Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
CITY OF TIGARD ! 4 MASTER PERMIT Nil - r, 11' � LS +:vii 2 - COMMUNITY DEVELOPMENT Permit#: MST2015-00145 Date Issued: 09/02/2015 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S114BA11900 Jurisdiction: Tigard Site address: 9530 SW MILLEN DR Subdivision: COPPER CREEK STAGE 3 Lot: 84 Project: Roth Project Description: Replace existing deck(with slightly smaller deck)and fence. Install a new covered patio. 10/8/2015 REPRINT permit for reduction in project valuation and permit fees. 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: 15 Smoke No Dwelling Units: 0 Third: 0 sf Right: 5 Detectors. Total: 0 sf Value: $18,419.00 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 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 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'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: ROTH,MELINDA BROWN BUILDING&DESIGNING LLC Required Items and Reports(Conditions) 9530 SW MILLEN DR PO BOX 197 TIGARD,OR 97224 LAKE OSWEGO,OR 97034 PHONE: PHONE 503-675-3909 FAX: Total Fees: $678.96 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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: /� CT�C_--. Permittee Signature: (24/ ��/ 4 / CAA /C1l/ �L' 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. IICITY OF TIGARD MASTER PERMIT ll I • COMMUNITY DEVELOPMENT Permit#: MST2015-00145 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/02/2015 Parcel: 2S114BA11900 Jurisdiction: Tigard Site address: 9530 SW MILLEN DR Subdivision: COPPER CREEK STAGE 3 Lot: 84 Project: Roth Project Description: Replace existing deck(with slightly smaller deck)and fence. Install a new covered patio. 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: 15 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: No Total: 0 sf Value: $80,000.00 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 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!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: ROTH,MELINDA BROWN BUILDING&DESIGNING LLC Required Items and Reports(Conditions) 9530 SW MILLEN DR PO BOX 197 TIGARD,OR 97224 LAKE OSWEGO,OR 97034 PHONE' PHONE: 503-675-3909 FAX: Total Fees: $1,727.97 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 issuanc= 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 7 nter. Those rule are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of -ru- • •irect questions to OUNC by calling 503...1987 or 1.800.3332. 4, / r Issued By: • /S�� — _ Permittee Signature: Call 5 ACM,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. fJuilding Permit Application Residential RECEIVED Received FOIZ OFFI( F I SE O\I.1 City of Tigard Date/By: /s 0 Permit No.: H61 1 S_W I S • 13125 SW Hall Blvd.,Tigard,OR,a 2 2015 /C [[( Awl Plan Review 1 U . I Phone: 503.718.2439 Fax: '503.5981960 Date/By: , � �j��Q ��1ei Penn": "I I Ci A IZ D Inspection Line: 503.63941 7 i�Y O TIGARD Date Ready/By:/Method: J�' ® Page 2 for Internet: www.tigard-or.gQY� �� C p "1)AJ oy — Supplemental Information f7 �fVi�.tON IMr aRQUIRED DATA:1-AND 2-FAMILY DWELL i ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. I Indicate the value(rounded to the nearest dollar)of all ►: •ddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OFt work indicated on this application. 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ CJZ)i oc=,0 ❑Accessory building ❑Multi-family Number of bedrooms: El Master builder ❑Other: Number of bathrooms: ;JOB SiTE INFORMATION AND LOCATION Total number of floors: Job site address: et S ix, 5 W 144 ill e„, New dwelling area: square feet City/State/ZIP: I)1 6,./11 O 2 Ctla.( Garage/carport area: square feet Suite/bldg./apt.no.: Project name: , n � Covered porch area Zq Q square feet Cross street/directions to job site: ''^ Deck area: 5( O square feet Other structure area: square feet :,GOMMI;RCIAL-USE CHECKLIST Subdivision: 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. �V 1 Valuation: $ det.-. 1c Existing building area square feet � New building area: square feet 4PROPERTY OWNER I ❑ TENANT Number of stories: Name: ONE Li"A..G Type of construction: Address: Ct X7 (1 w pen l 0 Occupancy groups: City/State/ZIP: "'J hi✓ C t O v_. o Z.Z,) Existing: Phone:( ) J Fax:( ) New: APPLICANT TCONTACT PERSON BUILDING PERMIT FEES* Business name: (Pleas a schedule) ii r Structural plan review fee(or deposit): Contact name: – C1�1!� o� FLS plan review fee(if applicable): Address: F.p, , I q6^7 1 ` Total fees due upon application: City/State/ZIP: °� 2 0 I 70' 71 i #16010,97 .� Amount received: Phone:(7�) G15--36t06‘ Fax: :( ) E-mail: 1 PHOTO*OLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: '�h Submit two(2)se of roof plan with connection•-tails i'fi;�r"' ' ti 4' �i \� and fire department. cess,along with the 21 , Oregon Address: P,d, if: it]l l Solar Installation S•-ct. j Code chec _ Permit Fee(includes City/State/ZIP: �4�i ,�„T t� Ctip� and administr•v $180.00 Phone:(( 1. ) Cold)"'��0 \ Fax:( �. � State surcharge(12°. s f permit fee): $21.60 CCB lic.: 1 Li Z \ To e due upon appication: $201.60 Authorized signature: 6., / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name: , h •t.— Date: -• _. _ = Service Board l:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) V Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLV City of Tigard Received 11111 P, 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical f I G a R D Internet: www.tigard-or.gov ❑ Other: "1'IIE FOLLOWING FILMS .-ARE REQUIRED FOR PLAN REVIEW 1 e No N/,1 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ • ❑ 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 ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 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- ❑ ❑ ❑ T b ' protection,etc. 10 3 plete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑ ' ing 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 ❑ ❑ ❑ 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- ❑ ❑ ❑ 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. ❑ ❑ ❑ 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- ❑ ❑ ❑ 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 ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑ 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 a licable to the project under review. 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x I 1"or 11"x 17". ❑ - 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ CI 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans 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. L\Building\PermitshBUP-RESPetmitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) M City of Tigard 1111111 COMMUNITY DEVELOPMENT DEPARTMENT ■ T l c n R n Building Permit Review — Residential Building Permit #: !`l d15 x4 45 Site Address: ,S--` 0 f0 ✓ 7p// ? ;r�-r2 . Project Name: &Vit ��'v Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: /1./PAc) (7i'vi',-eGe 6 M Verify site address/suite#exists and active in permit syste . Niiiiitver Terrace Neighborhood: ❑ Yes ( No Sit lan Elements: ree(3)copies of site plan [ sting structures on site . e plan must ke on 8-1/2"x 11"or 11 x 17"paper I�'Footprint of new structure(including decks)with finished wn to scale(standard architect or engineer scale) floor elevations arrow N. .° locations(required for new,may apply for additions) Vrth i address,project or subdivision name and lot number 'AI ' ,:,tion of wells/septic systems PA .licant information(name and phone number) ■.. '.sion control(including drainage-way protection,silt fence 14 • dimensions and building setback dimensions d ign,location of catch basin,etc.) 1• .t area,building coverage area,percentage of coverage and treet names pervious area(applicable if R-7,R-12,R-25&R-40) , )tfet tree size,type and location rope corner elevations(2 foot contour lines if more than 0ting trees to be retained with drip line,and tree 4 f t differential) protection measures Clean Water Se •ces—Service Provider Letter(lot platted prior to 9/10/1995): Required: es,applicant was notified ❑ No Received: ❑ Yes C12 4/Public Facilities Improvement(PFI)Permit: Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake d Use Case#: ning: etbacks: Front Rear /5 Side 5— Street Side AI/9,Garage ) edscape Requirement. QO ranot Coverage Maximum: 00 y Building Height: Maximum Height /jS Actual Height /1.c- /9)/4sual Clearance 14 A asements a Aensitive Lands: ❑ Yes ❑ No Type Qi/Y/erban Forestry Plan t 1onditions "Met"prior to issuance of building permit Notes: Approved By Planning: .--- ----"`".._ __ Date: 8 a Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw RES_07091 5.docx 4 .,_s Building Permit Submittal Original Submittal Date: (/ //< Site Plans: # Building Plans: # Building Permit#: QEnter building permit#above. Workflow Routing. $Planning engineering Permit Coordinator .B luilding Workflow Sign-off: O--Sign-off for Planning(include notes from planning review) Route Application Documents: .e( Engineering (1) copy of permit application, (1) site plan, (1) building plan and al 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: a i Date: _4/i /01-- (§-- Engineering Review ( Slope at building pad: .�7d LJ Conditions "Met"prior to issuance of building permit L8'Easements (encroachments)per engineering conditions of approval and plat ,I Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes E(No Assess Water Quantity Fee in-lieu: ❑ Yes l "No_ LIDA Facility on lot: CI � Yes I�No ❑ NOT Approved by Engineering: Date: Notes: ■LI 407"..)."; .�� _ � V Approved by Engineering: 4 .LJ Date: a--./3_/: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved El Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions"Met"prior to issuance of building permit ❑ Approved, NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: ❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A Tigard Trans SDC: ❑ Yes ❑ N/A Parks SDC: ❑ Yes ❑ N/A K to Issue Permit .. Approved by Permit Coordinator: Date: 3 I:\Building\Forms\BldgPermitRvw_RES_0709 I 5.docx ■ ■ g 16 1507:44p Brown Building and Design 503-675-3909 p.1 'e • RECEIVE!) . { t . 11 '' .' err 2 ?01 Clean Water Services File Number•le' AUG172015 II �� g Offill , etmv r` vile es ._ . Sensitive Area Pre-Screening Site Assessment 1. Jurisdiction: -r,c v../C 2. Property Information (example 1 S234A601400) 3. Owner Information f �\ Tax lot ID(s): e�5 114 d R 11 goo Name: //LQ\i.1�+o` 'el Company: Address: a 0 , ,I+ *.- - A Site Address: q ?Di) te)teje H I LLtiry .4,12., City, Sta:e,Zip Troyer A.1011._ ..\-7 723 _ City,State,Zip: —7 T C O v?t.,, G L 9-72- J/ Phone/Fax: Nearest Cross Street: E-Mail 4. Development Activity (check all that apply) 5. Applicant information .4i4 Addifior to Single Family Residence(rooms,deck,garage) Name: �r 5 ;13rJr...v/l ❑ Lot Line Adjustment :] Minor Land Partition Company: hoc..-_,v1 +A�k r ©25- 1"-1 j Residential Condominium [► Commercial Condominium Address: T o, �07c I°V'st J ❑ Residential Subdivision ❑ Commercial Subdivision /p� ❑ Single Lot Commercial ❑ Multi Lot Commercial City,Slate,Zip: 1 OS 1..... ■a? pit`-a7t�3� Other Phone/Fax: Sfe;ce4,1 c'31 CD E-Mail: B LP-C k.r.5 e y Cv• `-'„— 1 6. Will the project involve any off-site work? 0 Yes J No ❑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,Sito Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands andlor Department of the Army COE. AN required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form,the Owner or Owner's authorized agent or representative,acknowecges and agrees that employees of Clean Water Services have authority to enter the project site al all reasonable times fcr the purpose of inspecting project site conditions and gathering intimation related to the project site. I certify that I am'wilier with the infar-nation ccntained in this document,and to the best of rr y knowledge and befef,this intimation is complete,and accurate. Print/Type Na CIA-/j, ? �t/cot�f\ Print/Type Title l�rGS`,ct.,.. Signature /(,• _ Q^L' Date S FOR DISTRICT USE ONLY IJ Sensitive areas potentially exist on site or within 200'cf the site. 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 Repor may also be required. Li Based on review of the submitted materials aid best available information Sensitive areas do not appear to exist on site or within 200+of the site This Sensitive Area Pre-Screening See Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are suosequently aiscovered.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 crust be obtained and completed under applicable local,State and federal law. Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentiafy ensitive area(s)found near the site.This Sensitive Area Pre-Screening SiteAssessmenl coes NOT eliminate the need lo evaluate and protect add tiov,al water quality sensitive areas if they are subsecuently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07.23,Section 3.C21. All required permits and apprcvals must be obtained and completed under applicable local,stale and federal law. J This Service Provider Letter is not valid unless CWS approved site plan(s)are attached. U The proposed activity does not meet the definition of development or the lot was platted after 9/9195 CRS 52.010(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS RE UIRED. Reviewed by /_.-ei. Date i /` /5 MIR 2650 SW Hillsboro Highway - Hillsboro,Oregon 97123 • Phone:(603)681-5100 • Fax:(503)681-4439 • wvnv,cfeanwaterservices.org FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter S SW-1411 Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: > DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVE') AUG 19 201:5 FROM: COMPANY: BUILDING I�N CITY 01 l'1VAKU I�PHONE: B RE: ? -3C) : ( I /f..e c� C,Y�115 (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: I Description: Copies: Description: Additional set(s)of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(ex ain REMARKS: ts?�.: 06-01 &a5 FOR OFFI E USE ONLY Routed to Permit Technicia • Date: 2h Initials: Fees Due: • Yes r o Fee Descri•tion: Amount Due: Special Instructions: Reprint Permit(per PE): ❑ Yes I ❑No ❑ Done Applicant Notified: Date: Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 'i. TIr ' ai City of Tigard October 8, 2015 Brown Building&Design Attn: Chris Brown 1747 Conifer Dr Lake Oswego, OR 97034 Re: Permit No. lvIST2015-00145 Dear Applicant: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: 9530 SW Millen Dr Project Name: Roth Job No.: N/A Refund: ® Check #218848 in the amount of$1,049.01. _ Credit card"return" receipt in the amount of$ . _ Trust account"deposit" receipt in the amount of$ . Notes: A reduction in the project valuation from$80,000.00 to $18,419.00 resulted in a reduction and refund of plan review and permit fees paid. If you have any questions please contact me at 503.718.2430. Sincerely, rd) 'I,''''', , . ..21--C--- Dianna Howse Building Division Services Coordinator Enc. IA Budding\RefunlIAVII`i, ti , zit ON.erpTigo-krailOt gon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov City of Tigard TIG Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Pe1711it_Actio/Z form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Brown Building& Design DATE: 10/1/2015 Atm: Chris Brown 1747 Conifer Dr REQUESTED BY: Dianna Howse Lake Oswego, OR 97034 TRANSACTION INFORMATION: Receipt#: 202133 & 202433 Case #: MST2013-00143 Dace: OS/12/2015 & 9/2/2015 Address/Parcel. 9530 SAC Millen Dr Pay Method: CreditCard Project Name: Roth EXPLANATION: Refund overpayment of permit fees due to reduction of project valuation from 580,000 to $18,419 to remove landscape work from project valuation. REFUND INFORMATION: -Fee Description-From Receipt _ Revenue Account No -Refund Example: Building Permit Fee - - . . - - - Example:=2300000-43104 :•$Amount Plan Review 230-0000-43106 $383.23 Building Permit 230-0000-43104 392.66 12% State Surcharge 100-0000-24001 71.12 TOTAL REFUND: $1,049 01 APPROVALS: SIGNATURE S/DATE: If under$5,000 Professional Staff If under$12,300 Division Manager If under$25,500 Department Manager If under$50,000 City Manager If over 550,000 Local Contract Review Board FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY - Case Refund Processed: Date: /GJe//s By: 'C l v I\Budding\Refunds\RefundReyuest doc'09/01/2010 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT IN "+ Request for Permit Action !GAR!) 13125 SW Hall Blvd. •Tigard,Oregon 97223 • 503-718-2439 •www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits @tigard-or.gov FROM: ❑ Owner ❑ Applicant Contractor ❑ City Staff Check(1)one INVOICE OR Name: el ft S -JCL"-� c. INVOICE TO: (Business or Individual) Y, - ii ► � Mailing Address: 1-1 11'1 (O�.�. ✓ v r ) v1 City/State/Zip: L,e.„1/1....e_. C `,/mac' -U ()L q 7691 J k. Phone No.: -3\--2 -O'S ^' 1 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): ❑ : I._ VOID PERMIT APPLICATION. o % ERMIT FEES (attach copy of original receipt and provide explanation below). • INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: M ‘- -T-‘- -T- 0I `j CO CU f <E `J Site Address or Parcel#: C 530 C)c.0 H 1 LL I'J rj2- . Project Name: Subdivision Name: r Lot#: EXPLANATION:1G6,1114,k- /y JL,, (4,--.-•,-- v-rv� `��o C�GiC) Is,p",q 19 , I ,Ga-k'tk.c'-j t9-.ti. GM o.l r Sc' (1.I�._ 1-0,-)L c)--- c L� c ,..Q&- 5-t ..L-r.i-,E.4.0-k. - • C6k-ia..�1 ol—k V'. Signature: C--A\.' Date: c -5- j 5 Print Name: C\,\.r , C , J G N Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 800/s of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests.P tr 9'5'5, 35 34,A • 4,9 : 57,2.6 4, 12x4 /PA 09" - y3, Soz - 2/. �oz P �. 1 Goo,q� - a 3S, 25 � 3,es: a3 FOR OFFICE USE ONLY 11,e9.0/ Route to Sys Admin: Date 9 r7A"P B Route to Records: Date /iVe By Refund Processed: Date/40M AS- By .l4F Invoice Processed: Date By Permit Canceled: Date xJ 9 By Parcel Tag Added: Date By I:\Building\Forms\RegPermitAction_092314.doc 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 9530 SW MILLEN DR, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection PASS - No C of O MST2015-00145 David Young Correction complete. Violation Summary: Inspector Contractor