Permit (174) ilkiCITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2019-00120
T-I[_;A R 0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/16/2019
Parcel: 2S103CB06000
Jurisdiction: Tigard
Site address: 12249 SW HOLLOW LN
Subdivision: QUAIL HOLLOW-EAST Lot: 9
Project: Kephart
Project Description: Remove existing front porch stairs and railings. Replace with(9)new stairs and handrails and
reduce the rise.
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: 20 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $4,103.51 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 VB R-3 0
Owner: Contractor:
KEPHART LIVING TRUST WESTSIDE INDUSTRIAL COATINGS&CONC Required Items and Reports(Conditions)
BY KEPHART,PAUL W&BRENDA 20046 SW JOANN CT
J TRS BEAVERTON,OR 97003
12249 SW HOLLOW LN
PORTLAND,OR 97223
PHONE: 503-577-9799 PHONE: 503-349-6414
FAX:
Total Fees: $267.56
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 t. follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR••.%s 101-0090. Y•u mat stain a copy of --rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / -
Issued By: `/ Ail/./1, ✓ / ��
_ �, ,��.rmittee Signature: - —.......e:-;
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.
Building Permit Application
Residential rOFrE.I( I SE:ONl.1
City of Tigard oll Received �w�,
Date/By: � Lk\ S� Permit No.�/� — ���_M
41 13125 SW Hall Blvd.,Tigard,OR 97223(A P r, 2 01 g Plan Review
Phone: 503.718.2439 Fax: 503.598.196 Date/By: st t L_� At' Other Permit:
Inspection Line: 503.639.4175 Date Ready/By:
7 �y s: ® See Page 2 for
rt�a RE, Internet: www.tigard-or.gov C� �� � �� ( ( B
BUILDING DIVISION Supplemental Information
TYPE OF WORK 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.
and 2-family dwelling 0 Commercial/industrial Valuation: $4103.51
❑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:12249 SW Hollow Lane New dwelling area: square feet
City/State/ZIP:Tigard Garage/carport area: square feet
Suite/bidg./apt.no.: Project name:Stair Replacments 1(60kr Covered porch area: square feet
Cross street/directions to job site: Deck area: 50 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.
Remove erxisting front porch stairs and Railings Valuation: $
Replace with new 9 new staris and handrails i12ec:.V4.0 c._A - s — Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Brenda Kephart Type of construction:
Address:12249 SW Hollow Lane Occupancy groups:
City/State/ZIP:Tigard OR,97223 Existing:
Phone:(503)577-9799 Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Phone:( ) per;;( ) Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Westside Industrial Coatings&Concrete Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:6571 NE Cherry Drive#2-111 Solar Installation Specialty Code checklist.
City/State/ZIP:Hillsboro OR,97124 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)349-6414 Fax:( ) €.e (?.,,Aciv9 , - el State surcharge(12%of permit fee): $21.60
CCB lic.:212693 n r.-V < (, C 0-4Y` 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:Todd Westby Date:4/9/19 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
II e COMMUNITY DEVELOPMENT DEPARTMENT
: 1111
T I G A R D Building Permit Review — Residential
Building Permit #: `^�;\ST":?-c).\Ct .- CC` ;
Site Address: 12,2111 ;,,/ t,4ik LAt
Project Name: kz,Ph,ird' S ru,,`ir Ktpia�Mh- Lot #:
(Ne dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review p rr t r '
Proosal: Pv �e j. tied rt eitta { '4- �\IAYS. ; In,J S .ln 1 n L.,II rtMa..
Ir Verify address/suite#active in Accela. In River Terrace: LI No ❑ Yes,River Terrace Review Addendum
Sit lan Elements:
rosion Control
lpies of site plan on 8-1/2"x 11"or 11 x 17"paper etained trees with drip line and tree protection measures
Lid'Drawn to scale(standard architect or engineer scale) I: ..tprint of new structure(including decks)and FFE
,.�.,�-orth arrow
D. i : 'ty locations&easements(required for new and additions)
[i address,project or subdivision name and lot number P idewalk/driveway approach
MfAp licant information(name and phone number) „,Kation of wells/septic systems
L1,1
of dimensions and building setback dimensions 'Str=-t tree size,type and location
`, are footage of buildings to be demolished P!{. reet names
[ Existing structures on site 0 orner elevations(2'contours if more than 4'differentiaall)z
, Lot area,building coverage area,percentage of coverage and 1,000 sf of impervious area created or replaced? ❑Yes o
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes ❑No
Clean Water Services—Service Provider Letter of platted prior to 9/10/1995):
quired: CI Yes,applicant was notified Lid'No Received: ❑ Yes ❑ No
Lid' Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified fE No Applied For: ❑ Yes ❑ No,stop intake
idh-pand Use Case#: 'n ❑ Zoning:
Ler( Required Setbacks: Front: L3 Rear: I S Side: 3 Street Side: L9 Garage: U
Building Height: Max. Height: 30 Actual Height: 10 010.-,y
PR” Landscape Area: % (A-Lot Coverage Max: 0/0
t AL, ntrance ❑ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
NVQ Windows ❑ Minimum 12%of area of all street-facing facades
Ivi Garage ❑ Garage door is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
i` ❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
Lt,‘I`ku ❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
)
❑ Garage door width is ❑ 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
(d-Q64,c ❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
rr 1t. ❑ Accent siding ❑ Window trim ❑ Window recess CIWindow projection ❑ Balcony
iIVia isual Clearance ❑ Urban Forestry PiAn
ensitive Lands: ❑ Yes No Type:
Conditions met prior to issuance of btlilding permit
of s: COC ( ZIO, 030: 1. r
�i - k t(�,]s td . �Jty.- 1.\,1-91.\,1-9 ,�r Cw,)- 5iahIi.
Approved By Planning: ivyvt u( Date: 4-1-i 9
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_022819.docx
Building Permit Submittal
Original Submittal Date: Lk l i \Ct
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: d Planning L/ Engineering 2/Permit Coordinator 2/Building
Workflow Sign-off: Z ign-off for Planning(include notes from planning review)
Route Application Documents: ai Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
2/Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ;` � Date: Lit\Ot.k k of
Engineering Review
E 51ope at building pad: Sy,
Conditions "Met"prior to ance of building permit
CcKEasements (encroachments)per engineering conditions of approval and plat
L" Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes d No
Assess Water Quantity Fee in-lieu: ❑ Yes 2' No
_/ LIDA Facility on lot: ❑ Yes 2' No
L� Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:�
L( Approved by Engineering: f?- _.,1_ j 4tt;,,e,� Date: �{ -- U -2419
Revisions (after Building Submittal only) _�1 CJ Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: ❑ 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:
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
LIDA ❑ Yes cia N/A
C OK to Issue Permit
Approved by Permit Coordinator: Date: fio i
I:\Building\Forms\BldgPermitRvw_RES 022819.docx