Permit CITY OF TIGARD MASTER PERMIT
IIII
a COMMUNITY DEVELOPMENT Permit#: MST2020-00178
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/09/2020
T f G A R I) Parcel: 2S 102CA00209
Jurisdiction: Tigard
Site address: 13245 SW ASH DR
Subdivision: VIEWCREST TERRACE Lot: 7
Project: Peterson
Project Description: New 465 sf patio cover.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $11,332.05 Rear: 0
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 Prevnir: 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:
PETERSON,PAUL E BONNIE J BRIAN C PETERSEN CONSTRUCTION Required Items and Reports(Conditions)
13245 SW ASH DRIVE 5627 SE 92ND AVE
TIGARD,OR 97223 PORTLAND,OR 97266
PHONE: PHONE: 503-704-8177
FAX:
Total Fees: $561.51
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 throu h OAR 952-001-0090./Y/ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued Be9:. Permittee Signature: _�4.7 "9-"7/6141.1c-"1z7-7®.,/
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 k '' Okocedir-d slat ea
Residential MAY`` 21 202U FOR OFFICE C'Sa
E ON I.1 %
City of Tigard C 1 I T C. f::. neteeiaed 1 �' !� Pe"°rt -r O( 7 Q'
• 13125 SW Hall Blvd.,Tigard,OR 972 + 3 !�(� ST �I ��
t1 = gar l 6 9 t Plan Review ( !®7,.._AO
Phone: 503.718.2439 Fax: 503.598.1 - paye/g : L(( JTj1! I , Dyer Pam=
T 1(iARD Inspection Line: 503.639.4175 Dace Resdy/By: - ' -` 6tl See Page z for
Internet: www.tigard-or.gov •ill. *^a ` /-•() �� Supplemental Iafarmatios
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
I� ®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and th1e�o2fit for the
CATEGORY OF CONSTRUCtION work indicated on this application. ll 32.
+ J' "!❑ I-and 2-family dwelling ❑Commercial/industrial Valuation: $�
CI Accessory building 0 Multi-family Number of bedrooms:3 97°lLIC.}nt'T
❑Master builder ®Other: Number of bathrooms
JOB SITE INFORMATION AND LOCATION Total number of floors‹
Job site address:13245 SW Ash Dr. New dwelling area \ square feet
City/State/ZIP:Tigard Oregon Garage/carport area: square feet
Suite/bldg./apt no.: Project name:Patio cover Covered porch area: square feet
Cross street/directions to job site: SW Ash Ave Deck area: square feet
Ce struct fe /'AnJ
Other structure area: ��j square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: ,Lot no.: Permit fees*are based on the value of the work performed.
fax 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.
esign Build New cover into and over patio in back yard Valuation: $
1 Existing building area square feet
IN-( U r 75) //���7 -4// i S.S/�(1!/4j Lc t" • 1
2 L.eQ'11 New building area: square feet
® PROPERTY OWNER 0 TENANT I 1)7 Number of stories:
Name:Paul Peterson Type of construction:
Address:13245 SW Ash Dr. Occupancy groups:
City/State/ZIP:Tigard Oregon Existing:
Phone:(503)913-0984 Fax:( ) New:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES"
(Please refer la fee schedule)
Business name:Brian C Petersen Construction LLC Structural plan review fee(or deposit): /,) G
Contact name:Brian Petersen
FLS plan review fee(if applicable):
Address:5627 SE 92nd Ave.
Total fees due upon application:
City/State/ZIP:Portland
Phone:(503-)704-8177 Fax::( ) Amount received:
E-mail:brian@briancpetersen.com look for the"e" at the end PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Brian C Petersen Construction LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:5627 SE 92nd Ave. Solar Installation Speciaky Code checklist.
City/State/ZIP:Portland Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)704-8177 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:210404 Total fee due upon application: $201.60
Authorized signature:_� �� _ n This permit'appiicatiou empires if a permit is not obtained
(/�� within 180 days after it has been accepted as complete.
Print name: Brian C Petersen Date:05/20/20 *Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE 1 SE OIL‘
. City of Tigard Received
Date/B Permit No.:
II II 13125 SW Hall Blvd.,Tigard,OR 97223 A=v+ciated permits:
Phone: 503.718 2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
TIGARD Internet. www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQL IRED FOR PLAN REVIEW No 'O'
I Land use actions completed. See jurisdiction criteria for concurrent reviews. • ❑ I3Z
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. • ❑
3 Verification of approved plat/lot. ❑ 0
4 Fire district approval required. Name of district: ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 Lid
6 Sewer permit. 0 0 IN
7 Water district approval. 0 ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ® 0 0
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 ❑ ❑ ai
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 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ 0
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- ❑ ❑ Ei
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. El ❑ El
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 El
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
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 ]f
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 ® ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑
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 ® ❑ ❑
architect licensed in Oregon and shall be shown to be :r.licable to the tro'ect under review.
.)I'RISDICTIO\AL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 1l"or 11"x 17". ® 0 ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ® 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document ❑ 0
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ 0 El
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ 0
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, ® 0 0
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.
l:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COPW WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
11
T l c n Building Permit Review — Residential
Building Permit #: 11 S T ZD 20 — oor 7r
Site Address: 13245 SVI fah Dr.
Project Name: 4F le(Sfl 1'1 Lot #:
Planning Review
Proposal: Px ip Co'JeY
Verify address/suite#active in Accela. ., In River Terrace: V No ❑ Yes,River Terrace Review Addendum
Site Plan Elements: tasfrosion Control
7'3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper etained trees with drip line and tree protection measures
L brawn to scale(standard architect or engineer scale) 0-Footprint of new structure(including decks)and FFE
N�,,,N,�orth arrow )Jtility locations&easements (required for new and additions)
,T S-ite address,project or subdivision name and lot number Sidewalk/driveway approach
pplicant information(name and phone number) W1'ocation of wells/septic systems
XLot dimensions and building setback dimensions t 14;treet tree size,type and location
tquare footage of buildings to be demolished treet names
Jxisting structures on site 7.1 orner elevations (2'contours if more than 4'differential)
1h ,nt area,building coverage area,percentage of coverage and 1,000 sf of impervious area created or replaced? s j! o
Impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? e 111 No
o
.Xl Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ,K;Yes,applicant was notified ❑ No Received: ❑ Yes No
X Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified , No Received: ❑ Yes ❑ No
SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No
Public Facilities Improvement(PH-) Permit:
Required: ❑ Yes,applicant was notified ,lk No Applied For: El Yes ❑ No,stop intake
{{'2
NijArand Use Case #:
, ' Zoning: 1 q'-5—
J(Required Setbacks: Front: IJ`'Pc- Rear: 5 Side: 5 Street Side: N/Pt Garage: 2
'Building Height: Max. Height: 15 Actual Height: * I Z
andscape Area: % ot Coverage Max: %
En rance 1i Set back o mo e than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows It Minimu 12% f area of all street-facing facades
Garage 11 arage .oor is ehind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
• D.or ext ds no more than 5' from wall and there is a covered porch extending beyond garage.
• D.or ext ds no m: e than 5' from wall and there is a 12 sq ft.window above garage on 2.d floor.
• Garag: .oor dth is ■I 2'or less ❑ 50%or less of facade ❑ 60°/0 or less and includes 7 of following:
❑ Covered porch ■I t :essed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire s ' es ill Lap .iding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent s ding ri Window trim ❑ Window recess ❑ Window projection ❑ Balcony
'Visual Clearance ttkurban Forestry Plan I , I L
Sensitive Lands: Yes ❑ No Type: LOCI VA UM/ Y`GtiWt I
'Conditions met prior to issuance of building permit
Notes:
Approved By Planning: '% Date: S/ 170
Revisions (after Building Submittal .nly) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\B1dgPennitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: S72-//20
Site Plans: # 3
Building Plans: #
Building Permit#: -F.nter building permit# above.
Workflow Routing: . -Planning [ E girreering ❑-P-ertrl'it Coordinator ceding
Workflow Sign-off: D-Sign-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.
t ' Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: <`^ �fh . �r t Date: /3/ZO
Engineering Review
N'S`lope at building pad: 2 e/
C Conditions "Met"prior to issuance of building permit n A-
O-Easements (encroachments) per engineering conditions of approval and plat M f c.-
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 62---No
Assess Water Quantity Fee in-lieu: 0 Yes G'No
J LIDA Facility on lot: ❑ Yes C�No
LJ Final Plat Recorded: N /6,
0 NOT Approved by Engineering: Date:
Notes:
9 AP roved byEn Engineering:� T-1�c974-BY- % Date: 4Si/2OZ0
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 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:
g_SDC Exemption: 0 Received AL Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes K N/A
Tigard Trans SDC: ❑ Yes g N/A
Parks SDC: ❑ Yes CC N/A
LIDA ❑ Yes 5 N/A
-kr OK to Issue Permit
Approved by Permit Coordinator: n cl Date: (Q I Gl Ilf)
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
RECEIVED
JUL 092020 /1-/S7-,20 •2-a - 00/ 7e
CleanWater Services
SENSITIVE AIgk FSCREENING SITE ASSESSMENT
Clean Water Services File Number 20-001309
1. Jurisdiction: Tigard
2. Property Information(example: 1S234AB01400) 3. Owner Information
Tax lot ID(s): 2S102CA00209 Name: Paul Peterson
Company:
Address: 13245 SW Ash Dr.
OR Site Address: 13245 SW Ash Dr. City, State,Zip: Tigard, Oregon, 97233
City, State,Zip: Tigard, Oregon, 97223 Phone/fax: 5039130984
Nearest cross street: SW Ash Ave. Email: lazy3peterson@gmail.com
4. Development Activity(check all that apply) 4. Applicant Information
❑ Addition to single family residence(rooms, deck, garage) Name: Brian C Petersen
El Lot line adjustment 0 Minor land partition
Company: Brian C Petersen Construction LLC
❑ Residential condominium ❑ Commercial condominium Address: 5627 SE 92nd Ave
D Residential subdivision 0 Commercial subdivision City, State,Zip: Portland, Oregon, 97266-4629
❑ Single lot commercial ❑ Multi lot commercial Phone/fax: 5037048177
Other Concrete Pad Replacement and Patio Cover Addition Email: bcpete73@gmail.com
6. Will the project involve any off-site work? ❑Yes 0 No 0 Unknown
Location and description of off-site work:
7. Additional comments or information that may be needed to understand your project:
We are extending coverage of concrete with new pour.
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 Brian C Petersen Print/type title Owner
Signature ONLINE SUBMITTAL Date 5/12/2020
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 if
they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5, Section
3.02.1, as amended by Resolution and Order 19-22.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 19-5, Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and
approvals must be obtained and completed under applicable local,state and federal law.
X 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�Vj��ETTER�UIRED.
"•.
Reviewed by Date 5/21/2020
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 2.%2020
Main Office • 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 • p: 503.681.3600 f: 503.681.3603 • cleanwaterservices.org