Permit CITY OF TIGARD MASTER PERMIT
II 2 .,;' COMMUNITY DEVELOPMENT Permit #: MST2011 -00143
13 125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/26!2011
: ,-: . - Parcel: 2S102DB03300
Jurisdiction: Tigard
Site address: 13336 SW CHELSEA LP
Subdivision: CHELSEA HILL Lot: 10
Project: YOUNG
Project Description: Replacing deck and adding stairs to deck.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third', 0 sf Right: 0
Detectors: No
Total: 0 sf Value: $5,859.00 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
Drains: 0
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell- Trench Drain: 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 SrvclFeeders Branch Circuits
1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add9 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:
YOUNG, ERIC & CARRIE OWNER Required Items and Reports (Conditions)
13336 SW CHELSEA LOOP
TIGARD, OR 97223
PHONE PHONE:
FAX:
Total Fees: $377.48
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 do . ' - .: - ice 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
da . ATTENTION: 0 , ...on law -quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9.2- 001 -0010 through OAR • 11 -08:0. «u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � _ /_ /� 62 Permittee Signature: ___ ...........
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 proje .
Approved plans are required on the job site at the time of each inspection.
Building Permit Application '
Residential + �) FOR OFFICE USE ONLY
a City of Tigard j ri \� D �t R a� Permit No.: — 1312 SW Hall Blvd., Tigard, OR 97 1 Plan Review `/ P.& ° : '. Phone: 503:718.2439 Fax: 503.598.1960 �(
Inspection Line: 503.639.4175 j O S 10 Date Ready
/By: l at eJB : � �� `,� other
TI u A R Ready/By: ry See Page ntal 2 for
ation
Info
Internet: www.tigard- or.gov (* 4)l" Notified/Method: 3 _ A FM Supplemerm
C __I.: t w 1 -
TYPE OF WORK - / REQUIRED DATA 1- AND 2- FAMILY DWELLING' ,
❑ New construction El 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: Replace deck equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
i �'� 6`
1- and 2 -family dwelling Commercial/industrial Valuation: $ G o GL��
CI 1-
CI Accessory building ❑ Multi- family Number of bedrooms: 4
❑ Master builder ® Other: Deck Number of bathrooms:
' - JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13336 SW Chelsea Loop New dwelling area: square feet
City/State/ZIP: Tigard/OR/97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Deck re-do Covered porch area: square feet
Cross street/directions to job site: Omara/Chelsea Loop Deck area: 432 square feet APP
Brown house at the bottom of the loop Other structure area: square feet
REQUIRED DATA:. COMMERCIAL -USE, CHECKLLST
Subdivision: I 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.
Old deck needs replacement. Add stairs to the side yard. Valuation: $
^/J ® MO 1-FEeT A- Lckas, si0e: rAG.HailfzE 4. •),F Ghy"r• Existing building area: square feet
'TOTAL OF 10 X Al New building area: square feet
® PROPERTY OWNER ❑ TENANT ' Number of stories:
Name: Eric Young Type of construction:
Address: 13336 SW Chelsea Loop Occupancy groups:
City/State /ZIP: Tigard/OR/97223 Existing:
Phone: (503)521-6219 Fax: ( ) New:
❑ ,APPLICANT . ❑ CONTACT PERSON - BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: -
Structural plan review fee (or deposit):
Contact name:
FLS plan review fee (if applicable):
Address: 7 A
City/ State/Z1P:
Total fees due upon application: U
Amount received: /0 7 Phone: ( ) Fax: : ( )
,
E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof -top mounted PhotoVoltaic Solar Panel System.
Business name: none 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 lic.:
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
I within 180 days after it has been accepted as complete.
E ,12- I Print name: p I Date: 7 /2p 'L A I '* Fee methodology set by Tri- County Building Industry
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Building Division
Development Code Provision Review
T I CARD Residential Projects
Building Permit No: / /— _ . I
CWS Service Provider Letter Received: Yes r No ❑ N/A ❑
Routed Plans: y
Original Plan Submittal Date: II 4'7>
1st Revision Submittal Date: ❑ Site Plan Only
2nd Revision Submittal Date: ❑ Site Plan Only
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the
Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be
revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section.
Staff: please check items along left only if approved. ,�,,�� �
Planning Review (contact S-I 1 at 503 - 718 - - or �Tw @ ti or.
La9d Use Case No. Name
Zoning /2- 1 ''-D
Ii( Setbacks:
Ib Rear 1) ode J Street Side l Garage
E( Maximum Building Height (55 Actual Building Height
Er Visual Clearance
Easements > /�/ ) /� / J
Er Sensitive Lands Type: / 07) ( / P 1LK� de- '4Q (NY /, C
Notes: 4,/b fi
t>r ' StC?ll C �._ 1 . (34T1 C
Original Plan: Approved Er Not Approved ❑ Date: 3 'I I -
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov)
❑ Actual Slope: 7
Notes:
Original Plan: Approved Not Approved ❑ Date: = i I I
Revision 1: Approved ❑ Not Approved ❑ Date: P' P
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
Cii rborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard- or.gov)
tree s Trees
Protected Trees
Notes:
Original Plan: Approved Not Approved ❑ Date: vi pi
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard- or.gov)
❑ Conditions of Approval Prior to Issuance of Building Permit
Notes :
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to App ' • ant
Okay to Issue Permit: Yes N� 7 G
Date Routed to Building: ! /i / 1/
Page 2 of 2
RECErtiFL
Property Owner Statement AUG 1 1 2'
Regarding Construction Responsibiiities GAi} ,
Oregon Law requires residential construction permit applicants who are not Iicens '
Construction Contractors Board to sign the following statement before a building permit can be
issued. (ORS 701.325 (2))
This statement is required for residential building, electrical, mechanical, and plumbing per mits.
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 a II 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 w ill
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 hom eowner statement is true and accurate.
L A N G
Print Name of Permit Applicant ,
_. 7 li_to ) 7-0 1 ■
Sign. of Permit Appli .nt Date
Permit #: Ms /43
Address: / 333(x0 610 CW¢UL � - -l" `
/ j � T
Issue by: _ i !� ,,i IA ate: r 024(
I
//
This Copy for Permit Offices
: S� J - --1—L11 � Clean Wafter Services File Number
AUC 1 201 l r` I 11._ 00 ?L{ 10 I
C eanW ate Services
By ensitive Area Pre -Screening Site Assessme RECEIVED
"1. Jurisdiction: Tgard
2. Property information (example 1 S234AB014(10). 3. Owner Information
AUG 11
Tax lot ID(s): 2S Name: Eric and.,Cartie Young C MO
Company: .. .. ilLDINGA1V1S
Address:13336 SW Chelsea Loallo
13336 SW Chelsea Lo : i l i a nd
Site Address:. P City, State, Zip: 9 . _ , PR 97223
City, State, Zip: Tigard, OR 97223 Phone /Fax: 503•,5 -6
Nearest Cross Street Omara E -Mail: gento2@yahoo.corn..
4. Development Activity (check all that apply) 5. Applicant Information
54 Addition to Single Family Residence (rooms, deck, garage) Name: Eric Young
❑ Lot Line Adjustment ❑ Minor Land Partition Company:
❑ Residential Condominium ❑ Commercial Condominium Address: Z3336 SW Chelsea Loop
❑ Residential Subdivision (a Commercial Subdivision Ti ar OR 97223
❑ Single Lot Commercial l3 Multi Lot Commercial City, State, Zip: 9... d,
Other Deck Phone/Fax: 503 -521 -62'19
E -Mail: gento2 @ yatibo.COlT.
6. Will the project involve any off -site work? ❑ Yes _. No ❑ Unknown
Location and description of off -site Work
7, Additional comments or information that may be needed to understand your project
Pre - existing deck was removed and a new deck is being put in its place, slightly larger 20'x12'
This application does NOT replace Grading and Erosion Control Permits, Connection Permits, Building Permits, Site Development Permits, OEQ
1200 -C Permit or other
permits as issued tsy the Department of Environmental Quality, Department of State Lands and(4r 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 gees that empoyees of Glean Water Services have authority
to enter the project she at all reasonable times for the purpose of inspecting project site conditions and gating 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 tire, compete, and acaaate.
PrintlType Name Eric Young P e ;.. y Owner
YPe
Prin tlT Title : rop
Signature _. E ' ..: -" i f7Ji It
FOR DISTRICT USE ONLY
U Sensitive are* potentially exist on site or within : 20(1' of the site. THE APPUCANT MUST PERFORiVi A SITE ASSESSMENT.PRIOR TO ISSUANCE Of A
SERVICE PROVIDER Ll_ r i tx. If Sensitive Arm exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessrnerit Report
6)4 '00 be required.
lJ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 2W of the site This
Sensitive Area Prescreening SiiteAssessment does NOT eliminate the need to evaluate and protect water quakily sensitive areas if they are subsequently y
discovered. This document will senile as your Service Provider letter as requited by ReSOlUtiOn and Order 07 Section 3.021 All required permits and
ji pprovels m i ust e obtained and completed under applicable local, Siate. and federal taw.
Based on review of the sribmdted materaaIs and best avatiable lnfor rmhon the above roforericPd project wall not saga canny ict the e.40.09 or potentially
sensitive area(s) found near the site. This .Serrsirive Area Pre - , Screening Sole Assessrrentd es NOT eliminate the need to evaluate and protect additional water -
qu . areas if they MOSObSequentlidiscOVered. This document will serve as youf Service Provider Otter a. required by Resolution and Qrder
07-20, :Section 3.011. All required permits and approvals must be obtained and completed under applicable local, state' and federal law.
Nil This Service Provider Lefferts not valiid unless. I _ .CWS approved site plan(s) are attached.
cl The proposed activity does not meet the definition of development or the was platted after 919195 ORS 92:040(2). NO SITE ASSESSMENT OR
SERVICE PROVID LEI I.ER IS REQ ;:ED.
Reviewed b y i , , A : . Date 3 / 2- h I
2550 SWHo.3ocroL n: Hflsboro.' r:v 1.. 122 • Fh (3E1-511:0 n:.J it