Permit p CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2016-00009
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/02/2016
Parcel: 2S103DA04300
Jurisdiction: Tigard
Site address: 10660 SW PARK ST
Subdivision: FANTASY HILL Lot: 4
Project: Arreola
Project Description: New 330 sq ft covered front porch over a 224 sq ft deck and other area.
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: $4,500.00 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
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:
ROSALES,LUIS ARREOLA OWNER Required Items and Reports(Conditions)
ARREOLA,JESSICA
10660 SW PARK ST
TIGARD,OR 97223
PHONE: 503-890-8911 PHONE:
FAX:
Total Fees: $365.06
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 C Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You obtain a r direct questions to OUNC by calling 503 .1987 r 1.800.332.2344.
Issued By: Permittee Signature:
Call 5 by 7:00 a.m.for the next available inspectn date.
This permit card shall be kept in a conspicuous place on the job site until co ploti 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 Dat I �4' Permit No
13125 SW Hall Blvd.,Tigard,OR 97223 J AN 2 6 2016 Plan Review
ME Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175 CITY 01: TIGARD Date Ready y: Jurie: _®See Page 2 for
Internet: www.tigard-or.gov $UILDING DIVISION NotifieWethod: 1// Supplemental 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(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.
® 1-and 2-family dwelling ❑CommerciaUndustrial Valuation: $4,500.00
❑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:10660 SW PARK ST., New dwelling area: square feet
City/State/ZIP:TIGARD OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:ARREOLA Covered porch area: square feet
Cross street/directions to job site: Deck area: 224' square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:W258612 Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S103DA04300 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
l DESCRIPTION OF WORK work indicated on this application.
0
ADDING NEW DECK(<30")AND COVERD FRONT PROCH 330'SQ FT Valuation: $
Existing building area: square feet
P
�v New building area: square feet
a t ❑ PROPERTY OWNER ❑ TENANT Number of stories:
:"Name:JESSICA JOAN PATINO ARREOLA Type of construction:
Address:10660 SW PARK ST., Occupancy groups:
City/State/ZIP:TIGARD OR 97223 Existing:
Phone:(503)890-8911 Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES"
Business name:SIMPL HOME DESIGNS
lease o to feescAiedak
j
Contact name:MIKE MONTGOMERY Structural plan review fee(or deposit):
- '
FLS plan review fee(if applicable):
Address:5531 SW BUDDINGTON ST
Total fees due upon application:
City/State/ZIP:PORTLAND OR 97219
� Phone:(503)515-6495 Fax::(503)7194825
Amount received:
* E-mail:mikewmontgomery@gmail.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business namc;T:O-BW Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
Permit Fee(includes plan review
City/State/ZIP: and administrative fees): $180.00
Phone:( Fax:() State surcharge(12%of permit fee): $21.60
CCB lic.: Total fee due upon application: $201.60
Authorized signet �Vv%'
(7 J/ �// This permit application expires if a permit is not obtained
4MQ�_v I� within 180 days after it has been accepted as complete.
Print name:MIKE MONTGOMERY "Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doe 02/24/2011 4404613T(11/02/COM/WEB)
City of Tigard
r COMMUNITY DEVELOPMENT DEPARTMENT
■
Building Permit Review — Residential
Building Permit #: 7--c;25,16 l/'D OO 5�
Site Address: of s �,
Project Name: A rneol L, Lot #:
(New welling=subdivision name;,Addition or.AIteration=last name of owner)
Planning Review Q /
Proposal: �/O✓1 /IrGl�i
P'V-oify site address/suite# exists and active in permit system.
2 River Terrace Neighborhood: ❑ Yes No
Site an Elements:
e(3) copies of site plan 11 K� --ng structures on site
1it�lan must be on 8-1/2"x 11"or 11 x 17"paper Ly1 ootprint of new structure (including decks)with finished
Ni< n to scale (standard architect or engineer scale) fl vations
L� o h arrow ;�leocarions (required for new,may apply for additions)
iitt address,project or subdivision name and lot number ocation of wells/septic systems
LSA .cant information(name and phone number) ❑Erosion control (including drainage-way protection, silt fence
of dimensions and building setback dimensionsdeli location of catch basin,etc.)
-$Ifmr area,building coverage area,percentage of coverage and t names
impervious area (applicable if R-7,R-12,R-25&R-40) Feet tree size,type and location
17171ope%corner elevations (2 foot contour lines if more than ❑Existing trees to be retained with drip line,and tree
4 fo differentialprotection measures
Clean Nater Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑ No Received: Yes ❑ No
'$-public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was nptified ❑ No Applied For: ❑ Yes ❑ No,stop intake
❑ Land Use Case #:
❑ Zoning:
❑ Setbacks: Front LLA Rear _ Side Street Side Garage
$Landscape Requirement: %
'$"Lot Coverage Maximum:
❑ Building Height: Maximum Height Actual Height
-E3—Visual Clearance
V$ Easements
❑ Sensitive Lands: ❑ Yes No Type
-C—Urban Forest Plan
- —Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: Date: -Z l
Revisions (after Building Submi only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Fonns\B1dgPennit Rvw_RES_070915.docx
Building Permit Submittal
Original Submittal Date: //Z&/14,
Site Plans: # 3
Building Plans: #
Building Permit#: `1B-Enter building permit#above.
Workflow Routing: /
Planning 8'�gineering crmit Coordinator �` Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: L]/Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
oginal plan review routing form.
9- Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: e` Date:
E
ngineering Review
/J Slope 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 \Fater Quality Fee in-lieu: ❑ Yes No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engine ing: Date:
Notes: /
##da .0 r
Approved by Engineering: ) Date: ��f
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 Fees Entered: V"ash Co Trans Dev Tax: ❑ Yes P:�:k/A
"Tigard Trans SDC: ❑ Yes N A
Parks SDC: ❑ Yes A
K to Issue Permit /
Approved by Permit Coordinator: Date: 2-
1:ABuilding\FonnsvBldgPennitRvw_RES_070915.docx
Vr
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law requires residential construction permit applicants who are not licensed with the
Construction Contractors Board to sign the following statement before a building permit can be
issued. (ORS 701.325(2))
This statement is required for residential building, electrical,mechanical,and plumbing permits.
Licensed architect and engineer applicants,exempt from licensing under ORS 701.010(7), need not
submit this statement.This statement will be filed with the permit.
Please check the appropriate box:
❑ I own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
❑ I will inform my general contractor that a II subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
I will be performing work on property I own, a residence that I reside in, or a residence that I w ill
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
S QSS LC C& 020
Print Name of Permit Applicant
Sign re of Per�itApicant Date
Permit#: `1
Address: /of, I GS r
Issued by: Date: v? /
This Copy for Permit Offices
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
10660 SW PARK ST, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2016-00009
Jeff Grove
Violation Summary:
Inspector Contractor