Permit CITY OF TIOARD BUILDING PERMIT
PERMIT #: BUP2004 -00317
4 DEVELOPMENT SERVICES DATE ISSUED: 7/1/2004
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102DB -04500
SITE ADDRESS: 13219 SW CHELSEA LP
SUBDIVISION: CHELSEA HILL ZONING: R -12
BLOCK: LOT: 022 JURISDICTION: TIG
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: 12 ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: 40 psf LEFT: 5 ft RGHT: 5 ft FIR SPKL: SMOK DET:
DWELLING UNITS: 1 FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 480.00
Remarks: Construction of 12' x 14' patio cover.
Owner: Contractor:
MICHAEL DESMIT OWNER
13219 SW CHESLEA LOOP •
TIGARD, OR 97223
Phone: 503 - 968 -5729
Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Description Date Amount Footing lnsp
[BUILD] Permit Fee 7/1/2004 $62.50 Framing lnsp
[TAX] 8% State Surchar! 7/1/2004 $5.00 Final Inspection
[BUPPLN] Pin Rv 7/1/2004 $40.63
[CDCPLN] CDC Pln Rei 7/1/2004 $42.00
Total $150.13
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 these rules or direct questions to OUNC by
calling (51_ .699 or 1- 800 - 332-344.
Issue. By: A :-
Permittee ° r.
Signature: X t-t/` (•
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
Building Permit N Wicaltid ED ' FOR OFFICE USE ONLY '
I.1 ti I� M' �"' City of Tigard Date/Bea �O y PermitNo.: r P� - •Gy3 ( /
13125 SW Hall Blvd., Tigard, OR 9722`3. ' 2004 ' ` Plan Review
Phone: 503.639.4171 ✓Fax: 503.598.4960 t +\ Date/By: Other Permit.
Inspection Line: 503.639.4175 TIGARD e' II Date Ready /By: � J j ur ' is ) : B See Attached Checklist for
Internet: www.ci.tigard.or.us CITY OF Notified/Method I• / Supplemental Information
BUILDING DIVISION
TYPE OF. WORK= `" "`
> �, �RE � U IREDDATA:1 '' ND`2 "FAMIli t
� � � �� �,a..,.?i ''" � Q., A 1',iDW'ELliING <
':` ,`.. :'y u». k'tb%".e " ... .... . . , _ a< r >af. � .W o : «> � c
.. $t:,�> ,_>.._ ,�;a,a.' .. .' . .: '',n�n>'�.:: ''. :' >n�� �.. < £.'.,. .<..... .'_. *a F�En�.i:, ..� .. ., .. �. �,..,. .. ..... r. � r :: 1 ,..7„.,'W.560, , .a 5 • .... �.� o, rn• . . .
_.1} °�P 'pct .
❑ 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
°;� °�� "- :�' ��i °,?; M�;,r ;�� >.:,,: -„ work indicated on this application.
ti CAT mm. COSTRUC ; TION Y pp
-; �_- '.` � - ����,,. -N��. • ..., .,:�� >�.' . . ... Valuation: ��$4 ,0 o t �19 R �
111 1— and 2- family dwelling ❑ Commercial /industrial .
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ® Other: Number of bathrooms:
` >' Total number of floors:
, ; a =J013 ; SITE `;INF,ORMATION'A -- :i v t G'ATION . "
Job site address: 13219 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: Covered porch area: 16g square feet
Cross street/directions to job site: OMARA Deck area: square feet
Other structure area: square feet
R EQUIRED £DATA:: COMMERCIAL US EaCH ECKLI
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
.' ., * , r s' r >r; work indicated on this application.
z : , � ; DES CRIPTION,. OF WORK : y , , •
. , -. ��... ;`�. � �� • �.• �`> f 'mss
PP
PATIO COVER — re X I V Valuation: $
Existing building area: square feet
New building area: square feet
',; °'.:,. ;. am'
c., v,• a t „
".' � ®„ PROPERTY •OWl�ER= :r =� '- .,,,�;`4a �� ❑-,TE'NANT;�` Number of stories:
Name: MICHAEL DESMIT Type of construction:
Address: 13219 SW CHELSEA LOOP Occupancy groups:
City /State /ZIP: TIGARD, OR 97223 Existing:
Phone: (503)968 -5729 Fax: (503)968 -5729 New:
w
. APPLICAN �, , CONT ACT� PERSON :::£. : a:.:.a ''.� — .....�.
` u , t ® T . _ .. .... Y >, k+, 0.F,c ^ : ?da. �1
°- �..NOTIC €;w € °�y., s a'sF >T.:,:,
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:
°" i:; . s y CONTILAC TOR t. - m: o
Business name: OW iJG2 _, ;iiii .. ...
BIJIL > DING,yPERMIT < =. =.FEES r` ;
Address:
Please refer to fee schedule.
City/State /ZIP:
Phone: ( ) Fax: Fees due upon application RIO& 13
( )
Amount received
CCB lie.:
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: MICHAEL DESMIT Date: (j — 1 * Fee methodology set by Tri -County Building Industry
Service Board.
i:\ Building \Permits \BUP- PermitApp doc 12/03 440- 4613T( I I /02 /COM/WEB)
" ° /Jun.28. 2004' 2:51PM CLEAN WATER SERVICES 503 6814439 No.2066 P. 1 /1i'oot
9 [,P,1 \ d
r, JUN 2 2 2004 ile Number w sit N
Clean \ter Services
Our commitment is elem.. S 'ssi • ' : ■- ..- •" - -" Ing Site Assessment
Jurisdiction Date 6- Z2-°
Map & Tax Lot o 13 p '1 Owner M Ic },,n ab 1) y,, '
Site Address 2-19 w e.1.gl. &A L
TrC�6M } OQ q 1 tt3 Contact .S pw v -
Proposed Activity Address
II_ )( I (t -"iO Cover
• Phone 53 -%13. '12 1b 03) Sat Chev3
c# 503— (&.91 10
Official use only below this line
Y N NA Y N NA
Sensitive Area Composite Map Stormwater Infrastructure maps
Li ❑ Map # .2„S /4) ❑ ❑ QS # Wie,X0
❑ ❑ rw ❑ ❑ Locally adopted studies or maps k Other
LEV Specify Specify
•
Based on a review of the above Information and the requirements of Clean Water
Services Design and Construction Standards Resolution and Order No. 04.8:
I I Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT
MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE
PROVIDER LETTER OR STORMWATER CONNECTION PERMIT. If Sensitive Areas
exist on the site or within 200 feet on adjacent properties, a Natural Resources
Assessment Report may also be required.
I'�/ Sensitive areas do not appear to exist on site or within 200' of the site. This pre-
screening site assessment does NOT eliminate the need to evaluate and protect
water quality sensitive areas If they are subsequently discovered on your
property. NO FURTHER SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS
REQUIRED. THIS FORM WILL SERVE AS AUTHORIZATION TO ISSUE A
STORMWATER CONNECTION PERMIT.
❑ The proposed activity does not Meet the definition of development. NO SITE
ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED,
Comments:
a r •. /I Sep : • .. e.., .
Reviewed By: ` . . Date: `j-7 ,1p y
�� of I► Returned to Applicant
Date Post-it' Fax Note / n n/ 7671 ��j'Z q IPasPe Mail Fax Counter
TO • !!Q4�j D . ;T Fran' ` eu k /3
Co. /Dept. Co. d
Date jay
Phone # Phone # so 3 - 6 8 ('36as
- Fax # 5 . 05 _, 6 1 . 16 i[ � Fax# J V-'/
• . ,
. ,.,
CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.:
PLANNING DIVISION:
Required Setbacks: 1Approved 0 Not Approved
Side: — Stree!.
Front. — Garage: -- Rear: —
Visual Clearance: K 0 Not Approved
Maximum Building Height: _ feet
CWS Service Provider Letter Required: 5k Yes 0 No
•
B : '/, .,-/
---......;----
ENGI , ERING DEPARTMENT:
Actual Slope:_% 0 Approved 0 Not Approved
Site Plan: 0 Approved 0 Not Approved
B : Date: E. "2
Notes:
• .
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EL,p. Vbro i
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it-- Ili -4 if .
(40
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Suu COE L5LA LooF
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION, Business Line: (503) 639 -4171 MST
• BUP 0(60 .3/7
ti
Received Date Requested /b " AM PM BUP
Location Suite MEC
Contact Person Ph ( ) PLM
Contractor /� Ph ( ) SWR
BUILDING Tenant/Owner (� q/ (;-7 ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceilin g�,
Roof P
Other:
i
PASS PART FAIL
P MBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRIC AL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
S ITE El Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 9d 2- 7- ' 4- Inspector t Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL