Permit (92) CITY OF TIGARD MASTER PERMIT
Ill 2: ' COMMUNITY DEVELOPMENT Permit#: MST2019-00019
TIG RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/13/2019
Parcel: 2S108DB02600
Jurisdiction: Tigard
Site address: 15260 SW MISSOURI AVE
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 24
Project: JOY
Project Description: 120 sq. ft. deck addition.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: C sf Left: 5 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: C sf Front: 20 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $2,868.00 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
C
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: C
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 VVoodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders 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 SvclFdr: 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:
JOY,JEFFREY C&KAREN D RICKS CUSTOM FENCING&DECKING INC Required Items and Reports(Conditions)
3 SEACLIFF 4543 SWTV FMK#A
COTO DE CAZA,CA 92679 HILLSBORO,OR 97183
PHONE: PHONE: 503-640-5434
FAX:
Total Fees: $232.49
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 s nded for more the 180
days. ATTENTION: Oregon law requires you to follow •- •- --•••ted by the Oregon Utility Notification Ce to Those s are set forth in OAR
952-001-0010 through 952-001-0090 • a obtain:copy of the rules•;r direct questions to OUNC by calling 503.23 9 or 1.800 .2344.
Issued By: , L l...L. _ :- "' Permittee '•- ure:
3.639.4175 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 101:0111( L t 0\11
M City of Tigard Received
7223t4;"' E C Fi i i.:'r- Date/BY .2/51 r /477-- P)SrdC.511 Cr.Dtti
13125 SW Han Bird.,Tigard,OR 9 ., A, _,, 0 ,— , Plan R -
Phone: 503.639.4171 FSE 503.598.1960 - - Dateffieviewy: ..„9/-7 I /4-14-' Other. Peimit
Inspection Line: 03.639.4175 Date Ready/Sy. if , him ia See Page 2 for
Internet www.tigard-or.gov FEB 201.9 ---- .
... , /..., / " . Supplemental Information
TYPE OE ,191p5Di NI C.. 0 ittii i Si :-) • I ' .)i i 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
0-Additionlalterationheplacemext 0 Other: , equirnent,enateriab,labor,overhead,an4r_octforp
work indicated on this application.
CATEGORY OF CONSTRUCTION 4 i
Ag1905r15"
04-and 2-family dwelling 11 0(orammvialfindustrial Valmnion: $
Number of bedrooms:
0 Accessary WV* 0 Multi-family
aMasterbacler 0 Other: 1 \Amami Watbraces.
ios SITE u AND LOCATION Totals of E0OtS:.
Job site address /5"2. C C) S W AI 1 ssot&ys A.v i New dwelling area: square feet
City/StatetZIP: rii&VA 1 ars 1;2211 Garagelcarpmt area: square feet
SuitobldgJapt.no.: Project mune: To y Covered porch atea: squat feet
Cross street/directions to job site: 6 vo s e;vve, Or-> Deck area: square feet /20
Other strimture area: square fee
REQUIRED DATA:COSIAM CHECKLIST
Subcliviiion: I Lot no.: Permit fees*we based on the value of the Awn perfumed.
Indicate the value(rounded to the nearest dollar)of all
Tan mallifFared 80-: 25 108 080 2,6 elon equipmerd,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
_ Valuation: $
/4.14 aRti ___ 0....e.k to`m21 -fa £.44151-A-, H______
Existing building area: square feet
New building area: square feet
, •
ce-BROBEWIT OWNER 0 TENANT Number of stories:
Name: Teg./Ka.ve.,.. To ll Type of construction:
Address: /$*2,40 S IA) A i 014.4e e; Ars, Occupancy grows:
City/Stateffilt Tii1 ole• 7?-22.4( Existinw
Pb3ae:(citli) 2.Cir--* 112041 Fax:( ) New:
l'fir-ALTIACANT fig.LIVTACI PERSON NOTICE
Business name: Rryk-5 All contactors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: S 4,44, a.„4..L.jpe_
unikr ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP: apply:
Phone:( ) Fax::( )
i.---
E-mail: 6fc4c, 2.444,-• Rtuks '44.,e),"kit , Caw%
CONTRACTOR
Business name: Ra ck5 feat C 0,^if.- . BUILDING PERMIT 1FEES*
(Pkeserefrtofeesdrairse)
Address: IS'1 1 5,e , 77 V, 14,Any &muml plan review fee(or deposit): /7 3 zi
city/State/MP: is 0 I(5‘,t,„ ( cry, 17-113
FLS plan review fee(if applicable):
Phone:(50)) 994 -g8 R Fax:( )
Total fees due won plication
MB lk.: „Too 9 s, — —
Amount received:
Authorizedsignanne: A az____ mkt permit appfication expires if a permit is not obtained
within ISO days after it has been accepted as complete.
IPrint name: ,54..0,„ g.,44 ,.... I Date: 2-5- /I I * Fee methodology set by Tr-County Building Wintry
71 City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
GBuilding Permit Review — Residential
Building Permit #: 57
Site Address: I5 2 6 O S w N i S S o v e-i
Project Name: Toji d e L Lot #:
(New dweg=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: A at vk. 10x12, be c (,L, o n i-v -ex is fil l) Gt e ck
ltl Verify site address/suite#exists and active in permit system.
7 River Terrace Neighborhood: 0 No 0 Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
XThree(3)copies of site plan
)21Footprint of( Existing structures on site new structure(including decks)with finished
Site plan must be on 8-1/2"x 11"or 11 x 17"paper
Drawn to scale(standard architect or engineer scale)
orth arrow
Utility locations&easements(required for new and additions)
Site address,project or subdivision name and lot number floor elevations
VA hcant information(name and phone number) %Sidewalk/driveway approach
Plpp gLeeafion of wells/septic systems
Aot dimensions and building setback dimensions \ xisting trees to be retained with drip line,and tree
quare footage of buildings to be demolished
itg
rotection measures
hot 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) XStreet
Property corner elevations(2 foot contour lines if more than >1,000 sf names
impervious area created or replaced? ❑Ye
4 foot differential) p s �No
If yes,is a storm water quality facility shown? es
•9' Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
ARequired: ❑ Yes,applicant was notified 0 No Received:
Public Facilities Improvement(PFI)Permit: Yes 0 No
Required: 0 Yes,applicant was notified 0 No Applied For:
0 Yes 0 No,stop intake
Ff Land Use Case#: S U G 1-•0 I 5 _ 000 0 2
EJ Zoning: i i S
Required Setbacks: Front
Landscape Requirement
X � 7 Rear 1 s Side $ Street Side SGarage 2
-Q
Lot Coverage Maximum: pi/
A.... o/
o
/o
Building Height: Maximum Height 30N` }-
AVisual Clearance Actual Height
y Sensitive Lands: 0 Yes 0 No
Type
0 Urban Forestry Plan
I Conditions "Met"prior to issuance of building permit
Notes:
I�' Approved By Planning: Nl,`9�.:_� �
/ Date: 2..4/
Revisions (after Building Submittal only)
Revision 1: 0 Approved 0 Not Approved Reviewer Date
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\Building\Fomes\BldgPermitRvw_RES_061417.docx
Building Permit Submittal
Original Submittal Date: ,P2 Nig
Site Plans: # 3
Building Plans: # i
Building Permit#: a me uilding permit#above.
g
LL1'' n eerie it Coordinator
Workflow Routing: Tanning gm g
Workflow Sign-off: -off for Planning(include notes from planning review)
Route Application Documents:
1;4...
r . ngineering: (1) copy of permit application, (1)site plan, (1)building plan and
o al plan review routing form.
Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
Date: 7 ,
By Permit Technician: --��' �_
4,00r 4100,
:: ... ......
En . eering Review
ce
Slope at building pad: c1-276
CWConditions"Met"prior to issuance of building permit
['I asements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility
Assess Water Quality Fee in-lieu: 0 Yes No
Assess Water Quantity Fee in-lieu: 0 Yes No
�� LIDA Facility on lot: 0 Yes No
121 Final Plat Recorded:
Date:
0 NOT Approved by Engineering:
Notes:
E'Approved by Engineering: - ,.....41_
R. j � Date: 2.1 i,// y
Revisions(after Building Submittal only)
Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 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:
p(SIWash Co Trans Dev Tax: 0 Yes VN/A
DC Fees Entered:
Tigard Trans SDC: 0 Yes CeN/A
Parks SDC: 0 Yes [rN/A
LIDA 0 Yes Tr N/A
t❑ OK to Issue Permit /
/ /
Approved by Permit Coordinator:
Ihilate:
IABuildingWorms\BldgPeimitR°w_RES 010118.docx