Permit INCITR;
Y OF TIGARD MASTER PERMIT
.', COMMUNITY DEVELOPMENT Permit#: MST201600434
T(GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/01/2016
Parcel: 2S 110DA06400
Jurisdiction: Tigard
Site address: 10513 SW NAEVE ST
Subdivision: ERICKSON HEIGHTS Lot: 25
Project: JONES
Project Description: Patio cover installation over existing deck.
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: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $12,000.00 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
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 0
Owner: Contractor:
JONES,SEAN M&CYNTHIA L RICK'S CUSTOM FENCING&DECKING INC Required Items and Reports(Conditions)
10513 SW NAEVE ST 4543 SW TV HWY#A
TIGARD,OR 97224 HILLSBORO,OR 97183
PHONE: PHONE: 503-640-5434
FAX:
Total Fees: $551.51
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 Cent-r. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a co of the rules or direct questions to OUNC by calling 503.232.1 ,or 1.800. .2.2344.
�L�
Issued By:
/ � Permittee Signature: .1.� - _ _ ►—
03.639.4175 by 7:00 a.m. or Wriext 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 s D .
Residential FOR OFFICE t Sl: O\E1
City of Tigard 1 EW
PermitNo.: CC 3 itiih„„
13125 SWHallBlvdTigard,OR 972 � �+ P1°111
1 /� � �J��,�y��
■ Phone: 503.639.4171 Fax: 503.598.114 A :. •4 Date/By: )Q-43._--,- ) c other Permit:
TIRD Inspection Line: 503.639.4175 Date Ready/By: Juris: See Page 2 for
Internet: www.tigard-or.gov Notified/Method:� //IJ'v 1C''' 7.6 I ®Supplemental Information
� 16
0�', et19/l.- c7E-?0
TYPE OF WORK 1;.1 11469 REQUIRED DATA:1-AND 2-FAMILY DWELLING
$New construction 0 i ei o ION Permit fees'are based on the value of the work performed.
G I Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
01-and 2-family dwelling ❑Commercial/industrial /2.00
ElAccessory building 0 Multi-family Number of bedrooms:
D Master builder ❑Other: s t Dumber of ba ooms. t
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /05//3 ss w /L, r New dwelling area: square feet
City/State/ZIP: Tif oNf- ""(3► 24 Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name: C. zrcry ,j Covered porch area: - --, square feet a ti 4,1
Cross street/directions to job site: S(A) to(e_ &Ae 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 mapJparcel no.: 25110 /}Qc W(jC7 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.
Valuation: $
Tr c tl 1t,,,141.tti. w/Ik r y lrle— Avvve,t c
PoCt ) Co I t„- dye-v 6)LA S$— ®c.x Existing building area: square feet
New building area: square feet
PROPERTY OWNER 0 TENANT Number of stories:
Name: ei. `�'',(f_ ,� f Type of construction:
Address: � .� Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
APPLICANT 0 CONTACT PERSON NOTICE
Business name: R z eik s 6,4 ics,vt Fe.4 L All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
} + ,� under ORS 701 and may be required to be licensed in the
Address: t1 y ? S T:,11L/,,, jurisdiction in which work is being performed.If the
7 liT "' applicant is exempt from licensing,the following reasons
City/State/ZIP: /(j 1 It S 4,/-4-.4) 97/2
J raPP1Y:
Phone:(5 j3) 99 2—(B le Fax::( )
E-mail:51,,e -e-, it w 4-'e. �1.CONTRACTOR
OR c�Gi iNe eism
Business name: iQrc_Ya BUILDING PERMIT FEES*
Address: ��G�w`�` (Please refer to fee schedule)
Structural plan review fee(or deposit):
City/State/ZIP:
FLS plan review fee(if applicable):
Phone:(6bb)) grl 2.—de Fax:( )
CCB lic.: o��� Total fees due upon application: I1,/„ S
Lt'` /
Amount received:
Authorized signature: � This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: S4 c- tp O I Date: 0_ 26_ it, I ■ Fee methodology set by Tri-County Building Industry
i = 4-537. x...
City of Tigard
'I COMMUNITY DEVELOPMENT DEPARTMENT
1111 m
T I GA R D Building Permit Review — Residential
Building Permit #: $7 / --0010,1 i -
Site Address: / S7 3 3 A 2e , Z'. ,
Project Name: 776)11'g � v (2,,6Ver_. Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: illieia 44 c._: . A. h,, c,✓-e_r"
Verify site address/suite# exists and active instem.ermit system.
Y
12/
fdOver Terrace Neighborhood: ❑ No ❑ Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
VIThree(3)copies of site plan ('sting structures on site
)to plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
rawn to scale(standard architect or engineer scale) floor elevations
Of)!orth arrow 'ty locations(required for new,may apply for additions)
VJ ite address,project or subdivision name and lot number �` ration of wells/septic systems
pplicant information(name and phone number) '3 I,ting trees to be retained with drip line,and tree
L t dimensions and building setback dimensions srotection measures
area,building coverage area,percentage of coverage and \l: °et tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) I Street names
fdperty corner elevations(2 foot contour lines if more than
4 foot differential)
t'iklean Water Services–Service Provider Lette (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified No Received: ❑ Yes ❑ No
tElAublic Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
( hand Use Case#:
oning: k– S. S
Required Setbacks: FrontRear IS 5-Side Street Side ``�� G
} andscape Requirement: %�� �V Garage ��
fdof Coverage Maximum:aximum:
Vuildin Height:
mm Height Actual Height
()Visual Clearance
asements
11/ensitive Lands: ❑ Yes ZNo Type
r0 f irban Forestry Plan
if gai Ptonditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: ___-__y
,, Date: PM
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\B1dgPermitRvwREs 0912I6.docx
Building Permit Submittal
Original Submittal Date: / /)-&/i(
Site Plans: #
Building Plans: # 3
Building Permit#: [Enter building permit#above.
Workflow Routing: Planning ngineering g-1ermit Coordinator ceding
Workflow Sign-off: Ei"-Si -off for Planning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
ort 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: Date: igi-g/i(�
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: 4 Date: le)—__27/Z,
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:
-DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes 9/A
Tigard Trans SDC: ❑ Yes NN/A
Parks SDC: ❑ Yes r'N/A
rOK to Issue Permit
Approved by Permit Coordinator:
"irDate: 4°4 AA°
I:\Building\Forms\B1dgPermitRvw_RES 091216.docx