Permit CITY OF TIGARD MASTER PERMIT
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Is COMMUNITY DEVELOPMENT Permit#: MST2015-00142
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/28/2015
Parcel: 2S111 CA04400
Jurisdiction: Tigard
Site address: 9700 SW LAKESIDE DR
Subdivision: SUMMERFIELD NO.12 Lot: 664
Project: Smith
Project Description: Replace metal patio cover with wood patio cover. Electrical work under separate permit.
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:
Total: 0 sf Value: $7,480.00 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 DispDrains: 0
. 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Footing Drain: 0 Ice Maker. 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 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'I 500 sf: 0 201-400 amp: 0 201-400 amp0 W/O Svc/Fdr. 0
Mid 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 0
Owner: Contractor:
SMITH,KIRK H&CONNIE J NW OUTDOOR LIVING LLC Required Items and Reports(Conditions)
9700 SW LAKESIDE DR 1089 N 25 TERRACE
TIGARD,OR 97224 CORNELIUS,OR 97113
PHONE: PHONE: 503-995-0174
FAX
Total Fees: $446.63
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 donein dance 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. TENTION on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 01-0010 through OAR 95 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 pr 1.800.332.234
Is ued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection ate.
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 RECEIVED
Received ���
City of Tigard ��G 5 2015 Da[eB : 7 �"� Permit No.: `�/
n 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
Phone: 503.718.2439 Fax: 503.5 ]�`6 Date/By: Z _ Other Permit' �LyCI ��
Inspection Line: 503.639.4175 8 1 T OF TIGARD Date Ready/By. Juris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: a' � Supplemental lnformation
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(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.
ja'l-and 2-family dwelling C3Commercial/industrial Valuation: $ �L
❑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: �(yam J� �c�.�Lw✓i ; �,� New dwelling area: square feet
City/State/ZIP: `t'�-Z Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
37 Y
Cross street/directions to job site: L� t t Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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.
IR r'AC'fcZL& rli
Valuation: $
Existing building area: square feet
i ' ' New building area: square feet
[I PROPERTY OWNER ❑ TENANT Number of stories:
Name: Lam' �<y v�,t v� Type of construction:
Address: to � S; Occupancy groups:
City/State/ZIP: _
Q Existing:
Phone:( 0 Fax:( ) New:
[2-A—PPLICANT J-CONTACT PERSON BUILDING PERMIT FEES*
Business name: 1' ! C�� L •�: � L L�
Please refer to fee schedule
�J h/ - Structural plan review fee(or deposit):
Contact name: � •;
FLS plan review fee(if applicable):
Address: � 2
Total fees due upon application:
City/State/ZIP: i 13
Phone:( ) q9s� a1
Fax::( ) Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
1 Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection 'ls
�"}' � U' and fire department access,along with the>—Oregon
Address:
Z�j f t2./ Solar Installation ecial Code checkl'
City/State/ZIP: .ct Permit Fee(inc es plan revi
`,�� and admin ative es):
$180.00
Phone:(f435 ) 01 Fax:( ) State surcharge(12%of
CCB tic.: '7— 2 7 Total fee due tt ee .n application: $2 1.60
Authorized signature: This permit appli 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: Date: (p „ _ / 5 Service Board.
l:\Building\Permits\BUP-RESPermitApp.do 02/24/2011 440-4613T(i 1/02/COM/WEB)
City of Tigard
CONIMUNITY DI-VELOPIvIEN'I'DFPAlZ'FNII-NT
a
Building Permit Review — Residential
Building Permit #:
Site Address: 00 CW L U V2I i
Project Name: Lot #:
(Nexv dwelling= subdivision name;:Addition or Alteration=last name of owlier)
Planning Review
Proposal: "e_P Jt4W_ Mttr l PWh O (;O Vt ' n.e,W 01 W►'li►-Z
Verify site address/suite #exists and active in permit system.
River Terrace Neighborhood: ❑ Yes p/ No
Site Plan Elements:
/Three (3) copies of site plan Axisting structures on site
Site plan must be on 8-1/2" x 1 1"or"11 x 17"paper Footprint of new structure(including decks)xvith finished
gDraxvtn to scale (standard architect or engineer scale) floor elevations
North arrowt tv locations (required for new,tray apply for additions)
Site address,projector subdivision name and lot number. _ocation of xvells/septic systems
\pplicant information (name and phone number) �xrosion control (including drainage-way protection, silt fence
/Lot dimensions and building setback dimensions design,location of catch basin,etc.)
Loot area,building coverage arca ercentage of coverage and Street names
Omh ivibervious area (applicable i R-7 R-12,R-25&R-40) eet tree size,type and location
't� perrn corner elevations (2 foot contour lines if more than —Bl_Slsting trees to be retained with drip line,and tree
4 foot differential) protection measures
—Clc3i7tWater S"rvices—Service Provider Letter (lot platted prior to,9/1,01/1995):
Required' ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
_EI-Rublic facilities Improvement (PF'l) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
Land Use Case #: 74Y\JL 0-1 CAel9- S--
A Zoning: /2
Setbacks: �:L)V (q �( front Rear Side q Street Side Garage
--8--i-andscape Requirement: spQG c�-G %
`8r7-of Coverage Maximum: %
-f5-13uilding Height. Maximum Height Actual Hcight
'Visual Clearance
-Q-basements
-Z;]--Sensitive Lands: ❑ Yes ❑ No Type
-El-Urban Forestry Plan
-E4-eonditions "Met"prior to issuance of building pernut .
Notes:
Approved By Planning: 0 l? 1 (9 Date: A/ f
Revisions (after Building Submittal only) Reviexver Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Forms\BldgPetntitRv"-_RES_070915.docx
Building Permit Submittal g J
Original Submittal Date:
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit# above.
Workflow Routing: Planning �lgineering3errnit Coordinator Building
Workflow Sign-off: .B' 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
original plan review routing form.
Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes: L � t —
By Permit chnician: Date: g
Engin r g. Review
r2!rSlope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments) per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility,:
Assess Nater Quality Fee in-lieu: ❑ Yes No
Assess Water Quantity-Fee in-lieu: ❑ Yes No
LIDA Faciht>> on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: At I!UL W � Date: $ f S
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ 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 Dees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
OK to Issue Permit J
Approved by Permit Coordinator: ry� Date: 0,
Approved
I:\Building\Forms\Bldg Perm itRvw_RES_070915.doex
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
9700 SW LAKESIDE DR, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2015-00142
David Young
Ok per approved plans and engineering.
Violation Summary:
Inspector Contractor