Yes❑Nc CDBean Water,$ '4.• ` ' . •• '' ter•uali facili • shown? �j ervices-Service Provider utter not platted prior to 9/10/1995): Oyes ON( Required: Yes,applicant was notified 'Er Public Facilities Improvement(PFn PenniReceived: ❑ Yes 4� No ~ Required: ❑ Yes,applicant was notified ET-No d'i d Use Case#: applied For. ❑ Yes ❑ No,stop intake L144' Required Setbacks: Front rf Landscape Requirement 70— 1 Rear Side Street Side �' 1 Garagei. •t Coverage Maximum: % ill,Building Height Z ..ual Maximum Height �f Clearance Actual Height .I"t C e L Sensitive Lands: �/ Jo 0 Yes NUrban Forestry plan Type II Fes' Conditions"Met"p 'or to issuance of building per r { Notes: 1,✓I '��1- CI ' r rvat Fri Gt�Y,'. Approved By Planning: ‘448t Revisions(after Building Submittal o / Date:y- 3 -(; may) Revision 1: 0 Approved ❑ Not A Reviewer Revision 2: 0 Approved ❑ N 'proved Date ot Approved Revision 3: ❑ �_ pp Approved 0 Not Approved :iBwldingToms161dgpdmitRvw RES 061417.docx 1t4++,0•//moil ,,,,,,,l.,,,,-.-./ /,,,,,..4,-,n;1 ..+n+:,./ /:.,/L—,..«,,,;t «,,..« Building Permit Submittal G /3 /8' Original Submittal Date: # Site Plans: # Building Plans: #above. Building Permit#: Enter building permit n eering 'ermit Coordinator Building Workflow Routing: Planning[ � ` from planning review) (include notes Workflow Sign-off: L�Sign-off for Planning (1) siteplan, (1)building plan and (1) copyof permit application, Route Application Documents: [�'Engineering: original plan review routing form.717 engineer and Building original permit application,site plans,building plans, beam calculations and trust details,if applicable,etc. ' 41/Notes: By Permit Technician: tDate: . / En 'neering Review 4 [ pe at building pad: ,IO, 8'/• [Conditions"Met"prior to issuance of building permit [asements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: /✓//4 0 No Assess Water Quality Fee in-lieu: 0 Yes 0 No Assess Water Quantity Fee in-lieu: 0 Yes 0 No LIDA Facility on lot: 0 Yes i. gt Final Plat Recorded: Date: ❑ NOT Approved by Engineering: Notes: 4011Pj Date: cliff: Revisions (after Building Submittal I nly) inee ../..-00.' Date �pproved by Engineering: �,`- Reviewer Revision 1: 0 Approved 0 Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved Permit Coordinator Review ❑ Conditions"Met"prior to issuance of building permit Date: ❑ Approved,NOT Released: 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: Wash Co Trans Dev Tax: 0 Yes /A C Fees Entered: �� N/A Tigard Trans SDC: 0 Yes rip 0 Yes NON/A Parks SDC: ��, N/A LIDA 0 Yes </)' ? 4 to Issue Permit eOK , Date: (Approved by Permit Coordinator: I:\Buildine\Forms\B1dePermitRvw RES 010118.docx RECEIVED OFFICE _ CITY OF TIGARDClean Water Services File Number PLANNING/ENGINEERING NEERING rServices 18 001053 Sensitive Area Pre-Screening Site Assessment 1. Jurisdiction: Ti•and 2. Property Information (example 1S234AB01400 )Tax lot ID(s): 1S125DA02400 3. Owner Information Name: GARO WRIGHT Company: OR Site Address: Address: 6815 SW WALNUT TERRACE 6815 SW WALNUT TERRACE City, State,Zip: TIGARD,OR 97223 City, State,Zip: TIGARD OR 97223 Nearest Cross Street: 69TH Phone/Fax: 503-347-8028 E-Mail: GARO.WRIGHT@ECPOWERSLIFE.COM 4. Development Activity(check a//that apply)pp Y) 5. Applicant Information ❑ Addition to Single Family Residence(rooms,deck,garage) GARO WRIGHT ❑ Lot Line Adjustment Name: ❑ Minor Land Partition ❑ Residential Condominium Company: ❑ Commercial Condominium ❑ Residential Subdivision ❑ Commercial Subdivision Address: 6815 SW WALNUT TERRACE ❑ Single Lot Commercial ❑ Multi Lot Commercial City, State,Zip: TIGARD,OR 97223 Other REDUCTION IN GARAGE FOOT PRINT. CUTTING 12"OFF THE FRONT OF THE GARAGE. Phone/Fax: 503-347-8028 E-Mail: GARO.WRIGHT@ECPOWERSLIFE.COM 6. Will the project involve any off-site work? ❑Yes ❑No ❑Unknown Location and description of off-site work -------------------------- 7. Additional comments or information that may be needed to understand your project ALL WORK IS WITHIN THE GARAGE 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 the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. of By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authorityenterthe project site at all reasonable times for the purpose of inspecting project site conditions arid 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. to Print/Type Name GARO WRIGHT Print/Type Title OWNER Signature Garo Wright Digitally signed by Garo Wright Dale:2glt.V310DSS3- 00 Date 4/3/2018 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 I SSUNCE OF SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Reporttmay al be required. so ❑ 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. -h document will serve as your Service Provider letter as required by Resolution and Order 17-05, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,State,and federal law. 1 t3, X Based on 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 arid protect additional water•ualit' sensitive areas it they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 17-05,Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law. ❑ This Service Provider Letter is not valid unless _.CWS approved site plan(s)are attached. ❑ The proposed activity does not meet the definition of development or the lot was platted atter 9/9/95 ORS 92.040(2). NO SITE ASSESSMENTSERVICE PROVIDER LETTER IS REQUIRED. OR Reviewed by G fa`. Date 4/3/18 Once complete, email to: SPLRevlew@cleanwaterservices.org • Fax: (503) 681-4439 OR mail to: SPL Review, Clean Water Services, 2550 SW Hillsboro Highway, Hillsboro, Oregon 97123 Bevis ci 6/2077 APR30 ZQ� Clean Water Services File Number CITY OF.z �a�;f C �� 18-001053 1eanW aterServices tensitive Area Pre-Screening Site Assessm LAtv�lirvc ' I �,IR e 1. Jurisdiction: Ti•and nt 2. Property Information (example 1S234AB01400) Tax lot ID(s): 1S125DA02400 3. Owner Information Name: GARO WRIGHT Company: OR Site Address: 6815 SW WALNUT TERRACE Address: 6815 SW WALNUT TERRACE City, State,Zip: TIGARD,OR 97223 City, State,Zip: TIGARD OR 97223 Nearest Cross Street: 69TH Phone/Fax: 503-347-8028 E-Mail: GARO.WRIGHT@ECPOWERSLIFE.COM 4. Development Activity(check a//that apply) ❑ Addition to Single Family Residence(rooms,deck,garage) 5. NaApecantGAROWRIGHTInformation ❑ Lot Line Adjustment Name: WRIGH ❑ Minor Land Partition ❑ Residential Condominium ❑ Commercial Condominium Company. Address: ❑ Residential Subdivision 6815 SW WALNUT TERRACE ❑ Commercial Subdivision ❑ Single Lot Commercial13Multi Lot Commercial City, State,Zip: TIGARD,OR 97223 Other REDUCTION IN GARAGE FOOT PRINT. CUTTING 12"OFF THE FRONT OF THE GARAGE. Phone/Fax: 503-347-8028 E-mail: GARO.WRIGHT@ECPOWERSLIFE.COM 6. Will the project involve any off-site work? ❑Yes ❑No ❑Unknown Location and description of off-site work 7. Additional comments or information that may be needed to understand your project ALL WORK IS WITHIN THE GARAGE This application does NOT replace Grading and Erosion Control Permits, Connection Permits,Building Permits,Site Development P DEO 1200-C Permit or other permits as issued by the Department of Environmental Quality, Department of State Land the Army COE. All required permits and approvals must be obtained and completed under applicable local,state, a Permits, Lands and/or Department of By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Servicesvfederal law. the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete, have authority to enter p ) t site. I certify that I am Print/Type Name GARO WRIGHT p and accurate. Wright Print/Type Title OWNER Garo Wri Signature g Digi ally signed by Wngh gala:2U18A4 O3 10:0583-grog. Date 4/3/2018 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment TO ISSUANCE OF A be required. Report may also ❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.Th s document will serve as your Service Provider letter as required by Resolution and Order 17-05, Section 3.02.1. All required ed per its of the srov is must be we obtained and completed under applicable local,State,and federal law. q permits and approvals be Based on 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 arid protect additional water quality p sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 17-05 Sectlol� 3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law. ❑ This Service Provider Letter is not valid unless ❑ The proposed activity does not meet the definition of development or the was platted site laftes 9/9/95 attached.)are PROVIDER LETTER IS REQUIRED. ORS 92040(2). NO SITE ASSESSMENT OR SERVICE Reviewed by G--4,--,e. Date 4/3/18 Once complete, email to: SPLReview@cleanwaterservices.org * Fax: (503) 681-4439 OR mail to: SPL Review, Clean Water Services, 2550 SW Hillsboro Highway, Hillsboro, Oregon 97123 Rev,sec 6/2017 RECEIVED SITE COPY APR 0 3 2018 CITY O TIGARD Clean Water Services File Number PLANNING/ENGINEERING CleanWater\ Services 18-001053 Sensitive Area Pre-Screening Site Assessment 1. Jurisdiction: II.and 2. Property Information(example 1S234AB01400) Tax lot ID(s): 1S125DA02400 Owner Information Name: GARO WRIGHT Company: OR Site Address: 6815 SW WALNUT TERRACE Address: 6815 SW WALNUT-- ERRACE City, State,Zip: TIGARD,OR 97223 City, State,Zip; TIGARD OR 97223 Nearest Cross Street: 69TH Phone/Fax: 503-347-8028 E-Mail: GARO.WRIGHT@ECPOWERSLIFE.COM 4. Development Activity(check a//that apply)pp Y) 5. Applicant Information ❑ Addition to Single Family Residence(rooms,deck,garage) la Lot Line Adjustment Name: GARO WRIGHT ❑ Minor Land Partition CaResidential Condominium laCommercial Condominium Company: caResidential Subdivision LaCommercial Subdivision Address: 6815 SW WALNUT TERRACE ❑ Single Lot Commercial ❑ Multi Lot Commercial City, State,Zip: TIGARD,OR 97223 Other REDUCTION IN GARAGE FOOT PRINT. CUTTING 12"OFF THE FRONT OF THE GARAGE. Phone/Fax: 503-347-8028 E-mail: GARO.WRIGHT@ECPOWERSLIFE.COM 6. Will the project involve any off-site work? ❑Yes d No ❑Unknown Location and description of off-site work_ 7. Additional comments or information thatam yeb needed tounderstand your project ALL WORK IS WITHIN THE GARAGE 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 the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certifythat familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,co Servicesccuhave authority to enter Print/Type Name GARO WRIGHTI am complete,and accurate. Signature Garo Wright Print/Type Title OWNER Digitally signed by Garo Wnght Date:2018.04.03 10:05:53-07'00' Date 4/3/2018 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT'- SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a N'' be required. ❑ Based on review of the submitted materials and best available information Sensitive arP7- ' Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and p document will serve as your Service Provider letter as required by Resolution and Or, obtained and completed under applicable local,State,and federal law. Based on review of the submitted materials and best available information the above refe, sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment doe: sensitive areas if they are subsequently discovered.This document will serve as your Servir 3.02.1. Ail required permits and approvals must be obtained arid completed under applica ❑ This Service Provider Letter is not valid unless Lila The proposed activity does not meet the definition of development rr the loWS t was plved an e d at, PROVIDER LETTER IS REQUIRED. Reviewed by C/lsuz e Once complete, email to: SPLReview@cieanwaterservict OR mail to: SPL Review, Clean Water Services, 2550 SW Hilisbor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 6815 SW WALNUT TER, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2018-00107 Inspection Type: Inspector: 299 Final inspection Allyson Armstrong Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor