Permit CITY OF TIGARD MASTER PERMIT
N -- . COMMUNITY DEVELOPMENT Permit#: MST2020-00322
T I i A R.I-+ 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/25/2021
Parcel: 2S107AA00200
Jurisdiction: Tigard
Site address: 14219 SW 168TH AVE
Subdivision: ROSHAK RIDGE Lot: 2
Project: Sherlock
Project Description: New 112 sq.ft.deck.
BUILDING
Floor Areas Required Setbacks Reauired
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 st Front: 12 Smoke
Dwelling Units: 0 Third: 0 sf Right: 3 Detectors:
Total: 0 sf Value: $2,729.44 Rear: 0
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
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0
Bckflw Prevntr: 0 Catch Basins: 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
Fum>=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:
ALT SF VB R-3
0
Owner: Contractor:
SHERLOCK,SONIA YVONNE®AN,FAHLAND INC Required Items and Reports(Conditions)
14219 SW 168TH AVE 15880 SW TUALATIN ST
TIGARD,OR 97224 SHERWOOD,OR 97140
PHONE: PHONE: 503-925-8756
FAX:
Total Fees: $409.76
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 rules are set forth in OAR
952-001-0010 through�OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
`
Issued By: T[V\b\ \t ( A3 Permittee Signature: rjr. GcD'icoth Qi-'
Call 50 .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 13- ll k‘f w
Residential RECEIVE* FOR OFFICE USE 0\I
City of Tigard Received 'I '2 Pelt No.: /[ /�7� 'may o 7
g Re eive /� Z7 L(lZO {'� /`i cyr2a2l W 3GL
lig a 13125 SW Hall Blvd.,Tigard,OR 97223 N O t J 0 G 2020 11 I `
_ Phone: 503.718.2439 Fax: 503.598.1960 Pan Re Date/Byew /'/iu26 ,44, other Permit:
T I G e\R D Inspection Line: 503.639.4175 C i,TY Oil t i GA.A i) Date Ready/By. JL')(,
r '' ® SePage2for
Internet: www.tigardor.gov BULDNG DIVSON Notiified/Method: I2� SpplementalInformation
s,ev ,
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the rofit for the
work indicated on this application.a 7 'i'y CATEGORY OF CONSTRUCTION /
]-and 2-familydwellingValuation: $ �7t t:).
® ❑Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: VA?.L Cl 5ls_ ` p VIV\ New dwelling area: square feet
City/State/Z1P:' c. CI').a,-).L f Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 'S I'v2,.0 l O cL Covered porch area: square feet
Cross street/directions to job site: Deck area: srl-a. l t2__square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
( Valuation: $
N12-\0 L-L C-C)r\-S-i(-,U CA-t`dr\. �Jo S'6A: .^5 .
Existing building area: square feet
New building area: square feet
IT,PROPERTY OWNER 0 TENANT Number of stories:
Name: So n.iC� 5`Yke e i.o e k Type of construction:
Address: 142 t ek S(..0 `c 0 -) e_- Occupancy groups:
City/State/ZIP. ` 0.0 t, t p °I Th L4 Existing:
Phone:( din 4t --(AP-Q Fax:( ) New:
APPLICANT CONTACT PERSON BUILDING PERMIT FEES*
1_ `, ( I (Please refer to fee schedule)
Business name:
ACC V\Q C}0 C 1� Tt l ST?es`'A�G Y\! Structural plan review fee(or deposit):
Contact name: illict O'\Ai CI it FLS plan review fee(if applicable):
Address: `5 O w\S TV a(A'k-Z A 5\J`
,
City/State/ZIP:S I - Loct: l n R pl (if v Total fees due upon application:
Amount received:
Phone:(503)Cl a 5 7 1-Cp Fax::( )
E-mall:w e-- p� cv e ,C *I�-{- PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: V 'C eirvAci 0 (_,IC- o. L f Po r Halle{ Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: l'St$0 St3 Ma trt S� Solar Installation Specialty Code checklist.
City/State/ZIPS h cc,��a f D � '}� Permit Fee(includes plan review $I g0.00
L ` and administrative fees):
Phone:(503)ct D g - 5(Q Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: aD(4 -3._` 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.
Print name: P;inuaL el-tit— Date: f i,( Lo(Da' /,D *Fee methodology set by Tri-County Building Industry
Service Board.
I:iBuilding\Pennits BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
INCOMMUNITY DEVELOPMENT DEPARTMENT
I
T l c u D Building Permit Review — Residential
Building Permit #: M S72O2o-00322.
Site Address: 14219 SW 168th Ave
Project Name: Sherlock Deck Lot #:
Planning Review
Proposal: New deck on side of existing home
❑r Verify address/suite#active in Accela. 0 In River Terrace: ❑ No ❑r Yes, River Terrace ReviewAddendumV*
Site Plan Elements: erosion Control
0: copies of site plan on 8-1/2"x 11"or 11 x 17"paper ,_Retained trees with drip line and tree protection measures
MI rawn to scale(standard architect or engineer scale) ootprint of new structure(including decks)and FFE
II orth arrow �`\�" tility locations&easements(required for new and additions)
111 ite address,project or subdivision name and lot number \ Sidewalk/driveway approach
12 pplicant information(name and phone number) „vocation of wells/septic systems
Qom. dimensions and building setback dimensions ...Street tree size,type and location
ijije.uare footage of buildings to be demolished _`,zeet names
0 xisting structures on site ` Omer elevations (2'contours if more than 4'differential-
G •t area,building coverage area,percentage of coverage and >>1,000 sf of impervious area created or replaced? es o
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es ° o
Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑✓ No Received: 0 Yes CI No
Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: 0 Yes,applicant was notified ❑r No Received: El Yes CI No
�\ SDC Exemption for ADU applied for: ❑Yes CINo Received: 11 Yes El No
N Public Facilities Improvement(PFI) Permit:
Required: ❑Yes,applicant was notified 11 No Applied For: ElYes 11No,stop intake
Land Use Case#: ❑r Zoning: R-7
❑r Required Setbacks: Front: 12 Rear: 0 Side: 3 Street Side: N/A Garage: N/A
El Building Height: Max. Height: N/A Actual Height: N/A
❑s Landscape Area: 20 % ❑r Lot Coverage Max: 80
Entrance - back no more than 8'from street-facing wall ❑ Parallel to street or • .- 45 degrees or less
Windows Minim 2%of area of all street-facing facades
Garage Gara e door is • -. d widest street-facing wall 'v" ❑ Y- I No,one of the following is met:
❑gDoor extends no + - than 5' from wall and there• : overed porch extending beyond garage.
uuDoor extends no more th. -' from wall a.e i ere is a 12 sq ft.window above garage on 2nd floor.
CIGara e door width is E.12'or less 50%or less of facade 60%or less and includes 7 of following:
Covered porch I R- - ed entrance 1 Wall offset ❑ 1'Roof eave Roof offset
Fire shingles Lap Siding i. ❑ Roof itc 11 Gable,hi ,or gambrel roof ❑ Dormer
Acce :•. g Window trim Window rec-- 1Window projection ❑ Balcony
❑ Visual Cleara - ❑ Urban Forest Plan
❑ Sens- -. - ands: ❑ Yes Ll No Type:
E onditions met prior to issuance of building permit
Notes: --�
El Approved By Planning: S; r Date: 11/19/20
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:1Building\Fonns\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: ii&,20Z0
Site Plans: #
Building Plans: #
Building Permit#: Itnter building erermit# above.Workflow Routing: ❑'Planning CJ Engineering Bermit Coordinator 13-suilding
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:
By Permit Technician: Date: ///2'V/1r 0
En ineering Review
II lope at building pad: 2 /'
u�7�/Conditions "Met"prior to issuance of building permit
Uv asements (encroachments) per engineering conditions of approval and plat
Lf7YWater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes '�7-��.No
Assess Water Quantity Fee in-lieu: ❑ Yes L7 No
LIDA Facility on lot: ❑ Yes 'No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
[Approved by Engineering: Date: _/_/__/ ,‘—. --,e;'
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
AConditions "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:
. II SDC Exemption: ❑ Received Does not a..
II SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes /A
Tigard Trans SDC: ❑ Yes A
KIParks SDC: ❑ Yes /A
LIDA ❑ Yes pQ N/A
OK to Issue Permit
Approved by Permit Coordinator: — Date: /1
I:1Buil ding\Fonns1BldgPermitKvw_RES_122419.docx