Permit CITY OF TIGARD MASTER PERMIT
1. COMMUNITY DEVELOPMENT Permit#: MST2019-00404
T i c,AR p 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/30/2019
Parcel: 2S104DC06200
Jurisdiction: Tigard
Site address: 13722 SW FERNRIDGE TER
Subdivision: MORNINGSTAR Lot: 3
Project: DUNN
Project Description: Replacing the existing 450 sq. ft.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: $9,045.00 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
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 l 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:
DUNN,CATHERINE A DECKING SOLUTIONS LLC Required Items and Reports(Conditions)
13722 SW FERNRIDGE TER 554 SE 39TH AVE
TIGARD,OR 97223 HILLSBORO,OR 97123
PHONE: PHONE: 503-844-8867
FAX:
Total Fees: $518.17
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. Thi permit w' 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 •. follow the ules adopted by the Oregon Utility Notification C-i er. Those rules re set forth in OAR
952-001-0010 through OAR•..i 001-0014. You m. "btain cop •f the rules or direct questions to OUNC by calling 503.232 or .2344.
i
/� ;:•
Issued By: J ,L/ _ � Permittee Signature: ,1�
r 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 Folz of iici tsl: oNl.l
City of Tigard Received
w s Permit No..
13125 SW Hall Blvd.,Tigard,OR 97223 I Date/By: 1.aj / i ,' '"'l p•j a"/ ;, �°t /
g � ,' Plan Review '` �/�
Phone: 503.718.2439 Fax: 503.598.1960 42"//
a III I
Other Permit:
(�(' q Date/By: W -D / l AA
—
Inspection 1 G A R D Inspection Line: 503.639.4175 `I L2 2019 Date Ready/By: Jus ® See Page 2 for
Internet: www.tigard-or.gov ar y OF •.titled/Met ..• )�/ /(7 /w 1,.c Supplemental Information
�- g 6
TYPE OF WO -1.,JUI4.p S!O s REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑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.
ik 1-and 2-family dwelling ElCommercial/industrial Valuation: $ 91 01/5'e
0 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: l T� 5w reinc=� J e_ -ter New dwelling area:
Garage/carport area: squareuare feet
square feetCity/State/ZIP: "f04 g7aa3/
fr
Suite/bldg./apt.no.: Project name: jbv» `��Y b,�`, Covered porch area: square feet
Cross street/directions to job site: 5h! Mbrnl A ,std It r- Deck area: 95-4, square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: nor(1.8 tn� Lot no.: 3 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: as��W�{y�C t+IS� �� Indicate the value(rounded to the nearest dollar)of all
Y� equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
RernO Cp ek \ incl aur Gv some Valuation: $
6: , ��•
Existing building area: square feet
ze As) New building area: square feet
APROPERTY OWNER 0 TENANT Number of stories:
Name: CAI s c`'114 ,n r1 Type of construction:
Address: ►37a,2 SN Parr)f`)51.4fCa44 Occupancy groups:
City/State/ZIP: Ti ) 'OR i7.2,23 Existing:
Phone:( ) Fax:( )
New:
[ 'APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: oGt.V-sir. 5e iD/1S , LLL
Structural plan review fee(or deposit):
Contact name: D„ , Qa r,
FLS plan review fee(if applicable):
Address: 55y sr 3.0 ,14
( Total fees due upon application: 1
City/State/ZIP: f"�.�I d., 0i 57 t423
Amount received:
Phone:(&o3 ) 9yy- gg67 Fax::( )
E-mail: 1)t j,v' 0/4/t 1A07--c Ol i o N : eo ri PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
/CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: peel(In So(Dllo»S L L .. Submit two(2)sets of roof plan with connection details
t and fire department access,along with the 2010 Oregon
Address: 5-5.4/ 5t-- 344 Ate. Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review
ty MI4Lrd) oR 97r3 and administrative fees): $180.00
Phone: 3 17 O �O(S ) Lam/ �} 7
6 Fax:( )
c� ` State surcharge(12%of permit fee): $21.60
CCB lic.: /96 f/J� L /
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: 00.57/./i/ ,,v Date:/o/ *Fee methodology set by Tri-County Building Industry
�42/4. Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling loft of iicI i 'is ONLY
City of Tigard Received Permit No.:
13125 SW Hail Blvd.,Ti ard,OR 97223 Hall Bl, illvd. permits:
Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
T I G A R D
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No N/A
I Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 El El
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district approval required. Name of district: CICI CI
5 Septic system permit or authorization for remodel. Existing system capacityCI ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. 0 ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 ❑ ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 ❑ 0
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator,lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 ❑ ❑
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 0 0
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 ❑ 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ 0
architect licensed in Ore:on and shall be shown to be a..licable to the .ro'ect under review.
.JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ El ❑
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, El ❑ ❑
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:\Buildmg\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
r
Clean Water Services File Number
CleanWater\Services 19-003314
Sensitive Area Pre-Screening Site Assessment
1. Jurisdiction: Tigard
2. Property Information (example 1S234AB01400) 3. Owner Information
Tax lot ID(s): Name: Catherine Dunn
2S 104DC06200 Company:
Address: 13722 SW Fernridge Terrace
SE Site Address: 13722 SW Fernridge Terrace City, State,Zip: Portland, OR, 97223
City, State,Zip: Portland, OR, 97223 Phone/Fax: 5035043156
Nearest Cross Street: SW Morningstar Drive E-Mail: dustin@decking-solutions.com
4. Development Activity(check all that apply) 5. Applicant Information
❑ Addition to Single Family Residence(rooms,deck,garage) Name: Dustin Boleyn
❑ Lot Line Adjustment ❑ Minor Land Partition Company: Decking Solutions, LLC
❑ Residential Condominium O Commercial Condominium Address: 554 SE 39th Ave
❑ Residential Subdivision ❑ Commercial Subdivision
LiSingle Lot Commercial 13Multi Lot Commercial City, State,Zip: Hillsboro, OR, 97123
Other Phone/Fax: 5035043156
E-Mail: dustin@decking-solutions.com
6. Will the project involve any off-site work? ❑Yes la No ❑Unknown
Location and description of off-site work
7. Additional comments or information that may be needed to understand your project
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.
Print/Type Name Dustin Boleyn Print/Type Title Owner
Signature ONLINE SUBMITTAL Date 10/14/2019
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.
ill 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 if 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.
❑ 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 if 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.
lX This Service Provider Letter is not valid unless 1 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.
Reviewed by Date 10/29/19
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
Revised 6/2017
City of Tigard
IICOMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
Building Permit #: /'),S-T-- if_0,0 Li° i
Site Address: 13121 SW Fern ria9-t, -Teri"
Project Name: p tin Y\ e ciclvn G2 Deck- Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: ovt t' 4 - �
e1 ClCi X i s
PAY) II Imo? 9 d12-c-k__
71 Verify address/suite#active in Accela. , In River Terrace: %No ❑ Yes,River Terrace Review Addendum
Site Plan Elements: 1;1.P.rersion Control
/3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper SR-retained trees with drip line and tree protection measures
/Drawn to scale(standard architect or engineer scale) ,J l ootprint of new structure(including decks)and FFE
f North arrow city locations&easements(required for new and additions)
//Site address,project or subdivision name and lot number Sidewalk/driveway approach
Applicant information(name and phone number) mon of wells/septic systems
I.ot dimensions and building setback dimensions EfSwett-tree size,type and location
El-Senittre footage of buildings to be demolished Street names
ZExisting structures on site ,leCorner elevations(2'contours if more than 4'differential)
15{T,t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes,'No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? 0Ye§efINo
pi)Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified A No� �en 41 Received: ❑ Yes 1=1 No
VPublic Facilities Improvement(PH) Permit: 1,i �'N
Required: ❑ Yes,applicant was notified jZi No Applied For: ❑ Yes ❑ No,stop intake
and-Use Case#: /I Zoning: R1,S
Required Setbacks: Front: le Rear: 'i S Side: S Street Side: 1 S Garage: VC)
Building Height: Max. Height: 30 Actual Height:s 6
Landscape Area: r✓/ A % Lot Coverage Max: ,v/A
ntrance ❑ et back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
indows ❑ i.•.um 12%of area of..i street-facing facades
arage ❑ Garage .o• s behind dest street-facing wall ❑ Yes ❑ No,one of the following is met:
I A ❑ Door exte • o more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door exte•.s n. . ore than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
❑ Garage door .'dth is • 'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ Co -red porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ ire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
dual Clearance ❑ Urban Forestry Plan
.it;-ccerisitive Lands: ❑ Yes ❑ No Type:
❑ CSnditions met prior to issuance of building permit
Notes:
91 Approved By Planning: o f Date: 1 d/ 2 z/1 C'1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: ❑ Approved ❑ Not Approved
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Building Permit Submittal
Original Submittal Date: MAY/q
Site Plans: # '3
Building Plans: # 3
Building Permit#: [ rater building permit# above.
Workflow Routing: [Manning li-engineering Ll"1�rmit Coordinator Iding
Workflow Sign-off: [F--S" -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.
D--K lding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: � -- - Date: ,,,v,,,.,h,.,
Engineering Review
[Slope at building pad: /3z
❑ Conditions "Met"prior to issuance of building permit
❑Easements (encroachments) per engineering conditions of approval and plat
L7 Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 13."-No
Assess Water Quantity Fee in-lieu: ❑ Yes LJ No
LIDA Facility on lot: ❑ Yes Er--No
Z.-Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:Zr-Approved
Approved by Engineering: /
LJte � ,d.'.4 Date: /i/2 .hZi>r
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:
vision Notice 3: Date Sent to Applicant:
L'(SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes 71 ,N/A
Tigard Trans SDC: ❑ Yes 74(N/A
Parks SDC: ❑ Yes /A
LIDA ❑ Yes L� N/A
OK to Issue Permit
b ir*i I
Approved by Permit Coordinator: Date: 1
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