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CITY OF TIGARD MASTER PERMIT
111111
1 COMMUNITY DEVELOPMENT Permit#: MST2021-00460
Date Issued: 12/06/2021
T[GA R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110DD08200
Jurisdiction: Tigard
Site address: 15760 SW HIGHLAND CT
Subdivision: SUMMERFIELD NO.6 Lot: 298
Project: Hendrickson
Project Description: Adding a detached patio cover. 312 sf
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First 0 sf Basement, 0 sf Left. 4 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 10 Smoke
Dwelling Units: 0 Third: 0 sf Right: 4 Detectors:
Total: 0 sf Value: 87,999.88 Rear: 8
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 Drains: 0 Storm Sewer: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines 0 Catch Basins: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Bckflw Prevntr: 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 N
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
HENDRICKSON,BRAD&CHANTEL A OWNER Required Items and Reports(Conditions)
15760 SW HIGHLAND CT
TIGARD,OR 97224
PHONE: PHONE
FAX,
Total Fees: $581.97
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
o ri7_nn1_nnln rhrnnnh CIAR O5")_nn1_nnon ar,nhr0in a rnnrt of fhc ni doze nr rlircrr nilucrinnc rn CII INC hr,Tallinn FnQ 7'3'J 10R7 nr 1 Ann ZZO 7'3dd
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Issued By: Natty Vet-pi., D�1n/eg� Permittee Signature: A
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the iob site at the time of each inspection.
Building Permit Application ^► g w q fq 2
Residential ECE�V
City of Tigard E. 0 q 1021 aeme .�DateBy: \p` 1Z\ V Permit No._ns1-2A2\—oO- (a0
11 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review .� / n�
Phone: 503.7182439 Fax: 503.598.196JD'OF TIGARD Date/By: I!�/ I /j rn' Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By:__ 111 t iur ,, H See Page 2 for
Internet: www.tigard-or.gov 34I�DI�G DIVISION fied/Method: I t('•. Supplemental Information
l �1
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 ro f the
CATEGORY OF CONSTRUCTION work indicated on this application. 7f"9
fkl-and 2-family dwelling ❑Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
Number of bathrooms: �/�
0 Master builder ❑Other:
JOB SITE INFORMATION AND LOCATIONTotal number of floors:
Job site address: /_ f c'c) _CIA) �r rt� "3-r' New dwelling area: square feet
City/State/ZIP: { ' . �(J J o (7oic Ga ge/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: 4...
ei 40 square feet
Cross street/directions to job site: Deck area: square feet
/ i & 4'U Cr" k ( ,�^OYl n i� Other structure area: square feet
9 `- ( (/2S ' REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
�� C 4/-v4 ei—lei Valuation: $
v 1,
f71,a C�� . -C t( 11/45 Existing building area: square feet
t New building area: square feet
.l PROPERTY OWNER ❑ TENANT Number of stories:
Name: /J gilt) /161/20,721 GkSpx/ Type of construction:
Address: / 7G,) S-60 74 texe ( , Occupancy groups:
City/State/ZIP: L 2 6,f / `c Z09d/y Existing:
Phone:(6t23) J/e9--� X' Fax:dab?)
:?4"/ 'J 6 New:
1St APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:
Contact name: ev 'r-y cpea � Structural plan review fee(or deposit):
!!lIJJJJ
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Amount received:
Phone:( ) Fax::( )
E-mail: "�� t\ L�� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: ELT? / 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:( } Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lie.:
a Total fee due upon application: $201.60
Authorized signatu • 64,� 9I 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
Print name: {� (Gp Date: I Service Board.
1:\Building\Permits\\B`UP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c R D Building Permit Review — Residential
Building Permit #: oc -((Do
Site Address: 53-(p 0 H ryki, I oak C+
Project Name: grU ,0 ttk Co k !J i k,V) Lot #:
Planning Review
Proposal: C-e45-0 t/‘� Fet io (Over)
er)
Verify address/suite#active in Accela. ❑ In River Terrace: No ❑ Yes,River Terrace Review Addendum
Site Plan Elements: QEitsgion Control
/D3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper Retained trees with drip line and tree protection measures
Drawn to scale(standard architect or engineer scale) AFootprint of new structure (including decks) and FFE
ig North arrowity-1uratiminsc easements (-re ns)
fASite address,project or subdivision name and lot number Sidewalk/driveway approach
r' pplicant information(name and phone number)
::Lot dimensions and building setback dimensions d'
Street names
Existing structures on site
pLot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes in No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑YesZ.To
[� Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ig? No Received: ❑ Yes ❑ No
iN Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified )'No Received: ❑ Yes ❑ No
e or des LI AL u P ;v cl � cr--B- To
p Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified , No Applied For: ❑ Yes CI No,stop intake
n se ase : M Zoning: R
(la Required Setbacks: Front: 101 Rear: e 1 Side: 1 1 Street Side: Garage: 2.0
Ni Building Height: Max. Height: 3 5 I Actual Height:
IE Landscape Area: % II Lot Coverage Max:
Entrance ,L c_ 1 h. 8' c c n s
Windows s
Garage door is behind widest street-facing wall ❑ Yes ❑ No,one of the fol • • met:
❑ Door ex e more than 5'from wall and there is a covered porch ex • eyond garage.
❑ Door extends no more t ' om wall and there is a 1 .window above garage on 2"d floor.
❑ Garage door width is ❑ 12'or less ❑ f facade ❑ 60%or less and includes 7 of following:
❑ Covered porch ❑ Re ntrance ❑ Wall offset ' of eave ❑ Roof offset
❑ Fire shin Lap Siding ❑ Roof pitch ❑ Gable,hip,or gam oof ❑ Dormer
ccent siding ❑ Window trim ❑ Window recess ❑ Window projection Balcony
❑ fit Q Urban Fore.st y Plan
Sensitive Lands: ❑ Yes No Type:
❑ Conditions met prior to issuance of building permit /� ����1' ^��� �/
Notes: S' •i-A0acIC.5 - rom QVVlvtAtr2 N6I V' /v ast
E . Approved By Planning: / P9iv1 Date: 6 0 --2-6
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
1:\Building\Forms\B1dgPennitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: q`
Site Plans: # 5
Building Plans: # 3
Building Permit#: ['Enter building permit# above.
Workflow Routing: 2/Planning Ile-Engineering [Permit Coordinator 2-"Building
Workflow Sign-off: R/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.
[3 Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: `�a\ v c e )0 Date: 42 2-�
Engineering Review
Re�Slope at building pad: 2%
LIYConditions "Met"prior to issuance of building permit L1/6-
L�N'Easements (encroachments)per engineering conditions of approval and plat it 1�
/Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 2/No
Assess Water Quantity Fee in-lieu: ❑ Yes 2/No
LIDA Facility on lot: ❑ Yes [X No
L!7 Final Plat Recorded: it 1•
❑ NOT Approved by Engineering: Date:
Notes:
EI'VApproved by Engineering: ri t , },rie 1 Date: to/2.7/2a4
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ 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:
SDC Exemption: ❑ Received Does not appl
SDC Fees Entered: Wash Co Trans Dev Tax: CIYes N/A
Tigard Trans SDC: ❑ Yes A N/A
Parks SDC: ❑ Yes A N/A
LIDA ❑ Yes N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: II Ii ( Z'
1:\Building\Forms\BldgPennitRvw_RES_122419.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
_'PI Transmittal Letter
r 1 G AR r) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Allyson Armstrong DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Andrew Niemi DEC 12021
COMPANY: Lower Columbia Engineering, LLC CITY OF TIGARD
BUILDING DIVISION1 By.
PHONE: 503-366-0399 II
EMAIL: andrew@lowercolumbiaengr.com
RE: 15760 SW Highland Court MST2021-00460
• (Site Address) (Permit Number)
26'x 12' Patio Cover
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
x Additional set(s) of plans. X Revisions:
X Cross section(s) and details. X Wall bracing and/or lateral analysis.
X Floor/roof framing. Basement and retaining walls.
X Beam calculations. X Engineer's calculations.
Other(explain):
REMARKS:
FOR OF ICE USE ONLY
Routed to Permit Techn�ici,�a . te: I'LI I 21 Initials: -'A'
Fees Due: ❑ Yes r�f'No Fee Descriptio : Amount Due:
C L - $ 75- _
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes No ❑ Done ip-A
Applicant Notified: Date: Q!' Initials:
` 1
Property Owner Statement RECEIVED
Regarding Construction Responsibilities, ;
vEP a 2021
Oregon Law requires residential construction permit applicants who are not license 409,^,
Construction Contractors Board to sign the following statement before a building ia-i`EW'D
issued. (ORS 701.325 (2)) LDING DIVJSlOf�
This statement is required for residential building, electrical, mechanical, and plumbing permits.
Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not
submit this statement.This statement will be filed with the permit.
Please check the appropriate box:
I own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
I will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
I will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
&haI f
Print Name of Permit Applicant
?4,/ (4/
Signature of Permit Applicant Date
�`( SV 021-O)140G o _
Permit#: -------- - - ------ F
•
Address: \S102) ell) Ci nt z'.,
Issued by: Date: rL`tO'"2 -'
This Copy for Permit Offices