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Permit q CITY OF TIGARD MASTER PERMIT II I :' COMMUNITY DEVELOPMENT Permit #: MST2011 -00158 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/16/2011 Parcel: 1 S 135DC07000 Jurisdiction: Tigard Site address: 11675 SW 91ST AVE Subdivision: CHARBEN Lot: 9 Project: DRENNAN Project Description: 520 sq ft accessory structure. 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 Seconds 0 sf Garage 0 sf Front. 0 Smoke Dwelling Units 0 Third 0 sf Right 0 Detectors Total 0 sf Value $20,311.00 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 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 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: DRENNAN, JOHN W OWNER Required Items and Reports (Conditions) BURNETT, JOHN FREDERICK 1 Ersn Cntrl 503 - 681 -4444 PO BOX 23603 TIGARD, OR 97281 PHONE PHONE FAX Total Fees: $775.80 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 952 - 001 -0010 through OAR 952 - 001 -0090 You may obtain a copy of the rules • • erect questions to OUNC by calling 503 2 1987 1 800 332 2344. Issued By:- Permittee Signature: ' Lh (1 ) , - )Aa2/j c/'L` Call 503. • 3 , .141* :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 f the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application e FOR,OFFICE ONLY° • City of Tigard �O �� DateB Received , Q D Permit No 13125 SW Hall Blvd., Tigard, OR 97 % P lan Review 1I/ Yak . ,.∎ !— 004, Ill• S - Phone. 503.718 2439 Fax. 503.598.1960 C C ,AG` " � 5 � ' Date /B �a r& L+ e t Other Permit TI,GARD Inspection Line: 503.639.4175 O i 0 Date Ready/By , funs IA See Page 2 for Internet www.tigard -or gov C l `C1 `1 Notified/Method E Supplemental Information SO V )1 • t TYPE OF WOR V REQUIRED DATA: 1- AND 2- FAMILY DWELLING ■ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value ( romded 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 31 I Rj 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: //6 75 5. Lif/, 97 A sr �I v E * New dwelling area: square feet City /State /ZIP: T!O /T $f b o i n T72.23 Garage /carport area: square feet I Suite/bldg. /apt. no.: Project name: Covered porch area square feet Cross street/directions to ob site: ^ , 5T I !Y � co /7N�R �� � a12GeNt3f/ =ll4 Deck area: ,� v square feet Other structure area: �/. square feet REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision I Lot no : Permit fees* are based on the value of the work performed. / / T Indicate the value (rounded to the nearest dollar) of all Tax ma p / p arcel no. .� / DO D equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. 'oN$ r,g f/or/ma. o'1qGG - A U L / ll1Ai 6r Valuation: $ Existing building area square feet New building area: square feet 121 PROPERTY OWNER ❑ TENANT Number of stories: Name: JOHN IA/ .IJe v.' A-A( Type of construction: Address: 1 / 6 7 S t�/ V e Occupancy groups: City /State /ZIP: 7 /c'AIt Q � 37223 Existing: i Phone: (.5 ( 3 5 q 2 Fax: ( New: ril APPLICANT MI CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: TpH � � r� N/ViQN licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be 1censed in the Address: `/ el, 75- s i L✓, q 1 Cr A. ye .- . jurisdiction in which work is being performed. If the City /State /ZIP: / T/ 6 A R %/ Or', q 7 2.23 apply ant is exempt from licensing, the following reasons Phone: (soy 6 3 9 - S 71 2. Fax:: ( ) E -mail: t i drenna A 8e I)is.v. co/ I CONTRACTOR BUILDING PERMIT FEES* Business name: 5Ayl1�� (Please refer to fee schedule) /1 675' S, w �1 5r4 V . Permit fee Address: f State surcharge (12% of permit fee): City /State /ZIP: (/GAR i UI' . 6 17 2..2 3 FLS plan review (40% of permit fee): Phone: (So3) 6 39 - 57 9 2 Fax: ( ) (Due upon application) CCB lie.: //'' ll 1 Total permit fees: Authorized signature: W, I i e. �„ Amount received: This permit application expires if a permit is not obtained Print name: To M N 144 .beENNA N Date: within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry Service Board. I \B°Jdmg\Perm,ts\FPS- PermitApp doc 02/01/2011 440- 4613T(11/02/COM/WEB) ,i4)65-5-Z City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group • Density Design Area K. Factor Sprinkler Project Valuation: $ B.) Type I - Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Alarm • Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D.) Residential Sprinkler (Stand Alone System) Square Footage: Permit Fee: 0 to 2,000 $198.75 2,001 to 3,600 $246.45 3,601 to 7,200 $310.05 7,201 and greater $404.39 Sprinkler Project Square Footage: sq. ft. Fire Protection Permit Fees Project valuation subtotal (see A, B & C above): $ Permit fee based on project valuation (see fee schedule): $ Permit fee based on square footage (see D above): $ State Surcharge (12% of permit fee): $ FLS Plan Review (40% of permit fee): $ • TOTAL: $ Plan review requires a completed application and three (3) sets of plans at submittal. Plan review fees are required at submittal. • I \ Building \Permits \FPS - PermitApp.doc 02 /01/2011 2 '' Building Division Development Code Provision Review TIGARD Residential Projects Building Permit No: H6'TAO/ i —co /5g CWS Service Provider Letter Received: Yes yl No ❑ N/A ❑ Routed Plans: q, Original Plan Submittal Date: / /7 /1 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. ( c // , Planning Review (contact at 503- 718 -a J 1 or - 1 -'4NI.i @ tigard- or.gov) Land Use Case No. Name D2E .I. / Zoning - . 0' Setbacks: Front c0 Rear tc, Side Street Side f 5--- ` Gar El Maximum Building Height f< Actual Building Height �� P sual Clearance 12 Uasements 'R! Sensitive Lands Type: 0 / Notes: Original Plan: Approved LX Not Approved ❑ Date: ( 03/t t 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: S Notes: Original Plan: Approved Not Approved ❑ Date: 1 9 //4-/i1 Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City borist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov) S treet Trees P rotected Trees Notes: Original Plan: Approved Not Approved ❑ Date: . Revision 1: Approved ❑ Not Approved ❑ Date: / f 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 Applicant Okay to Issue Permit: Yes " No ❑ Date Routed to Building: :/ , Page 2 of 2 SE P 0 8 2 011 Clean Water Services File Number B ; • ; �M C1eanWate Services Ilk- - 2 -- v -Sensitive Area Pre - Screening Site Assessment .RECEI D 1. Jurisdiction: City of Tigard 2. Property Information (example 1S234AB01400) 3. Owner information lT Tax lot ID(s): 1 S135DC - 07000 Name: John W. Drennan Company: Homeowner S UI pSEP [ N' 1 li t 3 D Address: 1 1675 SW 91st Ave. I ON Site Address: 11675 SW 91st Ave, City, State d Oregon 97223 City, State, Zip: Tigard, Oregon 97223 Rhone /Fax[ 503 -639 -5792 Nearest Cross Street Greenburg Rd. E - Mail: j rennan8 @msn.com l _ 1 4. Development Activity (check all that apply) B. Applicant information ❑ Addition to Single Family Residence (rooms, deck, garage) Name: John W. Drennan ❑ Lot Line Adjustment ❑ Minor Land Partition Company: Homeowner ❑ Residential Condominium ❑ Commercial Condominium 11675 SW 91st Ave. ❑ Residential Subdivision Address ❑ C ommercial Subdivision , Ti ard Oregon 97223 U Single Lot Commercial la Multi Lot Commercial City, Stabs, Zip: 9 9 Other Detached Accessory Building Phone /Fax: 503 - 639 - 5792 E -Mail: ldrennan8 @msn.com 8. WIiI the project involve any off -site work? ❑ Yes kti No ❑ Unknown Location and description of off -site work 7. Additional comments or information that may be needed to understand your project This is a 520 sq. ft. Accessory building. The use is for storage. (Vt' Pty rYt6„Nk AA9 ,OL,QCi2t This application does NOT replace Grading and Erosion Control Penults, 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 zed agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times forthe purpose of inspecting project site e9nditons 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 Name Jo. W. Print/Type Title Homeowner Signature /X , (-4-efellecon Data 9- 8-2011 FOR DISTRIC USE ONLY [] Sensitive areas potentially exist on site or within 200' of the eke. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas artist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. 1st 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 evadable information the above referenced project will not significantly impact the existing or potentially sensitive areas) 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. The 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 end federal law. la This Service Provider Letter is not valid unless 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 OR SERVICE PROVID . R ER IS _EQUI -•. D. e Reviewed by r L 'S.r r I % 4-4.---' Date q / /( err 0 cvYI .I i ia1•• ∎ -, , • ., iN Gdr ^. ", c urs ) in .. :.0"1, UE. 1 -`'1 rQ • r ,501, y , . .r..A ^.a ..,tie r.4, is ;,,,•n∎a Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the 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 homeowner statement is true and accurate. Dfiiv VI/ bP A/A/A Ar Print Name of Permit Applicant I). ic - Zo /( Sign ure of Permit Applicant Date Permit #: /' I Y — kJ // t5tFe • Address: // S // It Art ° - ���\\V4 d I 3 Issued by: . f _ Date �j /6// C • ` • This Copy for Permit Offices 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 = Building Division T IGARD TRANSMITTAL LETTER TO: - /1/ /\/.-ZSpn/ DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED SEP 0 9 2011 FROM: `, O h-iN (4/ i EA/,VA ,v CITY OF TIGARD BUILDING DIVISION COMPANY: fOA f--r,uiAIt1 `�' - PHONE: 503- 639 -3-?q.2._ By � !��/ RE: //‘ 75 s‘,J 97 '' /15 ,c2o / 56/ci (Site Address) (Permit Number) Zit ��vAi/lA/ (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: • Copies: Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): REMARKS: FOR O FIC F, USE ONLY Routed to Permit Technician Date: ( (� fi / (i Initial`` Fees Due: ❑ Yes ❑t -go Fee Description: Amount Due: $ $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: Initials: 1.\ Budding\ Forms\ TransmittalLetter- Revisions.doc 02/08/2011 RECEIVED SEP 07 2011 CITY OF TIGARD BUILDING DIVISION EL. 98.5' iiC li ---'----- ---.....„ , ---.. / NEW EL. 97.5' ACCESSORY STRUCTURE 1__1,/, 13' -127" I in 6) / I EL. 96.0' 91.45' EL. 90.0' S kli.„&.... 1 EL. 95.0' EL. 95.0' 1 I 1 23' - 11.98" I , r 21' / 1m EXISTING HOME DRIVEWAY I lo � * I i 1 if) 0 I r I ^I I I I I I I I I I I , /C. S EL. 92.0' ti EL. 92.0\ .-' ...., i i IA 4 SITE 3,kt, FLAN VIEW) SCALE I" - 201 - 0"