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Permit C ITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2008 00139 COMMUNITY DEVELOPMENT DATE ISSUED: 4/24/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2 S 104AB - 06300 SITE ADDRESS: 12162 SW 131ST AVE ZONING: SUBDIVISION: MORNING HILL NO. 4 LOT: 092 JURISDICTION: TIG PROJECT: ROAST Project Description: Replace existing second story deck. REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: sf N: S: E: W: TYPE OF USE: SF SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5 -1 HR sf N: S: E: W: OCCUPANCY GRP: R3 TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 1,979.00 Owner: Contractor: BRAD & LAURA ROAST OWNER 12162 SW 131ST TIGARD, OR 97223 Phone: 503 - 590 - 3314 Contact #: Reg #: FEES Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 4/24/2008 $62.50 [TAX] 12% State Surch 4/24/2008 $7.50 [BUPPLN] Pln Rv 4/24/2008 $40.63 Total $110.63 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 than 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 -0100. You may obtain a copy of thes:- • - • -ct que ''ns to OUNC by calling 503.246.6699 or 1.800.332.2344. Iss , ed By: k . Og ,!I V A Permittee Signature: ` �� �'•� _ 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 Residential FOR OFFICE USE ONLY 4 City of Tigard t� DateB� —t / � 7 Permit No.: / 'Poo ) q 13125 SW Hall Blvd., Tigard, 0 223 R 4 200 Plan Review P hone: 503.639.4171 Fax: 503.5981960` Date/By: Other Permit TIGARD Inspection Line: 503.639 ( �I TY r - - 1 ! ° i ! �� fA® Date Ready/By: Juris: RI See Page 2 for Internet: www.tigard- or.gov �, - •li •, g � i �� Notified/Method: Supplemental Information TYPE OF WORK REQUIRED DATA: I- 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: $1,979 ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ® Other: DECK Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 12162 SW 131 AVENUE New dwelling area: square feet City/State/ZIP: TIGARD OR 97223 Garage/carport area: square feet Suite/bldg./apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: KATHERINE Deck area: 106 square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: MORNING HILL 4 Lot no.: 92 Permit fees* are based on the value of the work performed. Tax map /parcel no.: 2S104AB 06300 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. REPLACE EXISTING SECOND FLOOR DECK Valuation: $ Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: BRAD ROAST Type of construction: Address: 12162 SW 131 AVENUE Occupancy City/State /ZIP: TIGARD, OR 97223 Existing: Phone: (503)590 -3314 Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: 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: OWNER BUILDING PERMIT FEES* Address: (Please refer to fee schedule) • Structural plan review fee (or deposit): City/State/ZIP: FLS plan review fee (if applicable): Phone:( ) Fax:( ) - CCB lic.: Total fees due upon application: 111 Amount received: Authorized signature: J—` This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: = �/2�� Date: y e — c. • Fee methodology set by Tri-County Building Industry Service Board. t. APR 1 5 20!; ' • C1eanWater • ervlces • B Onr colnmilin iii i' •Ica r. CWS File Number Sensitive Area Pre - Screening I O - 00/ 0 7 ? I Site Assessment Jurisdiction: c: r T'{ C):=- Property Information: (example 1S234AB01400) Owner Information: Taxlot ID(s): S -I C'' ��°' L. -/ Name: InD Company: Address: I - ( c , ) Site Address: V ( 62 6 i i v r cz, i+ •7 6 1p °7 Z 23 Phone /Fax:L_5O s - F 0 ^ )y, / Nearest Cross Street: i` T E -mail: B t.-P- A.05 r / t . •-:::zz=t ° '( Development Activity: Check all that apply Applicant Information: Addition to Single Family Residence (room deck garage) Name: ©•E- Lot Line Adjustment ❑ Minor Land Partition ❑ Company: Residential Condominium ❑ Commercial Condominium ❑ Address: Residential Subdivision ❑ Commercial Subdivision ❑ Single Lot Commercial ❑ Multi Lot Commercial ❑ Phone /Fax: / Other o. E -mail: Will the project involve any off -site work: YES ❑ NO 1 2 Unknown ❑ Location and description of off -site work: Additional comments or information that may be needed to understand your project: R E PL fac f f'li_1.1 E* I t:, tc- 2)r it7 F=e -r3-.1 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 of 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 information contained in this document, and to the best of my knowledge and belief, this information is true, complete, and accurate. Print/Type N. r• - • 4 ;110" < T . Print/Type Title: Z lE e_ AL\ Signature: - � •�� Date: `Zi - 1 4 R te% F • - DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT 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. r= 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. ,. This Service Provider Letter is not valid unless f CWS approved site plan(s) are attached: ❑ 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 O�E PR VIDER LETTER IS REQUIRED. Reviewed By: Date: y,AA /D a 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 Phone: (503) 681 -5100 • Fax: (503) 681 -4439 • www.cleanwaterservices.org Revised: May 8, 2007 OD c _41 ._ _ ____ il U O i p 1.Ei 1Z yAIZD 0- ccs c z + / , LI ms o S t't E \v I c_K >, ( 2s-la FLc 2.) OD r a>ci 5 T C E r : / / ( ( sT Fe. ootZ) i / / S Y Iiz 5 / � ' / // , ./ / ` j / I / ' i i r , / / / / / / ; o I -c3 HQU6E S DE yARD • SITE PLA 12 IF- PI_ACE EX I ST I Iv G 0E C- IS 1 2 1 b 2 S \, 1 3 I s-r /s.■\/ JE 1.t CA E . CITY OF TIGARD BUILDING DIVISION PERMIT #: rtaP200800139 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/2412008 Phone: (503) 639 -4171 nom l� t llliii Inspection Requests (24 Hrs.): (503) 639 -4175 i INSPECTION WORKSHEET FOR DATE: 8/4/2000 TIME: 7:03AM PAGE: 17 SITE ADDRESS: 12162 SW 131ST AVE CLASS OF WORK: SUBDIVISION: MORNING HILL NO. 4 LOT #: 092 TYPE OF USE: PROJECT NAME: ROAST DESCRIPTION: Replace existing second stoly deck. OWNER: ROAST, BRAD & LAURA PHONE #: 503 -f�90 -3314 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/4/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message A ✓1,4 299 Final inspection 07366 01 503 - 590 -331; Y Corrections /Comments /Instructions: iS Rte If Vol -.- 6 rA.-- Ca,...) . PASS I PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS ❑ FAIL _ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector Date: e 7 /4 5 CnY Phone #: (503) 718 - .07/� CITY OF TIGARD BUIL6ING DIVISION PERMIT #: F3UP200B. 00139 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/24/2008 Phone: (503) 639 -4171 nwm1 + Inspection' Requests (24 Hrs.): (503) 639 -4175 ' 'IL . INSPECTION WORKSHEET FOR DATE: 5/1/2008 TIME: 7:00AM PAGE: 9 SITE ADDRESS: 12162 SW 131ST AVE CLASS OF WORK: SUBDIVISION: MORNING HILL NO. 4 LOT #: 092 TYPE OF USE: PROJECT NAME: ROAST DESCRIPTION: Replace existing second story deck. OWNER: ROAST, BRAD & LAURA PHONE #: X03- 590.3314 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/1/2008 Pour Time: 9:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 069182-01 503-781-2255 Y Corrections/Comments/Instructions: 411, Lad A�P SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: /.7.A Date: ,5" 7 -4' g Phone #: (503) 718- Z4)-q--