Permit IN ,l CITY OF TIGARD MASTER PERMIT
. ': COMMUNITY DEVELOPMENT Permit#: MST2019 00066
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/22/2019
Parcel: 2S110AC04000
Jurisdiction: Tigard
Site address: 11081 SW ANNAND HILL CT
Subdivision: ANNAND HEIGHTS Lot: 17
Project: Annand Heights, Lot 17
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 774 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 27 Bathrooms: 3 Second: 1135 sf Garage: 380 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 1909 sf Value: $245,480.05 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains. 0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'500 sf: 3 201-400 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+a m p/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: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 1909
Owner: Contractor:
ANNAND HILL LLC WINDWOOD CONSTRUCTION INC Required Items and Reports(Conditions)
BY RICHARDS,M DALE 12655 SW NORTH DAKOTA 1 Ersn Cntrl 503-639-4175
12655 SW NORTH DAKOTA ST TIGARD,OR 97223 2 Geo Tech Report Required
TIGARD,OR 97223 Prior To Pour
PHONE: 503-780-4375 PHONE: 503-625-6526
FAX: 590-7606
Total Fees: $30,413.73
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 co y rLthP rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ik- r--. Permittee Signature:
C. : .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• S
Residential FOR OFFICE USE ONLY
City of Tigard RECEI ':-' Permit No
- a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 3 t 1 R��^)r�
Phone: 503.718.2439 Fax: 501598.1960 telly: -1 Other Permit: `w V
FEB 2 7 201 Saris: 0 See Page 2 for
TIGARD Inspection Line: 503.639.4175 to Ready/By: rI i � Supplemental Information
Internet: www.tigard-or.gov CITY OF TIGAH�ifiea hod:J PP
LDING -F •
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
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. �Q�
�' Valuation: $ (�"� c/� (1 V0
z i-and 2-family dwelling ❑Commercial/industrial
Number of bedrooms:
0 Accessory building 0 Multi-family
0 Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION/ Total number of floors: Z 9
Job site address: /1 (,j "k) ,4A,and //,d4 e C/(,�/--'f _New dwelling area: /' 1 ' square feet J 12,c—
City/State/ZIP:
?,��
City/State/ZIP: .'�t��av�fi-/Lp Q 25 q-72. ._3 Garage/carport area:090 square feet L7✓111
Suite/bldg./apt.no.: Project name: nn,4 nd Bet" A46. Covered porch area: square feet
Cross street/directions to job site: so'!�'1--1) Deckarea: �O square feet
` Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: n/IQ Ad Alio f( /5 Lot no.:/7 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.
S P/2 Valuation: $
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: 144-MD (uOo J CO/LS ti- 1tT.POAJ Type of construction:
Address: /02,4,6---5- 5� Iva/L�h Da.kd /Lc.. 61,1-pre." Occupancy groups:
City/State/ZIP: T/ Q/-7,./ Q'2--.2.3 Existing:
Phone:(5-03 706'...-4-1376.- Fax:(513)) 1 U'7: ) : New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: ,/n e Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Amount received:
Phone:( ) Fax: :( )
J J Q/�1HOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: (Aim Quf�d esNa, �� Ce / 'CO "I
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
ti 1/, ' / dt. ,,-5 74,101„c__ Submit two(2)sets of roof plan with connection details
Business name: and fire department access,along with the 2010 Oregon
Address: /x655 51.E Nit C'i / 4_k 'AL 01 st Solar Installation Specialty Code checklist.
City/State/ZIP: 2 q��2
�/ t Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ,3) - ge -416 7$r Fax:( Sy- 69t--zad‘ State surcharge(12%of permit fee): $21.60
CCB lic.: 5-0/96, Total fee due upon application: $201.60
Authorized signature = This permit application expires if a permit is not obtained
i = within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name: ,';'/ _.,,E.,,_ . s- Date: Service Board.
l:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Applicatiol Ft. _,OFFICE USE ONLY
City of Tigard Date/By:dReceivePermit No., ik )v -
III "I 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960
RECEIVE Ila. Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris El See Page 2 for
Internet: www.tigard-or.gov FEB 2 7 2019 Notified/Method: Supplemental Information
TYPE OF WORK 6iTY UI- (i&ARD COMMERCIAL FEE" SCHEDULE - USE CHECKLIST
BUILDING DIVISION Mechanical permit fees*are based on the value of the work
)214'w construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
'"and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
Heating/cooling:
JOB SITE INFORMATION AND LOCATION, Air conditioning 46.75
Job site address: 104 ,54.1- 19-444.4.1 /h`/ /04pitFurnace 100,000 BTU(ducts/vents) .,'"'''. 46.75
City/State/ZIP: 7,t /7j (1Z 972.23 Furnace 100,000+BTU(ducts/vents) 54.91
` Heat pump 61.06
Suite/bldg./apt.no.: Project name: 4, `G,g- Duct work 23.32
/�
Cross street/directions to job site: /o .4.-- (� Hydronic hot water system 23.32
1� 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 23.32
Other: 23.32
Subdivision: mtn4Ad hke 0 it 71-5Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater .- 23.32
DESCRIPTION OF WORK Gas fireplace/insert ..''''' 33.39
Flue vent for water heater or gas
JC& <S'F1-- fireplace - 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
elfrfROPERTY-OWNER 0 TENANT
Environmental exhaust and ventilation:
Name: A)rtdio d X1.57/ Range hood/other kitchen
V/- /� equipment 33.39
Address: �6 5-5- 5C) /Vdf/A I&.&/ 5 fire---/ Clothes dryer exhaust .0,- 33.39
:
Cit /State/ZIP ( G C� 1.2�.3 Single-duct exhaust(bathrooms,
Y G�rrpp'Z y otoilet compartments,utility rooms) 0 23.32
Phone:( 5-0 3 .76 d - 76--- Fax:.3) gyp -74"06 Attic/crawlspace fans 23.32
LICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: 30 At.e $14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address: Wall/suspended/unit heater
City/State/ZIP: Water heater
Fax: : Fireplace
Phone:( ) ( ) Range
E-mail: 14.)/q (J -caC "t S/V a->&9(9,/11 C.c-1 I t (x" Barbecue
CONTRACTOR` Clothes dryer(gas)
Other:
Business name: F€rr l (14 d/
MECHANICAL PERMIT FEES*
Address: /3/55 /
_ "
'/ ielm,5 / ç' lot. Subtotal
�-y
City/State/ZIP: d/l �' 0/) y �[Jy� Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: 726;,3TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: Date: ,f).-7//g
I lRuildine\Permits\MEC PermitAoo 040 13.doc 440-4617T(I 1/02/COM/WEB)
Electrical Permit ApplicationF. __OFFICE USE ONLY
City of Tigard ������� Received
DateB Permit#:. ` ib r_C
- i 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 2 7 2019 Plan Review
•
• Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 CITY OF TIGAR 11 Ready Date/By: loris El See Page 2 for
-"GARP Internet: www.tigard-or.gov Supplemental Information
BUILDING DN►SI��
TYPE OF WORK PLAN REVIEW
New construction ❑Addition/alteration/replacement
Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF_CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
0 1-and 2-family dwelling ❑Commercial/industrial Accessory building amps for all other installations. buildings.
0 Multi-family ❑Master builder 0 Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#: Job site address:11,6,6 A^n ct,idA ii (6„,„,f looHP or more. ❑"A","E","I-z","1-3",
i ❑Six or more residential units. occupancy.
City/State/ZIP: / `t� 9�,,' 0 Health-care facilities. 0 Recreational vehicle parks.
`J ❑Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.#: Project name: 9-A�x 1 600 volts nominal.
/' 0 Service or feeder 600 amps or more.
Cross street/directions to job site: //AU tb FEE SCHEDULE
VV7 Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: nnnan.rf /L . Lot#:/7 Includes attached garage.
A-
6 1,000 sq.ft.or less il 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 I
DESCRIPTION OF WORK > Limited energy,residential 75.00 2
(with above sq.ft.)
$fjLt�f � � Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
OPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: I()atri lArddc/ 61,s (JIL4 Jll-- 200 amps or less 100.70 2
�},� 1 201 amps to 400 amps 133.56 2
Address: p�—�5,`S' �'C�} /�,/l'`44 Gl•�(/� 67/' 1 401 amps to 600 amps 200.34 2
City/State/ZIP: /C6 etzei ce.t. v•-0..23 601 amps to 1,000 amps 301.04 2
Phone:(' • 7,00...../1/3 7s-- Fax:(5v3 )5-90 —7414 Over 1,000 amps or volts 552.26 2
,, y� Temporary services or feeders installation,alteration,and/or
Email:�//IIC1 u/Aicfc1 l-cYP1 S /vv.) � (p v'et�(� / ,i-a/it
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature:
Date: 401 amps to 599 amps 168.54 2
Branch circuits—new,alteration,or extension,per panel
TCANT 0 CONTACT PERSON A.Fee for branch circuits with
Business name: ,' j nt,. above service or feeder fee,
7.42 2
l./'' each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: branch circuit
Each add'1 branch circuit 7.42 2
City/State/ZIP:
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Or-ca sc `��1 L
t� / Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: .. ,:la/ C.' deIt f—(/,q�/ p® panel,alteration,or extension. 0 See Page 2 2
1!y Each additional inspection over allowable in any of the above
City/State/ZIP: 0,- A(,& C.c. er2.3-5 Additional inspection(1 hr min) 66.25/hr
Phone:(�cj3) '7 ....6.-71,1 Fax:(51/3) ‘9'—97?-3 Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email: Inspections for which no fee is 90.00/hr
CCB Lic.://‘0.7c2.4 Electrical Lic.:L.-®efe Suprv.Lic.:11. Os specifically listed('/z hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name i (7,"3 kik/iv Date: 217-7/19 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
f.%________ TOTAL PERMIT FEE:
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name: c ,A r(, ma ,4., 4 Date: 9 7//r days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:`Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/15 440-41i 5T(11/05/COM/WEB
Electrical.Permit Application City >,lication— of Tigard •
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
riFee for all residential systemscombined: $75.00 Den QtY. Eacn ) Total
Reenn ewwaable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
L 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
with OAR 918-309-0040) 552.26 2
Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ V• acuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
n Other: Each additional inspection is 66.25/hr ]
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00
*
(SEE OAR 918-309-0000) Number of inspections allowed per permit.
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n C• lock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
fl Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
n M• edical
n Nurse Calls
❑ Outdoor Landscape Lighting*
_ Protective Signaling
' ❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1\Building'Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
Plumbing Permit Applicatio.
Building Fixtures FOR OFFICE USE ONLY
Received
Ci of Tigard Permit No..
Ili - n 13125 SW Hall Blvd.,Tigard,OR 97223 ECEIVE ate By: 1 1STc91 {"\"wake� i
Phone: 503.718.2439 Fax: 503.598.19 tan Rewew
ateBy: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris H See Page 2 for
Internet: www.tigard-or.gov FEB 2 7 2019 Notified/Method: Supplemental Information
TYPE OF WORK litlY OF TIGARD FEE* SCHEDULE
ew construction ElD itiO111NG DIVISION For special information use checklist.
j Description Qty. 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
/IE1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath L 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
E Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: /1(1 g( � nA fQ� ��4 I/ r-4 Catch basin or area drain 18.76
�� Drywell,leach line,or trench drain 18.76
City/State/ZIP: f I
Tx'72-23 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:igiviaric,a4, A,LI Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
/®S I-17 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: Mi nli.1.l li-es 05 Lot nol Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
t� 51=12- Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: J/nC/t 6)a cl e ,L51- i Q,, Fixture/sewer cap 25.02
� // 7 �i� 5-04--.L.6 .--1Floor drain/floor sink/hub 25.02
Address:
A.9..‘
C �'el® �ra '/ Garbage disposal 25.02
City/State/ZIP: T� (7-24,2,..4,2,3 Hose bib 25.02
Phone:( `2.,b a- '20 7S Fax:(.5--c,35-9. --704" Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: 5aen Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
E-mail: Ai/A-(i • y_ A-u"-es N4-7 Kr cili aisle (t� Urinal 25.02
CONTRACTOR Water closet 25.02
�'A /%m,h f/y /0 Water heater 37.52
�Qr
Business name: Water piping/DWV 56.29
Address: /6,// ) 5 ! `1 tjj / Other: 25.02
City/State/ZIP: orctut F d/t f775- Subtotal
Phone:(5V5) 7g2-3 -erg Fax:(5G3) 7• ,3,girl/ Minimum permit fee: $72.50
CCB Lic.: f/ ..2 /3 9 Plumbing Lic.no.3 0`O Plan review (25%of permit fee)
/ / State surcharge(12%of permit fee)
Authorized signature: 7!i!z-UTOTAL PERMIT FEE
Print name: n lc}kt Date: p . ).-Wii This permit application expires if a permit is not obtained within 180 days
t{/ J / after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(]0/02/COM/WEB)
1114 City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
l l C.A R l) Building Permit Review — Residential
Building Permit #: mT (TI LL
Site Address: //col ' /X) I M'/1 (? it 1
Project Name:
/91;4.3n /' 4 Lot #:
(New dwelling=subdivisione;Addition or Alteration=last name of owner) 1
Planning Review l
Proposal: IU-eit�`�
4erify site address/suite#exists and activ ermit system.
p Y
ver Terrace Neighborhood: Og No ❑ Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
ee(3)copies of site plan 10.'I+':xisting structures on site
co:hito plan must be on 8-1/2"x 11"or 11 x 17"paper a Footprint of new structure(including decks)with finished
Lawn to scale(standard architect or engineer scale) oor elevations
trth arrow • ty' locations&easements(required for new and additions)
o address,project or subdivision name and lot number v Sid walk/driveway approach
ai plicant information(name and phone number) !� :cation of wells/septic systems
Lfigot dimensions and building setback dimensions R Existing trees to be retained with dripline,and
m e:uare footage of buildings to be demolished .rotection measures
FA Lot area,building coverage area,percentage of coverage and 10':eet tree size,type and location
}tnpervious area(applicable if R-7,R-12,R-25&R-40)
Street names
Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? `VJYes ❑
4 foot differential)
If es,is a storm water •uali , facili shown? r1 Yes o
1 11�
ean Water Services—Service Provider Lettof platted prior to 9/10/1995):
Required: CIYe applicant was notified No Received:
11 0 Y;s. 0 No
Public Faciliti Improvement(PFI) Permit:
Required: Yes,applicant was notified 0 No Applied For: Yes 0 No,stop intake
Lliill7),A-aUse Case#: �` CS c"--4,t)00 y
r-
/Zoning: e_) P ))
/
equired Setbacks: Front /, Side � Street Side
�� Ni —Garage
andscape Requirement: ,,,,9 00/0
Frr
Z Coverage Maximum: ��
IL�1 Building Height: Maximum Height '' J IJ
t$ '`�'� Actual Height •. t (p
0 l isual Clearance
ensitive Lands: 0 Yes 0 No Type =W
ga rban Forestry Plan Cf/if-,...c
IV Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: '
—
Date: ,—.244ISPF
Revisions (after Building Submittal only) Reviewer
Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\Bu ilding\Forms\BldgPermitRvw_RES_061417.docx
Building Permit Submittal
Original Submittal Date: aln-.1 lq
Site Plans: # ___k_
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: ErPlanning Engineering Permit Coordinator R'Building
Workflow Sign-off: 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:
,4(
By Permit Technician: 1�`y. Date
Engineering Review
Er Slope at building pad: 42 s7..
Er-Conditions"Met"prior to issuance of building permit
ErEasements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility: �`
Assess Water Quality Fee in-lieu: ❑ Yes i No
Assess Water Quantity Fee in-lieu: 0 Yes No
LIDA Facility on lot: 0 Yes No
0'Final Plat Recorded:
0 NOT Approvedb Engineering: Date:
Y � �:
Notes: Gann cci- ,rad;,) oipg.'•r{f A coal', 5.7‘70-ell lade.-ed
[ I' Approved by Engineering: 6.,,.t.1 t?, . S.-k- Date: 2 - 27. 1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant
Revision Notice 2: Date Sent to Applicant
• ion Notice 3:lSDate Sent to Applicant:
1.
DC Fees Entered:
Wash Co Trans Dev Tax: s R' �fr A
Tigard Trans SDC: s I' 11,‘ A
Parks SDC: Yes `'
LIDA 0 YesN/A
OK to Issue Permit 2)24; Q
Approved by Permit Coordinator: Date: r
I:\Building\Forms\BldgPermitRvw_RES 010118.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.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Il
_ Transmittal Letter
T I G A R[) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: &Cal_ DATE RECEIVED:
DEPT: BUILL7NG DIVISION
RECEIVED
/' , MAR - 2619
FROM: 4/ t A c4CU d d
COMPANY: BUI Df . ,
By: �
PHONE: SZ3 7�7 _ /3 7.--
RE: //() f/ ,4 AJ /7 / L 7 Ar ?-Q96 6
(Site Address) (Permit Number)
14—/?
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
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): ,r^
REMARKS: /1,2,4,....) 74-t iy S 5 ; / J / Jl dj/('4) 7 —,
r47 S-e-e/ /(--7 "
FO7 OF ICE USE ONLY
Routed to Pe it Tec cian: Date: 3 g Initials: Afir
Fees Due: Ye ❑ No Fee Descrlpti : Amount Due:
1 — 1 c.Lv v-(1/•-) $ (I S
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes /' WTo ❑ Done,o_
Applicant Notified: Date: 3l( � l) Initials:
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
. 11 Transmittal Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.ti l and .r.l ov
TO: DATE REP IVED:
DEPT: BUILDING DIVISION
,� / '9
FROM: �� 4,,C./2�i FEBFE3 1 4 '
C,1
r COMPANY: (/1 / n dw a0j,, O7e5 BUIL' /
PHONE: 5-0 3 - 756 2---/ 3 7 / CNA
RE: / '0 e/ /1- iAGp{, 1, / T M57 /-060e,G
(Site Address) (Permit Number)
P170N6/ /f, a / / 6 -1-(7
(Pr ect name or subdivision name a�ot num.
ATTACHED ARE THE FOLLOWING ITE► S:
Copies: Description: Copies: Description:
Additional set(s) of plans. , / Revisions:
Cross section(s) and ay `,`fir i Wall bracing and/or lateral analysis.
Floor/roof framing. \ Basement and retaining walls.
TI
Beam calculations. - Engineer's calculations.
Other(explain): /
REMARKS: `� /U%5,?`, _ fcc/15/o'4- —
FOR FFICE USE ONLY �Q
Routed to Permit Tee Wan: Date- /11/Z Z c _ Initials: +
Fees Due: ❑ Yes i 2 o ee Descnp on: Amount Due:
$ (pC,
o .e.
NN) _._
Special
Instructions:
Reprint Permit(per PE : ❑ Yes ❑No ❑ Done
4_,
Applicant Notified:v Date: �-If/ ALo Initials:
I:1Building\Forms\TransmittalLetter-Revisions_061316.doc