Permit CITY OF TIGARD MASTER PERMIT
' COMMUNITY DEVELOPMENT
Permit#: MST2019-00221
T tGR 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/10/2019
�
Parcel: 2S104DA05300
Jurisdiction: Tigard
Site address: 13240 SW RAPTOR PL
Subdivision: QUAIL HOLLOW-WEST Lot: 39
Project: MONTGOMERY
Project Description: Replacing 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: 20 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $1,577.40 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:
OTR SF VB R-3 0
Owner: Contractor:
MONTGOMERY,JOAN RICK'S CUSTOM FENCING&DECKING INC Required Items and Reports(Conditions)
13240 SW RAPTOR PL 4543 SW TV HWY#A
TIGARD,OR 97223 HILLSBORO,OR 97183
PHONE: 503-789-7575 PHONE: 503-640-5434
FAX:
Total Fees: $191.88
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,`•r i work is susp' ded for more the 180
days. ATTENTION: Oregon law requires you to folio - rules adopted by the Oregon Utility Notification Cev-/ Those rul are set forth in OAR
952-001-0010 throe OAR 952-001- ob-n a cop = the rules or direct questions to OUNC by calling 503.23/:, or 1.800.332)44.
Issued By. -1 l r f Permittee Signature: `— 1/I
, Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
r nis p- m care snarl oe Kept in a conspicuous place on the Job site until compfedon of the prvjeut.
Approved plans are required on the job site at the time of each inspection.
Building Permit Applicagtion
Residential tAAY 2 9 a 1 OR O I H( I. t ,I.
O y 1.1
City g Received - 1/, //��/�/!./ ii' `I� ,frp 4--
Ci of Tigard P •
13125 SW Hall Blvd.,Tigard,OR.97223 ,p Plan Review
a Phone: 503.718.2439 Fax: 5t 3:5`Oli:'9 _ ` ''' Date/By: .----
' '3b 11 I ' Other Permit:
i i i,1 wInspection Line: 503.639.4175 Date Ready/By: Avis: la See Page 2 for
Internet: ww.tigard-or.gov Notified/M,• . r / Supplemental Information
i
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
t].Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,an he profit for the
CATEGORY OF CONSTRUCTION
work indicated on this application. L 5-77. 0
1-and 2-family dwelling 0 Commercial/industrial
Valuation: $ s
m
❑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: 132 90 S i,J R(Ito 1.. Pia - New dwelling area: square feet
City/State/ZIP: T;¢tw, (7 .223 Garage/carport area: square feet
Suite/bldg./apt.no.: d Project name: Mefylyyl-�-3` . �y tei
Covered porch area: square feet
Cross street/directions to job site: .S, W; 6 ii. L c .s.._ Deck area: square feet 4
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: Permit fees*are based on the value of the work performed.
j 0 y u G 53 a Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
r.� PIt.f-e. Ex.S 4- j Q..�J`
Existing building area: square feet
New building area: square feet
lig PROPERTY OWNER A TENANT Number of stories:
Name: Je CLyt Pl O ix 1-3 0-yh aM- Type of construction:
Address: 13 410 ,S t v 1, R� T'O to- OO1, Occupancy groups:
City/State/ZIP: Tr
C,wi 9?- .2 3 Existing:
Phone:(503) 78 R — 73`7s' Fax:( ) New:
14 APPLICANT SI CONTACT PERSON BUILDING PERMIT FEES*
Business name: p (Please referloIresched l)
R'i Lki u 5 tort 1-SLG:N*y Structural plan review fee(or deposit):
Contact name: S-1-�,.t R x..4..1 p �,
Address: 5 may- , j, FLS plan review fee(if applicable):
�' ` T. 1 I Total fees due upon application:
City/State/ZIP: f/) It s L - t (77-'123 --
Phone:(503) ?r797- d g?71 j Fax::( ) Amount received:
E-mail:j-. .R i���G j f�,yC��t r W�1� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
ContAC'roR Commercial and residential prescriptive installation of
roof-top mounted Photovoltaic Solar Panel System.
Business name: R �, cI 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.
Permit Fee(includes plan review
City/State/ZIP: and administrative fees): $180.00
Phone:( 5,3) in,_G8 79 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 500 A 8 3/I! , 1.12./ Total fee due upon application: $201.60
Authorized signature: �.� i'/.��LThis permit application expires if a permit is not obtained
( C i (,, within 180 days after it has been accepted as complete.
.5%.a - 1p *Fee methodology set by Tri-County Building Industry
Print name: , S-1- We ��D Date: 1 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
lig a COMMUNITY DEVELOPMENT DEPARTMENT
11
T 1 c A R>, Building Permit Review — Residential
Building Permit #: /fj j f47 20 jj—00AA
Site Address: 13L- 0 c' Ai/ ccw(Ir- It a
Project Name: Lot #: --
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review ii �n
Proposal: r �uu t 6-11,'", lc. di\ (�C:.J iu ru'_ (,, IL`��'� �-eo)
le Verify address/suite#active in Accela. ❑ In River Terra e: [ No ❑ Yes,River Terrace Review Addendum
• a Ian Elements: El •.sion Control
i* ,vies of site plan on 8-1/2"x 11"or 11 x 17"paper V;1'etained trees with drip line and tree protection measures
IP • wn to scale(standard architect or engineer scale) 4111: ootprint of new structure(including decks)and FF1
I!► orth arrow grfe i.: locations&easements(required for new and additions)
W S' • address,project or subdivision name and lot number We.idewalk/driveway approach
b" .plicant information(name and phone number) Ptocation of wells/septic systems
11! vt dimensions and building setback dimensionsP eet tree size,type and location
jShare footage of buildings to be demolished tr t names
L xisting structures on site r ,orner elevations(2'contours if more than 4'differential
Iglirot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes L`7No
lmervious area(applicable if R-7,R-12,R-25&R-40)
vCIf yes,is a storm water quality facility shown? ❑Yes ❑No
Clean Water Services—Service Provider Lette of platted prior to 9/10/1995):
equtred: ❑ yes,applicant was notified Lid No Received: [` yes ❑ No
Ll Public Facilities Improvement (PFI) Permit:
4
R aired: ❑ Yes,applicant was notified Lid`No Applied or:
Zoning: �❑ Yes ❑ No,stop intake
I and Use Case#: PD�<•UDO —61°:-:i'1 ,SLIt C,I 1G).— r� !
��'���
�� � �,>f",�1
I, Required Setbacks: Front: 1) Rear: r Street Side: J, Garage: .t- •
q � 1 S Side:
PI Building Height: Max.Height: 3Ca Actual Height G �}Q�L k, t,1 -f
V, A. andscape Area: % ❑ Lot Coverage Max:
i\ ntrance 1=1 Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows ❑ Minimum 12%of area of all street-facing facades
Garage ❑ Garage door is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2"d 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
O Fire shingles ❑ Lap Siding 0 Roof pitch 0 Gable,hip,or gambrel roof ❑ Dormer
,� /, ❑ Accent siding -Window trim ❑ Window recess ❑ Window projection El Balcony
LL'zisual Clearance R Urban Forestryy Pln
CrSensitive Lands: ElL
Yes W No Type:
.
, onditignl met priorito issuanc of b ding perms f
Note t Saba{ t .4- t.k.,,,L /'�, �Cpi.r�el{ .i-Li..4, ' , ,;u't fi,,,tu.„4" 'tv ()i"77'+'c i'J\ 4-€0,i.. e,
lI
Approved By Planning: e` 7<UL (_.F Date: S t'l-P I
Revisions (after BuildingSubmittal only) Reviewer
Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPernutRvw_RES_022819.docx
Building Permit Submittal /
Original Submittal Date: 7 'l/
Site Plans: #
Building Plans: #
Building Permit#: ► nter building permit#above.
Workflow Routing. a Planning Engineering Permit Coordinator Building
Workflow Sign-off: 'Sign-off for lanning(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.
7Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: / / < /
By Permit Technician: Ai A/./ .41.t.f Date: ___ /
Engineering Review
Z Slope at building pad: 3/
0
Q'Conditions "Met"prior to issuance of building permit N,744
[/Easements (encroachments)per engineering conditions of approval and plat
2/Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes L'No
Assess Water Quantity Fee in-lieu: ❑ Yes Er No
LIDA Facility on lot: ❑ Yes Er
[ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
ErApproved by Engineering: j,. 3..#,.. Date: 6/3/00/7
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:
ision Notice 3: Date Sent to Applicant:
SCJ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes /A
Tigard Trans SDC: ❑ Yes 3, 1/A
Parks SDC: ❑ YesA
LIDA ❑ Yes iNkr/A
OK to Issue Permit 4e:Approved byPermit Coordinator: l I
/�
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
Clean Water Services File Number
CleanWatee Services 19-001623
Sensitive Area Pre-Screening Site Assessmen
1. Jurisdiction: Mi`-‘,Y 2 g 1(j j9
2. Property Information(example 1S234AB01400) 3. Owner Information C T''
SC
:��1 9F
Tax lot ID(s): 2 S 104 0 A 0"�3 t) S C) Name: 4 L'rti liv'�.` �r*y'nels,
Company: /,} �-�
Address: J 32 9) S. W 1\ot o► e-r
QS Site Address: 132 iO S i'1J �c�. c ,t. P1, City,State,Zip: 1
City,State,Zip: T,f cw. �' ti?-22 3 Phone/Fax:
Nearest Cross Street S:kJ 1j. L- Or. E-Mail:
4. Development Activity (check all that apply) 5. Applicant Information
II—Addition to Single Family Residence(rooms,deck,garage) Name: -.S±'tA/e'.. t1+A t€`Ij R-
a Lot Line Adjustment Q Minor Land Partition Company: Fe4,t i.,;tA 9
la Residential Condominium U Commercial Condominium + ,
Address: 4/S<1 3 S is �T- { u
Residential Subdivision d Commercial Subdivision
Q Single Lot Commercial O Multi Lot Commercial
City, •State,Zip: /{ ii S,1>�Y� O - ' (23
Other Phone/Fax: ;i C.% - 992-4
92-4 �� �7 i
E-Mail:,S'fi e.v�, a 12 ,'T1 ec4z. R:,t:5 girt,"),"
6. Will the project involve any off-site work? (3Yes IjiNo ❑Unknown JJ r C yv►'t
Location and description of off-site work
7. Additional comments or information that may be needed to understand your project Reit) is c e 6:x:
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 law.
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 document,and to the best of my knowledge and belief,this information is true,complete,and accurate.
Printffype Name •.4 �V-�- J� t� ( Print/Type Title L vee..; iv^u c LA.c.t:c1r` 93
Signature _e. Ali- Date
FOR DISTRICT USE ONLY
❑ 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 materials 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 it they are subsequently discovered.This
r must be
- Section 3. 2.1. All required permits and approvals` nand Order 19 05 Sect o 0PP
document will serve as your Service Provider letter as required by Resolution q
obtained and completed under applicable local,State,and federal law.
❑ Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing
or potentially
sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality
sensitive areas it they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 19-05,Section
3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law.
❑ This Service Provider Letter is not valid unless CWS approved site plan(s)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. SEE QUAIL HOLLOW-WEST PLAT
Reviewed by All.111111.1111 Date 5/23/19
Once complete, email to: SPLReview@>cleanwaterservices.org • Fax: (503)681-4439
OR mail to: SPL Review, Clean Water Services, 2550 SW Hillsboro Highway, Hillsboro, Oregon 97123
Reviser JOAO