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Permit
CITY OF TIGARD MASTER PERMIT 7 !''> COMMUNITY DEVELOPMENT Permit#: MST2019-00440 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/17/2020 Parcel: 1S136AA01202 Jurisdiction: Tigard Site address: 6921 SW OAK ST Subdivision: None Lot: None Project: CULBERT Project Description: ADU: Convert 415 sf garage to habitable space with a new porch entrance, and one existing bedroom of 113 sf in primary residence for a total ADU space of 528 sf. TRADE PERMITS TO BUILDING Floor Areas Requi red Setbacks Required Stories: 1 Bedrooms: 1 First: 415 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 415 sf Value: $100,000.00 Rear: 15 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 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 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADU SF VB R-3 415 Owner: Contractor: CULBERT,PATRICIA LEIGH ALLERS REMODELING LLC Required Items and Reports(Conditions) HILLMAN,ELIZABETH LUTES PO BOX 82609 5000 MACARTHUR BLVD PMV 9914 PORTLAND,OR 97202 OAKLAND,CA 94613 PHONE: PHONE: 503-957-1235 FAX: Total Fees: $8,055.28 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. T se rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a :., . - ..estions to OUNC by calling 503.232.1987 . 0.332.2344. Issued By: r Permittee' Signature: _ . 75 by 7:00 a.m.for the next availaB e-Inspection date. This permit card shall be kept in a conspicuous place on the job site until completio of the project. Approved plans are required on the Job site at the time of each Inspe ' n. Building Permit Application Residential , FOR OFFICE I;SE ONLY City of Tigard a ', -"' FOR Date/By: fe f/ 14 ierf Permit No.: vii5Wit t/ 06 40 " 13125 S W Hall Blvd.,Tigard,OR 97223 2019 Plau Review �1 Z AJ�Gv I �atl Phone: 503.718.2439 Fax: 503.598 19tR 1 Date/By: f i Other Permit: Ti( A K D Inspection Line: 503.639.4175 r f r) Date Ready/By: ,/ 1„� of, • funs: I ® See Page 2 for Internet www.tigard-or.gov '.l `° �(�' '" t° Notified/Method:� �fJ � Supplemental Information 15741e'1-iL— hZ,L TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING 0 New constructionPermit fees*are based on the value of the work performed. 0Demolition IAA Indicate the value(rounded to the nearest dollar)of all ©Addition/alteration/replacement El Other: equipment,materials,labor,overhead Y,A f"^---"fnr the CATEGORY OF CONSTRUCTION work indicated on this application. _ __ © 1-and 2-family dwelling ❑ Commercial/industrial Valuation: $ 000 •J 'bpl007) ❑Accessory building El Multi-familyNumber of bedrooms: I El Master builder ❑Other: Number of bathrooms: ' JOB SITE INFORMATION AND LOCATION/F Total number of Do rs A' Job site address: o� e V 1 0 fic�- New dwelling-LP l square feet (-1,I S City/State/ZIP: Tigard,OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: Culbert ADU Covered porch area: )(P square feet Cross street/directions to job site: SW Oak between SW 71st and 69th _ Deck area: - square feet 3``J ��cy. ; f�l.L( / 7i ',T/.S -� ) ,t4 / Other structure area: square feet j -CA-C. ( �e7t1 f'�7( . T7 �N Ve. , UIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:le-/% e g/' -• Lot no.: 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.: IS136AA01202 equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. &fore et. M 72. U/65• 7 r nd''Y 4e-r,i,•em 3v elerrz- 'rt."it).6 Valuation: $ Convert lel gar.ge to ADU. Add new entry porch at new ADU. All electrical and plumbing required for a living unit included. Existing building area: square feet Lid PROPERTY�SOWNE C, 0 TENANT 1 Newb buildingof stories:. square feet Name: Trish Culbert Type of construction: Address: 5000 MacArthur#9914 Occupancy groups: City/State/ZIP: Oakland,CA 94613 Existing: Phone:( ) 510.336.1766 Fax:( ) New: 0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: EMC Interior Design,Ilc Structural plan review fee(or deposit): Contact name: Ellen Cusick FLS plan review fee(if applicable): Address: 4037 N Albina Ave Total fees due upon application: '7/ 17 City/State/ZIP: Portland,OR 97227 Amount received: Phone:( ) 503.544.8688 Fax::( ) E-mail: ellen@emc-id.cpm PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: Allen Remodeling Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( )503.957.1235 Fax:( ) State surcharge(12a/o of permit fee): $21.60 CCB lie.: 222106 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. L Print name: �LG�'0.f etig J eve_ Date: �Z• // . ZQ l el *Fee methodology set by Tri County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB) A Electrical Permit Application FOR OFFICE CM. (1\1.1 City of Tigard Received „ L 1114 • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ■ Phone: 503.718.2439 Date/B : Related Permit S: Email: TigardBuildingPetmits@Tigard-or.gov , Ready Date/By: Jmis: ® See Page 2 for TIGARD Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction 7"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. El Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Flo.• g buildings. 1-and 2-fam-y dwelling ElCommercial/industrial 0 Accessory building less to ground,or exceeds 14,000 II ommercial-use agricultural amps for all other installations. buildings. Multi-family 0 Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or •B SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived ❑Addition of new motor loa. .f system. Job#: Ob site address: (Al.( elk1 0 k -V 100HP or more. ❑"A" "E" "l-2" °1-s" City/State/ZIP: IA v h ( Q)2 Gil---a.: 0 Six or more residenti. units. occupancy. ❑Health-care facilit 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: LLT iss"()u 0 Hazardous I. ons. 0 Supply voltage for more than ❑Service or f-der 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Descrlpd. 1 Qty. I Each I Total 1 • New ,.sidential single-or multi-family dwelling unit. Subdivision: I Lot#: In des attached garage. ,100 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION)\OF WORK Limited energy,residential ,,.n �. CO �I.y�,��[+',�,, , 3 `', (with above sq.ft.) - 75.00 2 ( c ly,' (�E. ON V it44 1 0I TO ` f 3 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) OPRenewable Energy 0 See Page 2 PROPERTY OWNER I El TENANT Services or feeders installation,alteration,and/or relocation Name: '1-1,l4v\ &J L-VC _ 200 amps or less 100.70 2 Address: St7� `u,,,1 ` 1 . .. 4141 201 amps to 400 amps 133.56 2 V` 401 amps to 600 amps 200.34 2 City/State/ZIP: 0 Mt-Likt•i t I Gk 'l aile 601 amps to 1,000 amps 301.04 2 Phone:( ) C210 7 3Lp. 11-lp(„f 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 prop- , that 'rwn which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS ,,7,449, i , (� 0,and 701. 201 amps to 400 amps 125.08 2 Owner sign a V Date: ' - \ -l 401 amps to 599 amps 168.54 2 p APPLICANT I ►A CONTACT PE' •N Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: S-'IAK L 1(vt .(/t;,o-v to ,sA: above service or feeder fee, 7.42 2 Contact name: -'11-�u LA-14f1 eachbranch circuit B.Feeeb for branch circuits without service or feeder fee,first Address: 403I iv. "F'rt f l A- branch circuit 56.18 2 City/State/ZIP: "P• - CV- 40-7-21— Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) S 0.g • S A ' . g ID c- Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: "e e r (,- (d t (-OW\c Reconnect only 67.84 2 �n C• TRACTOR '. rap or irrigation circle 67.84 2 Business name: K% Si y or outline lighting 67.84 2 Address: Sign 1 circuit(s)or limited-energy El See Page 2 2 panel,:Iteration,or extension. City/State/ZIP: Each a.ditional inspection over allowable In any of the above Addition, inspection(1 hr min) 66.25/hr Phone:( ) Investigati. (1 hrmin) 90.00/hr Email: Industrial pi,It(I hr min) 78.18/hr Inspections f• which no fee is 90.00/hr CCB Lic.: Electrical Lie.: Suprv.Lic-: specifically listed(Y2 hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: _ Print name: Date: ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: j/ W�^�i This permit application expires if a permit is not obtained within 180 � Print name: `-'r(Q�1 .ck. Date: I T:i!, CI days after it has been accepted as complete. • Number of inspections allowed per permit LlBaildmglPermits\ELC_Pe milApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(I 1/05/COM/WEB Electrical Permit Application—City of Tigard • Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. I Each I Total I ` Fee for all residential systems combined: $75.00 Renewable 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: ❑ 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 ❑ Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr charged at an hourly(I hr min) Inspections for which no fee is 90.00/hr specifically listed(%hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): y + Number of inspections allowed per permit (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ 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_PamitApp_ELR_ERE.doc Rev 10/26/2017 Plumbing Permit Application ' Building Fixtures , FOR OFFICE USE ONI.I g . ` } -:v $'?°� City of Tigard , Received • 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Permit No.: l 9_0 4/i) Phone: 503.718.2439 Fax: 503.598.1960 1 1 Z 019 Plan Review Date/By: Other Permit No.: T I ti A It D Inspection Line: 503.639.4175 Date Ready/By: rods: 65 See Page 2 for Internet: www.ligard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE For special information use chec•1st New con ruction ['Demolition Description I Qty. Ea. I Total pAAddition/alt -tion/replacement 0 Other: New 1-2-family dwellings(includes 100 ft or each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 q11-and 2-famil y g dwe 'n SFR(2)bath 437.78 ❑Commercial/industrial ['Accessory building ID Multi-familySFR(3)bath 500.32 El Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE ' ORMATION AND LOCATION Site utilities: Job site address: (xi CA'Lk (2 f 6 A f t_ Catch basin or area 18.76 City/State/ZIP: �CA�j� + �L 4 l�ZZ 3 Drywell,leach line, .r trench drain 18.76 Footing drain(n..linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project :. e: C u(_ - h h4J Manufactur:. .ome utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain. . connector 18.76 S. 'A sewer(no.linear ft.:_) Page 2 .rm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK \ AwlBackwater valve 12.51 �� Clothes washer 25.02 11X f' Calder/1-A", �zh Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 V PROPERTY OWNER ❑ T IANT \ Expansion tank 12.51 Name: �^ Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: S O boKAA L�14 u <14114 City/State/ZIP: ®PAL.L-nr� Garbage disposal 25.02 �� 3 ose bib 25.02 Phone:( ) Cj\Q ' 3'(..2 ,.('.1(Q(f Fax:(. ) I -maker 12.51 R APPLICANT ❑ CONTACT PERSON Im eptor/grease trap 25.02 Business name: Medic. :as(value:$_) Page 2 1A%(C- ' � � Primer 12.51 Contact name: it 4 r�riv,,�. Roof drain( •mmercial) 12.51 Address: 4051A.- Sink/basin/lava • 25.02 City/State/ZIP: C O 1t J. p 4111-221- Solar units(potab•water) 62.54 �^ � t Phone:( SO 2 S� X . iic. Fax::( ) Tub/shower/shower... 12.51 E-mail: -6�I.0."- ! 'i 't• � . CO Urinal 25.02 yee CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimu .emit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge of permit fee) Authorized signa TOTALTAL PERMIT FEE Print name: r 1(4, . 'Aic„ Date. 12, 11 �(. , This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 'Fee methodology set by Tri-County Building Industry Service Board. I:\Buildng'Permits'PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COMAWEB) 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- 1"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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to Other Inspections or Feesand 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 each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) 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*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thru ❑ Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial ❑ Any complex structure as defined in OAR918-780-0040. -Domestic Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2" 3„ Isometric or Riser Diagram 4" ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) _Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lay/Bar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor plumbing permit can be issued. Water Closet-Toilet Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 City of Tigard E s . COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Building Permit Review — Residential Building Permit #: /rjST�U/y_ ,c)cty 0 Site Address: 512,1 Sw Oot 0. Project Name: Gv kt--- Al ) Lot #: — (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review �1 I ADO. i ` I ` Prop sal: Cer\vt44 ny, le �-0(), Rn prck. GI- n—w.✓/AD . All tltGiy-aAl 0.4 lot,�('k r11.,4 't�rc� Lld'Verify address/suite #active in Accela. l(d' In River Terrace: Ild" No ❑ Yes,River Terrace ReviewvAddendum 1 v^; Site Plan Elements: OjErosion Control [ 3/Copies of site plan on 8-1/2"x 11"or 11 x 17"paper < R ed trees with drip line and tree protection measures LlYDrawn to scale(standard architect or engineer scale) Tint of new structure(including decks)and FFE EK.. arrow l l'Utility locations&easements(required for new and additions) - address,project or subdivision name and lot number idewalk/driveway approach !� licant information(name and phone number) Ai" .cation of wells/septic systems [ Lot dimensions and building setback dimensions n ip.eet tree size,type and location kagpare footage of buildings to be demolished 0(5 eet names IL.Kxisting structures on site VComer elevations(2'contours if more than 4'cliff--ntial) / Laot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? U r es o im rvious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes ❑No Clean Water S�ces-Service Provider Lettot platted prior to 9/10/1995): / quired: Ei7 Yes,applicant was notified 2 No Received: 13 Yes Q No [ Public Facilities Improvement (PFI)Permit: �R quired: ❑ Yes,applicant was notified �No Applied For: ❑ Yes 0 No,stop intake IV/Land Use Case#: AW�l9-OOO I ' EU' Zoning �- Di Required Setbacks: Front: 10 Rear: IS Side: S Street Side: IA Garage: 2-4 W riuilding Height. Max. Height: 3 0 Actual Height: Il/u V jt 1-Landscape Area: % 1Lot Coverage Max: trance ❑ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less I�'J Windows ❑ Minimum 12%of area of all street-facing facades Garage ❑ Garage door is behind widest street-facing wall 0 Yes ❑ No,one of the following is met: .or A UV ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage. ❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2"floor. ❑ Garage door width is 0 12'or less 0 50%or less of facade 0 60%or less and includes 7 of following: - ❑ Covered porch ❑ Recessed entrance 0 Wall offset ❑ 1'Roof eave 0 Roof offset 04,ti"i ❑ Fire shingles ❑ Lap Siding 0 Roof pitch 0 Gable,hip,or gambrel roof 0 Dormer ❑ Accent siding �❑ Window trim ❑ Window recess ❑ Window projection 0 Balcony 'Visual Clearance IlY Urban Forestry,Plan E S nsitive Lands: 0 Yes [ No Type: IV Conditions met prior to issuance of building permit No Ifd Approved By Planning: 14_ "/ Date: 11-11-I CI Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: 0 Approved 0 Not Approved 1:1BuildingkForms\BldgPermitRvw_RES_022819.docx Building Permit Submittal Original Submittal Date: 42/0-/17 Site Plans: Building Plans: Building Permit#: r building permit#above. Workflow Routing: B''Planning 2--E gineering 8'lPet--m t Coordinator a tttg Workflow Sign-off: E,�k, l�ignoff for Planning(include notes from planning review) I[J Route Application Documents: El.. -tneering: (1) copy of permit application, (1) site plan, (1) building plan and orid9al plan review routing form. uildtng: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: ;r�� . Date: 1e1.J(4y Engineering Review d� Erg-lope at building pad: 6..-!� Conditions "Met"prior to issuance of building permit O'Easements (encroachments) per engineering conditions of approval and plat 2-Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ErNo Assess Water Quantity Fee in-lieu: ❑ Yes No � LIDA Facility on lot: ❑ Yes 2" No 2 Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: CR'Approved by Engineering: €u__ Date: /2 - /Co / Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved 0 Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: ❑ Approved 0 Not Approved Permit Coordinator Review ❑ Conditions"Met"prior to issuance of building permit 0 Approved, NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant SDC Fees Entered: Wash Co Trans Dev Tax: 0 N/A Tigard Trans SDC: [ "Y 0 N/A Parks SDC: C�"Yes 0 ,.NIA LIDA 0 Yes P N/A OK to Issue Permit Approved by Permit Coordinator: Date: /•2/ /I/ I:113uilding\Forms\BldgPermitRvw_RES_022819.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. MiCity of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT " Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: 31Q4/%' / DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: 1leAA Ci AC JAN 14 nal COMPANY: -(G (, to O,V---70-ecAq,-Y\ Kt,1 CITY OF TIGARD 1�11 BUILDING DIVISION PHONE: C26� - CJ44 -0(p j By. RE: (fit1C a(VS ()MC- ' A 2,OY (Site Address) (Permit Number) (A)LW M)u (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. t 4 Revisions: vp 4C.zw e i..k S t 5 Cross section(s) and details. Wall bracing an or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: ‘tA.6.tha Q. g A k- 1 v r` w� 01.0.. -PAS c„Lp_ 1LS�.QJ- t ➢„1A vO DI(Id uP_Thtt. . ��(( FO OF ICE USE ONLY Routed to P it Technician: Date: I IS— ZU Initials: Fees Due: Yes ❑No Fee Des ripti n: Amount Due: $ rv� /z O cr real ; 0� $ L/S . ✓" $ $ Special Instructions: Reprint Permit(per PE): Lf Yes iNo ❑ Done Applicant Notified: Date: I Initials: 4 '� 1:\Building\Forms\TransnuttalLetter-Revisions 061316.doc