Permit q CITY OF TIGARD MASTER PERMIT
°' s: ;" COMMUNITY DEVELOPMENT Permit #: MST2012 00258
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/18/2012
Parcel: 1 S134CC01000
Jurisdiction: Tigard
Site address: 12170 SW MERESTONE CT
Subdivision: MERESTONE Lot: 9
Project: Bahrs
Project Description: Replace 160 sq ft of existing deck and add 100 sq ft of additional deck over existing patio pavers.
• • BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $3,000.00 Rear: 15
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
Drywall- 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
•
• Fum > =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'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:
ALT SF VB R -3 0
Owner: Contractor:
BAHRS, ARTHUR HENRY & RICK'S CUSTOM FENCING & DECKING INC Required Items and Reports (Conditions)
SANDRA CATHERINE 4543 SW TV HWY #A
12170 SW MERESTONE CT HILLSBORO, OR 97183
TIGARD, OR 97223
PHONE: 503- 709 -9355 PHONE: 541- 648 -7830
FAX:
Total Fees: $296.71 ,
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 ac • e - - - - with approved plans. This permit will expire if work is not started within 180 days of issua • if work is suspended for more the 180
days, A ^ TION: Oreg• law requires you to follow the rules adopted by the Oregon Utility Notificati•• Center Those rules are set forth in OAR
952 -00 •010 through OAR • - -00 - % • a. You may obtain a copy of the rules or direct questions to OUNC by calling 3.232.1 • . 1.8 - - .2344.
Issu = • By: ' ■ �� /� ■JIB Permittee Signature: We.
-
Call 503.639.4175 by 7:00 a.m. for the next available inspec i e.
This permit card shall be kept in a conspicuous place on the job site until completi , • of the project. ,
Approved plans are required on the job site at the time of each inspection.
`Buildine Permit Application
Residential t ;. y V ) FOR OFFICE USE ONLY
Rece ived 19/� p No .
City of Tigard ODoZS
t3' g DateB : D v S � o7� /a -
; , 9 13125 SW Hall Blvd., Tigard, OR 97223 ® '1 % 1 plan Review - "IS, `` ^^ 7
8 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: < < V / 1(J ( 1 Other Permit:
Inspection Line: 503.639.4175 Date Re B ' l,ms. 8 See P e 2 for
I'I \Kl �P ��,�J� �Y Y' 0 � � Page
Internet: www.tigard or.gov `�1S1 Natified/Method: /0 S. 1.2 _, 6 Supplemental Information
TYPE OF WORK ' t t, IRED DATA: 1 - 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 Valuation: $3000.00
y g ❑ Commercial/industrial
❑ 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: 12170 SW MERESTONE CT New dwelling area: square feet
City/ State/ZIP: TIGARD OR, 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: BAHRS Covered porch area: square feet
Cross street/directions to job site: 121ST Deck area: 260 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.
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.
i Valuation: $
REPLACE EXISTING DECK EX �A NI 6- 4 in, f t_ (p p�
/4 a at& g)C/ s 77A/6� Pf}"t//&i S Existing building area: square feet
New building area: square feet
® PROPERTY OWNER I ❑ TENANT Number of stories:
Name: ART BAHRS Type of construction:
Address: 12170 SW MERESTONE CT Occupancy groups:
City/State/ZIP: TIGARD OR, 97223 Existing:
Phone: (503)709 -9355 Fax: ( ) • New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: RICKS CUSTOM FENCING AND DECKING (Please refer m fee srhedrrle
Structural plan review fee (or deposit): .7 7 , 5,
Contact name: JOE PERINI
FLS plan review fee (if applicable):
Address: 4543 SE TV HWY
City/ State/ZIP: HILLSBORO OR, 97123 Total fees due upon application:
Phone: (503) 640 -5434 I Fax: : ( ) Amount received: 7 9, .5 ,
E - mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: RICKS CUSTOM FENCING AND DECKING Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 4543 SE TV HWY Solar Installation Specialty Code checklist.
City/ State/ZIP: HILLSBORO OR, 97123 Permit Fee (includes plan review $180.00
and administrative fees):
Phone: (503) 640 -5434 I Fax: ( ) State surcharge (12% of permit fee): $21.60
CCB lic.: 50088
Total fee due upon application: $201.60
Authorized signature: ' I This permit application expires if a permit is not obtained
1 ._....----"- within 180 days after it has been accepted as complete.
I Print name: JOS PH P '1 1 I Date: 10/4/12 I * Fee methodology set by Tri- County Building Industry
• I.
I 11111 Building Division
Development Code Provision Review
T[GARD Residential Projects
Building Permit No.: / oZ 0 /r- — OOasef"
Site Address: /02/ 72 5 cJ /y E c -a.,/b- c T
Project Name & Lot No.: /9 79
CWS Service Provider Letter
Required: Yes ❑ No ❑
Received: Yes' No ❑
Routed Plans:
Original Plan Submittal Date: f
15t 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 /} L at 503- 718 -24 3z- t" or @ tigard- or.gov)
Land Use Case No. A'
❑ Zoning R-1-1.i
❑ Setbacks:
Front •..+> Rear 1` Side . 7 Street Side / 5 Garage 2-
❑ Maximum Building Height Actual Building Height
❑ Visual Clearance
❑ Easements . v�,� 1 � � 1
❑ Sensitive Lands Type: o
Notes: N r t.
1301141/1:/ \ [ per. j g • 77S , 026 , 'o /.-
Original Plan: Approved Not Approved ❑ Date: /v - l i /�
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (c ntact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov)
❑ Actual Slope:
Notes:
Original Plan: Approved ❑ Not Ap ed ❑ Date:
Revision 1: Approved ❑ Not Approve Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
City Arborist Re y 'ew (contact Todd Prager at 503- 718 -2700 or todd @tigard- or.gov)
❑ Street Trees
❑ Protected T es
Notes:
t i
Original Plan: Ap oved /❑ Not Approved ❑ Date: - —
Revision 1: App ved ❑ Not Approved ❑ Date:
Revision 2: App r ❑ Not Approved ❑ Date:
Permit Coordinatof Revie (contact Albert Shields at 503 - 718 -2426 or albert @tigard- or.gov)
❑ Conditions �f Approval rior to Issuance of Building Permit
Notes :
Original Ijlan: Date Sent to Applic t:
Revisio 1: Date Sent to Apphcan
Revisi h 2: Date Sent to Applicant
Ok to Issue Permit: Yes ❑ No ❑
Date Routed to Building:
r
Page 2 of 2
PAGE 01
09/26/2012 08:11
i■
• „.. 5°3""IECEIVED
RICKS CUSTOM FENCING
\' r‘
, 1 - 1
....
Clean Water Services File Number
I l j I
6 202 i CITY OF IGARD i I 2, - 00 5 1
1 li sLP 2., , u , BUILDIN 1'41- Services
ensitive Area Pre-Screening Site Assessment
-
_,....._- ito,--D
0 i.--Jurtsdintlorr ...... VW-U --------.
1 '1
2. Property Information (example 1$234A801400) 3. Owner InAortvatIon
Tax lot 10(s): Name: Ett Zci,kr 5
_
Company!
Address: illasL411Allitte_s_i___
Site A■ddress! i'..1 SW PA e..z 0.ek" City, State, Zip: Trier-r Ai- 1.3a2--3
City, State, Zip: Tirko.rk (Ti ft. q Phone/Fax: So 3 - 15•7_ ".k ST" '
Nearest Cross Street? E-Mail:
4. Development Activity (check all (het apply) 5. Applicant Information
1
IA Addition to Single Family Residence (roorna, deck, garage) Name:
lZI Lot Line Adjustment CI Minor Land Partition Company: .c / 1--S Cj
D Residential Condominium CI Commercial Condominium Addross: q 5 c TV J11,) q f
C:1 Residential Subdivision CI Commercial Subdivision
City, State, Zip: 1.-MS 6orn eye_ cr) I,
U Single Lot Commercial D Multi Lot Commercial
Phone/Fax: „ . 01 -440 -S
Other . ,
....-
E-Mail: • .? r' .41 1 • ...
- .
B. Will the project Involve any off-site work? D Yes ;into P Unknown f
Location and description of off-site work
7. Additional comments or nfo . ation that may be needed to understand your project
,
A ' 8., ...■ • NA "'"A - - k, I ■
0 • ,
Thu a application does NOT replace Grading and Erosion ontroi Perrnfte, Connection Permits, Building PermIta, Site Development Permits, DEQ
1200-C Permit or other permits as Issued by the Department of Environmental Quality, Department of State Lends and/or Department of the Army
COE. All required permits and approvals roust be obtained and completed under applicable local, state, and federal law.
By signing this form, the Owner or Owners authorized agent or representative, acknowledges end agrees that employees of Clean Water Services have authority
to enter the projectlite at all reasonable times for the purpose of inspecting project site conditions and pillaring information related lo the project site. I certify
that I am familiar with the informal • contained in this document, and to the best of my knowledge and belief, Otis intonation is true. =Nieto, and accurate.
i -
Print/type Name a, - 11,.... 11 . P rintflype Title • (ref—) Actkolp,r .
,
---,
Signature —
4111,41116 ..-' Date
. .
FOR DISTRICT USE ONLY
•
CI Sensitive areas potentially exist on site or within 200 of the erto. 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.
Ca 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 ere 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,
pi
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 Pra-8creening Site Assessment does NOT eliminate the need to evaluate and protect additional water
quality sensftive 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 i CWS approved alb: 0594 are attached.
• El The proposed activity does not meat the definition of development or the lot was platted after 919/95 ORS 92.040(2). NO SITE ASSESSMENT OR
SERVICE PROVO - - LETTER IS REQU - Eh ,
• Reviewed by Ao..,--, „a, . 'Mr k) Date /0 /I h 2. -
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09(28/2012 13:58 5036486397 RICKS CUSTOM FENCING PAGE 02
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