Permit CITY OF TIGARD MASTER PERMIT
• !s , Permit #: MST2009 -00144
COMMUNITY DEVELOPMEN
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/08/2009
Parcel: 2S1100608900
Jurisdiction: Tigard
Site address: 12420 SW ST ANDREWS LN
Subdivision: Lot: 0
Project: Whitcher
Project Description: Install new deck addition. Deck must not exceed 36" in height and must maintain a minimum of 3'
setback from side and rear property lines.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 3 Detectors:
Total: sf Value: $10,262.00 Rear: 3
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0
Drains: 0
Bckflw Prevntr: 0
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Fum <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! 500 sf: 0 20 1 -400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr:
Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add! Br Cir:
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:
Owner: Contractor: Required Items and Reports (Conditions)
ACCENT RESIDENTIAL HOMES INC DECKMASTER CONSTRUCTION
12583 SW AUTUMNVIEW ST 20094 S RIDGE RD
TIGARD, OR 97224 Oregon City, OR 97045
PHONE: PHONE: 503 -201 -2321
FAX:
Total Fees: $335.15
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. • ENTION: • =ion law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are s forth in OAR
952 -00 -0010 through OAR • •2-0. 01.. You may obtain a copy of the rules or direct questions to OUNC by calling 503. 6.6699 0 1.800.332.23 4.
Issued B c&a Permittee Signature:
. Building Permit Application
Residential FoR officir, lasE oN't.V
R eceived ^ �i
City of Tigard 7 g D y Permit No.: )14/ 0PF
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review im
II . Phone: 503.639.4171 Fax: 50 DateB : FM MEM Other Permit:
TI G n R D Inspection Line: 503.639.4175 Date Ready : , : lulls: El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
•
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: 26( 4 , acy ^ ?'
El 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: i Z ti. 2 fJ 566 414 Aj \/= New dwelling area: square feet
City /State /ZIP: 77&4 12.• ,)�, g717 L/. Garage /carport area: square feet
Suite/bldg. /apt. no.: / Project name: (AV lL (1 C:g—_ Covered porch area: square feet
Cross street/directions to job site: Deck area: , 5 j g 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.
/»741— - b e /� ' Z -- ri 0 6 V Valuation: $
t � > Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: ,C l 6_ km. - Type of construction:
Address: / •��K 2_6 40,) 977 j� bigOlit. LV Occupancy groups:
City/State /ZIP: ht--I
e q 7 2 2 L i Existing:
Phone: (93) $ (p'7 , , t!1 3..i Fax: (r 03) ( Z O " 2 g'7 New:
❑ APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax::( )
E -mail:
CONTRACTOR
Business name: b &-iz /V Cs- -r'Zm,GTI 6 BUILDING PERMIT FEES*
Address: 2.06q . 2] D6� (Please refer to fee schedule)
N I D ( Structural plan review fee (or deposit):
City /State /ZIP:
�j� Gl . �/Z 1 q 7046
Phone: (5' 7 C . Z? 2 i Z Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: 5 - 2 7 1 U V AT' Total fees due upon application:
l � Amount received:
Authorized signature: / This permit application expires if a permit is not obtained
1-7 within 180 days after it has been accepted as complete.
0 i z N Print name: '-f"? � As wiz N Date: 7 ,/ [ • Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building\Permits\BUP -RES PermitApp.doc 11/6/07 440 4613T(11/02 COM/WEB)
Building Permit Application Checklist
One- and Two - Family Dwelling Foil OrrlCl, usl•; ()Nix
City Of Tigard Received
71 g Date/By: Permit No.:.
q 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits:
I 'Ph'one: 503.639.4171 Fax: 503.598.1960 p
1 - 1 G A R 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard - or.gov ❑ Other: .
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Ves No NIA
I 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. ❑ ❑ ❑
4 Fire district approval required. Name of district: • . ❑ - 0 ❑
5 Septic system permit or authorization for remodel. Existing system capacity ,,, . ❑ ❑ ❑
- 6 Sewer permit. , , ❑ ❑ ❑
. 7 Water district approval. a., ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ' • t ❑ ❑ ❑
9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑
basin protection, etc.
10 3 Complete sets of IFgible plans. Must be drawn to scale,' showing conformance to applicable local and state - ❑ ❑ ❑
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 ❑ ❑ ❑
and location. ,. %'! •
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater ❑ ❑ - ❑
furnace, ventilation fans, plumbing'fiztilres, 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- • ❑ ❑ ❑
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 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 ❑ ❑ ❑
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 ❑ ❑ ❑
locations. Show attic ventilation.
18 :.Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑
• 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 ❑ ❑ ❑
• '1 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 ❑ ❑ ❑ . '
architect licensed in Oregon and shall be shown to be applicable to the . ro'ect under review.
JURISDICTIONAL, SPECIFICS
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, ❑ ❑ ❑
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. .
1:\ Building \Permits\BUP- RES- PermitApp.doc 0321/06 '1 440- 4613T(11 /02/COM/WEB) •
I o ° Building Division
One & Two - Family Dwelling
TIGARD Fees Checklist
PERMIT INFORMATION:..
Permit #: Plan #: Date: (a � 0 9
Site Address: - \Z,cZ( i' d r 11,04-pri Parcel #:
Subdivision: Lot #: Zoning:
Jurisdiction: Setbacks: Front: Rear: Left: Right:
Class of Work: Stories: First Floor:,
Type of Use: Height: Second Floor:
Construction: Floor Load: Third Floor:
Occupancy Group: Dwelling Units: Bonus Room:
Valuation: Bedrooms: Total Floors:
Bathrooms: Basement:
Decks: tL Garage:
- Porches: Other:
FEES:.. - De . ';- • . Fee. Amount: '•' 'Am Paid: Balance Du
Plan Check: Building: ( ,
Extra Set:
Permit: Building: e5 c 3 , l
Tax: '( . zd
Metro CET: •
School CET:
Mechanical
Tax:
Plumbing:
Tax:
Electrical:
Tax:
Low Voltage:
Tax:
CDC: CDC Ping. Rev.:
CDC LRP Fee: 1/
SDC: Parks:
TIF Res.: •
TIF MT:
Erosion Permit:
Erosion CWS:
Erosion COT:
Water Quality:
Water Quantity:
SUB - TOTAL:
Sewer: Permit:
Inspection:
SUB - TOTAL:
TOTAL MST & SWR:
I: \Building \Forms \ResPlanCheckFees.doc 01/19/07 Page 1
PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential equipment/systems)
Description I Qty. I Fee(ea.) 1 Total Description - I Qty 1 Fee(ea.) I Total
• New 1- & 2 - family dwellings Heating/Cooling
(includes 100 ft. for each utility connection) • Air conditioning or heat pump* 14.00
SFR (1) bath 249.20 Furnace 100,000 BTU (ducts /vents) 14.00
SFR (2) bath 350.00 Furnace 100,000+ BTU (ducts /vents) 17.90
SFR (3) bath 399.00 Gas heat pump 14.00
Each additional bath/kitchen 45.00 • Duct work 10.00
Rain Drain, single family dwelling 65.25 Hydronic hot water system 14.00
Fire sprinkler - sq. ft. 0 to 2,000 115.00 Residential boiler
Fire sprinkler - sq. ft. 2,001 to 3,600 160.00 (for radiator or hydronic system) 14.00
Fire sprinkler - sq. ft. 3,601 to 7,200 220.00 Unit heaters (fuel, not electric)
Fire sprinkler - sq. ft. 7,200 and greater 309.00 (in wall, in -duct, suspended, etc.) 14.00
Site Utilities Flue /vent (for any of above) 6.80
Catch basin/area drain 16.60 Repair units 12.15
Drywell /leach line /trench drain 16.60 Other Fuel Appliances
Footing drain - 1" 100' 55.00 Water heater 10.00
Footing drain - each additional 100' 46.40 Gas fireplace 10.00
Manufactured home utilities 110.00 Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
Manholes 16.60 Wood/Pellet stove 10.00
Rain drain connector 16.60 Wood fireplace /insert 10.00
Sanitary sewer - 1" 100' 55.00 Chimney /liner /flue /vent 10.00
Sanitary sewer - each additional 100' 46.40 Other: 10.00
Storm sewer - 1" 100' 55.00 Environmental Exhaust& Ventilation
Storm sewer - each additional 100' 46.40 Range hood /other kitchen equipment 10.00
Water service 1" 100' 55.00 Clothes dryer exhaust 10.00
• Water service - each additional 100' 46.40
• Fixture or Item • Single duct exhaust
Absorption valve 16.60 (bathrooms, toilet compartments,
Backflow preventer 27.55 utility rooms) 6.80
Backwater valve 16.60 Attic /crawl space fans 10.00
Clothes washer 16.60 Other: 10.00
Dishwasher 16.60 Fuel Piping
Drinking fountain 16.60 * *($5.40 for first 4, $1.00 each additional)
Furnace, etc. **
Ejectors /sump 16.60 Gas heat pump **
Expansion tank 16.60 Wall /suspended/unit heater **
Fixture /sewer cap 16.60 Water heater **
Floor drain/floor sink/hub 16.60 Fireplace **
Garbage disposal 16.60 Range **
Hose bib 16.60 BBQ **
Ice maker 16.60 Clothes dryer (gas) **
Interceptor /grease trap 16.60 Other: **
Primer 16.60 Total: •
Roof drain (commercial) 16.60 Mechanical Permit Fees
Sink/basin/lavatory 16.60 Subtotal: $
Tub /shower /shower pan 16.60 Minimum Permit Fee $72.50 $
Urinal 16.60 Plan Review Fee (25% of Permit Fee) $
Water closet 16.60 State Surcharge (12% of Permit Fee) $
Water heater . 16.60 TOTAL PERMIT FEE $
Other:
Other:
Plumbing Permit Fees ELECTRICAL FEES (residential single or multi - family)
Subtotal $ Description Qty. Fee Total Insp
•
Minimum Permit Fee $72.50 $ 1,000 sq. ft. or less 145.15 4
Plan Review (25% of Permit Fee) $ Ea. add'! 500 sq. ft. or portion 33.40 1
State Surcharge (12% of Permit Fee) $ Limited energy, residential 75.00 2
TOTAL PERMIT FEE $ Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Electrical Permit Fees
Subtotal: $
Plan review (25% of permit fee) $
State surcharge (12% of permit fee) $
TOTAL PERMIT FEE $
I:\ Building \Forms \ResPlanCheckFees.doc 01/19/07 Page 2
PERMIT NO
CleanWater Services
Our commi, rue nl is Clear. LOT ly
j /4C i 2S - 6vi0c/
EROSION CONTROL INSPECTION REPOR
DATE ile,0 INSPECTOR 414 17;;,,,,SUBDIVISION / v4<-
O WNER/PERMITEE ,. , 1 d q - �
-
SITE ADDRESS
APPROVED
FINAL INSPECTION
rY y v y
THIS SITE MEETS THE POST- CONSTRUCTION
EROSION CONTROL REQUIREMENTS SET
FORTH IN CLEAN WATER SERVICES
RESOLUTION AND ORDER
NOTE: IF POST - CONSTRUCTION EROSION CONTROL MEASURES ARE STILL BEING
EMPLOYED ON THIS SITE TO MEET CRITERIA FOR AN APPROVED FINAL INSPECTION,
THE MEASURE(S) MUST REMAIN IN PLACE UNTIL LANDSCAPING IS COMPLETE
OR PERMANENT GROUND COVER IS ESTABLISHED.
A COPY OF THE FINAL EROSION CONTROL INSPECTION REPORT MUST BE
FORWARDED TO THE NEW OWNER, AT WHICH TIME NEW OWNER ASSUMES
THE RESPONSIBILITY FOR MAINTENANCE, REPAIR AND REMOVAL.
OTHER
THANK YOU FOR YOUR COOPERATION!
INSPECTOR A�.o�� PHONE ;0‘. 0`-°� -�
STREET TREE CERTIFICATION
I Owner/Agent for
Yom► .�.
(PLEASE PRINT) (PERMIT HOLDER)
Do hereby certify that the following location t meets
City of Tigard and Washington C unty
land use and development standards for street tree installation.
ADDRESS: / 2 Z o S c, S' 4") 0,2 1 ti c N Z I- ob l
SUBDIVISION: m v, c-w . ze S LOT: /
SIGNATURE: DATE: 3/2 7/0 i
(OVAER /AGEi\'T)
RECEIVED BY: DATE:
(CITY OF TIGARD)
i
1: \ Building \ Forms \StreetTrecCertificate 01/19/07