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Permit
MASTER PERMIT CITY o f TIGARD PERMIT #: MST2008 -00001 "' i ' COMMUNITY DEVELOPMENT DATE ISSUED: 1/24/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S135AB-03202 SITE ADDRESS: 10455 SW 90TH AVE ZONING: R -4.5 SUBDIVISION: ASHBROOK FARM LOT: 010 JURISDICTION: TIG PROJECT: PRINCE Project Description: 400 square foot outbuilding. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ACS HEIGHT: 10 FIRST: sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND: sr GARAGE: 400 sf FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf 14,764 00 REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 0 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP H 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FOR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st WIG SVC /FDR: SIGN /OUT UN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNOSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable KEITH & KRISTIN PRINCE OWNER laws. All work will be done in accordance with approved plans. This 10455 SW 90TH AVE permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or direct Phone: 503 892 - 9154 Contact #: questions to OUNC by calling 503.246,6699 or 1.800 332.2344. Reg #: TOTAL FEES: $ 493.02 REQUIRED ITEMS AND REPORTS Issued By : w (�(J.c� Permittee Signature :A ..-- / ........7i,/,/f . Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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 . :-, w , Residential REcEIVE) FOR OFFICE USE ONLY ii - . City of Tigard O LOO D ateiv ed l / O r 0 PennitNo.:kGJ( Og - c '/ ® 13125 SW Hall Blvd., Tigard, OR 97223 O Y e � Plan Review Phone: 503.639.4171 Fax: 503.598. m`1" Y Or riekuk Date/By: ) ' a3.6 Other Permit: TI G ARD Ins ection Line: 503.639.417 '�`�� Date Ready /By: t 65 See Page 2 for p BUILDI� Cr 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. Valuation: $ 1)76 .c't) 1=1 1- and 2- family dwelling ID Commercial /industrial Accessory building 111 Multi-family Number of bedrooms: ❑ Master builder El Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: ) 0 4 Sc 5 ,i,J s New dwelling area: square feet City /State /ZIP: 9 -7 aq. 3 , -K- ' G 0.y. ek t Cf. e _ 01 ,,,„,, Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: p, , y\ C:e Covered porch area: square feet Cross street/directions to job site: c CI'( ' \-t4: Cao k-■,.. Deck area: square feet ( Other structure area: " 1/40 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. Q Z \ � Valuation: $ cA t.lt a t/1G. l� S ' ��" 'M` N ek .1:› ��i ` ` ( ` Existing building area: square feet 1�` d� New building area: square feet X, PROPERTY OWNER ❑ TENANT Number of stories: Name: Kelly Q ; c....-C-...— Type of construction: Address: 1 p 4 S s S ...,) . c( 0 !- Occupancy groups: City /State /ZIP: "`°` ,",� / , e. . 2_ 7___ 7___ Existing: Phone: ( TS) e t C 2.-- 9 1 S (I — Fax: ( ) New: ❑ : APPLIWT [ CONTACT PERSON NOTICE Business name: 1 All contractors and subcontractors are required to be / licensed with the Oregon Construction Contractors Board Contact name: �` ", pr t ✓i r - C._ under ORS 701 and may be required to be licensed in the Address: �� OA e` jurisdiction in which work is being performed. If the City/State/ZIP: applicant is exempt from licensing, the following reasons � �� +t - C� apply: Phone: C'Lq_ ef *.II - z 1 C L -8 414. Fax:: ( ) C'/ G1 n3 ,29 E -mail: y • ?)CI CONTRACTOR Business name: ti., v1 �_ BUILDING PERMIT FEES* Address: (Please refer to fee schedule) Structural plan review fee (or deposit): City /State /ZIP: Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lic.: Total fees due upon application: 1 . ' , Amount received: t1lP1 t- Authorized signature: - r f A ^ ^c n /, /l� ` X This permit application expires if a permit is not obtained Print name: Date: . ` * within 180 days after it has been accepted as complete. • 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) 1 • Building Permit Application Checklist 4-.. • • One- and Two - Family Dwelling . .FOR OFFICE USE `.ONLY ` . • City of Tigard Received Permit No.: li pq Date/By: a 1 3125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 Associated permits: 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical T I G A R D Internet: www.tigard-or.gov El 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. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 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 legible 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 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- ❑ ❑ ❑ 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- ❑ ❑ ❑ 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 ❑ ❑ ❑ 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 project under review. JURISDICTIONAL SPECIFICS 23 Five (5) site plans are required for 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 accompanied by 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. I:\Building \Permits \BUP -RES- PermitApp.doc 03/21/06 440- 4613T(I I /02/COM/WEB) A Plum.bii g Permit Applicatid .� 1i E Building Fixtures b t EC I FOR OFFICE USE ONLY City of Tigard JAN 0 9 ZU08 Received / Q s/ r' Date/By: 7 6 7� / Permit No.: 7 - AI j� - e a:0/ I s 'u 13125 SW Hall Blvd., Tigard, OR 97223 v "` Plan Review • Phone: 503.639.4171 Fax: 503.598.19 I Y ®F 11UARD Date/By: Other Permit No.: Inspection Line: 503.639.4175 BUILDINGOIVISION Date Ready/By: 7 ® Page 2 for See Pa TIGARD Internet: www.ti ard -or. ov y Y � g g g Notified/Method I !(j Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction 1:1 Demolition For special information use checklist Description I Qty. I Ea. Total ❑ Addition/alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 ❑ Master builder ❑Other: Each additional bath /kitchen 45.00 Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address:/GS c , (,,, c �'E-t''‘• Catch basin or area drain 16.60 City /State /ZIP: G exre) C/ G� 2_2 -3 Drywell, leach line, or trench drain 16.60 J Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name: pr'( t„ <.'e, Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: /00) 1 Page 2 Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 - `-- DESCRIPTION OF WORK Backflow preventer Page 2 O crs_\-- vr'° ; ` ate N c,.. Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 PROPERTY OWNER ❑ TENANT Ejectors /sump 16.60 Name: /c J5 S 5 .e.) . 9 / © -4-L ` Expansion tank 16.60 Address: Ke: �� R,J-- c__---C-- Fixture /sewer cap 16.60 City /State /ZIP: 7 ` ar 4 ©.- C e,- i•-) C _l . '7 22_ -3 Floor drain/floor sink/hub 16.60 Phone: (SO� . d z _ e, [ 5 c ! :l(Q 7(J Z t _ ©4 1 4 Garbage disposal 16.60 12 APPLICANT T ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: ( ) Fax: : ( ) Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: Water heater 16.60 Address: 0146 Other: City /State /ZIP: Subtotal Minimum permit fee: $72.50 7a G� Phone: ( ) Fax: ( ) Residential backflow minimum permit fee • $36.25 •J CCB Lic.: n Fr" sing Lic. no.: Plan review (25% of permit fee) State surcharge (12% of permit fee) . 11, Authorized signature: -, TOTAL PERMIT FEE Print name: Date: 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. t:\Building \Permits \PLMF- PermitApp.doc 12/27/06 440- 4616T(10/02 /COM/WEB) Plumbing Permit Application - City of Tigard . _ Page 2 - Supplemental Information • Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qt Fee (ea) Total Squar e ' Footage: Permit Fee: Footing drain - 1 100' 55.00 0 to.2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Q ty. Fee (ea) Total additional $100.00 or fraction thereof, to and Fixture or Item including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to • (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Plan Review for Plumbing Installations Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees ❑ Any new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type: Replace engineer. Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font _ as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacu7ri/Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial -Domestic Isometric or Riser Diagram . Drinking Fountain Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink - 2" that meet the qualifications above. - 3" -4" Car Wash Drain Garbage - Domestic Comments regarding fixture work: Disposal - Commercial • - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be.issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: i.\ Building \Permits\PLM- PermitApp.doc 12/27/06 JAN 10 2008. 7: 09FIM HP LASERJET 3200 P, 2 U ii ii i l , - li 'L; JA 1 0 2008 Ii fl C]eanWat Services Our•commiiment i clear. -- -•— -- - -,1 CWS File Number Sensitive Area Pre - Screening I 0 '- 00009/ I Site Assessment • Jurisdiction: Property Information: (example 1S234A801400) Owner Informatio ^ C_ �T Taxlot ID(s): IS 1 ,413 ti��1�� 1`� Name: t". I V J ' t ■1A Company: (.4. e „4,, c en.t..Nrs..e._V .. Address: 1.0 tkSS ,(.J. 9 0 L‘.. 4\ 41 .-- Site Address: 1 0 L( S l c c p bi r �O -k " Ave.__ T t ar t� .r_ , , t - 2 ?. " U e�,r•c, C�✓e•ve.v% G i - i aa-s Phone/Fax:,r�© r ° I - � f / g/ Nearest Cross Street: S\- . E -mail: t\e,,A.e Development Activity: Check all that apply Applicant Information: Addition to Single Family Residence (rooms, deck, garage) 1■1! Name: Lot Line Adjustment ❑ Minor Land Partition ❑ Company: Residential Condominium ❑ Commercial Condominium ❑ Address: Residential Subdivision ❑ Commercial Subdivision ❑ Single Lot Commercial ❑ Multi Lot Commercial El Other \.3C% A0 iee dk \' wt."-Nke�11 v'' F� , Phone'Fax: / J / E -mail: Will the,project involve any off -site work: YES n NO RI Unknown n Location and description of off -site work: • Additional comments or Information that may be needed to understand your project This application does NOT replace the need for Grading and Erosion Control Permits, Connection Permits, Building Permits, Site Development Permits, DEQ 1200 -C Permit or other permits as Issued by the Department of Environmental Quality, Department of State Lands and /or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. By signing this form, the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees or Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the i for • on con • d in this document, and to the best of my knowledge and belief. this information is true, complete, and accurate. Print/Type Name: a t�� r` ✓1 Print/Type Title: A45 £41.6_ ®c_j v �� Signature: Ar e" /�� - Date: - � ---- S I FOR. DISTRICT USE ONLY ❑ Sensitive areas potentially exist on cite or within 200' of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT I PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. if Sensitive Areas exist on the site or within 200 feet on • adjacent properties, a Natural Resources Assessment Report may also be required. ❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200' of the site. This Sensitive Area Pre- Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, State, and federal law. * Based on review of the submitted materials and best available information the above referenced project will not significantly . impact the existing or potentially sensitive area(s) found near the site. This Sensitive Area Pre- Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. n This Service Provider Letter Is not valid unless CWS approved site plan(s) are attached. n The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT 0 SERVICE PR IDER LETTER IS REQUIRED. • Reviewed By: ' /= ie-- -- Date: / 471_4 8 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 )4.4/1... Phone: (503) 681 -5100 • Fax: (503) 681 -4439 • www.cleanwaierscrvices.ora Revised: May 8, 2007 Pr . ... j. — - - -- AN 0 LOQ8' �.Ja jam' CITY OF 11 © _ X ±5 i + ��R -��T vR �� l � u�c ®ONt� a ON — 1--- - CITY OF TIGARD - SITE PLAN R IE 1 BUILDING PERMIT NO.: 4+- 1hso'ic� .0 . _ -! _ _: PLANNING DIVISION: ( .. , , , Required Setbacks: Appro _ v ■ . . _ot Approve — - - - ed Side: 5 Street Side: ,- t� Front. ' Garage: Rear: 45 � i 1 C l e a r a n c e : Idin�, Heig�Ap r f d�/� D- Not Approved s ' Maximum CW; Service Prpvider Lette ' e uired: Dir Yes No • ❑ Receiv — I'> D a 1100 1 ENGINEERING EP R k , (NGINEE ENT 1 Actual, Slope: ° � 4 ',Approved • - - - - -- - - - - -- - L . -- - PP ❑ Not Ap roved • _ Site — ' — n �A 'roved - - �. , t Approved PP N — I i B Date: • / 4 6 6 • -r Notes :' ,r',, ' i 1 L 'G" - i ' 1 1 ' l Y OF. TIGARD I I i BUILDING — —[ ! — - -' CITY ITE;PLAN REVI I�_. _ PERMIT NO: II $ — Der0 . ;'' — f i I ppr ❑ A p r i .;9 I , .A oved Protected Trees: I � Not � � , � � � � 1 -- � i - B: I I ® Approved ❑ Not'Ap . ■ ved ! < < -. U°`. y 4c ? ter Date' �ro� � \; ; � , �� Not 6114 c , s e� knee 3 / \� ` - ' I I c.�i 5.0 3'718-A7 0 0 \ . i f - _ • / - / / I i / • - , - - -- - - / f � ' . I -- - 1 - - , / / I �i- -- //` - - - - - - - -- - - - { F. / . Pr'O pc_f t'c� , , .,,,, i W _r — O ' D"tp ..►�,t k t. J .max (-X- 8/ it ' . / . , CITY OF TIGARD _ BUILDING DIVISION PERMIT #: Ms1i2O08.00001 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: .I fe };12008 Phone: (503) 639 -4171 j °a�lpu�ii @I�j1il Inspection Requests (24 Hrs.): (503) 639 -4175 _� =__.. INSPECTION WORKSHEET FOR DATE: 10/28/2008 TIME: 7:01AM PAGE: 8 SITE ADDRESS: 1045 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASI-IBROOK FARM LOT #: 010 TYPE OF USE: PROJECT NAME: PRINCE DESCRIPTION: 400 square foot outbuilding. OWNER: PRINCE, KEITH & KRISTIN PHONE #: 603”892- 91 %4j CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/28/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Finial inspection 077272-01 503- 882 -9154 N Corrections /Comments /Instructions: /VD 6 67 , Al i s? -x%77 ()= c - -TGcv�a 0 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS III FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /1 28 Phone #: (503) 718 - Z -------7 CITY OF TIGARD 0. . BUILDING DIVISION AA ., PERMIT 1 1 ft: ms 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1124/2008 Phone: (503) 639-4171 i ttilly Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 7/30/2008 TIME: PAGE: 4 7:01AM SITE ADDRESS: 10455 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHBROOK FARM LOT #: 0 TYPE OF USE: PROJECT NAME: PRINCE DESCRIPTION: 400 square foot outbuilding. OWNER: PRINCE, KEITH & KRISTIN PHONE #: 503.892_9-m CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7 /30/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 073472-01 503-892-9154 N Corrections/Comments/Instructions: . • el A L.:- 1 /a - ' 1--1-4.-: ..ifiEfilt, 1-' :LAIIIPArZ01. - ---,- - ---'-' .ff z i- -;( Jr. - A • - 11- - 11,5S fl PARTIAL APPROVAL 0 CANCEL r7 NO ACCESS FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: i Date: 7— /e,—,. 9I Phone #: (503) 718- -244,41- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008.00001 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/24/2003 A, Phone: (503) 639-4171 „41Itilit Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 3/7/2008 TIME: 7:00AM PAGE: 7 ) SITE ADDRESS: 10155 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHBROOK FARM LOT #: 010 TYPE OF USE: PROJECT NAME: PRINCE DESCRIPTION: 400 square foot outbuilding. OWNER: PRINCE, KEITH & KRISTIN PHONE #: 503-892-91E CONTRACTOR: OWNER PHONE #: A ,Afr C Inspection Request Scheduled For: Date: 3/7/2008 Pour Time: A k I (i Code # Inspection Description Confirm # Contact # Mes : r 4' 275 Framing 066302-01 971-210414 Correc ions/Comments/Instructions: .--\.____ tL\-0--e___SLaza -v,,z-A s--.---iath. Z ) .""-- e* '‘k,e)L5..ls C.0 6 ‘■P'0.-.\ --- t" -- b\(:) .. - "\ -- 6 p ow— / () ) (4- • - I '2 (.0-4-0,..„./.2„-- - c s r) Le v c Vr6—■:-.-■3 ./Q / 6,3/641g@t r . . G -- , 0 0= 0 c.. t eAA C--41•-.1-N"--C . t % C a .... - _ Cr a--t I ( ))%raitAi I--■; L i i ) \( V6/4 ‘ a ( 5 T ) 6 - ' 1 1 o * * CY ? ---.1' . ( ' C ( -' - -- Not A CEV PASS PARTIAL A OVAL . CANCEL E FAIL 1 E CALL FOR INSPECTION FY 0 El ADDITIONAL FEES ASSESSED Inspector: 1/6 c,( Date:) /) 6 Phone #: (503) 718- 2,-/ 2-4 _ . CITY OF TIGARD ,, BUILDING DIVISION PERMIT #: M;Otis 0t }t".;11 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: -1/;1 /2fa00 Phone: (503) 639 -4171 . = ' a �� fI 1 " Inspection Requests (24 Hrs.): (503) 639 -4175 Ai INSPECTION WORKSHEET FOR DATE: 2/15/2008 TIME: 7:00AI i PAGE: 6 SITE ADDRESS: 10455 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHBROOK FARM LOT #: 010 TYPE OF USE: PROJECT NAME: PRINCE DESCRIPTION: 400 square foot outbuilding. OWNER: PRINCE, KEITH 11., KRISTIN PHONE #: 603.892 -91 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 2115/2000 Pour Time: 1:00 Code # Inspection Description Confirm # Contact # Message 305 Footing 065114-01 503 -892 -9154 N Corrections/Comments/Instructions: re •" r , , u , — At . of %s s> ' .2.P ` 4 -- - Z. - - PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED / Inspector: N Date: '� c s --c� �- Phone #: (503) 718- �V CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST2008-00001 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/24/2008 Phone: (503) 639 -4171 :4,1f�l1l Inspection Requests (24 Hrs.): (503) 639 -4175 �' INSPECTION WORKSHEET FOR DATE: 1/28/2008 .TIME: 7:00Am PAGE: 18 SITE ADDRESS: 1045% SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHBROOK FARM LOT #: 0.0 TYPE OF USE: PROJECT NAME: PRINCE DESCRIPTION: 400 square foot outbuilding. OWNER: PRINCE, KEITH & KRISTIN PHONE #: 503.892 -9164 • CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: a (/78/2008 Pour Time: 1 -C Code # Inspection Description Confirm # Contact # Message 205 Footing 064056-0/ 503.892 -9154 N Corrections /Comments /I structions: • 4 i co _9) ❑ PASS PARTIAL APPROVAL ❑ CANCEL [l NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 4, v Date: v" / d Phone #: (503) 718- �� L L INSPECTOR'S SIGNATURES ARE NOT Inspections Required for: MST2008 -00001 REQUIRED ON GREEN INSPECTION CARD. 1Gode' `'+ Irispection' =,'° k `_= `PASS >Date:`$y ", °;t MST - Master Permit 405 Excavation 410 Fill 415 Grading X 205 Footing 805 MFG - Structure grading /footing ' 210 Foundation walls 215 Footing drain 305 Plumbing underslab 105 Underground /slab cover X 220 Slab 310 Crawl drain 315 Post /beam plumbing 605 Post /beam mechanical 225 Post /beam structural 230 Underfloor insulation X 235 Shear walls /anchors X 240 Exterior sheathing 242 Interior shear walls 245 Firewall X 250 Roof nailing 255 Wtr proofing basement walls 265 Masonry 270 Reinforcing steel (rebar) 320 Plumbing rough -in 322 Shower pan 610 Gas line 615 Mechanical rough -in 110 Temporary electrical service 115 Electrical service 120 Electrical rough -in 135 Low voltage 910 Sprinkler rough -in X 275 Framing 810 MFG- Structure set -up 280 Insulation 330 Water service X 335 Rain drain 340 Storm drain 505 Sanitary sewer 350 Septic tank 285 Drywall nailing 289 Approach /sidewalk 295 Misc. inspection: 899 MFG - Structure final 498 Grading final 699 Mechanical final X 399 Plumbing final 199 Electrical final X 299 Final inspection /d -/b I: \ Building \ Forms \InspCard- MSI'- Blank.doc 02 /02/07 A i -' .. CITY OF TIGARD MASTER PERMIT PERMIT #: MST2008 -00001 COMMUNITY DEVELOPMENT DATE ISSUED: 1/24/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S135AB SITE ADDRESS: 10455 SW 90TH AVE ZONING: R - 4.5 SUBDIVISION: ASHBROOK FARM LOT: 010 JURISDICTION: TIG PROJECT: PRINCE Project Description: 400 square foot outbuilding. BUILDING REISSUE' CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ACS HEIGHT: 10 FIRST: sf BASEMENT. sf LEFT: 5 SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND sf GARAGE: 400 sf FRONT: 20 PARKING SPACES • TYPE OF CONST: 5N DWELLING UNITS. THIRD. sf RIGHT: 5 VALUE OCCUPANCY GRP' R3 BDRM: . BATH: TOTAL: 0 sf 14,764.00 REAR 15 PLUMBING SINKS: WATER CLOSETS. WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 0 TRAPS LAVATORIES' DISHWASHERS: FLOOR DRAINS: SEWER LINES. SF RAIN DRAINS 1 CATCH BASINS: TUB /SHOWERS. GARBAGE DISP: WATER HEATERS: WATER LINES. BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < WOK: . BOILJCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES. GAS OUTLETS' ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 3 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION• PER INSPECTION. CPI EA ADD'L 500SF; 201 - 400 amp. 201 - 400 amp: 1st W/O SVC /FDR: SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY' 401 - 600 amp: 401 - 600 amp' EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT. ` MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v. MINOR LABEL: b 1000+ amp /volt : 0 PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC 8 ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL O AUDIO P. STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: ZO BURGLAR ALARM: OTH: BOILER. HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: A `j GARAGE OPENER. CLOCK: INSTRUMENTATION: MEDICAL: OTHR: \ HVAC: DATA/TELE COMM: NURSE CALLS' TOTAL 0 SYSTEMS. This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable KEITH 8, KRISTIN PRINCE OWNER laws. All work will be done In accordance with approved plans. This 10455 SW 90TH AVE permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct Phone: 503 - 892 -9154 Contact #: questions to OUNC by calling 503.246.6699 or 1 800.332.2344. Reg #: TOTAL FEES: $ 493.02 REQUIRED ITEMS AND REPORTS Issued By : r Permittee Signature :x : ma - �' ii� /� 9 s Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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.