Loading...
Permit (24) i NI City of Tigard 1114 COMMUNITY DEVELOPMENT DEPARTMENT ■ Building Permit Review — Commercial - With Land Use T1GARt) Building Permit #: ,9Gj, ,,,j,-„„)(,,(D Site Address: pc-2- G ..c2i6, /T?.c, /9j Suite/Bldg#: Project Name: kk AQ„-i-4 (Name of commercial busineas occupying the space. If vacant,enter Spec Space.) Planning Review )) Q Proposal: /n t2Piu `,CPon RMITM 5-L ZG/ ` Det,-a „ dl k4d r_ �o rc. . 1 art / '1�l1/'• fo�t Ur,t \�f MGn le"- . rtr"VAIW. c'/J \ rui V� r ft L Vri S��Yp"^14 icitg (.YMTriulP ifs i J � A Verify site address/suite#eiusts and active in permit system , 0 'ver Terrace Neighborhood: 0 Yes V No VjAnd Use Case#: lllAr�p j t 3 . coo()/ 1,Q PlanyMatch Approved Land Use: MI Site Plan 41 ndscape Plan then: Urban Forestry Plan W ' levation Plan /BLA—uilding Height: Maximum Height � A ial Height A.2 e c Conditions Met: 0 Prior to Submittal j Pnor to Permit Issuan ❑ Business License: Exists: 0 Yes No,applicant notified to obtain business license \£�Y{y'ublic Facilities Improvement(PH)Permit: Required: �❑ Yes, applicant was notified ) NJ No Applied For: ❑ Yes 0 No,stop intake Notes: C.!J1C 171� CA/7 i71ti1t.F — do I7b ) cLU Levid r--a-rtA o c ....44 /1.7_, Approved by Planning: ---__--'_— Date: / Revisions (after B ding Submittal only) ewerl/_ Date ��Revision 1: Approved ❑ Not Approved t Revi ` 3_1-142(1 Revision 2. 0 Approved ❑ Not Approved Revision 3: ❑ Approved 0 Not Approved Building Permit Submittal Original Submittal Date: / Site Plans: # Building Plans: # • Building Permit#: �n'ter b i ding permit# Workflow Routing. tong ngineering ermtt Coordinator uildtng Workflow Sign-off: gff for Planning(mclude notes fiu,u planning review) Route Application Documents: wilding. original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: >) 4- ( b1/4`07 fr-r.tA '3Iivy 1 �+r i t.,k- jef-i .J n 071 34/-76 GtuG -1` G.. By Permit Technician: �s! Date: 3/24A 9 . 1:1Bu ilding\Fonns\BldgPetmitRvw_COM_W itlllandUsc_060I 16.docx Engineering Review Er Slope at building pad: (N. Q PFI Pemut#: N IA, Conditions "Met"prior to issuance of building permit Eic'Easements (encroachments)per engineering conditions of approval and plat (not typical on SDR/CUP) h ['Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes No Assess Water Quantity Fee in-lieu: 0 Yes No LIDA Facility on lot: 0 Yes No ❑ NOT Approved by Engineering: Date . Notes: Approved by Engineering: 5 f4;%�� Date: 3 2 i 7Revisions (after Building Submittal only) Reviewer Date Revision 1: [ "Approved ❑ Not Approved z L %% 3/1/2626 Revision 2: ❑ Approved ❑ Not Approved Revision 3: 0 Approved ❑ Not Approved "k Permit Coordinator Review i ❑ ditions "Met"prior to issuance of building permit t . Approved,NOT Released: ,a�/G Date: 3 ?f l qi Notes: 1 Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant. Revision Notice 2: Date Sent to Applicant R sion Notice 3: Date Sent to Applicant SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes CAN/A Tigard Trans SDC: ❑ Yes U N/A 7 Parks SDC: 0 Yes N/A /4 j ~o 71I OB to Issue Permit LT �/ fl f Approved by Permit Coordinator: Date:Ct t:l6uilding\Fonus dgPermitRvw_COM_WithLandUse_070915.docx 71 CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit#: BUP2019-00066 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/05/2019 TIGARDParcel: 1 S 136DA00800 Jurisdiction: Tigard Site address: 11540 SW PACIFIC HWY Project: Kaleafa Subdivision: FRUITLAND ACRES Lot: 2 Project Description: TI for new tenant: (2)new bathrooms. Scope of work includes a new demising wall. Bathrooms are located within adjacent space at 11536 SW Pacific Hwy. Contractor: DIAMOND CONSTRUCTION Owner: HIGH HAT RESTAURANTS, INC PO BOX 33072 11530 SW PACIFIC HWY PORTLAND, OR 97292 TIGARD, OR 97223 PHONE: 503-936-7700 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 06/05/2019 $301.85 Demolition Occupancy Grp: B Occupancy Load: 49 12%State Surcharge-Building 06/05/2019 $36.22 Dwelling Units: 0 Plan Review 03/21/2019 $196.20 Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 06/05/2019 $98.00 Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 06/05/2019 $120.74 Value: $15,000 Info Process/Archiving-Lg$2.00(over 06/05/2019 $6.00 11x17) Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $759.01 Required: Required Items and Reports(Conditions) Fire Sprinkler: Parapet: Fire Alarm: Protected Corridors: Smoke Detectors: Manual Pull Stations: Accessible Parking: 0 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 may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: Call 503.639.4175 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. FOR OFFICE USE ONLY—SITE ADDRESS: 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 Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard_or. ov_ �iDATEwent TO: ' DEPT: BUILDING DIVISION OCT 16 2i FROM: R',7A ((-25616,1- -5 CITY OF- GARD BUILD)► DIVISION COMPANY: -(G�,;J 63(ccAtx) ,;(...rc �-- PHONE: \ c TC> By:4 L ; RE: [tt2fl ( 5;.,`1 'GIS t b- A‘i 47i 2c-)6 -- CD 1R-L1 (Site Address) (Permit Number) ?--DKACY--, 1-05\-- S (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: i pies: Description: Additional set(s) of plans. 1 X Revisions: SV w4 h` r1S ;..S S1.1.-/‘1 Cross section(s) and details. .\J Wall bracing and/or lateral analysis. Floor/roof framing. �� Basement and retaining walls. Beam calculations. 1Engineer's calculations. Other(explain): p r REMARKS: U FO OF�ICE USE ONLY � J� Routed to Pe •' Tec•, ician: Date: 10 ((e ( 1 Initials: !T v l Fees Due: Yes ❑ No Fee Desc ption: Amount Due: $ a l/2 p Uw\- rg.,Jr1.--W $ Li $ $ Speci. JI ctions: ' eprint Permit(per PE): ❑ Yes To ❑ Done Applicant Notified: i7 Date: `06/`{ Initials:, . 1:\Building\Forms\TransmittalLetter-Revisions_061316.doc CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit#: BUP2019-00066 TRGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/05/2019 Parcel: 1 S 136DA00800 Jurisdiction: Tigard Site address: 11540 SW PACIFIC HWY Project: Kaleafa Subdivision: FRUITLAND ACRES Lot: 2 Project Description: TI for new tenant:(2)new bathrooms. Contractor: DIAMOND CONSTRUCTION Owner: HIGH HAT RESTAURANTS, INC PO BOX 33072 11530 SW PACIFIC HWY PORTLAND, OR 97292 TIGARD, OR 97223 PHONE: 503-936-7700 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: VBPermit Fee-Additions,Alterations, 06/05/2019 $301.85 Demolition Occupancy Grp: B Occupancy Load: 49 12%State Surcharge-Building 06/05/2019 $36.22 Dwelling Units: 0 Plan Review 03/21/2019 $196.20 Stories: 0 Height: 0 ft DC Provision Review, COM TI-Ping 06/05/2019 $98.00 Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 06/05/2019 $120.74 Value: $15,000 Info Process/Archiving-Lg$2.00(over 06/05/2019 $6.00 11x17) Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $759.01 Required: Required Items and Reports(Conditions) Fire Sprinkler: Parapet: Fire Alarm: Protected Corridors: Smoke Detectors: Manual Pull Stations: Accessible Parking: 0 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 folio - - adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a c. . the rule •r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2 44.2 Issued By: Permittee Signature: j// 111110 Cal 503.639.4175 by 7:00 a.m.for the next available in�ion dat This permit card shall be kept in a conspicuous place on the job sityr' it completion of the project. Approved plans are required on the job site at the ti ''of each inspection. Building Permit Application Commercial 1 OR OI 11( I: 1 11:(101,1 City of Tigard ECEIVEReceived ...? No.:/Q II " 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Revie�� ``i � '✓ � C�— 1 I Phone: 503-718-2439 Fax: 503-598-1960 Date/By: .3,...,17- J '/ Related Permit: �(7A jej ej�C ' T 1 c;a u nInspection Line: 503-639-4175 MAR 21 2019 Date Ready/By: Jung: ® See Paget2 for Internet: www.tigard-or.gov �y �� Notified/Method: (� S /t( 4.7)-- '- p Supplemental Information CITY OF t 11GA�yo-R6..i Q7 ' /.. 1-+ 1. TYPE OF 191ADING IS I O N REQUIRED DATA: AND 2-FAMILY DWELLING 0 New construction 0 Demolition Permit fees*are based on the value of the work performed. fjAddition/alteration/replacement 0Other: Indicate the value(rounded to the nearest dollar)of all ePequipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑1-and 2-family dwelling Et-Commercial/industrialValuation: $ ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: // 5-.a tA> QR-c4r/G H-ic,t.A4)(141New dwelling area: square feet City/State/ZIP: rta j, art- Garage/carport area: square feet Suite/bldg./apt.#: Project name: 1,-r• Covered porch area: square feet Cross street/directions to job site: 5-P° �� Deck area: square feet 9``i)/9r/�t�r`/`/ f�/�/1 W t(SI � Other structure area: square feet �fr ""1ry REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot#: Permit fees*are based on the value of the work performed. Tax map/parcel#: j tj 1 3 6 b A 0° gy:)a 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.s /71+.2�..-r /�i.,-,......„.e.4,-r.... /1 /l t Valuation: $ r7,��� A- /J`� `/_ i 'i f, /i1 o S , ��¢G Existing building area: square feet ?T�� L% "[ vY7 New building area: pi/A square feet 0 PROPERTY OWNER C) TENANT Number of stories: d Name: Type of construction: YL Address: Occupancy groups: v , � 1L -- City/State/ZIP: Existing: 1 Phone:( ) Fax:( ) New: 1-4p G i G e- in APPi APPLICANT +1 CONTACT PERSON BUILDING PERMIT FEES* (PlBusiness name: 4 I-r itt.Po pt-.4 view feeler to depschosit): rD (640/Ge-A -1 Structural plan review fee(or deposit): Contact name: 4 t A.. ` 1 FLS plan review fee(if applicable): Address: 4 to pa 'p4 kVV City/State/ZIP: Q i 1) o Q-- g.12.1 1 Total fees due upon application / it 1'o Phone:Vit)Vit)3) 7�f/•k 9l� Fax::( ) Amount received: v E-mail: 5 C,�'layG /4 !i.�/T~'` PHOTOVOLTAIC SOLAR PANEL'STEM'FEES*" " Commercial and residential prescriptive installation of ."" £ONTRAC " , . , roof-top mounted PhotoVoltaic Solar Panel System. Business name: p1 A I)P CO 13 S-w,uG i Iv N Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 1 1 , 30 7.1% Solar Installation Specialty Code checklist. City/State/ZIP: Of 1'it4A.44 c4, 6,7 'iv Permit fee(includes plan review $180.00 t and administrative fees): Phone:(503) 3 -7 70,3 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB Lic.: t.7 XVI ,1/1,1 Total fee due upon application: $201.60 Authorized signature: ' This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 1Print name �/ � f Date: * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-46131(11/02/COM/WEB) City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Accessibility: Barrier Removal Improvement Plan Commercial & Multi-Family - Additions or Alterations 1 1 c;A B D 13125 SW Hall Blvd. •Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov REQUIREMENT: OREGON REVISED STATUTE(ORS)447.241. (1) Every project for renovation,alteration or modification to affected buildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom, telephones and drinking fountains are readily accessible to individuals with disabilities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. (2) Alterations made to the path of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty-five percent(25%). VALUATION: Total of all renovation,alteration or modification being done, excluding painting and wallpapering [1] $ /5 0 C 3 MULTIPLIER(25%bather removal requirement): x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 5 75 0 o ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: (a) Parking $ (b) An accessible entrance: $ (c) An accessible route to the altered area: $ (d) At least one accessible restroom for each sex or a single unisex o� restroom: $ f%',ec)C (e) Accessible telephones: $ (f) Accessible drinking fountains:and, $ (g) When possible,additional accessible elements such as storage and a0, alarms: $ /1 000 TOTAL(shall equal line[2] of Valuation Computation): $ I:\Building\Permits\BUP COM_PermitApp.doc Rev.03/05/2019 Albert Shields From: Albert Shields Sent: Monday, March 25, 2019 12:24 PM To: 'slfirpo@gmail.com' Subject: BUP2019-00066 Sue, as you know there are two conditions of approval on this project under MAR2019-00001 and neither of them have yet been met. Accordingly, I will code BUP2019-00066 as "Approved (for Plan Review) but Not Released." Plan Review will proceed but the permit will otherwise be on hold until the conditions are met. Please let me know if you have any questions. Albert Shields. City of Tigard III ■ q COMMUNITY DEVELOPMENT DEPARTMENT TiGARD Building Permit Review — Commercial - With Land Use Building Permit #: /9k,o?v _60066, Site Address: //c2-/C 7k) /J(, Suite/Bldg#: Project Name: (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: 7"l., /2P/t7 4A„172---- Xfy site address/suite# exists and active in permit system. 0 •ver Terrace Neighborhood: CI Yes IJ No nd Use Case#: 41/9->c, C/ (3 6000 I Plan/Match Approved Land Use: LJ Site Plan Ii° andscape Plan Other: AiP6rban Forestry Plan 1 ! levation Plan rigi Building Height: Maximum Height L/ Actual Height JO 0/002.__ ❑ Conditions Met: El Prior to Submittal ❑ Prior to Permit Issuanc ❑ Business License: [Exists: CI Yes No,applicant notified to obtain business license TIS 'Public Facilities Improvement (PFI) Permit: Required: El Yes,applicant was notified NJ No Applied For: ❑ Yes ❑ No, stop intake Notes: ( '5& 4 / 2 )il AC'As -- O I?e� ) SLC �a'II�'� � taX 9'7�o.,),\,' Q Approved byPlanning: ,/ Date: ,� c, PP g� ��� � Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved El Not Approved Revision 3: ❑ Approved ❑ Not Approved Building Permit Submittal Original Submittal Date: , „ / `j Site Plans: # Building Plans: # Building Permit#: Cri—Enter b 'ding permit# bove. �rm Workflow Routing: anntng ngineering t�Peit Coordinatoruildtng Workflow Sign-off: cor Planning(include notes from planning review) Route Application Documents: utlding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: /ter" _ � Date: �� Ai f AF I:\Building\Forms\BldgPermitRvw_COM_WithLandUse 060116.docx Engineering Review CSI Slope at building pad: 7,3 ET PFI Permit#: N I* Conditions "Met"prior to issuance of building permit Easements (encroachments)per engineering conditions of approval and plat (not typical on SDR/CUP) 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 No ❑ NOT Approved by Engineering: Date Notes: Approved by Engineering: ,43A.•.4.1✓_ i5Date: 5 • 27 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 iditions "Met"prior to issuance of building permitroved,NOT Released: �L G �/G gW' ate: 3/2-)5/1/ Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: R ision Notice 3: Date Sent to Applicant: SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes RrN/A Tigard Trans SDC: ❑ Yes leN/A Parks SDC: ❑ Yes N/A ❑ OK to Issue Permit q Approved by Permit Coordinator: Date: �'� f`/ / I:\Building\Forms\BldgPermitRvw_COM_WithLandUse_070915.docx FOR OFFICE USE ONLY-SITE ADDRESS: 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. 1111 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT = . Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.ti and-or. v TO: ,rr DATE RECE ED: DEPT: BUILDING DIVISION s; EIVED JUL 8 2019 FROM: "'"t P-PD CITY OF TIGARD BUILDING DIVISION COMPANY: t_._ Ft i Q o ') St 6,13 jc-p_Pr-(' PHONE: ' p3 Sf> (1/2-f5 By: e RE: 11' 40 sw 17-,u-"F 2.01 -- 0OO to h (Site Address) (Permit Number) (Project name or subdivision name and lot nu •ser) ATTACHED ARE THE FOLL I 'I' S: Copies: Description: •11\ Copies: Description: Additional set(s) of plans:. Revisions: Cross section(s) and detail, Wall bracing and/or lateral analysis. Floor/roof framing. / Basement and retaining walls. Beam calculations. / Engineer's calculations. A Other(explain): /` L-1 6,WTI 1J h Pcjk-1J REMARKS: FOR OFFICE USE ONLY Routed to Permit,Technician: Date: / _ j I -- 1 ``� Initials:` Fees Due: ❑ es Fee Description: Amount Due: Special Instructions: Reprint Permit(per PE): ❑ Yes I Nov ❑ Don Applicant Notified: _Date: 77/1 76' . Initials Jr I:\Building\Forms\TransmittalLetter-Revisions_061316.doc FOR OFFICE USE ONLY—SITE ADDRESS: 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 = Transmittal Letter 114 T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.ti gur -or_;Dov TO: '461#e4 % DATE RE EIVED: DEPT: BUILDING DIVISION " ECEIVED DEC 19 2019 FROM: .J 6►vt. { urr-e.1 CITY OF TIGARD BUILDING DIVISION COMPANY: Ibreoutofrwl CoAsil-ut..,4ar Rom/wit-11; irt,'-.- PHONE: 6D5S4, `7760 By:4 77 RE: //R C1 4/'4C L` -a:J (a(P (Site Address) (Permit Number) 41-41/1‘)\. iSpekl,Sotry (Project name or subdivision naive and lot numb- ATTACHED ARE THE FOLLOWING T `► Copies: Description: � Copies: Description: Additional set(s) of plans. ►�,�� Revisions: Cross section(s) and details. \ Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: Aid c;>i e '!.<i� 'J -.lA l20// up akd Svc door 4-r vtcua-#kr S©tc-'J-k roll o f da:: r be 1Qwo v ed a r.d r ep le*e-Q d r os ik S re_4c clip ti-u'al eor' b(p ad, diAoa 1 4o Zkr ++rzwcal(, 6_cQ (AsIv 5u''L. FOR OFFICE USE ONLY Routed-o Permit TOmi an: Date: I _ ) c Initials: Fees DueN2 M No Fee Description: Amount Due: ) 4/ p, Vzees w $ $ $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes No �/ ❑ Done Applicant Notified: Date: LL /rgh h Initials: I:\Building\Forms\TransmittalLetter-Revisions 061316.doc