Permit CITY OF TIGARD MASTER PERMIT
I COMMUNITY DEVELOPMENT Permit #: MST2012 -00143
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/21/2012
Parcel: 1 S133DA05100 •
Jurisdiction: Tigard
Site address: 12730 SW GLACIER LILY CIR
Subdivision: AMART SUMMER LAKE Lot: 73
Project: Staab
Project Description: Installation of fence over existing raised patio.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 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:
Total: 0 sf Value: $2,500.00 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
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum > =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 add'I 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:
OTR SF 0
Owner: Contractor:
WHEELER, TIFFANY I RICK'S CUSTOM FENCING 8, DECKING INC Required Items and Reports (Conditions)
STAAB, M ANDREW 4543 SW TV HWY #A
12730 SW GLACIER LILY CIR HILLSBORO, OR 97183
TIGARD, OR 97223
PHONE: 503 -887 -6412 PHONE: 541- 648 -7830
FAX:
Total Fees: $211.21
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, : if w• • is su-p� ded for more the 180
days. A - • • L: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification -nter. / ose r 5 are -I forth in OAR
952 -0 - 95 " -0010 throug •AR 9.Q01 -090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. j ' ;7,• :':7,Z1.811.33 . 44.
Issue. -��:
=y: P ermittee Sig nature:
Call 503.839.4175 by 7:00 a.m. for the next available Inspe on date. v
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.
RMLSweb - Agent Full Page 12 of 12
Buildletlf & MAY INCLUDE BOTH FINISHED & UNFINISHED AREAS - CONSULT BROKER FOR INFO.
SCHOOL AVAILABILITY S • • - .
Residential FOI (1FFICl_ I SE ON1.1
City of Tigard RECE may <i oft 4.01.. . ' Permit N°.: it- t51a39/�-/ j?
45/
a 13125 SW Hall Blvd., Tigard, OR 972 Plan Review
II Phone: 503.718.2439 Fax: 503.598.1960 JUN I A I IV 2012 Date/By: Other Permit:
TiGARD
Inspection Line: 503.639.4175. J V Date ReadyBy: >uris: ® See Page 2 for
Internet: www.tigard -or.gov Notified/Method: Supplemental Information
CITY OF TIGA !D
TYPE OF wailLDING °NVOOf"
REQUIRED DATA: 1- AND 2- FAMILY DWELLING
g 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.
12(1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ 2, 00
❑ 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: ) Z 7 30i S (,J G l,Pc zER UGLY New dwelling area: square feet
City/State/ZIP: "[t S 0 f ?7Z-2...3 Garage/carport area: square feet
Suite/bldg. /apt. no.: N/p I Project name: FE PRL1T Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: S U 1.h0e, L.A,K Lot no.: Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
nNSTkL -lAmo CF FE1JGt 141-0616 EDGE 0 F KettsED Nyco. Valuation: $
FENCA TO Re TVSTA-L., FD <uJ/ Posy - ExT1-� �r sc, I I4-RO l )CAN Existing building area: square feet
jjfrr t.: t7�f�/E'S t17- - EY No Gl.)(' , 2 n - 'g1J 'ia V R 0U (i.) - New building area: square feet
P ROPERTY OWNER ❑ TENANT Number of stories:
Name: AN .Dglnl STAt3 Type of construction:
Address: ! Z7 6 S (IJ C'7LAGZEK L'r1 y C, RC,I ,E Occupancy groups:
City/State/ZIP: Y r & A . g 0 O R 9 7 7 2 , 3 Existing:
Phone: (5C3) 88'7- Gy ( 1_ Fax: ( ) New:
153 APPLICANT [CONTACT PERSON BUILDING PERMIT FEES*
Business name:
• (Please refer to fee schedule)
Structural plan review fee (or deposit):
Contact name: Si E AS Ads 0 ye:
FLS plan review fee (if applicable):
Address:
City/ State/ZIP: Total fees due upon application:
Phone: ( ) I Fax::( )
Amount received: 12, /. °t'
E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installati. r • f
roof- . .I ousted Photo Voltaic Solar Panel Sys - I..
Business name: Submit two sets of roof plan with cone r on details
R�r,1 <S i) �t�r, F � 11( :t;IJ ( 3 and fire dep. •.. t access, along with • 2010 Oregon
Address: SP ry 1-1-1,0f Solar Installation S. ally Code ist.
City/ State/ZIP: / P Fee (inclu. - • .1. 1 - view
I �8 OR $180.00
Phone: (SQ3) (A 0 - S 3 I Fax: ( ) and admini fees):
y
State surcharge (12 °/ . f permit fee . $21.60
CCB lie.: J C 0 0 B % Total f upon application: $201.60
Authorized signature: / / � This permit application expires if a permit is n i • . rained
within 180 days after it has been accepted as complete.
. „ r ;,l,; . � � 1 � , � • F metirodolo set b Tri-Co Budding Indus
h .rmi we , .co I en In - _c s� _r = - , . u l — i = n _ _ � D AR RAY ... 6/ 0/2012
NDIZEi�J Sr>4A� . 6 Z0IZ - —
1 e ° Building Division
Development Code Provision Review
TIGARD Residential Projects
Building Permit No:
r2-0 /P- 00 /'' 3
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A ❑
Routed Plans: / /
Original Plan Submittal Date: 6 (Z / / A
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 t 503 - 718 - e el 3 tf or @tigard- or.gov)
Land Use Case No. /" it Name
❑ Zoning
• ❑ Setbacks:
ront Rear Side Street Side Garage
Maximum Building Height Actual Building Height
I"Visual Clearance
❑ Easements
❑ Sensitive Lands Type: 1
Notes: "
_vt.f
Original Plan: Approved Not Approved ❑ Date: ( - 2 - ( Z
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:
Notes:
Original Plan: Approved ❑ Not Approved ❑ Date:
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
City Arborist Review (contact Todd Prager at 503- 718 -2700 or todd @ tigard - or.gov)
❑ Street Trees
❑ Protected Trees
Notes:
Original Plan: Approved ❑ Not Approved ❑ Date:
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 Applicant
Okay to Issue Permit: Yes ❑ No ❑
Date Routed to Building:
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