Permit CITY OF TIGARD MASTER PERMIT
is .
a COMMUNITY DEVELOPMENT Permit #: MST2010 00131
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/31/2010
Parcel: 2S115AD02900
Jurisdiction: Tigard
Site address: 10676 SW TUALATIN DR
Subdivision: Lot: 0
Project: Whiteside
Project Description: Replace and enlarge existing deck, new steel supports and (1) house support.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 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: Yes
Total: sf Value: $50,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0
Drains: 0
Bckflw Prevntr: 0
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum > =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 20 1-400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr:
Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add'I Br Cir:
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
Owner: Contractor: Required Items and Reports (Conditions)
WHITESIDE, RANDEL & LORI C DPM CONTRACTING CO 1 MST Structural Welding
10676 SW TUALATIN DR PO BOX 587
TIGARD, OR 97224 Beaverton, OR 97075
PHONE: PHONE: 503 -481 -7893
FAX: 503 -430 -7278
Total Fees: $1,364.12
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 dog accordan.- ith 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
d= . ATTENTION: Orego law - quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
• 2- 001 -0010 through OAR 95 • 11 - 00. •u may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Is- •d By: L _! A_1 / Permittee Signature: TJ p------1.-- ..di.
wr
' Building Permit Application
Commercial RECEIVED FoR 1iSI•:OM.V
City of Tigard A , , - Received �e Permit No. �,/� /
Tigard, OR 97223 Plan Review)
13125 SW Hall Blvd., Ti Q Date/B : � it t/ / _ co
�
:
Phone: 503.639.4171 Fax: 503.598.1960 , rt C D Date/By: Art s. Oth Permit: 56 T 0
i . i MM
> Inspection Line: 503.639.4175 CITY O a . ; ate Ready : y: Juri • ® See Page 2 for
Internet: www.tigard- or.gov BUIL DING DlVr St °totifed/Method: /3I/1V / -/ (a Supplemental Information
5 0 L✓ Pee."'
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
�j Addition/alteration/replacement ❑Other: equipment, materials, labor, overhead, and the profit for the
I ` CATEGORY OF CONSTRUCTION work indicated on this application.
1- and 2- family dwelling ❑ CommerciaCommercial/industrial Valuation:
j V�
Accessory building ❑ Multi- family Number of bedrooms: $
❑ Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /04, 2 � J 7 A 7, p.... New dwelling area: square feet
City /State /ZIP: ! 1 a f + D ! 7.2p1 Garage /carport area: square feet
Suite/bldg. /apt. no.: ` / ! Project name: tail c �` lie Covered porch area: square feet
Cross street/directions to job site: DecKarrea: VA, 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: c 44
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
RAF/due t l 5f , Pr lie e-k-S 1 New 5 fie i 5 (., „,. /
I 145 R S r I- Existing building area: square feet
/�Vl 4 �� New building area: square feet
PROPERTY OWNER I ❑ TENANT Number of stories:
Name: k c i co c l W A,/,,,, c ' Q Type of construction:
Address: /04 �0 5 w roc I 44 n pg Occupancy groups:
City /State /ZIP: r -J d 4 9 7a_Y Existing:
Phone: ( ) Fax: ( ) New:
X APPLICANT ❑ CONTACT PERSON NOTICE
Business name: 77 pm Con fia r i l l All contractors and subcontractors are required to be
Contact name: /�. h Q om / / J licensed with th e Oregon Construction Contractors Board
Cy' S under ORS 701 and may be required to be licensed in the
Address: O 401 a�1� 7 jurisdiction in which work is being performed. If the
City /State/ZIP: Sig oer-' / ' 'I b 9 '7Q 7 applicant is exempt from licensing, the following reasons
7� apply:
Phone: ($ 3) ` / E/ -!! T 3 Fax: : t (93 T , 3() - 22_7”
IQ
E -mail: d t CO/1l`f ,A /L co 4�3 , COL`
P CANTRA T I
Business name: 7) pnA .... DYt4t(GC Cll W li BUILDING PERMIT FEES'
Address: ib J3ox .5*`g '7 (Phase refer rojee schedule)
City /State /ZIP: / Q0, , I i e- / /'( '7 7f Structural plan review fee (or deposit):
Phone: ( ,3) L/ / - 7 5 T) Fax: 133) qv -wig-
FLS plan review fee (if applicable):
CCB lic.: / 7 - � / (Nt, Total fees due upon application:
Amount received: 4 q 7 ,(. l y
Authorized signature: ..^•—∎ - This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: ' )QC L4 1 114 �.."-- Date: 1012) 20 1 0 • Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 10/01/09 440 -4613T(11 /02/COM/WEB)
I
Mr
III v Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
I:\ Building \Pemrits \BUP -COM PermitApp.doc 06/25/08
. 1
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j�C[ te\
DPM CONTRAC ED
t 50' -10"
I TUALATIN DRIVE BEAVERTON OREGON AUK ® (503) 481 -7893
r5' -7 � ,",uiL�iiiv iii` /ISIOT�
TITLE: Deck Exten. /Replacemt
JOB: Randy & Lori Whiteside
i
DATE: 05/18/2010
DRAWN BY: Dean Moser
N5 ' _ 7" Notes:
CITY OF --SITE PLAN REVIEW
,DING PitMrt NO.: 1 - Ob t O( 13*
44' '
PLANNING DIVISION:
Required Setba ks: [Approved ❑ Not Approved '
Side: Street Side: ) 1.Extend Upper Deck to 10' Lower
Front.._ Garage: Rear: (...( ! deck to 12'
Visual Clearance: ; 7- -- .N. 1 .!
ppro ved t0 Not Approved ' - 2. Install new Spiral stair case from
Maximum Buildin>; Height' feet Existing House upper to lower deck.
CWS Service Provider Letter Required 6 Yes ❑ No
7 J 3 . New 1/8" Cable Railing.
I t
Received 4. New Decking to be Tile
I3: ALc- e Date: 011 lI r) j 5. New steel supports
ENGINEERINgpE A ' TMENT: w
Actual Slope. - Approved a Not Approved 2 4
Re roM D�ate: Q Not 6 ved 11' -10 " — x_23 _6 °� 81,0 Site PI:. . / �_ pp roved 0 m =
B ` L,u6
Notes: ete -cce— pu�64.14 A5 4—
1 / p Deck New Uppeii Deck
7 2,r,„„t, 44VVc / 6 . 7 - r.A .f , Deck 1 I
5 u_i
45 -4 � - i 1 /
■ 7' -11fi "f
- 7' -10, 6"
N
CITY BGA r -SITE PLAN klt�*V
3U11.DiNG PERM1 NO:
AKa .
PIM 2543 SQ. FT Street frees. Randy & Lori Whiteside
1995 Protecred Tree Approved 10676 Sw Tualatin Dr.
A
3 BDRM pp*trved ❑ N. • .pro ;,
3 Bath 47 Diate: , /I Tigard, Oregon 97224
PROJECT LEGAL Notes: .
Parcel #00414322 / rce. tom term « Try
nh,,a , r
Elevation 401' - 450'
LOT AREA Est. Acres 0.16 ,,'l G
r..iF . 65' I
PAGE OF
SITE PLAN 1 1
SCALE:1 /16" = 1' - 0" \ /
il .1
RECEIVED
o Community Development JUL 15 2011
TIGARD Request for Permit Action
CITY OF TIGARD
BUILDING DIVISION TO: CITY OF TIGARD
Building Division Services Coordinator
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov
FROM: ❑ Owner ® Applicant n Contractor n City Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or Individual) e in ` n � �4- , 6 ... 6
Mailing Address: /d , i c
7
City /State /Zip: igea /L / -L 0/2._ 9 7o 7S
Phone No.: 5779 - cal W5-
V 0 1 0
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
❑ CANCEL PERMIT APPLICATION. _
REFUND PERMIT FEES (attach receipt, if available). C'-. //1/4/ n INVOICE FOR FEES DUE (attach case fee schedule and explain below). /Gr L/N
T1 REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: /14 1 fl d / o —D a /5/
Site Address or Parcel #: /e 4 Zi? 5') t drt r-t /4 ; qLr /1
Project Name: ',4 k 1
Subdivision Name: Lot #:
EXPLANATION: /!',r , is 4 4 1 IG ' C I , • e 14,
t.%
•
,r - L%ad _ /v-C / A..D_A! : OA Ce--S I . � � do 7l d'
Si. ' atu e: 41 Date: 7 15`2,0
Print Name: ]6,A4V7 6'61
Refund Policy
1. The Director or Building Official may authorize the refund of:
a) any fee which was erroneously paid or collected.
b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 80% of the land use application fee for issued permits.
d) not more than 80" /o of the building plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than 80% of the building permit fee for issued permits prior to any inspection requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 - weeks for processing refunds.
FOR OFFICE USE..ONLY
Rte to Sys Admin: Date By Rte to Bldg Admin: Date (f,02./// By ''��
Refund Processed: Date �a /j/ By, ._ Invoice Processed: Date / By
Permit Canceled: Date // By 'ia . -arcel Tag Added: Date B
Receipt #/79 6 Date ,*•_ ?j //d Method (' e Amount $ e f-- f _ 9(f-
I: \Building Forms \RegPermitAction.do Kell/7/26/07
b °I
City of Tigard
August 2, 2011
DPM Contracting Co.
PO Box 587
Beaverton, OR 97075
Attn: Dean P Moser
•
Re: Permit No. MSt2010 -00131
•
Dear Mr. Moser:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 10676 SW Tualatin Dr.
Project Name: Whiteside
Job No.: N/A
Refund Method: n Check # in the amount of $
® Credit card "return" receipt in the amount of $653.58.
Note: Please allow 2 -5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account "deposit" receipt in the amount of $
Comment(s): Per applicant's request as job was cancelled. Refund 80% of permit fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
4
Dianna Howse
Building Division Services Supervisor
Enc.
•
I:\ Building\ Refund \311 151i EAlegi+daneriif ' i'd, apii itton 97223 ° 503.639.4171
TTY Relay: 503.684.2772 0 www.tigard- or.gov
1111
City of Tigard
TIGARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building application
fees. Receipts, documentation and the Request forPermit Action form (if applicable) must be attached
to this request. Refund requests are due to Accela System Administrator by Wednesday at
5:00 PM for processing by the following Wednesday. Accounts Payable will route refund
checks to Accela System Administrator for distribution. Please allow up to 2 weeks for processing.
PAYABLE TO: DPM Contracting Co. DATE: 8/1/2011
Attn: Dean P Moser
PO Box 587 REQUESTED BY: Dianna Howse
Beaverton, OR
TRANSACTION INFORMATION:
Receipt #: 179289 Case #: MST2010 -00131
Date: 08/31/2010 Address /Parcel: 10676 SW Tualatin Dr.
Pay Method: CreditCard Project. Name: Whiteside
EXPLANATION: Per applicant's request as job was cancelled. Refund 80% of permit fees.
:REFUND INFORMATION:
;:Fee:Descr pion From Recei 't .
.• _ P,.. `R e nue•A ceouitii Noe • - - �R`efiiiid,
Example: '.Building Perrrit•.Fee' `Example: =' 2
300.000 = 431'04::: -''` `:::.•.:,• , . ,, ...
Buildin Permit Fee
g 230- 0000 -43104 $5856
12% State Surcharge 100- 0000 -24001 70.02
TOTAL REFUND: $653.58
APPROVALS: i/t/ty
If under $5,000 Professional Staff
If under $12,500 Division Manager
If under $25,500 Department Manager
if under $50,000 City Manager
If over $50,000 Local Contract Review Board
FOR.TIDEINI: ARK• SYSTEM ;ADMINISTRATIO. -ONL
Case Refund Processed: I Date: °L�r I B I
I: \Building \Refunds\ RcfundRcqucst.doc x 09 /01/2010
I III CITY OF TIGARD RECEIPT
i . 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 179289 - 08/31/2010
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
MST2010 -00131 Building Permit - Additions, Alterations, 2300000 -43104 $729.45
Demolition
MST2010 -00131 CDC Plan Review, RES 1003100 -43112 $64.00
MST2010 -00131 CDC Plan Review, RES - LRP 1003100 -43117 $9.00
MST2010 -00131 12% State Surcharge - Building 1003100 -24001 $87.53
Total: $889.98
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 411362 DADAMSKI 08/31/2010 $889.98
Payor: Dean P Moser - DPM Contracting Co.
Total Payments: $889.98
Balance Due: $0.00
Page 1 of 1
CITY OF TIGARD RECEIPT
V
t s . . 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 183519 - 08/02/2011
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
MST2010 -00131 $ - 653.58
Total: $- 653.58
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 411362 DHOWSE 08/02/2011 $- 653.58
Payor: Dean P Moser, DPM Contracting Co.
Total Payments: $ - 653.58
Balance Due: $653.58
A Th7 C
° Accela
11-4 System Administration
Finance Department Request
Date: `0
To: �j Liz Lutz
t / Kathy Gende
From: Dianna Howse/
Re: Receipt #: /79,g/1 tF 3 dam/ 9
Please process this request as follows:
Journal Entry (route copy of JE to
Dianna Howse).
Reversal (fees have been reversed on
Revenue Account Report).
Credit Card Return (fees have been
reversed on Revenue Account Report).
Other /Explanation:
"Ae e Es s p2:tc, VA
Thank you! , __ _
I: \Building \Fo rmA\Rte5lip- FinanceReq.doc
Page 1 of 1