Permit . CITY OF TIGARD MASTER PERMIT
'' 111 COMMUNITY DEVELOPMENT Permit #: MST2012 -00304
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/08/2013
Parcel: 2S104CA08100
Jurisdiction: Tigard
Site address: 13266 SW 136TH PL
Subdivision: HILLSHIRE Lot: 81
Project: Mangum
Project Description: Replace existing deck.
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: No
Total: 0 sf Value: $10,000.00 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
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 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
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'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:
MANGUM, DANIEL K & STACY A THREE RIVERS CUSTOM DECKS INC Required Items and Reports (Conditions)
13266 SW 136TH PL 23885 S MOUNTAIN TERRACE
TIGARD, OR 97223 BEAVERCREEK, OR 97004
PHONE: 503 - 524 -7718 PHONE: 503 - 632 -8777
FAX: 503- 632 -8770
Total Fees: $487.17
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 iss • .. • ' work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Not at •n Ce' er. = e rules are set forth in OAR
952- 001 -0010 through OAR 95 1 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling .232.1 • :7 or 1.: %1.332.2344.
Issued By: Permittee Signature: ` ` OW
-
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 project.
Approved plans are required on the job site at the time of each inspection.
Bu- ld:'ng Permit Application
EEIVED
I OR OF LICE ICE ,USE ONLY-
` M � / ' / ! .0 2
City of Tigard Received Date �7- Permit No.: pJ D
,,.,•-_, lig q 13125 SW Hall Blvd., Tigard, OR 9 %. C 1 3 2012 i
5 Phone: 503.718.2439 Fax: 503.598.1960 Date/B Plan Rev :P�� Other Permit:
T I G A 1i u Inspection Line: 503.639.4175 CITY OF TIG a D I'1 Date Ready : y: t Juris, S ee Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental upplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
•
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (roweled to the nearest dollar) of all
' ddition/alteration/replacement El Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
and 2- family dwelling ❑ Commercial /industrial Valuation: $ '0�o
❑ Accessory building El Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: t 3 24 (P 'S'- t 3(0 1-1.1 RL . New dwelling area: square feet
n P L
City /State /ZIP: - U ) 91 aoZ 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area square feet
Cross street/directions to job site: Deck area: 39, (p 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 (rotnded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
P-1tT Valuation: $
Existing building area square feet
New building area: square feet
DcitOPERTY OWNER ❑ TENANT Number of stories:
Name: j f A G Ii Type of construction:
Address: J Occupancy groups:
City /State /ZIP: Existing:
Phone: (56) 6c9 Ll •- 7 / g Fax: ( ) New:
R APPLICANT ❑ CONTACT PERSON NOTICE
Business name: 2 2t, j e er , C_t i - J /\ 6 Q - 5 All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: , J J
4-S� '^ under ORS 701 and may be required to be licensed in the
Address: c 23 2es 5 . �N■ 0 V Tit l 14 ) 0E,Q • jurisdiction in which work is being performed. If the
City/State/ZIP: /� applicant is exempt from licensing, the following reasons
Cit
y - ' 6 `� Q� apply:
Phone: 93) g ) — 62 O J 9 Fax:: ( )
E-mail: j rav e_ .5 3 1(� o € it 5 • CO k✓1
"�� J CON CTOR BUILDING PERMIT,FEES*
(Please refer to fee schedule)
Business name: Permit fee:
Address: f C1 A
State surcharge (12% of permit fee):
City /State /ZIP: FLS plan review (40% ofpermit fee):
Phone: ( ) I Fax: ( ) (Due upon application.)
CCB lic.: 17 ( ti '1 It3 Total permit fees:
Authorized signature: ( °—"-----7 Amount received: 0/ �� . 7
( This permit application expires if a permit is not obtained
Print name71)w I h COtf a Date: Ili \�) I
* within 180 days after it has been accepted as complete.
Fee methodology set by Tri- County Building Industry
Service Board.
1:\ Building \Permits\FPS- PermitApp.doc Rev 01 /05/2012 440- 4613T(II /02/COM/WEB)
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 Rev 01/05/2012 2
J
11 " Building Division
. . Development Code Provision Review
TIGARD Residential Projects
Building Permit No.: SST Aor . -c9op 36 '-t
Site Address: I3 A Igo a.,0 '& o pt.
Project Name & Lot No.: Hit06uH
CWS Service Provider Letter
Required: Yes ❑ No 6 �f PU} 0 <o f.C6 L'TG y --rits 6.i Mg.„
Received: Yes ❑ No sp
Routed Plans: n
Original Plan Submittal Date: /2// �
Pt 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
4,,,,0 at 503-718- WO or @tigard - or.gov)
Land Use Ca No.
Zoning -' 77
id Setbacks:
Front Rear / .5' Side 5 Street Side Garage
❑ Maximum Building Height: Actual Building Height
❑ Visual Clearance
❑ Easements
❑ Sensitive Lands Type:
❑ Street Trees
❑ Protected Trees 1 Notes: l / ll ie « (5 6 6��' /���'e - C ` , 1 / k)p- /90
AO dtaA40/_ rzv/ — /4,4 ,,,,e -
a.
Original Plan: Approved X Not Approved ❑ Date: 010/l 0 ----
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date: ,
(Review Continues on Page 2)
Page 1 of 2
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @ tigard - or.gov)
Actual Slope: (-S
Notes:
Original Plan: Approved Not Approved ❑ Date: / I ? ) 2—
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 Appli t
Okay to Issue Permit: Yes No ❑
Date Routed to Building:
Page 2 of 2