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Permit (189)
III CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2016-00511 T r C;;y I:f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/05/2016 Parcel: 2S111CB04900 Jurisdiction: Tigard Site address: 10286 SW LADY MARION DR- Subdivision: MARION ESTATES Lot: 22 Project: Conroy Project Description: Replace existing deck, like for like, 334 sq ft. 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: $7,454.88 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 0 Storm Sewer: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Bckfiw Prevntr: 0 Catch Basins: 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 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: CONROY,JOHN D JR RICK'S CUSTOM FENCING&DECKING INC Required Items and Reports(Conditions) 10286 SW LADY MARION DR 4543 SW TV HWY#A TIGARD,OR 97224 HILLSBORO,OR 97183 PHONE: 503-601-9674 PHONE: 503-640-5434 FAX: Total Fees: $410.15 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. ' 1 • .. •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95 001-0010 through OA- •52-00 -r X90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232. 7 or 1.80:2.2344. Is- ed By: A 4 . 9. fL / fe Permittee Signature: >( 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. : 112 a IRE 'e !1 pp caii i Residential ii0triCi `� MCity of Tigard �: ii Aq /!P Permit No.: 1'1✓ra9Oge,'CO 5'/1 13125 SWHallBlvd-,Tigard,OR 97223N0V 2 9 201h PtaR Line: Fax 5 3,s . 960 ice_p,�:{/QJ a- 1 - 1 C a Permit: o L` I Lie: 503.639.4175 k i . , 1?y , De'yBJ �° ♦ � R re Page labanet Www. -aCgW AlotifiedtMethn�/ /�� :�/� �fJ Mill,,-7`''1%:i'; i 7i: ,1/L .57 c' TYPE OF WORK REQUIRED DATA:i-AND 2-FAMILY DWELLING Cl New construction Q Demolition Permit fees;are based on the value of the work paced Ind the value(rounded to the nearest dollar)of all Wien ewipment,materials,labor,overhead,and the profit fir the CATEGORY OF CONST RITCTION work indicated on this application. 0-a d2 fa y p vast: $ /3,3s' .�— 0 Accessory building ❑Mniti-fatrrily Number of berhooms: '1 3 Mastexb> l El Other a li wattages. l 1 SITE IN) kTRAI AND LOCATION Tt�tait offlotxs: Job site address: /0.28C 5 W L 0..J.y 44 a. :-0-,.. Or. New dwelling area: square ket City/Statef P: Ti. 9--a z k GINligelauport area: square feet Suite/bldg./apt no.: I Project covered porch area: square feet Cross streevkeelions to job sits S W /03 A,, Deck area: 3311 l square feet 3 Ty dr' Other sbucture area: spare feet REQUIRED DATA:COMIIIERCIALUSE CHECKLIST Subdivision: Lot no.: Permit fees*me based on the value of tlb work performed. Tax mapJpar:rd Indicate the (rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the ORFION OF WORK work Masted on this application. Reeigt - eKttTfv., pu..k. 1.. rt.. -Co,' 1: . Valuation: s Existing building area: Meet New building area: square feet e.PROPERTY © TENANT Number of sem: Name: Jo k h C W1,r W/ ,,,,AA W: /� Type of construction: Address. /02 g s u1 L 1PIGa pV-1 OCCLIPanCYt City : j;5 R 9 9-2 2.' Existing: Phos(,su3) 401- 96 ?'4 Fax:( ) New: R.APPLICANT la-CONTACT PE ON NOTICE Business Ban= R.)AS ( ,ç 40'w. F-Grt...J1,c All co cors required to osbe Board Contact ruamei {w G t 44 !/ it sed with the Oregon Construction may Address: y 5 q 3 s E T✓.t-ro 7 jurisdiction in which work is being performed.If the City/Stat/ZIP: g 3 6t s b�-c) • licara is exert from licensing,the followingreasons • Y Phone:(SOP 992-687-9 Fax::( ) Email: %s-c 44-C-. R.4.+1.e e( e:c..kr 4e.ot.t 1". . c''dn-k CONTRACmOR Business n Rrvk.,f - BUILDING PERMIT FEES* Adder fPlsanerarmrfaa3ie� a City/Stater/2P: Structmal plea review fee(or deposit): P ( ) Fax( FLS plan review fee(if applicable): CCBlig sop�,8 Taal fees doeupon applie�n: Amami received: it q6,.3 r A°thOrtt°d �� 1644This permit application expires if a permit is not(drained within 180 days after it has been accepted as complete. I Print name: Si,w.e R.,4d I Date: Ii-29- 14. I • Fee methocblogv set by Tri-County Building lndustry Building rermIt4Pnucauon_ Residential RECEIVED a City of Tigard =Blvd- / Mallnall Paini"4°-: /10r, ° b--CO 5/ 13125 SW Hall Blvd.,Tigard,OR 97223N0 V 2 921316 Plan Review Other Parent Phew 503.639A171 Fax: 501598.1960 Daida . Inspectiai Line: 503.639A175 crni. OF 1`16iii0 1a,Read}4BY: ba. El See PeRe 2 for IntanW www.tiganl-ar.gov Notified/Moho& Seppiesmemed lefeneader - 111111,DINGDIVNioy TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING [3New 0011SRUCti011 El Demordice Permit fees*me based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all E;(Addhionfalterationfreplacement 0 Other: equipment,materials,labor,overhead,and the profit for the vvork lode:gal on this application. CATEGORY OF CONSTRUCTION K dwValuation: $ 13,35"C.5°— a-and 2-family elling 0 Commathdfaulostnal Number of bedrooms: 0 Accessory bullring 0 Mrdli-farnily * s 0 Master bailer 1 0 Other t Ituthz ottiiktera. 3OR SITE ININDINIATION AND LOCATION Total umber°Moon: Job sile addrax /0486 S knI Lel.4110.4:0,, Or. New dwelling aita: square feet 7 City/StriteRJP: -rv„..4 9?-az1/4{ optaa. square feet Suite/bldg./apt.naz I Plejeet alliW CCTV% r I;1 y Covered porch an= squire feet dr' as streetkfirections to job sitm,5 Si 103 4.4.4. Deck area: j3 it ie.- squwe fret 3 pi Other Stream area: square feet , REQUIRED DATA:COMMERCIAL-USE CIIECKLIST Subchvis'kw Lot no.: Permit fees*me based on the value of the work performed. Inchoate the vadue(mangled to die newest dolla-)of all Tax maptpateel no.: equipmat,materials,labor,ovahead,and the profit for the DESCRIPIION OF WORK work inflated on this application. Vahndion: $ Repta.c.e... eK Ls.+1-7 0.44_k_ L; k... ..c.., 1 1 kt. Existing bulling nen square feet New building area: square feet Pg.ritorzgrv owl= 1 0 TENANT N. Number of stories: , Name: l'O 11 rk C 011,r&y Type of construction: Address: /0 2 5 4. 6 tni Lej7 114 irre:tv% arl OccuPancY rouPs: City/State/ZIP: M aej 9 22.41 Existing Phoom(503) iilf(- 94 744 Fax:( ) New: a Arri.wArir RI-CMITAGT PERMXY NOIICE &table"aim: R1 CAtS ewS 40VtA Fe.s.1.4.1. All connactors and subcontractors we required to be Canted licensed with the Oregon Construction CadraCIONS Board name: .51.-cAtc. R..4-1 wer ORS 701 and may be rewired to be licensed in the "leas: q 5 q 3 „SE T_V:et; id jurisdiction in which work is being performed.If the applicant is exempt from licensing,the following reasons City/State/22P: g 3 ti s locry.0 141111Y: Phane:(SO 1U-4S 7-9 I Fa=:( ) E-mail: 64-CAC-. lt...-ike+-(0 2;4 ki $4.44( 1‘1•1 . edn't COVIERACTOR - Business namm RuAe___; BUILDING MOW MKS6 "am refers.fee Addremc ad)iStaterZIPStructural plan review fee(or deposit7 : FLS plan review fee(if applicable): Mom( ) Fax ( ) Total fees due upon implicidai. n: u CCB Gm: 509 g 8 Amount receive' d: Authorized signabwe: ih._ zig This permit appiades expires la permit is not obtained . within 180 days after it has been accepted as complete. I Print name: st to.c. RIA,44 effiee_ I Date: II-21- 1 C. I * Fee methodology set by Tri-County Building Industry l*r Ouuu-OG5/( � Clean Water Services File Number C1eanWater\ Services , 16-004386 Sensitive Area Pre-Screening Site Assessment 1. Jurisdiction: 1 i liar 2. Property information(example 15234AB01400) 3. Owner Information Tax lot ID(s): 2,,S/f f C.t O 4 Y oo Name: ,'o h v, (' ,- y Company: Address: .29Et•A9 I 6 6W tik!ty 0714,y;ni1 Site Address: /(p 2 Re s kJ I e, ✓;e x dr. City,State,Zip: City,State,Zip: T; ari( oY 9 .Z2 q T'/0/-- �'• 9"`^t� fir, t Phone/Fax: S7?3—t,0/ Nearest Cross Street: 103 rd l}vilk. E-Mail: 4. Development Activity(check all that apply) S. Applicant Information .121" Addition to Single Family Residence(rooms deck, arage) Name: 54- cure. ❑ Lot Line Adjustment U Minor Land artition Company: (Q;��C,s f wS � c U Residential Condominium ❑ Commercial Condominium Address: yS 4 3 j.6. T.t/ l U Residential Subdivision ❑ Commercial Subdivision U Single Lot Commercial ❑ Multi Lot Commercial City,State,Zip: /H a I(sb�,,,o O,-- 9 -Jz 3 Other IZ.e elgc,t. ex t s -:n1, ilk k. kc 34✓ LikPhoneiFax: 3- 992 - pl ;t9 E-Mail: + . e / .4I ' a/lC' 6. Will the project Involve any off-site work? U Yes 0No ❑Unknown -A2,1 Location and description of off-site work 7, Additional comments or information that may be needed to understand your project / i rL.. L2f k This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands and/or Department of the Army COE.All required permits and approvals must be obtained and completed under applicable local,state,and federal taw. By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this doaxnent,and to the best of my knowledge and belief,this information is true, complete,and accurate, Printflype NameL }-eve �.t erf,p_ Print/Type Title Stat fay' �/ `.�S fire ' Signature tel/ /�� `�` `� tk. �r• Date /1—.2 9-1.l FOR DISTRICT USE ONLY U Sensitive areas potentially exist on site or within 200'of 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 Report may also be required. ❑ Based on review of the submitted materiels and best available information Sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.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 must be obtained and completed under applicable local,State,and federal law. ❑ Based on review of the submitted materials and best available information the above referencedwill not lly .sensitive area(s)found near the site.This Sensitive Area projectneededitoa evantlyluate impactte andprotect et6hg or nal water Pre-Screening Site Assessment does NOT eliminate the to evaluate additional water quality sensitive areas if they are subsequently discovered.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 must be obtained and completed under applicable local,state and federal law. Q Thu Service Provider Letter is not valid unless CWS approved site plans)are attached. ❑ The'proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed by Date 11/29/16 2550 SW Hillsboro Highway • Hillsboro,Oregon 27123 • Phone:(503)631-5100 • Fax(503'1681 4430 • wn:V. rserviccs.erg City of Tigard " COMMUNITY DEVELOPMENT DEPARTMENT T c A R 1, Building Permit Review — Residential Building Permit #: ) -(y row/(9—006/ Site Address: 1 0246 (o Sy,/ Lelci (Nom 0 ,-. Or Project Name: Co r) ro t1 Lot #: (New dwelling=su'bdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: (2 !cc ta.. -e_x i s el ,, GU ck Verify site address/suite#exists and active in permit system. River Terrace Neighborhood: ❑ No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: )1 Three(3)copies of site plan fZExisting structures on site Site plan must be on 8-1/2"x 11"or 11 x 17"paperootprint of new structure(including decks)with finished C/Drawn to scale(standard architect or engineer scale) floor elevations ;eNorrh arrow E4#ility locations(required for new,may apply for additions) /Site address,project or subdivision name and lot number ❑Lo. stion of wells/septic systems Applicant information(name and phone number) L Sling trees to be retained with drip line,and tree /Lot dimensions and building setback dimensions protection measures area,building coverage area,percentage of coverage and ❑Street tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) XiStreet names �'eperty corner elevations (2 foot contour lines if more than 4 foot differential) V Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified El No Received: El Yes ❑ No .Ea-Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: 0es ❑ No,stop intake "'Land Use Case#: Zoning: ; 3, S Required Setbacks: Front 2 Rear i S Side , Street Side Garage Landscape Requirement: ,..--' 0/0 aJ Tot Coverage Maximum: .,�-- ©'wilding Height: Maximum Height ?0 Actual Height -PVisual Clearance '"Easements sensitive Lands: ❑ Yes ❑ No Type Ea-Urban Forestry Plan "Conditions "Met"prior to issuance of building permit Notes: Approved By Planning: M 6\--N--..... r/1l� Date: 1 Z CI i I Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: El Approved El Not Approved I:\Building\Forms\B1dgPermitRvw REs 091216.docx Building Permit Submittal / Original Submittal Date: /1/8 9 /I o Site Plans: # 3 Building Plans: # 3 Building Permit#: VEnter building permit#above. Workflow Routing: D'Planning engineering alermit Coordinator f'Building Workflow Sign-off: II 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. ['Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Co. .(20,062. 4-c-4,c1 Date: //7,49//e0 Engineering Review .Slope at building pad: 'NA- ❑ 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 CV No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: /14 1 V.Z, 1�.) . Date: II ii h, 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 /A Tigard Trans SDC: ❑ Yes /A Parks SDC: ❑ Yes ' ItN/A P,�OK to Issue Permit ii/2"1/49A((PP roved by Permit Coordinator: /71 Date: I:\Building\Forms\BldgPermitRvw_RES 091216.docx