Permit (112) CITY OF TIGARD MASTER PERMIT
1 ' COMMUNITY DEVELOPMENT Permit#: MST2019-00282
i_i t;;Air 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/30/2019
Parcel: 2S111DB13000
Jurisdiction: Tigard
Site address: 15134 SW 96TH AVE
Subdivision: 1991-034 PARTITION PLAT Lot: 2
Project: MCNAMEE
Project Description: 203 sq. ft.sunroom addition. Adding wall cadet heater. New habitable space.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 0 First: 203 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 10 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 203 sf Value: $24,859.38 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
Drains: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 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'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 2
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:
ADD SF VB R-3 203
Owner: Contractor:
MCNAMEE,MELVIN CARL JR&RISA L OWNER Required Items and Reports(Conditions)
- 16134 SW8eTH-AVE
PORTLAND,OR 97224 15134 SW 96TH AVENUE
TIGARD,OR 9
PHONE: PHONE: 503-957-4759
FAX:
Total Fees: $1,252.62
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 y to folio, the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OA -001-009 Yo y obtay-co/of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: PP _
Permittee Signature: /, !- . `�Z�� LL.
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.
Building Permit Application
Residential , ► OR 011 I( 1. ► til.t l y►-1
14E( NED
INCity of Tigard "'" ! iew
ved E �y Permit No.:
;. " 13125 SW Hall Blvd.,Tigard,OR 97223 // / f i /yy_l r iPhone: 503.718.2439 Fax: 503.598.1960 JUL. 11 2 /
� / 1� • Other Permit:
Inspection Line: 503.639.4175 ! Date/Ry: /
T 1(;A K O p f Date Read/B Jury;
Internet: www.tigard-or.gov `e` �' '" 1 I RAI' Noti e y See Page 2 for
lri � !i, C % Supplemental Information
3Uti DING DIVISION
REQUIRED DATA:1-AND 2-FAMILY DWELLING
Permit fees*are based on the value of the work performed.
0 New construction ❑Demolition
Indicate the value(rounded to the nearest dollar)of all
ition/alteration/replacement 0 Other: equipment,materials,labor,overhead,anda p�ou t for the
,�, CATEGORY OF CONSTRUCTION work indicated on this application.d l�(�'js�
�t-and 2-family dwelling — Valuation: $
0 Commercial/industrial
0 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: / 9 /3 see,/c7 A 64.�/`�p g New dwelling area: 3 square feet
City/State/ZIP: y-i''i',9 a/2 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:7-77c, -7 4-�, Covered porch area: square feet
�� q
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I 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.
"V 3 - Valuation: $
j !.t/✓✓?,,-,K N r-i f i!r 2i GKI ,..vi,,,,,4, <0/ -c71"+.4
kg-zit„t, Wr.11 . 1n, ,c 0' Existing building area: square feet
Iv 47 b s,fv,r,_.L, New building area: square feet
0 PROPERTY OWNER ❑ TENANT Number of stories:
\Name: A4 I Ll eiL,r4.,. : A,C A/ ,40/z e 1.- Type of construction:
Address: /c.._5-7 3 q i AC2, /.. " Occupancy groups:
City/State/ZIP: /j CV/i-/ /j CIA //_v
j� � 7� ,2� Existing:
(iik Phone:(90;) - a 1 (1 3-"? Fax:( ) —
New:
0 APPLICANT
0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: / (Please refer to fee schedule
.7)- !d�70n/� Structural plan review fee(or deposit):
Contact name:
Address: FLS plan review fee(if applicable):
City/State/ZIP: Total fees due upon application: ( L.. yi
Fax::( ) _ Amount recetve3
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR
Fax:( ) Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name: eiinfer'-
Address:
City/State/ZIP:
Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
Permit Fee(includes plan review $180.00
Phone:( )
and administrative fees):
State surcharge(12%of permit fee): $21.60
CCB lie.:
Total fee due upon application: $201.60
Authorized signs / C This permit application expires if a permit is not obtained
1.- '1'--C t /-�6-e within 180 days after it has been accepted as complete.
Print " Or i! 224 c 2 Date: "tj - *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling Poll 01 1 1( I. 1 ovl.v
City of Tigard
Rec
Received Permit No.:
Dateive
13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
I Phone: 503.718.2439 Fax: 503.598.1960
0 Electrical 0 Plumbing 0 Mechanical
1 l C n R D 24-Hour Inspection Line: 503.639.4175
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les yo y k
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 • •
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0
3 Verification of approved plat/lot. ❑❑ 0
4 Fire district approval required. Name of district: 8
5 Septic system permit or authorization for remodel. Existing system capacity . ❑
0❑
6 Sewer permit. A
07 Water district approval. 8
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0
basin protection,etc. 0 0 0
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 0
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage. 0 0 0
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size
and location. 0 0 0
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater,
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 0 0
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc. 0 0 0
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable. 0 0 0
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non-
prescriptive path analysis provide specifications and calculations to engineering standards. 0 0 0
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load. ❑
20 Manufactured floor/roof truss design details. s B
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑
for four or more appliances. 0 0 0
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or
architect licensed in Ore.on and shall be shown to be a'slicable to the .r&ect under review.
.ILRISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 08 8
24 Two(2)sets each are required for Items 16, 19,20 and 22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. A
0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑❑ 0
27 "Drawn to scale"indicates standard architect or engineer scale.
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval. 0 0 0
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions,
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9,1995.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Electrical Permit Application
i.OR OH 1( lel: 0\1.1
City of Tigard d" Received
FEMORMMin
u 13125 SW Hall Blvd.,Tigard,OR 97223 " �'- Date/B
111111
Phone: 503.718.2439 Plan Review
nn q t, Date/B Related Permit#:
1 WARD
Email: TigardBuildingPermits@Tigard-or.gov 11;i_ i 1 Z.u 1J Ready Date/By: Js;
Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: Supplemental See Page 2 Informationnr
.li 3 Cit-. FIGA M�P
TYPE OF W i._ (C�t Nd'P PLAN REVIEW
❑New construction 0 Addition/alter • i� � � " Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ❑Othef: 0 Service or feeder 400 amps or more 0 Building over three stories.
" where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or
El1-and 2-family dwelling ❑Commercial/industrial0 Floating buildings.
0 Accessory building less to ground,or exceeds 14,000 0 Commercial-u
se agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder
0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
l' ❑Addition of new motor load of system.
Job#: Job site address:
1 c / 3e7 ..7 '?‘, t//499 1001-IP or more. ❑"A" "E","1-2" "1-3"
6e/J h )' �� ' 0 Six or more residential units. occupancy.
City/State/ZIP: /4--7/
V�/��„
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: /(it C A7/Xf(..:, 0 Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal.
FEE SCHEDULE
Description Qty. Each I Total
New residential single-ormulti-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
DESCRIPTION OF WORK Ea. 500 sq.ft.or portion 33.92 1
0) (teti/+ Limitedited energy,residential
61%0/C4- V\ t- �� i `( (with above sq.ft.) 75.00 2
V\
, 1 Limited energy,multi-family
�ADJV'�� residential(with above sq.ft.) 75.00 2
V�
Renewable Energy 0See Page 2
0 PROPERTY OWNER I 0 TENANT
Services or feeders installation,alteration,and/or relocation
Name: (t4'Le.. L‘,/,,,•‘.., c AA 1. /v/1�/f�Z c 200 amps or less 100.70 2
Address: r%5—/ 3 // �J 7 A v 201 amps to 400 amps 133.56 2
City/State/ZIP: L/ h �` 401 amps to 600 amps 200.34 2
i''zi'�{/ c d601 amps to 1,000 amps 301.04 2
Phone:(G-2-)3 __ , _/ �/ Over 1,000 amps or volts 552.26
( �� T 2
Email: � A6 �, Temporary services or feeders installation,alteration,and/or
1'‘ -•,� /14V /T - + caverj�? 1fi4v— relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or change,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: yyZ c -,:- K- C C - -_ Date: )—// /!-- 401 amps to 599 amps 168.54 2
' 0 APPLICANT I 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
Business name: A.Fee for branch circuits with
above service or feeder fee,
Contact name:
each branch circuit 7.42 2
B.Fee for branch circuits without (,('1
Address: branch
t feeder fee,first }�
circuit 56.18
City/State/ZIP: Each add'l branch circuit 7.42 2
2
Phone:( ) Miscellaneous(service or feeder not included)
Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
CONTRACTOR
Pump or irrigation circle 67.84 2
Business name: -
- _
- - or fil�S. --.- 6T.$4
Address: - Signal circuit(s)or limited-energy
panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Phone:( )
Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: I Electrical Lic.: I Suprv.Lic.: specifically listed('V hr min) 90.00/hr
Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES
Subtotal:
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
I This permit application expires if a permit is not obtained within 180
Print name: I Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB
C
4
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
FEE SCHEDULE
JPENTIAL WORK ONLY: Description I QtY• I Each I Total
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved: 5.01 to 15 kva 133.56 2
El Audio
to 25 kva 200.34 2
Audio and Stereo Systems*
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance 55226 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
>100 kva-no additional charge 0.0 3
❑ Vacuum Systems* Each additional inspection over allowable in any of the above:
Each additional inspection is 66.25/hr 1
❑ Other: charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/z hr min)
'EI:EC'1lttCAL'PERMtTE$"
CU 'WO Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 s Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ C• lock Systems
❑ Data Telecommunication Installation
El F• ire Alarm Installation
❑ HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
El Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
El Protective Signaling
El Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017
1,� ` Information Notice to Owners About
Construction Responsibilities
c (ORS 701.325 (3))
Homeowners acting as their own general contractors to construct a new home
or make a substantial improvement to an existing structure, can prevent many problems
by being aware of the following responsibilities:
• Homeowners who use labor provided by workers not licensed by the Construction Contractors
Board, may be considered an employer, and the workers who provide the labor may be considered
employees. As an employer, you must comply with the following:
• Oregon's Withholding Tax Law: Employers must withhold income taxes from employee wages
at the time employees are paid. You will be liable for the tax payments even if you don't actually
withhold the tax from your employees. For more information, call the Department of Revenue at
503-378-4988.
• Unemployment Insurance Tax: Employers are required to pay a tax for unemployment insurance
purposes on the wages of all employees. For more information, call the Oregon Employment
Department at 503-947-1488.
• Oregon's Business Identification Number(BIN): is a combined number for both Oregon
Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or go to
htti://www.oregon.gov/DOR/BUS/docs/211-055.Ddf for the appropriate forms.
• Workers Compensation Insurance: Employers are subject to the Oregon Workers Compensation
Law, and must obtain Workers Compensation Insurance for their employees. If you fail to obtain
Workers Compensation Insurance, you could be subject to penalties and be liable for all claim costs
if one of your workers is injured on the job. For more information, call the Workers Compensation
Division at the Department of Consumer and Business Services at 503-947-7815.
• Tax Withholding: Employers must withhold Social Security Tax and Federal Income Tax from
employee wages. You may be liable for the tax payment, even if you didn't actually withhold the tax.
For a Federal EIN number, call the IRS at 1-800-829-4933 or visit their website at www.irs.gov.
Other Responsibilities of Homeowners:
• Code Compliance:As the permit holder for a construction project, the homeowner is responsible
for notifying building officials at the appropriate times, so that the required inspections can be
performed. Homeowners are also responsible for resolving any failure to meet code requirements
that may be found through inspections.
• Property Damage and Liability Insurance: Homeowners acting as their own contractors should
contact their insurance agent to ensure adequate insurance coverage for accidents and omissions,
such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be
redone. Liability Insurance must be sufficient to cover injuries to persons on the job site who are not
otherwise covered as employees by Workers Compensation Insurance.
• Expertise: Homeowners should make sure they have the skills to act as their own general
contractor, and the expertise required to coordinate the work of both rough-in and finish trades.
CONSTRUCTION CONTRACTORS BOARD
700 Summer St NE, Suite 300, PO Box 14140, Salem, OR 97309-5052
Telephone: 503-378-4621 —Fax:503-373-2007
Website Address:www.oregon.gov/ccb
f/property_owner adopted 9-23-08 This Copy for Permit Applicant
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law requires residential construction permit applicants who are not licensed with the
Construction Contractors Board to sign the following statement before a building permit can be
. issued. (ORS 701.325 (2))
This statement is required for residential building,electrical, mechanical,and plumbing permits.
Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not
submit this statement. This statement will be filed with the permit.
Please check the appropriate box:
I own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB#
Expiration Date
I will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
Print Name of Permit Applicant
Signature of Permit Applicant Date
Permit#:
!.i-,1,.4.
Address: �I" '
• zn\III ='
• aura F%'*►►11
Issued by: Date: E13
This Copy for Permit Offices
11111 City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
•
T 1 c A R o Building Permit Review — Residential
Building Permit #: "ris7-094 IT Ur -.),
Site Address: /sl c73 9(
e-A /9142--
Project Name: MC , an,„„,___ Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Reviewe,,r: L, „ le ,; 47,,- :,; ,1 - 7I ,1v- ')L
Pro sal: £.' v r-ep . ---1_c -
Verify address/suite#active in Accela. OK $er Terra : Y No ❑ Yes,River Terrace Review Addendum
Sit Plan Elements:
Erosion Control
Dopies of site plan on 8-1/2"x 11"or 11 x 17"paper tri`�,tained trees with drip line and tree protection measures
Xawn to scale(standard architect or engineer scale) �1 .otprint of new structure(including decks)and FFE
rth arrow ! •
BILL_ty locations&easements(required for new and additions)e address,project or subdivision name and lot number .ewalk/driveway approach
ICDA..licant information(name and phone number) .• ,tion of wells/septic systems
r4.t dimensions and building setback dimensions 1,R -et tree size,type and location
I • are footage of buildings to be demolished 114 ,-et names
J E .ting structures on site i Corner elevations(2'contours if more than 4'differenti,,a_l,)/
,11'�.t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes L�N
im.ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown?131. � 1 Yes 1112‘
►�► lean Water Services—Service Provider Lettteu'(lot platted prior to 9/10/1995):
R:.uired: ❑ Yes,applicant was notified ,1[f No Received: ❑ Yes ❑ No
LS ` blic Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notifiedlld No Applie or: ❑ Yes ❑ No,stop intake
10and Use Case#: Zoning: _2 C—
J gnired Setbacks: Front: ' Rear: / Side: Street
Side:
___ _,/,19-' Garage:_ —a—din Height: Max. Height: 0 Actual Height: l0
ndscape
Area: % of Coverage Max: %
Entrance -t back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 •-
ees or less
Windows ❑ minim _°, of area of all street-facing facades
Garage ❑ Garage door is behin. ..'•- t street-facing wall , ❑ Yes a No,one of the following is met:
❑ Door extends no more than •a wall anti there• : overed porch extending beyond garage.
❑ Door extends no more than 5'from w.lc ocla-re is a 12 sq ft.window above garage on 2"d floor.
❑ Garage door width is ❑ 12'o - ❑ 50%or less o . ._• Cl 60%or less and includes 7 of following:
❑ Covered porch 5 'ecessed entrance ❑ Wall offset ■ ' •. eave ❑ Roof offset
.n-
-- ■ - '. --, _ _ _ _-----='.-;•... _--•_:._ .-_. ■---,--; j,,-argam.r=41311 Dormer
ill
Accent siding �❑/Window trim CI Window recess ❑ Window projection C,lcony
��1 isual Clearance ? rban Forestry P n
to sitive Lands: ❑ Yes V No Type:
L ► onditions met prior to issuance of building permit
j‘s:
Approved By Planning:
r — z, Date: - "0
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
i:\BuildirtgWonns\BldgPermitRvw_RES_022819.docx
Building Permit Submittal
Original Submittal Date: S.//f
Site Plans: #
Building Plans: #
Building Permit#: ❑ Enter building permit#above.
Workflow Routing: ❑ Planning ❑ Engineering ❑ Permit Coordinator ❑ Building
Workflow Sign-off: El Sign-off for Planning(include notes from planning review)
Route Application Documents: El 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: /LiM 1.t" 4.446.• r 314/
By Permit Technician: /_
Date: '7/j S
Engineering Review
'Slope at building pad: or
E"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: El Yes ErNo
Assess Water Quantity Fee in-lieu: Cl Yes ErNo
LIDA Facility on lot: ❑ Yes 0No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
-ET Approved by Engineering: r
Date: 7(2 Viii9
Revisions (after Building Submittal only)
Reviewer Date
Revision 1: Cl Approved ❑ Not Approved
Revision 2: ❑ Approved El Not Approved
Revision 3: El Approved ❑ Not Approved
Permit Coordinator Review
El 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:
Reision Notice 3: Date Sent to Applicant: /
vvi
DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes LId' N/A
Tigard Trans SDC: ❑ Yes �,N/
Parks SDC: CIYes [ /A
LIDA El Yes N/A
Et
OK to Issue Permit rC�'
i Coordinator: mKDate: /'/ Z 5i11‘/ \
Approved by Permit
1:\Building Worms\B1dgPermitRvw_RES_022819.docx