Permit CITY OF TIGARD MASTER PERMIT
111111 I' ' COMMUNITY DEVELOPMENT Permit#: MST2019-00151
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 t '` Date Issued: 05/07/2019
T I�;r1[t D 1 Parcel: 2S114AD02900
• Jurisdiction: Tigard
Site address: 16672 SW 89TH PL +�
Subdivision: WAVERLY ESTATES Lot: 28
Project: PARKINSON
Project Description: Replacing a 206 sq.ft. deck. 8/12/2019: REPRINT permit to reduce new deck from 250 to 212
sq ft.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $5,066.80 Rear: 15
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0
Catch Basins: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea addl 500 sf: 0 201-400 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: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr. Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
PARKINSON,ANDREW D&KRISTEN J STRUCTURE BUILDING SOLUTIONS INC Required Items and Reports(Conditions)
48872 SW UTH-RL 639e
TIGARD,OR 97224 TIGARD,OR 97224
PHONE: PHONE: 503-941-6911
FAX:
Total Fees: $436.98
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 ou to follow he rules adopted by the Oregon Utility Notifi 'tion Center. Those rules are set forth in OAR
952-001-0010 through 52-00,s$90. Y•t ay obtain- ivy of th- ules or direct questions to OUNC by callin• 03. _ 332.2344.
AI/A �� ,t
Issued By: /���- ��-� . Permittee Signatu � �a� . ,
Call 03.639.4175 by 7:00 a.m.for the next availab .• specti:i 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.
City of Tigard
° COMMUNITY DEVELOPMENT DEPARTMENT
I
T l c A R o Building Permit Review — Residential
Building Permit #: ,,,71jT-4//-- /5/
Site Address: l to ii`12- ..svJ eqtn F1
Project Name: 17411k littcolA Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: A(t l-h wl d gillIN ound C c4- Si.,_IS- �
Verify address/suite#active in Accela. In River Terrace: aaNo ❑ Yes,River Terrace Review Addendum
iSiie Plan Elements: rosion Control
ti 3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper 7II etained trees with drip line and tree protection measures
C 1510rawn to scale(standard architect or engineer scale) ► ootprint of new structure(including decks)and FEE
t/ forth arrow fiertility locations&easements(required for new and additions)
site address,project or subdivision name and lot number `idewalk/driveway approach
pplicant information(name and phone number) ,Location of wells/septic_systems
'" m Lot dimensions and building setback dimensions b'' reet tree size,type and location
7A quare footage of buildings to be demolished •I Street names
Existing structures on site orner elevations(2'contours if more than 4'differential),,
-- Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes�No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? E 4-0No
Clean Water S5rvices—Service Provider Letter(lot platted prior to 9/10/1995):
Required: Yes,applicant was notified ❑ No Received: 0 Yes No
XPublic Facilities Improvement(PFI)Permit:
Required: 0 Yes,applicant was notified No Applied For: 0 Yes 0 No,stop intake
VA-Land Use Case#: Zoning: R.-12 h
,�'Required Setbacks: Front:N/A-- Rear: 1S Side: S Street Side: NIA- Garage: N/k
i - ', Building Height: Max.Height: 55 Actual Height: IS
'iLandscape Area: 2D % 'i Lot Coverage Max: 't
Entrance 0 Set b ck no ore than 8'from street-facing wall 0 Parallel to street or offset 45 degrees or less j
Windows 11 ' ', urn 1 %of, ea of all street-facing facades
Garage k Gara_e doo is b• : d widest street-facing wall ❑ Yes 0 No,one of the following is met:
0 Doo exte • • ore than 5'from wall and there is a covered porch extending beyond garage.
a Doo ext. •s ,o more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
I Garage do r wid is 0 12'or less 0 50%or less of facade 0 60%or less and indudes 7 of following:
0 Cov red porch 0 Recessed entrance 0 Wall offset 0 1'Roof eave 0 Roof offset
❑ Fire • gles 0 Lap Siding 0 Roof pitch 0 Gable,hip,or gambrel roof 0 Dormer
� -Acteut sic -- E xio�ev!»r _ -❑ Winslow recess Window-projection ❑ Balcony
` r —
Visual Clearance til"Urban Forestry Plan
Sensitive Lands: El Yes
No Type:
NA-Conditions met prior to issuance of building permit
Notes: t r
Approved By Planning: 1 al � Date: L1 (22I VAI
ft
Revisions (aer�Budiing Submittal only) Revi er Date
Revision 1: ( Approved CI Not Approved / Z SI-4-1q
Revision 2: CI Approved CI Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
.
` Building Permit Submittal
Original Submittal Date: fdahq
Site Plans: # 3 I
Building Plans: # 3 j
Building Permit#: E =nter building permit bove.
Workflow Routing: [�—Fan g l(�Engineering Coordinator Lam}—Bt ii g
Workflow Sign-off: [g -Off for Planning(include notes from planning review)
Route Application Documents: L n�gineering: (1) copy of permit application, (1) site plan, (1)building plan and
original plan review routing form.
riildtng: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: _ Date: ,y/�-/t,i
1 Engineering Review 47
g Slope at building pad: 70
a Conditions "Met"prior to issuance of building permit
;2' Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes fT No
Assess Water Quantity Fee in-lieu: ❑ Yes -0- No
LIDA Facility on lot: ❑ Yes -E No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
2"-Approved by Engineering: (1 j)'-' Date: ( /7
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
1 U Conditions "Met"prior to issuanceofbuilding permit
0 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:
C Fees Entered: Wash Co Trans Dev Tax: ❑ Yes 41 N/A
Tigard Trans SDC: ❑ Yes [ 'N/A
VParks SDC: 0 Yes f /A
LIDA El Yes [�' TN/A
OK to Issue Permit
Approved by Permit Coordinator: Date: 5/ 1
I
j I:\Building\Fonns\BldgPermitRvw_RES_022819.docx
FOR OFFICE USE ONLY-SITE ADDRESS: ( (Q(Q ( c l) e ''- 'F1 , l i aye/ T3-?9(/
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.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
'Pi Transmittal Letter
1 I c;A i n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • w .tigard-or.gov
TO: DA RECEIVED:
DEPT: BUILDING DIVISION y4 qF
FROM: i -iAUG -- 7 2019
COMPANY:
LLii' .:i a �= Of+J
PHONE: Liti5Q ' 1 b• I SG2 .0 / By: di
RE: itQtA c) (2) ( • i/ Df - 0015-1
(Site Address) �' (Permit Number)
1)e d c --.e_p lase vw
(Project name or subdivisibn name and lot nu )
ATTACHED ARE THE FOLLOWING I . S:
Copies: Description: I / Copies: Description:
Additional set(s) of plans. ' 3 Revisions: Q viAry0C, an jrs
Cross section(s) and details.*AN Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: (r e_t 13 O i 4. CA 'L.ct c firs --r-cy-r^ A e.ck
) ..&��L. 4-- L, I _1A- 4
4.- 5 tC On kbel if e u t.3 O-I \ , 1 c AA,9)._
Routed to P- ' echnici : Date: G ts (1 Initials: A T
Fees Due: 4 Yes • o Fee Descripti. : Amount Due:
//1.-- 1nAvNr fli,nr $ •
e
act, ZSa S
$ " ys- "
Special hot,) g.VD-a .&-Lc —
Instructions: -c-SS 3t 1i
Reprint Permit(per PE): ►i YesNo ■ Done
Applicant Notified:M /s7- s ate: "7707-- 6 Initials: .6a7SL. r-----
I:\Building\Forms\TransmittalLetter-Revisions 061316.doc
CITY OF TIGARDIS MASTER PERMIT
I COMMUNITY DEVELOPMENT Permit#: MST2019-00151
Date Issued: 05/07/2019
T I G A R.0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S114AD02900
Jurisdiction: Tigard
Site address: 16672 SW 89TH PL
Subdivision: WAVERLY ESTATES Lot: 28
Project: PARKINSON
Project Description: Replacing a 206 sq.ft.deck.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $5,975.00 Rear: 15
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!500 sf: 0 201-400 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 N
Other: N Other Description: Ecompasing.
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
PARKINSON,ANDREW D&KRISTEN J STRUCTURE BUILDING SOLUTIONS INC Required Items and Reports(Conditions)
16672 SW 89TH PL 6396 SW LANG TREE ST
TIGARD,OR 97224 TIGARD,OR 97224
PHONE: PHONE: 503-941-6911
FAX:
Total Fees: $431.53
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 Notifi - '•n Center. Those rules are set forth in OAR
952-001-0010 through R 952-001-00•A You may obtain a copy• e rules or direct questions to OUNC by calling .43.232.198 • 1.800.332.2344.
• i \
Issued By: �`/ �� Permittee a Signature: !1 '. ._' ! i AIL .
Call 603.639.4175 by 7:00 a.m.for the next available inspect. .ate.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved pla..e ere required on the job sib at the time of each inepection.
Building Permit Application
Residential FOR OFFICE l 'NI: (lyLv
City of Tigard ReceivedDatemy. it/ t q 4.1 --- ii
Permit No.: 57A6 147—0'.1>,—/
NI 13125 SW Hall Blvd.,Tigard,O' V) El V E D Plan Reviews r �/
_ Phone: 503.718.2439 Fax: 503.,' Date/By: a Aly
Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: 1i JAS gi See Page 2 for
Internet: www.tigard-or.gov APR 2 2 2019 otified/Meth,,•, L/G 7Supplemental Information
//
TYPE UfLQ�J,, FG TIDIVISGARDION
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. q Bo
441
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: i"�.Y�" S 1 7S,
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:16672 SW 89th Place New dwelling area: square feet
City/State/ZIP:Tigard Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Replace deck Covered porch area: square feet
Cross street/directions to job site:92"and Waverly Drive Deck area: ....MG'6' elquare feet
2""Cul-du-sac on Waverly Drive / }'Q/� ..e.,1,401'71-r.. . T 4" i Other structure area: square feet
Behind Tigard High School � ,1e5:::, ....—if.... -/ /<4 .•4 REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Waverly Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Replace deck Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Andrew and Kristen Parkinson Type of construction:
Address:16672 SW 89th Place Occupancy groups:
City/State/ZIP:Tigard/OR/97224 Existing:
Phone:(480)518-1560 Fax:( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
evS `21V41� Structural plan review fee(or deposit): /'tr„, -7 7
Contact name: lr
FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Amount received:
Phone:( ) Fax::( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Structure Building Solutions,Inc. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:2043 NE Chehalem Drive Solar Installation Specialty Code checklist.
City/State/ZIP:Newberg,OR 97132 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)941-6911 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:198403 ((
(f / Total fee due upon application: $201.60
Authorized signa — rCk✓r kk I V1,01,1 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
i *Fee methodology set by Tri-CountyBuilding Industry
•
Print name ( � jrI10
Date: a a �� Service Board.
I:\Building\Permits 3 UP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
RECEIVED
APR 2 2 2019
Y � j an Water Services File Number
C1eanWater ®IVISIRI19 001205
Sensitive Area Pre-Screening Site Assessment
1. Jurisdiction: Tigard
2. Property Information(example 1S234AB01400) 3. Owner Information
Tax lot ID(s): Name: Andrew&Kristen Parkinson
2S114AD02900 Company:
Address: 16672 SW 89th PI
Site Address: 16672 SW 89th PI City,State,Zip: Tigard,OR,97224
City,State,Zip: Tigard,OR,97224 Phone/Fax: 480-518-1560
Nearest Cross Street: 92nd and Waverly E-Mail: kjparkinson@reagan.com
4. Development Activity(check all that apply) 5. Applicant Information
U Addition to Single Family Residence(rooms,deck,garage) Name: Andrew&Kristen Parkinson
❑ Lot Line Adjustment ❑ Minor Land Partition Company:
❑ Residential Condominium ❑ Commercial Condominium
Address: 16672 SW 89th PI
❑ Residential Subdivision U Commercial Subdivision
Li Single Lot Commercial ❑ Multi Lot Commercial City,State,Zip: Tigard,OR,97224
Other Phone/Fax: 480581560
Replace Deck/Add stairs E-Mail: kjparkinson@reagan.com
6. Will the project involve any off-site work? ❑Yes XJ No ❑Unknown
Location and description of off-site work
7. Additional comments or information that may be needed to understand your project
Replace old deck-185 sq.ft with new deck of appx.206 sq.ft to include stairs.
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 Services have authority
to enter the project site at all reasonable times for the purpose of inspecting project site conditions and 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.
Printlfype Name Andrew&Kristen Parkinson Print/Type Title
ONLINE SUBMITTAL Date 4/18/2019
FOR DISTRICT USE ONLY
U Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A
SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report
may also be required.
U 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.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.
X Based on review of the submitted materials and best available information the above referenced project wit 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 and protect additional water
quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order
07-20,Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law.
X This Service Provider Letter is not valid unless 1 CWS approved site plan(s)are attached.
U The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR
SERVICE PROVIDER LETTER IS REQUIRED.
Reviewed by C 4" ?; - Date 4/22/19
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City of Tigard
IIl COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R o Building Permit Review — Residential
Building Permit #: rn57-X<9— t5
Site Address: 1 l0(17 2- &v f eottn P1
Project Name: P4 c Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: AM-h i„I ( S'ol l rc A hid Gkc -
.Er Verify address/suite# active in Accela. l In River Terrace: ISL No ❑ Yes,River Terrace Review Addendum
Site Plan Elements: rosion Control
`43 copies of site plan on 8-1/2"x 11"or 11 x 17"paper 4/.'etained trees with drip line and tree protection measures
'yawn to scale(standard architect or engineer scale) -^"P-01 ootprint of new structure(including decks)and FEE
7riorth arrow tility locations&easements(required for new and additions)
Site address,project or subdivision name and lot number idewalk/driveway approach
. pplicant information(name and phone number) ,Location of wells/septic_systems
n Lot dimensions and building setback dimensions b'"treet tree size,type and location
ti
TA quare footage of buildings to be demolished a treet names
Existing structures on site r.Romer elevations(2'contours if more than 4'differential),„
Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes allo
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Li -LiNo
Clean Water,Sices—Service Provider Letter(lot platted prior to 9/10/1995):
Required: [1? Yes,applicant was notified ❑ No Received: ❑ Yes [ "No
X Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified X No Applied For: ❑ Yes ❑ No,stop intake
)JA1—Land Use Case#: ' Zoning: R.--I 2- /h
Required Setbacks: Front:NM- Rear: IS- Side: S Street Side: N`P Garage: N A
.Building Height: Max. Height: E Actual Height: IS-
'Landscape Area: 20 % 14 Lot Coverage Max: eaD
Entrance ❑ Set b ck no ore than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows !■ ' 'c urn 1 %of• ea of all street-facing facades
Garage L Gara'le doo is b•4, d widest street-facing wall ❑ Yes ❑ No,one of the following is met:
❑ Doo exte . , . ore than 5'from wall and there is a covered porch extending beyond garage.
0 Doo ext• s ,o more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
ill Garage do r wid is ❑ 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ Coy red porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire s • gles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
VVisual Clearancetilt Forestry Plan
Sensitive Lands: ❑ Yes No Type:
NA-Conditions met prior to issuance of building permit
Notes: , r /� �
,Approved By Planning: 7 O4`L-- Date: 9 (22-I L"
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved 0 Not Approved
I:\Building\Forms\BldgPermitRvw RES 022819.docx
Building Permit Submittal
Original Submittal Date: � l j.l
Site Plans: # /
Building Plans: # 3
Building Permit#: 12 =nter building permit bove.
Workflow Routing. g ®engineeringermit Coordinator g
Workflow Sign-off: [.- -Off for Planning(include notes from planning review)
Route Application Documents: ngineering: (1) copy of permit application, (1) site plan, (1) building plan and
original-plan review routing form.
13i ildtng: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ! Date: y1��-/t,€
Engineering Review .4.7
7c>, Slope at building pad: 0
2-Conditions "Met"prior to issuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
C7-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes IT No
Assess Water Quantity Fee in-lieu: ❑ Yes -r No
LIDA Facility on lot: ❑ Yes -ErNo
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
,'`Approved by Engineering: F(2Date: l
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:
C Fees Entered: Wash Co Trans Dev Tax: ❑ Yes 441 N/A
Tigard Trans SDC: ❑ Yes IfrN/A
Parks SDC: ❑ Yes N/A
LIDA ❑ Yes E N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: 50 if
I:\Building\Forms\BldgPermitRvw_RES_022819.docx