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Permit (2) III a TIGARD City of Tigard November 8, 2019 Sage Built Homes 1815 NW 168th P1 Beaverton, OR 97006 Re: Permit No. MST2019-00360 Dear Applicant: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: 9714 SW Windswept P1 Project Name: Canyon Court,Lot 8 Job No.: N/A Refund: ® Check#233862 in the amount of$1,453.64. ❑ Credit card "return" receipt in the amount of$ . ❑ Trust account"deposit"receipt in the amount of$ . Notes: Due to staff error, a payment was made on the wrong permit,resulting in an overpayment. Refund difference of$1,453.64. If you have any questions please contact me at 503.718.2430. Sincerely, e;9v-o--„ Dianna Howse Building Division Services Coordinator Enc. I:\Building\Refundsl\AdnunisS.W tr1 tvke•aTd1Za0C/t,�fegon 97223 • 503.639.4171 it Re ay: 5'3.684.2/772" • www.tigard-or.gov :III I ill Cityof Tigard 1 c n u D Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Sage Built Homes DATE: 11/1/2019 1815 NW 168' P1 Beaverton, OR 97006 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt#: 426403 Case #: MST2019-00360 Date: 10/14/2019 Address/Parcel: 9714 SW Windswept P1 Pay Method: CreditCard Project Name: Canyon Court,Lot 8 EXPLANATION: Due to payment error on the wrong permit,an overpayment resulted. Refund 100%of overpayment. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Cash Over 100-0000-48001 $1,453.64 TOTAL REFUND: $1,453.64 APPROVALS: SIGNATU ES/ E: If under$5,000 Professional Staff If under$12,500 Division Manager If under$25,000 Department Manager If under$100,000 City Manager If over$50,000 Local Contract Review Board FOR ACCELA SYSTEM ADMINISTRATION USE ONLY d1�� w Case Refund Processed: Date: '73 /j./ By: I:\Building\Refunds\RefundRequest.doc x 09/01/2010 CITY OF TIGARD RECEIPT a 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: Canyon Court, Lot 8 Site Address: 9714 SW WINDSWEPT PL 72-66.11\7_6 Receipt Number: 436191 - 09/03/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2019-00360 $-1,453.64 Total: $-1,453.64 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 233862 DHOWSE 09/03/2021 $-1,453.64 Payor: Sage Built Homes Total Payments: $-1,453.64 Balance Due: $1,453.64 Page 1 of 1 uam+..,_-.... ru nr., L, g..vu.. yrm.wx y.,.. .,u. ,aa •.,�. v.v, u CITY OF TIGARD RECEIPT $ 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 Tt(3ARI) Project Name: Canyon Court,Lot 8 Site Address: 9714 SW WINDSWEPT PL /v -4/� P11-sF .,_ Receipt Number: 426403 - 10/14/2019 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2019-00360 Building Permit-New Construction 230-0000-43104 $1,499,32 MST2019-00360 Plan Review 230-0000-43106 $1.34 MST2019-00360 12%State Surcharge-Building 100-0000-24001 $179.92 MST2019-00360 DC Provision Review,SF-Ping 100-0000-43112 $102.00 MST2019-00360 Info Process/Archiving-Lg$2.00(over 230-0000-43135 $36.00 11x17) MST2019-00360 Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $21.50 11x17) MST2019-00360 Metro Const. Excise Tax 230-0000-24010 $290.55 MST2019-00360 Tig-Tual School CET-Residential 230-0000-24102 $2,454.30 MST2019-00360 Permit Fee-Elect(SF or 1st MF 220-0000-43103 $270.30 dwelling unit) MST2019-00360 Limited Energy 220-0000-43103 $75.00 MST2019-00360 12%State Surcharge-Electrical 100-0000-24001 $41.44 MST2019-00360 Air Conditioning 230-0000-43102 $46.75 MST2019-00360 Furnaces< 100K BTU 230-0000-43102 $46.75 MST2019-00360 Water Heater 230-0000-43102 $23.32 MST2019-00360 Gas Fireplace 230-0000-43102 $33.39 MST2019-00360 Range Hood/Other Kitchen 230-0000-43102 $33.39 MST2019-00360 Clothes Dryer Exhaust 230-0000-43102 $33.39 MST2019-00360 Single Duct Exhaust(Bathrooms,Toilet, 230-0000-43102 $116.60 Utility Rooms) MST2019-00360 Fuel Piping 230-0000-43102 $14.15 MST2019-00360 12%State Surcharge-Mechanical 100-0000-24001 $41.73 ' MST2019-00360 SFR-Baths 230-0000-43101 $500.32 MST2019-00360 12%State Surcharge-Plumbing 100-0000-24001 $60.04 MST2019-00360 Erosion Control w/Development 640-0000-43134 $311.40 MST2019-00360 Plan Review 230-0000-43106 $223.22 MST2019-00360 Wash Co Trans Dev Tax-SF Detached 405-0000-43320 $8,968.00 MST2019-00360 Tigard Trans SDC Improvement-SF 415-0000-43300 $6,335.00 Detached MST2019-00360 Tigard Trans SDC Reimbursement-SF 415-0000-43301 $365.00 Detached MST2019-00360 Parks SDC Improvement-SF Dwelling 425-0000-43300 $5,523.00 (detached/attached) MST2019-00360 Parks SDC Reimbursement-SF 425-0000-43301 $1,530.00 Dwelling (detached/attached) MST2019-00360 Parks SDC Neighborhood-SF Dwelling 425-0000-43300 $2,048.00 (detached/attached) MST2019-00360 Cash Over 100-0000-48001 $1,453.64 <-- Total: $32,678.76 Page 1 of 2 i Receipt Number: 426403 - 10/14/2019 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Fund Transfer DHOWSE 10/14/2019 $32,678.76 Payor: Total Payments: $32,678.76 Balance Due: $0.00 Page 2 of 2 Q BUBBLE-SHEET'Deep Clean, X , Dr.Diana Schwarzbein,Endo X PayGov-Edit Orders }f ( PayGt v - XFirk Social Security- - https://adrnin.paygov.usfMair�tiEditOrders.aspx ••• Q � � El)Reports .. PI .--. � f .. n g _ Aflac t 0365 «; i�! Admin Amex !:� PMT 4-�KEY FB Cr' TransLink NewReports2 t+:! IF �ONB !�! DC Trello Online Ticket Ports Sign In (�+i ount Management Edit Bank Info Manager Orders Manage Gateway Trans Log Manage Agency Reports Tax Report ACH Detail Card Types Ai 5647671 ® Card Holder Name: Search Payment Service Transaction Agency Gateway Agency Agency Paymenttotai Service Fee to Methgt Fee IyPe Nacre N IC.ID Credit PERMIT PERMIT 10/10/2019 (971) Etna Card 5835.00 175.05 CENTER CENTER Other :221 63880 5.08.14 PM P(anning@sagebuilthomeslic.com 336 6911 Re° _eway Data for Orderld 5647671 Issue Refund On Payment Only Refund Amount: 43.61 — /fp, Reason { Void Payment Only Void Service Fee Only _ Refund Service Fee Only Tigard-PERMIT CENTER 20066 see t Q ® d Dianna Howse From: Dianna Howse Sent: Friday, November 1, 2019 9:52 AM To: Supervisor;Cal Cc: #Building Permit Technicians Subject: RE: Refund Request Importance: High Hello, I have not had a response to this refund request from 3 weeks ago. Please provide me a copy of the refund receipt for$43.61 for this transaction as soon as possible. Thank you. Dianna L. Howse Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits From: Dianna Howse <Dianna@tigard-or.gov> Sent:Tuesday, October 22, 2019 2:04 PM To:Supervisor<Supervisor@paygov.us>; Cal<cal@paygov.us> Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: Refund Request Importance: High Hello, I sent this request for a refund on 10/15 and have not received a reply back. Can you please respond to let me know the status of this refund as I informed the customer that they would have the refund show on their statement within 2-5 business days. Thank you. Dianna L. Howse Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits From: Dianna Howse Sent:Tuesday, October 15, 2019 4:26 PM To: Supervisor<SupervisorPpavgov.us> 1 Cc:#Building Permit Technicians<TigardBuildingPermits@tgard-or.gov> Subject: Refund Request Importance: High Hello, On 10/10/2019 a customer was instructed to pay permit fees of$32,678.76 for permit MST2019-00349 (see order number 5647682), however this was the wrong permit. The correct permit was MST2019-00360 with fees due in the amount of$31,225.12. I have made the corrections to our permit program by transferring the funds from one permit to the other, and they will receive a refund for difference or overpayment in the amount of$1,453.64, however the customer should also be refunded for the 3%card service fee on this amount for a total of$43.61 as shown below. ORDER#: 5647671 10/10/2019 Permit fees paid in error: $ 32,678.76 Permit fees should have paid: $ 31,225.12 Amount overpaid: $ 1,453.64 Card service fee overpaid: 3% PayGOV refund amount: $ 43.61 I have attached receipt documents to support the refund as follows: • Receipt#426371 for$32,678.76 paid on 10/10/2019. • Receipt#426403 for$32,678.76 transferred on 10/14/2019 showing a line item for'cash over' in the amount of $1,453.64. Thank you and please let me know as soon as the refund has been processed. Dianna L. Howse Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule." 2 Dianna Howse From: Dianna Howse Sent: Tuesday, October 15, 2019 4:26 PM To: Supervisor Cc: #Building Permit Technicians Subject: Refund Request Attachments: SKM_C554e19101516320.pdf Importance: High Hello, On 10/10/2019 a customer was instructed to pay permit fees of$32,678.76 for permit MST2019-00349 (see order number 5647682), however this was the wrong permit. The correct permit was MST2019-00360 with fees due in the amount of$31,225.12. I have made the corrections to our permit program by transferring the funds from one permit to the other, and they will receive a refund for difference or overpayment in the amount of$1,453.64, however the customer should also be refunded for the 3%card service fee on this amount for a total of$43.61 as shown below. ORDER#: 5647671 10/10/2019 Permit fees paid in error: $ 32,678.76 Permit fees should have paid: $ 31,225.12 Amount overpaid: $ 1,453.64 Card service fee overpaid: 3% PayGOV refund amount: $ 43,61 I have attached receipt documents to support the refund as follows: • Receipt#426371 for$32,678.76 paid on 10/10/2019. • Receipt#426403 for$32,678.76 transferred on 10/14/2019 showing a line item for'cash over' in the amount of $1,453.64. Thank you and please let me know as soon as the refund has been processed. Dianna L. Howse Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits 1 11111 CITY OF TIGARD RECEIPT * 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 iiC AiiP7, Project Name: Willow Brook, Lot 5 Site Address: 11444 SW GABRIEL ST Receipt Number: 426371 - 10/10/2019 I 1 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2019-00349 Building Permit-New Construction 230-0000-43104 $1,822.26 MST2019-00349 Plan Review 230-0000-43106 $1.34 MST2019-00349 12%State Surcharge-Building 100-0000-24001 $218.67 MST2019-00349 Wash Co Trans Dev Tax-SF Detached 405-0000-43320 $8,968.00 MST2019-00349 Tigard Trans SDC Improvement-SF 415-0000-43300 $6,335.00 Detached MST2019-00349 Tigard Trans SDC Reimbursement-SF 415-0000-43301 $365.00 Detached MST2019-00349 Parks SDC Improvement-SF Dwelling 425-0000-43300 $5,523.00 (detached/attached) MST2019-00349 Parks SDC Reimbursement-SF 425-0000-43301 $1,530.00 Dwelling (detached/attached) MST2019-00349 Parks SDC Neighborhood-SF Dwelling 425-0000-43300 $2,048.00 (detached/attached) MST2019-00349 DC Provision Review, SF-Ping 100-0000-43112 $102.00 MST2019-00349 Info Process/Archiving-Lg$2.00(over 230-0000-43135 $42.00 11x17) MST2019-00349 Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $30.50 11x17) MST2019-00349 Metro Const. Excise Tax 230-0000-24010 $378.25 MST2019-00349 Tig-Tual School CET-Residential 230-0000-24102 $3,111.75 MST2019-00349 Permit Fee-Elect(SF or 1st MF 220-0000-43103 $304.22 dwelling unit) MST2019-00349 Limited Energy 220-0000-43103 $75.00 MST2019-00349 12%State Surcharge-Electrical 100-0000-24001 $45.51 MST2019-00349 Air Conditioning 230-0000-43102 $46.75 MST2019-00349 Furnaces< 100K BTU 230-0000-43102 $46.75 MST2019-00349 Water Heater 230-0000-43102 $23.32 MST2019-00349 Gas Fireplace 230-0000-43102 $33.39 MST2019-00349 Range Hood/Other Kitchen 230-0000-43102 $33.39 MST2019-00349 Clothes Dryer Exhaust 230-0000-43102 $33.39 MST2019-00349 Single Duct Exhaust(Bathrooms, Toilet, 230-0000-43102 $93.28 Utility Rooms) MST2019-00349 Fuel Piping 230-0000-43102 $14.15 MST2019-00349 12%State Surcharge-Mechanical 100-0000-24001 $38.93 MST2019-00349 SFR-Baths 230-0000-43101 $500.32 MST2019-00349 12%State Surcharge-Plumbing 100-0000-24001 $60.04 MST2019-00349 Erosion Control w/Development 640-0000-43134 $386.40 MST2019-00349 Plan Review 230-0000-43106 $433.13 MST2019-00349 Backflow Preventer 230-0000-43101 $31.27 MST2019-00349 12%State Surcharge-Plumbing 100-0000-24001 $3.75 Total; $32,678.76 Page 1 of 2 Receipt Number: 426371 - 10/10/2019 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 5647682 PUBLICUSERO 10/10/2019 $32,678,76 Payor: Total Payments: $32,678.76 Balance Due: $0.00 Page 2 of 2 li CITY OF TIGARD MASTER PERMIT 1 . COMMUNITY DEVELOPMENT Permit#: MST2019-00360 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/14/2019 Parcel: 1S135CD16100 Jurisdiction: Tigard Site address: 9714 SW WINDSWEPT PL Subdivision: CANYON COURT Lot: 8 Project: Canyon Court, Lot 8 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 680 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1138 sf Garage: 400 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1818 sf Value: $242,124.28 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 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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+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: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 1818 Owner: Contractor: MAOZ LLC SAGE BUILT HOMES Required Items and Reports(Conditions) 1800 NW 167TH PL STE 150 1815 NW 168TH PLACE 1 Ersn Cntrl 503-639-4175 BEAVERTON,OR 97006 BEAVERTON,OR 97006 PHONE: PHONE: 971-221-4597 FAX: 503-533-5164 Total Fees: $33,428.76 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 rul- et forth in OAR 952-001-0010 throu OAR 952-001-0090. You may obt ' the rules or direct questions to OUNC by calling 503.232.1987 or 1.8 .2344. Issued By: Permittee Signature: 41111 all 503.639.4175 by 7:00 a.m.for the next available inspec i 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. 1 Building`Permit Application Residential RECEIVED FOR OFFICE USE ONLY Cl SEP 5 2019 Received _ Permit No.: 13125rof Tigard SW Hall Blvd.,Tigard,OR 97223 Mte/By: PlDaan Review ' `v P:140/3-17—, /My °2�)/,�� 3(() Phone: 503.718.2439 Fax: 503.598.196�ITY OF TIGARD Date/By: ��11 l� OtherPermi. ,'� . TIGARD Inspection Line: 503.639.4175 BUILDING DIVISIO Date Ready/By: / kris. 10 See Page2 for Internet: www.tigard-or.gov Notifie,2 e-od: Supplemental Information TYPE OF WORK 'EQUIRED 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. ❑ 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ �it,)/ l l ❑Accessory building ®Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms . 'j JOB SITE INFORMATION AND LOCATION Total number of floors: 2 ii I E. Job site address: \ t 1 SW Windsept Place New dwelling area: \ 3\'i square feet \-3 City/State/ZIP:Tigard Oregon Garage/carport area:> Q4)square feet UTZ Suite/bldg./apt.no.: Project name:Canyon Court Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Canyon Court Lot no.: C 7 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. New Residential Construction Valuation: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:Sage Built Homes LLC Type of construction: Address:1815 nw 169th Place Suite 1040 Occupancy groups: City/State/ZIP:Beaverton Oregon 97006 Existing: Phone:(503)533-5167 Fax:(503)533-5164 New: ® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name:Sage Built Homes LLC (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name:Alex Rodriguez FLS plan review fee(if applicable): Address:Same as above Total fees due upon application: City/State/ZIP: Amount received: Phone:(971)336-6911 Fax: :( ) E-mail:planning@sagebuilthomesllc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name:Same As Above Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:Same as Above Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.:189330 �/� Total fee due upon application: $201.60 Authorized signature:( \ 1 �� lV This permit application expires if a permit is not obtained yi — within 180 days after it has been accepted as complete. Print name:Alex Rodriguez Date:c\s-\'c *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist , I One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Received INg Permit No.: a 13125 SW Hall Blvd.,Tigard,OR 97223 Dated at m Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: TIGARD 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing El Mechanical Internet: www.tigard-or.gov ❑ Other THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ 0 4 Fire district approval required. Name of district: 0 ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacityCICI CI 6 Sewer permit. ❑ ❑ El 7 Water district approval. ❑ El ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- El ❑ ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ 0 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 ❑ ❑ ❑ 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. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size El ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ Cl 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 ❑ ❑ 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. 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. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 ❑ 0 prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ 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 El ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ El ❑ architect licensed in Oreton and shall be shown to be a..licable to the .ro'ect under review. JURISDICTIONAL. SPECIFIC'S 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑ 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. ❑ ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 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 ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ 0 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) . Mechanical Permit Applic FOR OFFICE USE ONLY City of Tigard Received E I V E D Date/By: Permit No IN - " 13125 SW Hall Blvd.,Tigard,OR 972 F yS��O`�^ �� bb r 5 2 019 Plan Review Phone: 503.718.2439 Fax: 503.598.1 Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Jurts (il See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ®Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 46.75 Job site address: U i t--t- SW Windsept Plac Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75 City/State/ZIP:Tigard Oregon Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Canyon Court Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision:Canyon Court Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas New Residential Construction fireplace 23.32 1\,q).t CO Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ® PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name:Sage Built Homes LLC Range hood/other kitchen equipment 1 33.39 33.39 Address:1815 nw 169th Place Suite 1040 Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP:Beaverton Oregon 97006 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(503)533-5167 Fax:(503)533-5164 Attic/crawlspace fans 1 23.32 23.32 �1 APPLICANT 0 CONTACT PERSON Other: 23.32 Business name:Sage Built Homes LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Alex Rodriguez Furnace,etc. Address:Same as above Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:(971)336-6911 Fax: :( ) Fireplace Range E-mail:planning@sagebuilthomesllc.com Barbecue CONTRACTOR Clothes dryer(gas) Business name:All Time Heating&Cooling Other: MECHANICAL PERMIT FEES* Address:PO Box 1341 Subtotal City/State/ZIP:Lake Oswego,OR 97035 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)208-2276 Fax:( ) State surcharge(12%of permit fee) CCB lie.:18457 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 CQ days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name:Alex Rodriguez Date: CON\\ct I:iBuilding\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/ M/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040113.doc 2 f s . Electrical Permit Applicati+�t1E 1 ED I'Ok Oi I U III 'l O\I.\ City of Tigard SEP 5 2019 Received DateByr R r11 . • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503,718.2439 Fax: 503.598rlClf OF TIGARD Date/By: f l(,A[.[) Inspection Line: 503.639.4175 BUILDING DIVISION Ready Date/By: Innis ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK I PLAN REVIEW ' ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑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 ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations buildings. 0 Multi-family _ ❑Master builder ❑Other: 0 Fire pump 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: l Job site address: \� ,1A.`�- � �l1,\t\slj , �\ 0 100H Addition of newremotor load of system. W l `F✓ � \"S'1J) 1• IOOHP or more. ❑"A","E","1-2","1-3", City/State/ZIP: Tigard Oregon ❑Six or more residential units, occupancy. h g g 0 Health-care facilities ❑Recreational vehicle parks Suite/bldg./apt.#: Project name: 0 Hazardous locations 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Dacription 1 Qty. I Each 1 Total I • New residential single-or multi-family dwelling unit. Subdivision: Lot 4: Includes attached garage. L��JJJJ 1,000 sq ft or less 168.54 4 Tax map/parcel#: Ea add'l 500 sq.ft.or portion 33 92 1 DESCRIPTION OF WORK Limited energy,residential New Residential Construction 75 00 2 (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft) ® PROPERTY OWNER ❑ TENANT Renewable Energy 0 See Page 2 I I Services or feeders installation,alteration,and/or relocation Name:Sage Built Homes LLC 200 amps or less I 1 100 70 T 100 70 12 Address: 1815 nw 169TH Place Suite 1040 ~201 amps to 400 amps I 133.56 I f 2— 401 amps to 600 amps 200 34 2 City/State/ZIP:Beaverton Oregon 97006 601 amps to 1,000 amps 301.04 2 Phone:(971)221-4597 Fax:( ) Over 1,000 amps or volts 552.26 2 ' Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation: This installation is being made on property that I own which is not 200 amps or less 59 36 1 I 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 ® APPLICANT j ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A Fee for branch circuits with Business name:Same As Above above service or feeder fee, 7.42 2 each branch circuit Contact name: Alex Rodriguez B.Fee for branch circuits without I Address: service or feeder fee,first Sb,18 2 branch circuit City/State/ZIP: Each add'l branch circuit 7,42 2 Miscellaneous(service or feeder not included) Phone:(971)336-6911 Fax: :( ) Each manufactured or modular 67 84 2 "" " dwelling,service and/or feeder Email:Planning@sagebuilthomesllc.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Ross Electric Sign or outline lighting 1 I 67.84 1 12 Address:2870 SE 75th Ave 203 Signal circuit(s)or limited energy 0 Page 2 12 panel alteration or extension. City/State/ZIP:Hillsboro Oregon 97123 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)642-2800 Fax:( ) Investigation(1 hr min) 90.00/hr Email: fill Industrial plant(I hr min) 78.18/hr tot G Inspections for which no fee is 90 00/hr CCB Lic.: 157891 Electrical Lie.: 34-436C Suprv.Lie.:q 2 l specifically listed(V2 hr min) ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: AR Subtotal: Print name: Stephen Ross 5.1 . 0,4ci, k 's r Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signatur ' t..........._ ------------.) TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Alex Rodriguez Date: 2/1/2018 days after it has been accepted as complete. • Number of inspections allowed per permit. 1:\Building\Permits\ELC_PennitApp_ELA.,ERE.doe Rev 06/17/2015 440-4615T(11/05/COM/WEB Plumbing Permit Application Building Fixtures RECEIVE 10 FOR OFFICE USE ONL\ City of Tigard 5 2019 Received - g SEP PlanRe Date/By: Permit No.tsc ;,a ck t . "4 w 13125 SW Hall Blvd.,Tigard,OR 97223 plan Review / \ rpt l 'V Phone: 503.718.2439 Fax: 503.598.19�pITY OF TIGARD Date/By: Other Permit No.: 'Ci TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION DateReadyBy: Juris: H See Page 2for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ®New construction ❑Demolition For special information use checklist Description Qty. Ea. Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ®Multi-family SFR(3)bath x 500.32 32 Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:tJ SW Windsept Place Catch basin or area drain 18.76 11 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard Oregon Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name:Canyon Court Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Subdivision: Court Lot no.: b Water service(no.linear ft.: ) Page 2 CanyonFixtureeorr item: Tax map/parcel no.: . even 1-- 1.7-L---Srzr DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 1 25.02 25.02 New Residential Construction Dishwasher 1 25.02 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name:Sage Built Homes LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 1815 nw 169th Place Suite 1040 Garbage disposal 1 25.02 25.02 City/State/ZIP: Hose bib 2 25.02 50.04 Phone:(503)533-5167 Fax:(503)533-5164 Ice maker 12.51 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:Sage Built Homes LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Alex Rodriguez Roof drain(commercial) 12.51 Address:Same as above Sink/basin/lavatory 5 25.02 \2 l0 City/State/ZIP: Solar units(potable water) 62.54 Phone:(971)336-6911 Fax::( ) Tub/shower/shower pan 12.51 2 . .. o2.. E-mail:planning@sagebuilthomesllc.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 1 37.52 37.52 Business name:Edward Mullen WaterPP i m WV 56.29 Address:1601A SE River Rd Other: 25.02 City/State/ZIP:Hillsboro Oregon 97123 Subtotal Phone:(503)572-4586 Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.:92689 Plumbing Lic.no.: State surcharge(12%of permit fee) Authorized signature TOTAL PERMIT FEE Print name:Alex Rodriguez Date: `y c- It I This permit application expires if a permit is not obtained within 180 days 1 after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\BuildinglPermits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) r Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-151 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to I� and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Plan review is required for any of the following. Work Performed: Capped Added Relocate Baptistry/Font Please check all that apply. Bath Tub/Shower 111 Any new commercial building with water service 2"and -Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3" 4" Isometric or Riser Diagram Car Wash Drain Garbage Domestic-non-food CI Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: S:\Sage Built\Purchasing\Subdivisions\Canyon Court\Apps\Plumbing.doc2 City of Tigard q COMMUNITY DEVELOPMENT DEPARTMENT PhC -r l G lz D Building Permit Review — Residential Building Permit #: mS i _WNPO Site Address: 2:/2/ / Jl 7L /• Project Name: (Atli-7i-- Lot #: g (New = subdivision name;Addition or Alteration=last name of owner) Planning Review Pr.,.osal: Ake 4 Verify address/suite#active in Accela. InRiverTerr e: t No ❑ Yes, River Terrace Review Addendum SiSitit Plan Elements: I ''V F. 9sion Control ' opies of site plan on 8-1/2"x 11"or 11 x 17"paper `'4',ained trees with drip line and tree protection measures Il% raven to scale(standard architect or engineer scale) LI footprint of new structure (including decks) and FFE IO orth arrow 7i •'ty locations&easements (required for new and additions) e • address,project or subdivision name and lot number Sidewalk/driveway approach Vhipplicant information(name and phone number) w` )cation of wells/septic systems Lot .. ensions and building setback dimensions 7treet tree size,type and location �VZ;:, are footage of buildings to be demolished W. greet names 1�f � 'sting structures on site 7 Corner elevations(2'contours if more than 4'diff ential) VA Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replace.? VI Yes E o im.ervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? 1 a Yes No I'i lean Water Services–Service Provider Lett (lot platted prior to 9/10/1995): /Required: ❑ Y s,applicant was notified No Received: ❑ Yes ❑ No I Public Facili . s Improvement (PFI) Permit: Required: Yes,applicant was notified E No Appli For: Yes ❑ No,stop intake [and Use Case#: CP/19- 2 OP-— CC i 114 Zoning: P--1.2 equired Setbacks: Front: lc Rear: / Side: Street Side: IL .% Garage: V, uildin Height: Max. Height: Actual Hei�oh4•} ‘,..28'Landscape ea: % Lot Coverage May' t 'L 0/. Entrance121 t back no more than 8'from street-facing wall ICJ Parallel to street or offset 45 degrees or less Windows IVII>timum 12%of area of all street-facing facades Garage V Gaara •door is behind widest street-facing wall ❑ Yes CJ No,one of the following is met: 1a Door extends no more than 5'from wall and there is a covered porch extending beyond garage. 17❑ Door extends no more than 5'from wall and there is a 12 sq ft. . ow above garage on 2nd floor. Gara door width is ❑ 12'or less ❑ 50%or 1 of facade %or less and includes�7/o)following: Ig overed porch E 'ecessed entrance rr Wall offset Roof eave 1d Roof offset Fire shingles 1I' Lap Siding ❑ Roof pitch Yr Gable,hip,or gambrel roof ❑ Dormer ❑ Accent siding I Window trim ❑ Window recess ❑ Window projection E Balcony IV Visual Clearance A Urban Forestry Plan I,tiensitive Lands: ❑ Yes [i2/No Type: r1 Conditions met prior to issuance of building permit Nom Approved By Planning: Y.A. . Date: .� Revisions (after Building Submittal only) Reviewer Date Revision 1: E Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_022819.docx Building Permit Submittal Original Submittal Date: C\1I)'tq' Site Plans: # S Building Plans: # Building Permit#: g Enter building permit#above. Workflow Routing: Rv Planning D. Engineering D Permit Coordinator 0 Building Workflow Sign-off: [Sign-off for Planning(include notes from planning review) Route Application Documents: D/Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. E Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: k../.___ Date: q 1 '\\j E:9gineering Review dill i Slope at building pad: 4 Conditions "Met"prior to issuance of building permit CfrfEasements (encroachments)per engineering conditions of approval and plat 1Uater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes [c/No Assess Water Quantity Fee in-lieu: ❑ Yes LIQ o LIDA Facility on lot: ❑ Yes lir No Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: ,‘11. — Date: 9Aar Revisions (after Building Submittal only) ' Reviewer Date 1 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: Lf/SDC Fees Entered: Wash Co Trans Dev Tax: [/Yes ❑ N/A Tigard Trans SDC: ��,�Y ' El N/A '6' Parks SDC: ' x eS ❑ N/A VLIDA ❑ Yes VN/A OK to Issue Permit LIDA Approved by Permit Coordinator: Date: / I:\Building\Forms\BldgPermitRvw_RES_0228I 9.docx c _ 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 74 a Transmittal Letter T!,. n n 1, 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: er\`k- 43v\ ()SY sfirn \CT DATE RECEIVED: DEPT: BUILDING DIVISION SEP 2 ZQ19 FROM: 'N-ey.._ 'h6\i1r, , COMPANY: S(k J fx)\`` �\ -'�I I ) \lC.• �', E,__. PHONE: 00.1 - 3a12 -U9,11 ' By: - RE: onkik ww\4 1. �'�' ,`u�� 1 1 \� n- Do?1 Q 0 (Site Address) (� (Permit Number) c' v�. bA SA �- I. c (Project n e 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): G s REMARKS: `�`M\Ivq\ \-Ir Q.�- 1?t;\` — i ri,5- C°av-(l' FOR FFI E USE ONLY f �� Routed to Pennit Technic' ate: y &Co�L`� Initials: r'"� Fees Due: ❑ Yes milN Fee Descri lion: /// Amount Due: N •N p $ Special Instructions: 1 Reprint Permit (per PE : ❑Yes o ! ❑Done f-- Applicant Notified: y-tv Date: 7- /C) ( 7 /t I Initials: 1:1Bui1ding\Forms\TransmittalLetter-Revisions_061316.doe