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Permit
CITY OF TIGARD MASTER PERMIT 111 s COMMUNITY DEVELOPMENT Permit#: MST2014-00121 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/14/2014 Parcel: 2S 102CA00215 Jurisdiction: Tigard Site address: 13185 SW ASH DR Subdivision: VIEWCREST TERRACE Lot: 13 Project: Louw Project Description: Replace portion of exisiting deck and adding onto it and building storage room below. 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 of Garage: 0 sf Front 20 Smoke Dwelling Units' 0 Third: 0 sf Right: 5 Detectors: No Total: 0 sf Value: $10,000.00 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 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 Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add/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: ADD SF VB R-3 0 Owner: Contractor: LOUW,JAN PETER A OWNER Required Items and Reports(Conditions) PO BOX 230624 PETER LOUW TIGARD,OR 97281 13185 SW ASH DR TIGARD,OR 97223 PHONE: 503-442-3106 PHONE: 503-442-3106 FAX: Total Fees: $595.47 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. 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 9 . '090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 87•r 1.800.332.2344. Issued By: At /le..jL 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 FOR OFFICE USE()NUN City of Tigard Date/Bey .g ,4 Permit No.:H T ), - .%)/9-/ • 13125 SW Hall Blvd.,Tigard,OR 9 II g N Plan Review Phone: 503.718.2439 Fax: 503.59 K.—Other Permit. Date/By: TI C;A R D Inspection Line: 503.639.4175 • 2% `6\6( Date Ready/t . 4 uris: El See Page 2 for Internet: www.tigard-or.gov J�� No'fled/Method:r /3 ) 4%1. Supplemental Information TYPE OF W0101 REQUIRED DATA:1-AND 2-FAMILY DWELLING _`+ ❑New construction ❑ ;« y4 � Permit fees*are based on the value of the work performed. J� Indicate the value(rounded to the nearest dollar)of all (i Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. O 'I-and 2-family dwelling ❑Commercial/industrial Valuation: $ /jI O j3 r ❑Accessory building ❑Multi-family Number of bedrooms: ``''►► ❑Master builder ❑Other: Number of bathrooms: y JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1 311 8 S 5 W A S s r New dwelling area: square feet City/State/ZIP: ^ 1 cn A0.fl ©0. al l—1_1....3 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: I... out.w Covered porch area square feet Cross street/directions to job site: Deck area: square feet y CAI !V+ IN.v Q. b. CA 0-% -t‘i 4 Other structure area: square feet lb REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: Permit fees*are based on the value of the work performed. a Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: 2SI l72 CA 002I5 equipment,materials,labor,overhead,and the profit for the Z DESCRIPTION OF WORK work indicated on this application. d t r.� Valuation: S N 1?. Q\ 1"—t— t o Q.. w d S"'-o c's Existing building area square feet s5 t.. rc�ow. bL,\uW p New building area: square feet Vh A PROPERTY OWNER I 0 TENANT Number of stories: N Name: �tA. . L a kivs.is J Type of construction: Address: ' 1 % 8 5 Su, A S t ij . Occupancy groups: 4 City/State/ZIP:—I"- ,%�.,,,d , O e a) .4 x,13 Existing: Phone:(So 3) y L{t — "1)10 t., Fax:( ) New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: City/State/ZIP: Total fees due upon application: Phone:( ) Fax: :( ) Amount received: if/'/ ,..7 7 E-mail: ' OTOVOLTAIC SOLAR PANEL SYSTEM FE. Comme -'.I and residential prescriptive instal . -.n of CONTRACTOR roof-top mo.Ited Photo Voltaic Solar Pan- ystem. Business name: Submit two(2 -is of roof plan with •.nnection details twt Nr' f and fire departme .ccess,alon: •tth the 2010 Oregon Address: Solar Installation Spe e .'e checklist. Permit Fee(in ..es . . review City/State/ZIP: . administrativ es): $180.00 Phone:( ) Fax:( ) Stat- -. harge(12%of permit fee): $21.60 CCB lic.: Total fee due upon appication: 11.60 Authorized signature: This permit application expires if a permit is not obtained e.-------- within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name: 7th. i �‘,,,_ Dater to „I A.,%c Service Board I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(l 1/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONL1 Received City of Tigard Date/By: Permit Nn 14 13125 SW Hall Blvd.,Tigard,OR 97223 Associatedpermits: Phone: 503.718.2439 Fax: 503.598.1960 I I( AItl) 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www_tigard-or.gov ❑ Other THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No _N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ til 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ 4 Fire district approval required. Name of district: ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ fil 6 Sewer permit. ❑ ❑ IR 7 Water district approval. ❑ ❑ EA 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ El basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ® ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if I ❑ ❑ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ® ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ® ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- f►] ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. E ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- tZl ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ® ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ® ❑ ❑ systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists E ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ i 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ Kl for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ® ❑ ❑ architect licensed in Ore•on and shall be shown to be applicable to the sro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x IT. IC ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ® ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"buildingplans will not be accepted. ❑ ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ® ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPerrnitApp.doc 02/24/2011 440-613T(11/02/COM/WEB) Mechanical Permit AppiiiiEEN ED FOR OFFICE USE ONLY City of Tigard Received q Date/By: 7 A. Permit No.: �r ,�(�� Eril 13125 SW Hall Blvd.,Tigard,OR 9721jtj 2 S ZO14 ' Phone: 503.718.2439 Fax: 503.598.1960 Plan Review r��pr� Date/By: Other Permit: TI G A R D Inspection Line: 503.639.4175 cm I I1 NIL! Date Ready/By: Juris: El See Page 2 for Internet: www.tigard-or.gov1-y.-_Yf���' Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction I Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* Y 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: i 3 1 t S $ t...1 C\S C'• Furnace 100,000 BTU(ducts/vents) 46.75 . City/State/ZIP: •....r.' t h Q r, 1.--2...`? Furnace 100,000+BTU(ducts/vents) _ 54.91 . Heat pump 61.06 Suite/bldg./apt.no.: Project name: l o rr.w Duct work 23.32 Cross street/diredions to job site: Hydronic hot water system 23.32 ^ Q /� Residential boiler(radiator or `"'� t w 1� � A S 1•■ 0 c ;vat_ hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert _ 33.39 Flue vent for water heater or gas i fireplace 23.32 t� O C.o►'C't Gyp,S +rsn a_�C tr �1 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: , 23.32 1 PROPERTY OWNER El TENANT Environmental exhaust and ventilation: Name: t o kw Range hood/other kitchen equipment 33.39 Address: 13 ‘ v..,5 5 u.J o S V, 0 f Clothes dryer exhaust 33.39 City/State/ZIP: "--C .4,3 r,A t r "41'L3 Single-duct exhaust(bathrooms, Gj 1 toilet compartments,utility rooms) 23.32 Phone:EO'3)-. 492, 3 I p C, Fax:( ) Attic/crawlspace fans 23.32 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Fuel piping: Business name: $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax: :( ) Fireplace Range E-mail: Barbecue _ CONTRACTOR Clothes dryer(gas) /`J / Other: Stiedr}Tf 6.:„,4 ,1,1f Business name: rik. MECHANICAL PERMIT FEES* Address: Subtotal 94%).0‘7 City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) Id'SV CCB lic.: TOTAL PERMIT FEE /QO. r47 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: ,....6/ ii.--- ------- " Fee methodology set by Tri-County Building Industry Service Board Print name:A01A b u� Date: 1 ..-t t 1 ty I:\Building\Permits\M C_PennitApp_040113.doc 440-4617r(II/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040I 13.doc 2 . . • 71 City of Tigard ■ COMMUNITY DEVELOPMENT DEPARTMENT T 1 G A R D Building Permit Review — Residential / Building Permit #: H'3T 9D / S�— 66 /o-/ Site Address: 131435 SW A-stit Dnv) Project Name: Louyv AM rtUVI Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: R e56SStIn deck_ avo. Strom vary) (.,LrvJJ r l\t&-,, Al Verify site address/suite #exists and active in permit system. Site lan Elements: // LVlee(3)copies of site plan l 1 ting structures on site e plan must ke on 8-1/2"x 11"or 11 x 17"paper L'footprint of new structure(including decks)with finished [ }awn to scale (standard architect or engineer scale) flog elevations R,_,_,&oorth arrow ty locations(required for new,may apply for additions) L11'St address,project or subdivision name and lot number lion of wells/septic systems I applicant information(name and phone number) rosion control(including drainage-way protection,silt fence C4L:dimensions and building setback dimensions de*,n,location of catch basin,etc.) LU'I.ot area,building coverage area,percentage of coverage and LL Seet names impervious area(applicable if R-7,R-12,R-25&R-40) [ Stet tree size,type and location L�J'Property corner elevations(2 foot contour lines if more than hd•Existing trees to be retained with drip line,and tree 4 foot differential) protection measures Clean Water Services—Service Provider Letter: (lot platted prior to 9/10/1995): Required: XYes El No Received: ❑ Yes % No 1271/,and Use Case #: Ni I R' oning: g y.5 L`1 Setbacks: Front 2 Rear IS' Side 5 Street Side NJ I Pc Garage N NK. ndscape Requirement: N/A- % VWLot Coverage Maximum: di Height: Maximum Height W) Actual Height }ic�'f r �G(({■,• l()l L�_KVisual Clearance J [ 'Easements ,,, 1 g Sensitive Lands: R" Yes ❑ No Type CANS Veo� .C(►IGw, I l'-Urban Forestry Plan ratol . voltdc Vl01ti [onditions Met Notes: kpph C Apph CAM SV1ottl ktc*Yl L-- CAWS S,oXVICQ pawkdiD+ it -. Approved By Planning: A701416 LA— Date: 1.213.14 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Forms\BldgPermitRvw_RES_042914.docx Building Permit Submittal Original Submittal Date: 7% T/Ati Site Plans: # 3 Building Plans: # 3 Building Permit#: p-Enter building permit#above. Workflow Routing: L- Planning -Er Engineering hermit Coordinator -Building Workflow Sign-off: ign-off for Planning(include notes from planning review) Route Application Documents: j]-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: C Date: -7/..7g-Ac Engineering Review ❑ Actual Slope: ❑ Conditions Met Notes: Approved by Engineering: 7—_---,---..„ kl--- ----. Date: 7/Z / Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved d7 //(/ Permit Coordinator Review le ❑ Conditions Met-Prior to Issuance of Building Permit A' S AIL Notes: � , �J I ,_.Q-Pt_ 1 ' �t-'f1��, Revisions (after Building Submittal only) Lt,....13 Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: �' V , O Revision Notice 3: Date Sent to Applicant: Cb\ f3OK to Issue Permit ,� /' Approved by Permit Coordinator: //77/K7Date: '� )4//'`f 1:\B u i l d ing\Forms\B I dgPerm i tRvw_RES_042914.docx •r1 e`,Aiot. 4. 2014: 9:49AM03-747'-7695 TIGAUVILLE ND. 1 ' 12 FP. 1 01/01 .• �— ■ IVEDSrcO/ )— CEO 1 D1 . - 5 _ t!r .. i , AUG 4 2014 Clean Water Services Fite Number SUI. 2 8 219 -/�I2/, Y L. �J CITY OF 1�y4t ,i..f ate>r Services Se t M� ' 're-Screening Site Assessment I CEIVF 1. Juriedtctlon: `L_t 1531:1- (1 BUG 4 2014 2, Property information(example 1S234A00 400)) 3. Owner intormatlon ,lVof f.' , • Tax lot ID(s): c4-..„to 6 e3 2 U Name: P e..H ea._ '4,e_ea (Lte s-'\ �1JQ 'V- rrc..c a Company: Y fj f}tJCif4 P,1 e,1 k \ L a _ 1-1„ Address: t 31 Q - __S 4..\ s L C) y , Site Address; 1' %( i S ,S,3,4_1 ,.c h f f City,State,Zip:`-i . -ck t Q c-, °1 z.,_3 City,Siete,zip; _ y - z. PhonelFax. S 0 - '-\ k.1 2 ^ 314 C) T— Neareat Cross Street s. Aye _&.Q i1 p'.'_ _ f-man: _ ____ ~ 4. Development Activity(check all that apply) 6. Applicant information 4 Addtaon to Single Family Residen(x(morns,deck,garage) Name: 3_ ''E..b wt., 11011‘ Lot Line AdjUetment Q Minor Land Partition Company: U Residential Condominium ❑ Commercial Condominium Address; 1'3 t q5 5 LA A .1..,. fl r- L) Residential Subdivision 1] Commercial Cubdlvieton U Single L01 Commercial ❑ Muni Lot Corhmerctal City,State,Zip: "T'4c �� k7)�z'L Other _ Pttone/f=ax: G.1 , t ty 7, A' ICI i E-Mail: B. Will the project involve any afresite work? i_jYes .l NA ❑Unknown Location and description of off-site work 7. Additional comments or information that may be needed to understand your project - This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,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 COL All required permits ant approvals must be obtained and completed under applicable local,state,and federal law. By signing this fOrm,Ma Owner or Owner's authorized agent or representative adawuiedges end agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions end gathering information related to the project Ate. I certify that I am familiar with the Information contained in this document,and to the best arm,knmviedge and belief,this information is UUa,complete,end acceteta. Print/Type Name IP. 1w 0 tK•e.i Print/Type'[ttle 0 LAY\ Cs .- Signature :,...am----- Date k-^Z e, -...rai ----— - ... . FOR DISTRICT USE ONLY ❑ Sensitive areas pn*sntialty exist on silo or w4tlin 200'of the site THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER, if Sensitiive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. ❑ Eased on review of the submitted materials and best available tnfermatlen Sensitive areas do not appear to exist On site or wllhki 200'of the site.Trig SenettiveAres Pre-Sawing Site Assessment does NOT eGminato the need to evaluate and protect weier quaky sensitive seas if they are subsequently discovered.This document wit serve as your Salvias Provider letter as required by Resolution and Order 07-20, Section 3.021. All requkod parmite and approvals must be obtained end completed under applicable focal,State,and federal law. XBased on review of the submitted materials and beet available information the above roterenced project wii not significantly impact the existing or potentiaAy Sensitive area(s)found near the As.This SensieveArea Pre-Saeering SaaoAssess/no t does NOT eliminate the need to evaluate and protect additional water Quaky sensitive ersae tf they are eubsequerely discovered.Tills 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 cnxnpteted tinder eppliceble focal,slate and federal taw. This Service Provider Letter is notvaild unless t CWS approved site plan(s)are attached, The proposed activity does not meet the definition of development or the lot was platted after AIP/95 ORS 92.040(2). NO SITE ASSESSMENT MENT OR SERVICE PROVID R LETTER 19 REQUIRED, _-___. Reviewed by ,....4,.....,,,<,,. . _ .A..! Dote cis- irrl m,Ht,storo.'!i:Utr.7G • H•1l-.!-.1':7.(.)fl:rcn tli 12J , ",:!,ti!:(LO' 3C ::':'):7 • 7JY.;511 .-J. .ri • •, dr[I�: .r4, ' ,. e7A4g. 4. 2 014: 9:5 0AM33-747-7695 TIGARDVILLE No. 1112 Pr. 2 02/82 - i 1 11,(' a. --002-13g • Approved I Clean Water Service ! I 1meal I YlU1/1• rM v _Date ell 1o1i/iq / '1P c, M tokc'w. k I D4 I o• ¢ ad,A.k6,.„ 131,.9 \*1 fi t.A 4 ;� +'lbS - J x `y 4 " 4� • "r1C›Qa,4�J f3 . Vi • c, c a L. 3 10 "L. 1 5'- vii RECEIVED JUL 28 2014 CITY OF fiCARD BUfD1NGI ISIOP' 03'- O 0 2`1._b11 A cial+torl �z�o % 51-0 i-A°t+' f? x 2. LAI "� N • 131es Sw AcH QR. S Cr QLf\ J h otiL CITY OF TIGARD Approved by Planning Date: 1.28.1y c.) 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N. . . 1 i19`. // Feet / C 21 'I? / 1■1•11 is' . / Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 13185 SW ASH DR, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - No C of O MST2014-00121 David Young Perminate installed temp railing to code installed for future stair access. Stairway to be permitted and inspected at time of installation, not part of this final inspection. Violation Summary: Inspector Contractor