Permit (2) CITY OF TIGARD11
MASTER PERMIT
1. 8 '- COMMUNITY DEVELOPMENT Permit#: MST2019-00436
Date Issued: 01/08/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111DB14300
Jurisdiction: Tigard
Site address: 15150 SW 92ND AVE
Subdivision: LAUNALYNDA PARK Lot: 30
Project: Arnett
Project Description: New vaulted trusses and repairs due to fire damage. Kitchen remodel, Trade permits to be pulled
separately.
BUILDING
Floor Areas Required Setbacks Required
Stories: Bedrooms: First: sf Basement: sf Left: Parking Spaces:
Height: Bathrooms: Second: sf Garage: sf Front: Smoke
Dwelling Units: Third: sf Right:
Detectors: Yes
Total: sf Value: $200,000.00 Rear:
PLUMBING
Sinks: Water Closets: Washing Mach: Laundry Trays; Rain Drain: Urinals:
Lavatories: Dishwashers: Floor Drains: Sewer Lines: SF Rain Storm Sewer:
Tubs/Showers: Garbage Disp: Water Heaters: Water Lines: Drains: Catch Basins:
Bckflw Prevntr:
Footing Drain: Ice Maker: Hose Bib: Backwater Value:
Other Fixtures:
Drywell-Trench Drain:
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: Clothes Dryers:
Heat Pump: N Hoods: Other Units:
Furn<100K: Vents: Woodstoves: Gas Outlets:
Furn>=100K:
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0-200 amp: 0-200 amp: WI Svc or Fdr:
Ea add'I 500 sf. 201-400 amp: 201-400 amp: W/O Svc/Fdr:
Mid Home/Feeder/Svc, 401-800 amp: 401-600 amp:
801-1000 amp: 601+amp-1000v:
1000+amp/volt:
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
Owner: Contractor:
ARNETT,JOAN L&MICHAEL G TRS CREATIVE FENCES&DECKS INC Required Items and Reports(Conditions)
16995 SW ARBUTUS DR 23300 SW STAFFORD MILL DR
BEAVERTON,OR 97007 WEST LINN,OR 97068
PHONE: PHONE: 503-826-7641
FAX: 503-521-9840
Total Fees: $3,384.61
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 of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
II503.639.4175 by 7:00 a.m.for the next available Inspection d
This permit card shall be kept in a conspicuous place on the job site until completion of the pro et.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
lliesidential _ I {n.4 a .,, a . Received of Tigard Datemy i Permit No.:�SVvl1__ot%
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503918.2439 Fax: 503.598.19 9 Z019 Date/BY: Other Permit:
Inspection Line: 503.639.4175 t �{ t'� Date Ready/By: / ]aria: ® See Page 2 for
TIGARD Vi'r i Tl�v:.AR . N ~/�! Supplemental Information
Internet: www.tigard or.gov V I �( t t r"
:317}lI niS�lfaLJNisi +N
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $200,000.00
El1-and 2-family dwelling ElCommercial/industrial
Number of bedrooms: 3
❑Accessory building 0 Multi-family
❑Master builder ❑Other: Number of bathrooms: 2
JOB SITE INFORMATION AND LOCATION Total number of floors: 1
Job site address:Mike and Joan Arnett New dwelling area: square feet
City/State/ZIP:15150 SW 92ND AVE.TIGARD OR,97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Mike and Joan Arnett Covered porch area: square feet
Cross street/directions to job site:SW Snifter St. Deck area: square feet
Other structure area: square feet
As QUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:R500675 Lot no.: �a` .� ermit fees*are based on the value of the work performed.
no.:2S111DB14300 I -- 1� Indicate the value(rounded to the nearest dollar)of all
Tax
map/parcelkn1 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK `W work indicated on this application.
Repairs and new construction do to fire damage, new vaulted trusses over living Valuation: $
dining room. Se....r4d,r.v44ji(ELT fr 11,a 17ir,( Existing building area: square feet
-Wei ri C f rfin r f j _ f_t- it/Tr./ ,-,, rce it New building area: square feet
0 P OPERTY OWNER '7 0 ANT Number of stories:
Name:Mike and Joan Arnett Type of construction: ,--
Address:16995 SW Arbutus Drive Occupancy groups:
City/State/ZIP:Beaverton OR 97007 Existing:
Phone:(503)341-0077 Fax:( ) New:
0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Mane refer
Business name:SIMPL HOME DESIGNS
ml�xliek
Structural plan review fee(or deposit):
Contact name:MIKE MONTGOMERY
FLS plan review fee(if applicable):
Address:5531 SW BUDDINGTON ST
Total fees due upon application: / 1/ 7
City/State/ZIP:PORTLAND OR 97219
Amount received:
Phone:(503)515-6495 Fax::(503)719-4825
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:mikem@ezpermits.biz
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Northwest Restoration mike@uwrestoration.com Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:PO Box 3264 Solar Installation Specialty Code checklist.
City/State/ZIP:Tualatin,OR 97062 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)678-2343 Fax:() State surcharge(12%of permit fee): $21.60
CCB lic.:147483 41-/ I Total fee due upon application: $201.60
Authorized signatt This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:MIKE MONTGOMERY Date:12/06/19 *Fee methodology set by Tri County Building Industry
Service Board.
I:1BuildingTermitslBUP-RESPemiitApp.doc 02/24/ 11 440-4613T(]C/02/COM/WEB)
[ / � ��1� - po '1.3
- 4UEI V L5 }y \� Clean Water Services File Number
DEC 3 0 2019 CleanWater\ Services
CITY OF TIGARLSensitive Area Pre-Screening Site Assessment
3UP 'ENG DIVISION
1. Jurisdiction:Tigard
2. Property Information(example 1S234AB01400) 3. Owner Information
Tax lot ID(s): Property ID W252263 Name: Mike and Joan Arnett
State ID 2S111DB14300 Company:
Address: 18995 SW Arbutus Dr.,
Site Address: 15150 SW 92ND AVE City, State,Zip:Beaverton OR 97007
City, State,Zip:Tigard, OR 97224 Phone/Fax:(503)341-0077
Nearest Cross Street: SW Settler St. E-Mail: mlke.arnett@outiook.com
4. Development Activity(check all that apply) 5. Applicant Information
❑ Addition to Single Family Residence(rooms,deck,garage) Name: MIKE MONTGOMERY
❑ Lot Line Adjustment ❑ Minor Land Partition Company:SIMPL HOME DESIGNS
❑ Residential Condominium ❑ Commercial Condominium Address:4931 SW 76TH AVE., PMB 211
( Residential Subdivision ❑ Commercial Subdivision City State Zip:PORTLAND OR 97225
ID Single Lot Commercial ID , ,Multi Lot Commercial 503-515-6495 0/503-719-4825 F
Other REMODEL INTERIOR OF EXISTING HOUSE Phone/Fax:
DUE TO FIRE, REPLACEMENT OF TRUSSES E-Mail:mikem@ezpermits,biz
6. Will the project Involve any off-site work? ❑Yee El 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
1200.0 Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands andfor Department of the Army
COE, All required pennita 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 al 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 Informstion ntalned In this document,and to the best of my knowledge and belief,this information Is true,complete,and accurate,
Print/Type f�rre 1 e Mont erp— ------ Printfiype Title Agent for owner
Signature �1 Date Dec 17, 2019
FOR DISTRICT USE ONLY
❑ Sensitive areas potentially exist on site or within 200'of the site. T 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 If they are subsequently
discovered,This document will serve as your Service Provider letter as required by Resolution and Order 07.20, Section 3.02.1, All required permits and
approvals must be obtained and completed under applicable local,State,and federal law.
La Based on review of the submitted materials and best available information the above referenced prefect will not significantly Impact the existing or potentially
sensitive area(s)found near the site,This SensitiveArea Pre-Screening SheAssessmentdoes 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
07-20,Section 3.02.1. All required permits and approvals must be obtained end 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 d.'.s not meet the definition.f development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR
SERVICEPROVID ETT -IS RE*•IRED,Reviewed by d. . . .' A I Date if
maiwr, rce i
2 55 SVV 1-lillsboru I Ifph:voy • I-I,llsho,u,Oregon 571 Phone-150 )Gf;1-511x) • Fax.(503)Wit 41S(1 • SIMAv.cicanwotcrsc tvla,::.mq
City of Tigard
IIICOMMUNITY DEVELOPMENT DEPARTMENT
a= Building Permit Review — Residential
TIGARD
Building Permit #: /1751-T 426 i Y- ck)'7 34,
Site Address: I S'ISD S1n/ q2 yid 5 ree—
Project Name: AL.y- Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: I p 1W-4 du?, {o lci-c diti ma t, l i€W cfes
Verify address/suite#active in Accela. xt In River Terrace: fyi. No 0 Yes,River Terrace Review Addendum
Site Plan Elements: drosion Control
,1gt3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper detained trees with drip line and tree protection measures
,�TSrawn to scale(standard architect or engineer scale) +Footprint of new structure(including decks)and FFE
eigNorth arrow F! tility locations&easements (required for new and additions)
mite address,project or subdivision name and lot number 'l-': dewalk/driveway approach
WApphcant information(name and phone number) Gi .cation of wells/septic systems
krl.ot dimensions and building setback dimensions 110Street tree size,type and location
MA/Square footage of buildings to be demolished . Street names
,'Existing structures on site r AComer elevations (2'contours if more than 4'differential)
rippeot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? Y s o
• "impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? e o
.N. Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: K Yes,applicant was notified ❑ No Received: k Yes
. Public Facilities Improvement(PFI) Permit: t?/ 10* ) d/3 T,
Required: ❑ Yes,applicant was notified , .No Applied For: ❑ Yes ❑ No,stop intake
ttitLand Use Case#: 1 4 Zoning: a l•s-
,Required Setbacks: Front: 20 Rear: IC Side: 5 Street Side: l S Garage: 2O
J Building Height: Max. Height: -20 Actual Height: f 1 4
andscape Area: % of Coverage Max:
Enhance Il Set back o more than 8'from street-facing wall ❑ Parallel to street or offset 4 degrees or less
4&SF/I1• o
Windows NOME 12% lif area of all street-facing faca.es 0,4)51. BKJdtfirti: eptlyttivvf:ems loAtt rop,. ..47
Garage II e d i or is 'nd widest street-facing wall ❑ Yes ❑ No,one of the following is met:
el Door ext: . . more than 5'from wall and there is a covered porch extending beyond garage.
❑ 110..r ex nds II. more than 5'from wall and there is a 12 sq ft.window above garage on 2°1 floor.
I' Garage .oor width is >• 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ C.vered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
t\disual Clearance 161Crban Forestry Plan
,"Sensitive Lands: ❑ Yes No Type:
( -Conditions met prior to issuance of building permit
Notes: ND a cto f tin foe pvzt'rt- oFlout 1011 —li'ctrabt ih Wind.•.• aura on Ndeffristeti No_
►- / /Jf 11 Std-t-
.Vi Approved By Planning: l.�. i�� Date: /� y /
Revisions (after Building Submittal o f y) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Fomrs\BldgPennitRvw_RES_022819.docx
Building Permit Submittal
Original Submittal Date:
Site Plans: #
Building Plans: #
Building Permit#: er uilding permit#above. � �/
Workflow Routing: nning ering �.,'Permit Coordinator
Workflow Sign-off: n-off for Planning(include notes from planning review)
Route Application Documents: [ —En ieering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
• g: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: � �= Date: /.1'/D/�'f
Engineering Review
❑ Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
O Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: 0 Yes • 10
❑ Final Plat Recorded:
O NOT Approved by Engineering: Date:
Notes:
O Approved by Eng'i - -ring: Date:
Revisions (after ' ilding Submittal only) Reviewer Date
Revisi.• : 0 Approved ❑ Not Approved
.sion 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
O Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Released: Pcr 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 T. . 0 Yes 0 N/A
Tigard Trans SD . 0 Yes 0 N/A
Parks SD 0 Yes 0 N/A
LI ' 0 Yes 0 N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPennitRvw RES 022819.docx