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Permit (55) L____ C*.) 1 [2._ . .. • Building Permit Application REri`�, 'ka 1 Y Residential FOR OFFICE USE ONLY City of Tigard MAR 2 0 201: Received City g Date/By: Al Permit No.:44d, p1(— ° 13125 SW Hall Blvd.,Tigard,OR 97223 Tv Review / ' �✓ I Phone: 503.718.2439 Fax: 503.598.1960 p CITY OF TIG, �� e�B : J it; Other Permit: _ t; J3 I/ TIGARD Inspection Line: 503.639.4175 BUILDING DMS i�/,"� eadyBy: 7uris: H See Page2 for Internet: www.tigard-or.gov �► lti lu a �e Supplemental Information &-117,9,.L /1//(jell-L TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ®New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all \f- ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead nd the profit for-,(' 9) CATEGORY OF CONSTRUCTION work indicated on this application. 01 (16® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ Q0 Accessory building 0 Multi-family Number of bedrooms: ' 0 Master builder 0 Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 3 Li 11C9 Job site address: I\I p 1L4 SW 1)eS&Nues New dwelling area: '--6(495 square feet 'us City/State/ZIP:Tigard,OR 97224 Garage/carport area: 4(i) square feet VZ5tl Suite/bldg./apt.no.: Project name:River Terrace East Covered porch area square feet --)1,6.-- Cross )36.-- Cross street/directions to job site: Deck area: va l square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:River Terrace East Lot no.: 1 LS— Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:ADVL Land Holdings,LLC Type of construction: Address:7600 E Doubletree Ranch Road Occupancy groups: City/State/ZIP:Scottsdale,AZ 85258 Existing: Phone:(602)694-4031 Fax:( ) New: - ® APPLICANT0 CONTACT PERSON BUILDING PERMIT FEES* Business name:Polygon WLH,LLC (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name:Nichole Thorpe th FLS plan review fee(if applicable): Address:109 East 13 Street Total fees due upon application: City/State/ZIP:Vancouver WA 98660 Phone:(360)695-7700 Fax::( ) Amount received: E-mail:Nichole Thorpe PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name:William Lyon Homes,Inc Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 109 East 13th Street Solar Installation Specialty Code checklist. City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60 CCB lic.:207247 � Total fee due upon application: $201.60 Authorized signature:% ����� `L� g/tiy– permit application expires if a permit is not obtained 1/ This within 180 days after it has been accepted as complete. Print name:Nichole Thorpe Date:06/16/2017 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application roK ofFICE ['SE 0\1,1 City of Tigard Received Permit No.: i . 13125 SW Hall Blvd.,Tigard.OR 97223 Date/By: Phone: 503.718.2439 Fax: 503.598.1961 Plan Review t)ate/By: Other Permit. T I G A R.D Inspection Line: 503,639.4175 Date Ready/By. .hiris. ®See Page 2 for Interact: www,tigard-or.gov Notifed/Method: Supplemental Information -� '° Ti'PE;OF WORK , COMMERCIAL PEE* SCNEOULE - USE CHECKLIST Mechanical permit fees'are based on the value of the work ®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment.labor.overhead,and profit. Value:$ 'CATEGORY CONSTRUCTION IIES1DEN11ALEQU'IPMENT/S1STEMSFEES* ,,I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special informalion use di eckiLni. _ I I Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total = JOH'SITT"If FPRM1cl'f1Oi OP LOCATION Heatingicooling. . Job site address: ID(n l L) SV,,) DeschutesAir conditioning I 46.75 / Furnace 100.000 BTU(ducts/vents) I 46.75 City/State/ZIP:Tigard,OR 97224 • Furnace 100,000+BTU(ducts/vents) 54.91 Ilea'pump 61.06 Suite/bldg./apt.no.: Project name: R-w.c r 1'e)trate.. S,r Duct work 23.32 Cross street/directions to job site: Ilydronic 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 I 23.32 Subdivision: �i,IP,M'� X � Yr'xf e....., ' z 27" - Lot no.:` Other. 23.32 Other fuel appliances: Tax map/parcel no.: Water heater r 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 si PROP:ERT'.OWNER 0 TENANT Other: 23.32 1p �1 Environmental exhaust and ventilation: Name: PPD�!I LRange hood/other kitchen �( equipment I 33.39 Address: 1(000 tr ®ohv.,-tree.k ,, .,._1 _ K7)�01 Clothes dryer exhaust 1 33.39 City/State/ZIP: SC .ksaa 'ar1�-U.532)1 t`^r Single-duct exhaust(bathrooms, -mow! _� t7� toilet compartments,utility rooms) 1't' 23.32 Phone:tool olL4_L1CP l Fax:( ) Attic/crawlspace fans 23.32 :APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name;Polygon WLI-1,LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Cno �rn Furnace,etc. I Address:1O Bnoe4^„^" , z4 �SillR/ x`11) Gas heat pump M"^',� Wall/suspended/unit heater City/State/ZiP:Vancouver,WA 98660 Water heater Phone:(360)695-7700 Fax::(360)693-4442 Fireplace I Range E-mail: 1 Barbecue '' _4-„....,:i NRA 9R- Clothes dryer(gas) Business name:Apex Air LLC Other: Address: 18004 NE 72"d Ave ;' 4 :jlld�) iC+r L•P. sr Subtotal City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee) CCB tic.:203034 • TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 1811 days after it has been accepted as complete. Authorized signature: ' Fee methodology set by Tri-County Building Industry Service Board Print name; .r Date: aj•/7./(.. I\nuildingtPomilsaMEC_PerritApp_040113.due 4154617(1I/OJCOM/WEI3) w..wu ,u v,.4 utlnH u.A]k. Alll4W uaus•nn {:�. � .8s't _ -?$st,.` oz� -...),!,,,,i0;_.:4'�4r. r�� �-m'. C- m.�:s:° `r. k City of Tigard Received Permit I/ A ,. 13125 SW Halt Blvd„Tigard,OR 97223 • • Date/By: Rev N,i' Dale Ry; Related Permit!/: Phone: 503.718.2439 Fax: 503.59$.1960 Date/By; `� Inspection Line: 503.639 4175 ReadyDate/By:; ITIGARI3 r'- ;.4 Internet: www.tigard-or,gov o Aids: Su See Pagel for Notified/Method: �+1, _ Supplemental Information f`yt�".aY{,,�y' "J.�riv`. µxy Yytit'`.'eli rY';'ii%".':':F` .S/'o - r. :•q't: '�'• t lit •5iY•'•N._""rF�A:-,cv'S: nS ..`l�.• �Y:•: RyyKy :::�iR;` 1. :y£:...�::i - t•.{1., _ •.t� ,e.•.......t .,.• ... mai': it :.:t�`l. ®New constructiont..2 sets$ofpp n._...'ite s '• ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans�J/items aheeked):'M1, ©Demolition ID Other: ❑Service or feeder 400 amps or more 0Building over three stories, ..ri'•k. ; where the available fault current ❑Marinas and boatyards.•j' a�ri' ! YgiTJCy¢ ai1rCtittV, t•aT iO :5;; ;? ` ia exceeds 10,000amps nt150volts or J Floating buildings ❑X L.and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural =- 0 Multi-family . ❑Master builder 0amps Frail other installations. •buildings. Other: - �•�-;,'< :<` ❑Fire pump• 0 Installation of 150 KVA or tir ,i < :. , . . I 't. hI !ID If:QXTI019 . '.'��': � • .: _-? , ❑Energenysystem• larger separately derived - Job# J Job site address: Plpt S�� 0 Addition of new motor load of system. )e_.5 e ,r r0^r'or more. Q"A,>«E„,.1_2»,.73., City/State/ZIP:Tigard,OR 97224 R Six:?more residential units. occupancy, Suite/bldg./apt.#: -•� QHealtl?-oarefaeilities. ❑Recreational vehicle parks. I Project name: 12 N�� C-e..x mace,EUS$ ❑Hazardous locations. D Supply voltage for more than Cross street/directions to job site: 0 Service or feeder 600 amps or more. 600 volts nominal, •s< 0i ' : ,. TO ; .• , . .. nacription I Qty. IEncd I Total I a New residential single-or multi family dwelling unit. Subdivision: ,de)te-¶ _ I Lot#: \Z --i 7nclndes attached garage. Tax map/parcel/#; 1,000 sq,R,or less 168.54 4 -,,1 .��;I's••, :i:,t'j<«4=m,:T::<!, -:ir i�• •a • Ea.add'1500 sq.R.or portion � 33.92 ,dr:: -+, _f,,a.......r i 1.3+'tS,,CYtIPTIIDN,s WQRTC,{ 5:;;`' 1 • � . • • • Limited energy,residential (with above sq.ft.) 75.00 2 Limited energy,multi-family residential(with above aq.ft.) 75.00 2 ";;fi;�+4t t; j.. .x-:.gT: ::,x:;:f: ;: .;R1;:<,:� Renewable Enc �i-•.-�a nki-0It'0 •tO ::c :;...t,: :;i i 1'i: :•.. ►>rs 0 See ,a e 2 °•..� � .,....�....;�k_....�!�;grlll:`.: �'•-'•-��';,��:. :., %':`•'i.� ;::.<:_:.is�7..'PFlN�1.,VT, <�c',•t..•rs z>i g '^^1 Services or feeders installation alteration,and/or relocation Name:, g 'U I, t Y l U i nqS1 ', 200 amps or less 100.70 2 Address;' j� 201 amps to 400 amps - 133.56 �� 1�h i air! i _ A ?4 i__.4( 401 amps to 600 amps - 200.34 _© City/State/ZIP: at i T., C 525B f� G Over 1,00000 to amps amps 301.04 �® Phone: bin-W�t�,.[�03 r� F�,t;( ) amps or volts II "u _1552.26 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 S9.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps H 125.08 I I 2 Owner signature: , '`s` Date: 401 amps to 599 amps 168.54 2 RM.l?:-=ti >i O -.�'st 1s' Branch cixcuits-ne v :le" i f �'�t �rt�,(� t� 4. :}$,;' ti teration t' Anel � -.':� ..,.....,.,-,�.�r:;,c•:::�,�::'ta;;a'ii�=:3t:;:i•Si51?.,:�t,=J.3{OH4::T �1 1�:'r' ,,.,�y ti.i` > >0 extension, rCY, Business name:Polygon WLH,LLC A.above brvneh rifeede fee, above service or feeder fee, each branch circuit 7.42 ■I Contact name: ` cAnsoke;pcx Dew..., B.Fee for branch circuits without Address: 10'7, 6n•,,,ii 4 B.service or feeder fee,first - branch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98660 Bach add'I branch circuit 7.42 2 Phone:(360)695-7700 11~ax;:(360)693-4442 Miscellaneous(service or feeder not included) Bach manufactured or modular Email: `��� p ala dwelling,service and/or feeder G7.84 • 2 �::s<;;:sFf Ids •,Ytoiy!y �.<rturtir*\ornes_•z , .: st:, ) Reconnect only 6 .8�. 'aJ[.,tv7,w;':i.'NSI''..a?i.':IllJ'i4t:: 4:,.,''•.�,,,\C;,,;.-.:•.11 N /^` '�_::s>:a.:'fi:• <ir;,�:...it4:,. 74 _©v.. z.. Oxa, :=,.._.,-.<,.,;, =,,,, `,Ya. ...-r?rslltii;4<.-i'- Pum or p irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2 Address:402 Valley Ave NW Ste 106 Signal circuits)or limited-energy 0 see rage 2 panel,alteration,or extension. 2 City/State/ZIP;Puyallup WA 98371 Each additional inspection over allowable in any of the above Additional inspection(1 fir min) 66.25/lir Phone:(253)872-6051 I Fax:(253)872-1801 Investigation(1 hr min) 90.00/hr Email:bdaniols@gwet[sa.corn Industrial plant(1 fir min) 78.18/hr Inspections for which no fee is CCB Lie,: C1158 Electrical Lie,: 208174 I Suprv,Lie,: 4496S specificall listed(h hrnnin 90,00/hr Sri 1v.Electrician ty�m � -•. ... .::i.,i° ._. iF4i?'6°',�T-'RIL� # 1 r ,N' i p ec rician signature,required: , P/ A.!` �Z- 1 s t jls c`; ,; ;;"• Subtotal: Print name: Joan P Albert I Date: 0 Plan Review Required(25%of permit fee): ______ State surcharge(12%of permit fee): Authorized signature: .:-.--- • _ 'TOTAL PERMIT FEE: I This permit npinlicnttan expires if a permit is not obtained within 180 Print name: Bill Daniels I Date: days after itims been accepted as complete I:18uildinglPerroits�aLC PcrmitApp_I3Llt 11kE.doo acv 06/17/2015 * Number of inspections allowed per permit. 440.4615T(I 1/05/Cohrwga Plumbing Permit Application Building Fixtures City of Tigard ReceivedDermic No.: 0 13125 SW Hall Blvd.,Tigard OR 97223' Plan R By: Phone: 503.718.2439 Fax: 503.598,1960 Daffy, Other Permit No.: T l G A R D Inspection Line: 503.639.4175 Date Ready/By: runs: 0 See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE*,SCHEDULE. For special information use checklist. ®New construction ❑Demolition Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION , ,-,. ' SFR(1)bath 312.70 -- ®1-and 2-familySFR(2)bath 437.78 dwelling ❑Commercial/industrial SFR(3)bath 3 D Accessory buildingk 500.32 ❑Multi-family Each additional bath/kitchen 25.02 El Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOS SITE INFORMATION AND LOCATION. Site utilities: Job site address: C 1p` "7 Svc eSCIA L.L.i-PS y C _ Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97224 1��"`� Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt,no.: Project name: ([O01, + 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 t,ger Tem,o,69_,Eo- •-i- Lot no.: 125.)-- Fixture or item: Tax map/parcel no.: Backflow preventer I 31.27 DESCRIPTION OF,WORK, Backwater valve � 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ®a.PROPEItTy OWNER I 0 TENANT Expansion tank 12.51 Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:7600 E Doubletree Ranch Road Garbage disposal 25.02 City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02 Phone:(602)694-4031 Fax:( ) Ice maker 12.51 A' APLICANT ❑:.CONTACT.`PERS ON-,° Interceptor/grease trap 25.02 { {1 ILL_ ^ Medical gas(value:$ ) Page 2 Business name: Po 1u 1`k1 t Li 4�s� N J 1 Primer 12.51 Contact name:.1 V` > .{T/hp Roof drain(commercial) 12.51 Address: L b� 16y00 W"r7 i�`��5' -1- S'� ,�0 Sink/basin/lavatory /.0...U1;A/Ly / 25.02 City/State/ZIP:Vancouver,WA 98660"4 Solar units(potable water) / 62.54 Phone:(360)695-7700 I Fax::(360)693-4442 Tub/shower/shower pan 12.51 Urinal 25.02 E-mail:.Nk cit) .e. j Water closet 25.02 ,y CO CTOR ., u ;:,,. .„. Water heater ,9 37.52 Business name: G.4.4 i 14,1/410)c �5V3.0.4.- Water piping/DWV 56.29 Address: p.ti. 3..ox, op, Other: 25.02 City/State/ZIP: ST. P ewe_ get I3' Subtotal Phone:(5'03-std.- I'U"l Fax:(R1% ..-7gi..4.11/1) Minimum permit fee: $7250 CCB Lic.: ISL/3'7. Plumbing Lie,no.Pi Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: 7 TOTAL PERMIT FEE -1-fdV t. F%.1)1�Q Date:g-'3 D I This permit application expires if a permit is not obtained within 180 days Print name: after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:1BuildmglPermitAPLMU-PcnnitApp.dac 10/01/09 440-4616T(10/02/COMIWEB) City of Tigard 71 II N COMMUNITY DEVELOPMENT DEPARTMENT T 1 c A a o River Terrace Building Permit Review Addendum Building Permit #: Site Address: 1“i'1 SVI Oey" Lit, Litiv Project Name: Rjute 7{rra(e E4.f Lot #: 1L!* (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review of River Terrace Plan Dist . t Design Standards (18.640.070.1.): Is the project subject to the plan district design standards? [Yves ❑ No 1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional element required for lots with over 60 ft. of street frontage shall be provided every 30 ft. Porch min. 5 ft. deep Balcony w/ access 2 Window Projection Vertical Wall Offset a Gabled dormer ft. deep min. 2ft.,5 ft.wide min. 2 ft., 6ft.wide ❑ ❑ ❑ ❑ 2. Eyes on the street: a minimum of 2%of each street facing facade must include windows or entrance doors. Percentage Shown: i a,f 3. E�trances:At least one entrance must meet both of the folio g standards: L�'Max. 8 ft. setback from longest street- facing wall Parallel to street, angle no more than 45° from street, / or open onto porch Entrance opens to a porch: 'LSI Yes ❑ No �/ Iff y5s,all the following apply: L[27225 sq.ft. min. ID/0 e street facing entry L,__ld,�,,"1ff ft.max.roof above floor of porch 11 ft. depth min. Ly'30%min.porch roof coverage 4 . J,Yetailed Design:All buildings shall include a min. of five offile following elements on all street-facing facades: ICovered porch min. 5 ft.wide x 5 ft. deepRecessed entry area min. 5 ft.wide x 2 ft. deep 0 mall offset min. 16 inches ❑ Dormer min.4 ft.wide [/Roof eave min. 12 inch projection ❑ Roof offset min. of 2 ft. ❑ Roof shingles either tile or wood VGable,hip or gambrel roof design ❑yLoof pitch oriented south min. 500 sq. ft. 0 Horizontal lap siding min. 3-7 inches wide [Accent siding min. 40%of street facade ❑ Window trim min. 2 1/2tt wide by 5/8"deep ❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft.wide by 2 ft. deep ❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35%or less of street facade 5. Garages and Carports:May face the front or side lot line on a co er lot. Setbacks: No closer to front or side lot line,than longest street-facing wall. Yes ❑ No. If No (Check one): ❑�,Vlay extend up to 5 ft.if there is a covered front porch and garage does not extend beyond the front porch. • May extend up to 5 ft.where the garage is part of a two-story building and there is a window at the second story above the garage that faces the street with a min. area of 12 sq.ft. Width: (Check one) �� ❑ 12-foot-wide garage door Lid'40%max. of street facade ❑ 50%max. of street facade with 7 detailed design elements Notes: Approved By Planning: -iL ! Date: 5"1"-112 I:\Building\Forms\BldgPermitRvw_RES_RT_121417.docx City of Tigard. COMMUNITY DEVELOPMENT DEPARTMENT 1 T 1 cz n Building Permit Review — Residential Building Permit #: A ,� 1 A 'I+ Site Address: 166I4 S ' (XS 6ilvte5 L ii,e.. Project Name: Ri,ltr 7errAcz E asi-- Lot #: 1 Zg (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: 1\kt4 S r r< 12( erify site address/suite# exists and active in permit s stem. R ver Terrace Neighborhood: CI No Yes,See River Terrace Review Addendum Attached S.V Plan Elements: T/ Leyiree(3)copies of site planL11Eisting structures on site e plan must be on 8-1/2"x 11"or 11 x 17"paper {i4 ootprint of new structure(including decks)with finished awn to scale(standard architect or engineer scale) floor elevations N�rth arrow tr. ;'ty locations&easements (required for new and additions) [ e address,project or subdivision name and lot number I Sidewalk/driveway approach 11IZ pplicant information(name and phone number) F •cation of wells/septic systems IE e of dimensions and building setback dimensions If xisting trees to be retained with drip line,and tree �b uare footage of buildings to be demolished totection measures OlItot area,building coverage area,percentage of coverage and VSyeet tree size,type and location pervious area(applicable if R-7,R-12,R-25&R-40) lettreet names M'Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? LJYes ❑No _/4 foot differential) If yes,is a storm water quality facility shown? ❑VIP No lid' Clean Water Services—Service Provider Le_ttteOof platted prior to 9/10/1995): 4PPuiA iv'1-11equired: CI Yes,applicant was notified IlL No Received: ❑ Yes ❑ No Imo" Public Facilities provement(PFI)Permit: / l�� �L [equired: applicant was notified ❑ No Applied For: Q Yes ❑ No,stop intake ,_,_,j�andUseCase#: ���Z17������ni L�" oning: 12-1.S (el/ I�- 7-LPO) Lid' Required Setbacks: Front Rear 10 Side ,"j Street Side Ni/I- Garage (2,,o JJitRequirement: ot Coverage Maximum: y(,l LLfBuilding Height: Maximum Height 30 Actual Height Z VAo Visual Clearance Sensitive Lands: ❑ Yes (No Type ar-yrban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: /Approved By Planning: ,, 12., Ce Date: '- 1 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES 06141'7.docx Building Permit Submittal Original Submittal Date: ,Zj2.4()l(r Site Plans: # Building Plans: # Building Permit#: i nter building permit#above. Workflow Routing: IV'Planning Engineering Permit Coordinator Building Workflow Sign-off: r 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: By Permit Technician: / / " / Date: S-717// Engineering Review es ,Slope at building pad: 51) ('6 Conditions "Met"prior to issuance of building permit gf Easements (encroachments)per engineering conditions of approval and plat J2 Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 1 No Assess Water Quantity Fee in-lieu: El Yes e No LIDA Facility on lot: ❑ Yes LXNo AFinal Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: UAL I 14K. W 4 Date: 5/1! i$ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved 0 Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: ❑ Approved 0 Not Approved Permit Coordinator Review X'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 ❑ N/A Parks SDC: 'Yes ❑ N/A LIDA ❑ Yes N/A OK to Issue Permit �' Approved by Permit Coordinator: (g Date: 5 l I:\Building\Forms\BldgPermitRvw_RES_010118.docx