Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2016-00344
T IG ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/08/2016
Parcel: 1 S125DB11300
Jurisdiction: Tigard
Site address: 7440 SW ELMWOOD ST
Subdivision: ELMWOOD PARK Lot: 7
Project: Carlson
Project Description: Add 128 sq ft covered,screened in porch
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: $6,000.00 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 Drains: 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 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:
CARLSON LIVING TRUST PROGRASS INC. Required Items and Reports(Conditions)
BY CARLSON,CAROLEE T TR 29895 SW KINSMAN RD
7440 SW ELMWOOD ST WILSONVILLE,OR 97070
TIGARD,OR 97223
PHONE: 360-513-2746 PHONE: 503-682-6076
FAX: 503-682-9876
Total Fees: $394.48
Th. ermit 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
e done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance ;.r if work is s -pended for more the 180
days. ATTENTION: Oregon la requires you to follow the rules adopted by the Oregon Utility Notification - ter. Those es are set forth in OAR
952-001-0010 through OAR 9 -001 0 0. You may obtain copy of the rules or direct questions to OUNC by calling 503.2 987 or 1.800. .2344.
1�����
Issued By: Permittee Signature: ��ALLki
Call 503.639.4175 by 7:00 a.m.for the next available inspec ion/Ir.
This permit card shall be kept in a conspicuous place on the job site until corn.I- ion of the pro/Ar
Approved plans are required on the job site at the time of each inspection.
Building Permit Application m4
Residential
S P 1` } i
City of Tigard Received Al �(`Q Permit No.:{-� / /LL/
III * 13125 SW Hall Blvd.,Tigard,OR 97223 Plan l ►"X� ` (10/6
/lD�W3 K
Plan Review . 1 C
Phone: 503.718.2439 Fax: 50� .1 6(I f 1 Date/By: -j� Other Permit:
T c;>>h D Inspection Line: 503.639.4175 Date Ready/By: , Iuris: ® See Page 2 for
Internet: www.tigard-or.goy , a t { Notified/Method: 7/�P I Supplemental Information
I ! ,Vis foN REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® I-and 2-family dwelling 0 Commercial/industrial Valuation: $6000
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:7440 SW Elmwood St. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 CA-.21_60 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: ek Covered porch area: `2.g square feet
Cross street/directions to job site:West of 7'"at SW Elmwood Deck area: 128 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.
add 16'X8'Covered Deck Valuation: $
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: C/-?_5'9j' Z/L.1,,,,16- 72 f-- Type of construction:
Address: 74 1_-0 SCJ - jv1i..,. :G,,f7
Occupancy groups:
City/State/ZIP: 7400. 76/1Q r 6,1"Z_ e7,� P Existing:
Phone:(AA))."/ 'Z 7lfG Fax:( ) New:
El APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Zarosinski Engineering and Design,Inc. (Please refer mfee schedule)
Structural plan review fee(or deposit):
Contact name:Dean P.Zarosinski PE
FLS plan review fee(if applicable):
Address:1400 NW 155thCircle
City/State/ZIP:Vancouver,WA Total fees due upon application:
Phone:(360)513-2746 Fax::( ) Amount received: //D7. Z-2
E-mail:dpzski@hotmail.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mount-• 'hotoVoltaic Solar Panel System.
Business name:Prograss Submit two(2)sets • roof plan with connection details
and fire department acc- along with the 2011 r -gon
Address:29895 SW Kinsman Rd, Solar Installation Specialty ,e chec .
City/State/ZIP:Wilsonville,OR 97070 Permit Fee(includes plan r---w $180.00
and administr. "e fees):
Phone:(503)682-6076 Fax:( ) State surcharge(1 °,of permit fee): $21.60
CCB licto 71 5- /
i /`
i/ Total f- due upon application: $201.60
Authorized signature � This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: ,q,z,GO 2A�c.,5j,,,.,f -4 Date: 8-2,3/G *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
IIIq■
COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: N`-{tar Lc l te_ C eD 4
Site Address: 1 94 0 s'w E I r»woo c( s 4--.
Project Name: Cu r 1 r 0 n peck Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: cV eArlt 00 V`er-cA / S c-u D.eC
. 2i.Verify site address/suite# exists and active in permit system.
0 River Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
Three(3)copies of site plan /Existing structures on site
,ZiSite plan must be on 8-1/2"x 11"or 11 x 17"paper 71Footprint of new structure(including decks)with finished
)IIIIIrawn to scale(standard architect or engineer scale) floor elevations
Ai North arrow y locations(required for new,may apply for additions)
/IZSite address,project or subdivision name and lot number etscrtion of wells/septic systems
/Applicant information(name and phone number) -EI-Existing trees to be retained with drip line,and tree
,ZiLot dimensions and building setback dimensions protection measures
ELot area,building coverage area,percentage of coverage and -EI-Street tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) RStreet names
lall! roperty corner elevations(2 foot contour lines if more than
4 foot differential)
Alf Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
-2-13t 1ic Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
Laud Use Case#:
Zoning: (z 4. S
7 Setbacks: Front 2;0 Rear ' S Side 5 Street Side ' s Garage 1.-O
❑ Landscape Requirement:
Ei of Coverage Maximum: 0/0
l Uiiilding Height: Maximum Height 30 Actual Height
❑ Visual Clearance
EhE sements
ff-SEiisitive Lands: ❑ Yes E No Type
B-Urban Forestry Plan
❑_Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: f -. . 11-1n ` Date: J/ 2-1—/ I c.
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 060116.docx
Building Permit Submittal
Original Submittal Date: c5la3ll(o
Site Plans: # 2
Building Plans: # �j
Building Permit#: 12'Enter building permit#above.
Workflow Routing: Planning "ngineering [I1rmit Coordinator wilding
Workflow Sign-off: a Sign-off for Planning(include notes from planning review)
Route Application Documents: ❑ Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
� original plan review routing form.
[I ]3uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: I »_ .D—. _ice 1 Date:
g47//
Engineering Review
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 Water Quality Fee in-lieu: ❑ Yes No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 1r�� Date: g—"--/6,
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: Wash Co Trans Dev Tax: ❑ Yes /A
r/ATigard Trans SDC: ❑ Yes
Parks SDC: III Yes N/A
( to Issue PermitINIC
Approved by Permit Coordinator: Date: OV/4::'
I:\Building\Forms\B1dgPermitRvw_RES_060116.docx