Permit (86) CITY OF TIGARD MASTER PERMIT
1111
!; COMMUNITY DEVELOPMENT Permit#: MST2017-00450
Date Issued: 11/21/2017
TtnAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S135CD03700
Jurisdiction: Tigard
Site address: 11605 SW 95TH AVE
Subdivision: None Lot: None
Project: DAW
Project Description: Above-ground storage tank.
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: $3,550.00 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 RainStorm 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
Ecompasing: N
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
DAW,LAWRENCE D ENVIRONMENTAL WORKS LLC Required Items and Reports(Conditions)
DAISY L 2634 SE STEELE ST
11605 SW 95TH AVE PORTLAND,OR 97202
TIGARD,OR 97223
PHONE: PHONE: 503-719-6715
FAX: 503-972-1866
Total Fees: $329.63
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 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 Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.—
---- �." y
l ��.n
Issued By: _ :. "1-+ �< -..e/ Permittee Signature: —` '"`. 6'- < "
all 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.
Building Permit Application
Residential 14 T FOR OFFICE USE ONLY
• Received
City of Tigard l / Permit No.: r.,1„, 1'
" 13125 SW Hall Blvd.,Tigard,OR 0:‘,N
Date/By: S � � `�— "��
,74
= g Plan Date/By:
Review Filar '
Phone: 503.718.2439 Fax: 503. 1960 DB Other Permit:
I Date Read/B See Page 2 for
TIGARD
Inspection Line: 503.639.4175 i. �d� Ready/By: t B
Internet: www.tigard-or.gov �w i" 1 Notified/Method: ' /7 Anil
�` Supplemental Information
'ik
" Pl!t t 4 tt 2 4 ttkg3 t1i , 'e#t* Al l)3 rA I Y I'f`V IM:f 1G`
®New construction r�i)� ton Permit fees*are based on the value of the work performed.
ivy Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
t GA ,� ; � Y i work indicated on this application.
Valuation: $3,550
® 1-and 2-family dwelling ❑Commercial/industrial
LI Accessory building ❑ Multi-family Number of bedrooms: 4
❑ Master builder ❑Other: Number of bathrooms: 1
lTotal number of floors: 1
Job site address: 11605 SW 95'h Ave New dwelling area: square feet
.43 City/State/ZIP:Tigard/OR/97223 Garage/carport area: 200 square feet
Suite/bldg./apt.no.: Project name:Larry Daw Covered porch area: square feet
Cross street/directions to job site:SW Lewis Lane Deck area: 225 square feet
House is on the corner of SW 95th and SW Lewis Lane Other structure area: square feet
Subdivision: Lot no.:R2749 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 1 S135CD Indicate the value(rounded to the nearest dollar)of all
fequipment,materials,labor,overhead,and the profit for the
� 1#g ` z ` work indicated on this application.
Intalling a new above ground storage tank on the south side of the house Valuation: $
`✓ Tank will be located behind red wooden fence Existing building area: square feet
New building area: square feet
►e I' *,f11*O;,* tiv Number of stories:
Name:Larry Daw Type of construction:
Address: 11605 SW 95th Ave Occupancy groups:
City/State/ZIP:Tigard/OR/97223 Existing:
Phone (503)639-4227 Fax ( ) New:
lea! ` 14?�J,� �I.'. `v.,r / Z � X4211 a7i t EY i z " I5'' M0,+L i.1 1 ,rt y
Business name:Environmental Works LLC
z . K .. ria fee,sehe> 1
2.
Structural plan review fee(or deposit):
Contact name:Andy Truong
FLS plan review fee(if applicable):
Address:2634 SE Steele St
> Cit /State/ZIP:Portland/OR/97202 Total fees due upon application:
a � Y
sPhone:(503)719-6715 Fax: :(503)972-1866 Amount received
1 '4,' '`� 1 A Al .. �> � .
E mail Andy@eworksnw com -, ,
„ � Commercial and residential prescriptive installation of
, % �' � Vs roof-top mounted Photo Voltaic Solar Panel System.
Business name:Same as applicant 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.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
CCBPhone
li ( )
( ) Fax: State surcharge(12%of permit fee): $21.60
lic.: Total fee 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:Andy Truong Date: 11/14/17 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Building Permit Submittal
Original Submittal Date: /J/j31i 7
Site Plans: #
Building Plans: #
Building Permit#: er building permit#above.
Workflow Routing: 15lanning eering [ -'1'ermit Coordinator L7 Building
Workflow Sign-off: [s7-sign-off for Planning(include notes from planning review)
Route Application Documents: ngineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
ding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: � - Date: ej/�s '7
Engineering Review
R SI pe at building pad: 0
.1 "-Conditions "Met"prior to issuance of building permit
2'ETasements (encroachments)per engineering conditions of approval and plat
Er—Vater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes [ —No
Assess Water Quantity Fee in-lieu: ❑ Yes Li—No
LIDA Facility on lot: ❑ Yes ia-'No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: V,k,., y)4-tC Date: / J - 2 ' -17
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
O 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 ji N/A
Tigard Trans SDC: ❑ Yes II ► /A
Parks SDC: ❑ Yes I, N/A
LIDA ❑ Yes N/A
XOK to Issue Permit
Approved by Permit Coordinator: GJ V Date: '`V7/6\\1
I:\Building\Forms\BldgPermitRvw RES 061417.docx
:114C•
ity of Tigard
M COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Residential
Building Permit #: /'7S-rxi 7m-C (y15
Site Address: / Lioc cS k) 3C/A �.. _,
Project Name: s ow ) Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review d717)rori-e..Proposal: /U- ) vlo1/-2 — 7'DIDn i
V Verify site address/suite# exists and actio n permit system.
11 �''ver Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached
Siie Plan Elements: /
6 1 ree(3)copies of site plan Existing structures on site
• ite plan must be on 8-1/2"x 11"or 11 x 17"paper titKtprint of new structure(including decks)with finished
• rawn to scale(standard architect or engineer scale) or elevations
VI orth arrow 'ty locations&easements(required for new and additions)
rI to address,project or subdivision name and lot number L1dSidewalk/driveway approach
• pplicant information(name and phone number) 11 %cation of wells/septic systems
`l/_JLot dimensions and building setback dimensions ; W.__ • rees to be retained with drip line,and tree
P\ikkr*.....,=.-fr,,,tigc of buildings to be demolished protection measures
coverage area,percentage of coverage and Ogreet-t-r-oe-si.2e,type and location
im.ervious area(applicable if R-7,R-12,R-25&R-40) Vtreet names 1
M '�operty corner elevations (2 foot contour lines if more than >1,000 sf of impervious area created or replaced? EYes�J
4 foot`differential) If yes,is a storm water quality facility shown? .RE1Yes ONO
Olean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified V No Received: ❑ Yes ❑ No
'ublic Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified I No Applied For: ❑ Yes ❑ No,stop intake
,�j -> '_J
and Use Case#:
/Zoning: � `� � j
O Required Setbacks: Front Rear OI Side Street Side 1c- Garage Orr
landscape Requirement:
Okfot Coverage Maximum: 0/0
Oiq+ wilding Height: Maximum Height 30 Actual Height NO
,pp�Tisual Clearance
'( 1Sensitive Lands: ❑ Yes ❑ No Type
, rban Forestry Plan
a 0t onditions "Met"prior to issuance of building permit
otes:
Approved By Planning: /ij Date: / "
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_061417.docx