Permit .� CITY OF TIGARD MASTER PERMIT
Ill 2 COMMUNITY DEVELOPMENT Permit #: MST2013 -00116
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439 Date Issued: 06/06/2013
Parcel: 2S104AA09300
Jurisdiction: Tigard
Site address: 12815 SW KATHERINE ST
Subdivision: BELLWOOD NO.3 Lot: 114
Project: Poling
Project Description: Replace upper and lower decks
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 $9,545 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
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'l 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:
POLING. ADA L & ROBERT D RICK'S CUSTOM FENCING & DECKING INC Required Items and Reports (Conditions)
12815 SW KATHERINE ST 4543 SW TV HWY #A
TIGARD, OR 97223 HILLSBORO, OR 97183
PHONE 503 -579 -5216 PHONE: 541 -648 -7830
FAX
Total Fees: $489.67
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 A NTION • -gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0 -001 • through O • . 0' 0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 o 1.800 332 2344.
Issu d By: a / ' Permittee Signature:
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.
Building Permit Application
Residential roll OFFICE l'SE ONI.1
Received I Permit No . r 0/ �// -
City of Tigard D�e - .
III
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Reim AMIAIDIVMIll Other Pcmut:
Phone: 503.639.4171 Fax: 503.598.1960 DateB mu
, J Ju ' See Page 2 for
Ins ion Line: 503.639.4175 Date ' y' //7 /3 ;0,f, Sopptemeotat loformatioo
l" 1 A F D Notified/Method: '
Internet: www.tigard -0r.gov V M . P191//-6 TYPE OF WORK I REQUIRED DATA: 1- AND 2- FAMILY DWELLING
0 Permit fees* are based on the value of the work performed.
New construction ❑Demolition Indicate the value (rounded to the nearest dollar) of all
Addition/alteratior�repl en ❑ Other: equipment, materials, labor, overhead, and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION
Valuation: S 9 5- 11 C—
AI- and 2- family dwelling 0 Commercial/industrial
Number of bedrooms:
0 Accessory building 0 Multi - family
k k k N\lmber dbakVMS.
0 Master builder D Other.
30B SITE INFORMATION AND 'LOCATION
Total number of (loots:
,,
Job site address: [2 9( c Si,) l tf Elia / N 51— New dwelling area: square feet
City/State/ZIP: '1"(•G_ 6, QJ) 0R-. q 3 Garage/carport area: square feet
Suite/bldg./apt. no.: I Project name: Covered porch area: square feet
Cross street/directions to job site: / o�.-T5 1 ( 74- /4_0 R Deck area: f}tr. y 4t7 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.
Indicate the value (rounded to the nearest dollar) of all
/ l no : equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK
Tax �P work indicated on this application.
_ Valuation: $
R E P 1. e (a9 pp EP__ #4 ,.., l� ra-> 2- e. square feet
Existing building area: sq
New building area: square feet
Er PROPERTY OWNER I
TENANT Number of stories:
Type of construction:
Name: 'IZeg Fe L /N G-
Address: ) 2 '> ( S 9 (,�) err 4F / /Up 57
I Occupancy groups:
City/State/ZIP: "if G (L R q-2-2:--z_ 5 Existing:
F ) New:
Phone: (��-1,) 5 q 5 - a f (
APPLICANT KCONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
_ licensed with the Oregon Construction Contractors Board
dJ
Contact name: , p (Q R-D Y e / under ORS 701 and may be required to be licensed in the
jurisdiction in which work is being performed. If the
Address: applicant is exempt from licensing, the following reasons
/ City/State/ZIP: apply:
1 Phone: (5c)3) Z S p c, 1 Fax:: ( )
E -mail:
CONTRACTOR �
Business name: . Z. 5 C:i [ Od- F ?" E - 1 E , r j BUILDING PERMIT FEES*
l �- (Please refer to fee schedule)
Address: ,¢•c-1{ . J 5 E —Fir c4.4., y Structural plan review fee (or deposit):
City/State/ZIP: t-F16.....&_5' Re9 p U // O [ � . 7 2 : 7 _3 FLS plan review fee (if applicable):
Phone: ( Sa3) .6-7 Lf ( h I Fax: ( ) Total fees due upon applies • n:
I 4, CCB lic.: a0 e 8 I Amount ived: 10/44 . 7 /
Authorized signature' This permit application expi es if a permit is no 1 7,1=41
dd within 180 days after it has en.accepted>ls complete.
Print name: 120 p r p 2 J I Date: S 3 -- �3 I Fee methodology set by Tri County Building Industry
.
° Building Division
Development Code Provision Review
T I G i\ R D Residential Projects
Building Permit No.: M /D7 5 —60 / / 40
Project /Subdivision Name: t3C°o• , Lot #:
Site Address: la S ,-et) P -f-
CWS Service Provider Letter:
Required: Yes ❑ No ❑
Received: Yes ❑ No ❑
Plans Routed:
Original Plan Submittal Date: 6 r 3 Routed By: CD!&.
1St Revision Submittal Date: ❑ Site Plan Only Routed By:
2 Revision Submittal Date: ❑ Site Plan Only Routed By:
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 (1) 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 V-000.12.- at (503) 718 -j4 VI or @tigard-
or.gov) v
Land Use Case No.
Zoning R 4.5
Setbacks: � 1 ��
ront 2d Rear Side Street Side �S Garage
(' Maximum Building Height: ?'O' Actual Building Height N I Pc
Ii sual Clearance N �R
❑ asements
I Sensitive Lands Type: NON
[� eet Trees N � A
Protected Trees
Notes:
Original Plan: Approved X Not Approved ❑ Date: 1
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
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•
Engineering Review (contact Mike White at 503- 718 -2464 or MikeW@tigard- or.gov)
,r Actual Slope:
Notes:
Original Plan: ApprovedAEr Not Approved ❑ Date: I
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 Appli nt
Revision 2: Date Sent to Ap cant
Okay to Issue Permit: Yes No ❑
Date Routed to Building:
Page 2 of 2
I. \CURPLN \ Masters \Development Code Provision Review \DCPR_RES.doc Rev. 01/16/13
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12815 SW KATHERINE ST, TIGARD, OR, 97223
Residential - Master Permit
205 Footing
06/14/2013 09:00
MST2013-00116
PASS
Violation Summary:
Inspector Contractor