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Permit CITY OF TIGARD MASTER PERMIT i 11 o COMMUNITY DEVELOPMENT Permit #: MST2010 -00165 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/29/2010 Parcel: 2S102DC00501 Jurisdiction: Tigard Site address: 9085 SW EDGEWOOD ST Subdivision: Lot: 0 Project: Sullivan Project Description: 520 SF accessory structure. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 14 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front 0 Smoke Dwelling Units: 0 Third: 0 sf Right 5 Detectors: NO Total: sf Value: $19,484.40 Rear. 5 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! 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! 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) SULLIVAN, RICHARD A & SUZANNE OWNER 1 MST Ersn Cntrl 503 - 681 - 4444 P 9085 SW EDGEWOOD TIGARD, OR 97224 PHONE: PHONE: FAX: Total Fees: $784.79 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuanc if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification en . Those rules are set forth in OAR 952 - 001 -0010 throu e • = • R 952 - 001 -0100. You may obtain a • • : les or direct questions to OUNC by calling 503 4 99 or 1.800.332.2344. c T Issued ByV '. � . / ��.0 Permittee Signature: —'i Building Permit Application ` Residential' �p FOR OFFICE USE ONLY AA � L R e c e ived City of Tigard , ` ld b p 0 Date /B ,. : • o Permit No le f 71 ° 13125 SW Hal Blvd. Tigard, OR 9 S � �GP p�' Plan Review 4 111 Phone: 503.639.4171 Fax: 503.598.1960 G^' 00 f 2 D /B P q RE 10 Other Permit: T t G A R D Inspection Line: 503.639.4175 VO Date Ready /By: ® See Page 2 for Internet: www.tigard or.gov ` 0�� Notitie. Method: 1 MIN Supplemental Information 16\\..- z LVM AN Q; > k TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ® New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION - work indicated on this application. ❑ I- and 2 -famil • dwelling 1 y g ❑ Commercial /industrial Valuation: t 1 ifkAo$ 4_5 g Accessory building ❑ Multi-family Number of edrooms: ❑ Master builder El Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: C109 Sw L ar„ ewoca 51.'" New dwelling area: square feet City /State /ZIP: t t o, a 2 0 Ore cri 2,1, -S Garage /carport area: .5'?_,;:) square feet Suite/bldg. /apt. no.: Project name: , / /fvciAJ Covered porch area: square feet Cross street/directions to job site: Deck area: square feet 0 PV Oro,. -4-0 06, Q 0 S l • Other structure area: square feet (,- REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: 0 5P WOO a ..ii.-. Lot no.: 1. Permit fees* are based on the value of the work performed. Tax 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. r Valuation: $ l�u:1 A zo' tc Z. (.0 , 5 flora c 12 yr� c�� Existing building area: square feet New building area: square feet la PROPERTY OWNER ❑ TENANT Number of stories: Name: R ,,k_ i S,J ZA Ai AI +i &AA.l t V A A., Type of construction: Address: Ot 0 ca S 5 W C. t) , $ +- Occupancy groups: City /State /ZIP: '�–t %mod 012-0, et72.- Existing: Phone: (Su3) (0 20 – CZ. (o l Fax: ( 1 New: . ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: • � ! All contractors and subcontractors are required to be Contact name: — � licensed with the Oregon Construction Contractors Board \,) under ORS 701 and may be required to be licensed in the Address: !6 k l \ jurisdiction in which work is being performed. If the City/State/ZIP: � �� � Rr� applicant is exempt from licensing, the following reasons ii4 t apply: Phone: ( ) Fax: : ( ) E -mail: '. OR . Business name: (`-R 1 al r- (A; c k BUILDING PERMIT FEES* Address: 144, J (Please refer w fee schedule) • . City /State /Z.IP: e 1 ` Structural plan review fee (or deposit): Phone: FLS plan review fee (if applicable): LSZ13) 6 -6.3? --Z Fax: ) CCB lic.: Total fees due upon application: 7 G(6 ,?.0 Amount received: Authorized signature: / / < This permit application expires if a permit is not obtained � within 180 days after it has been accepted as complete. )i Print name: ,. / /1... .5 . /ft t./Q t1 Date: ' / Z, Y //Q • Fee methodology set by Tri- County Building Industry Service Board. I: \Building \Permits \BUP- RFSPermitApp.doc 10/01/09 440- 4613T(1I /02 /COM /WEB) Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.055 (4)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CC Bit Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. rO . I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. 2 , c IC . A— Pt I 1 e� -■ P of Permit Applicant - . L 9 1 / f o Si nature of Permit Applicant Date Permit #: fiir/T3 IUr UU (CPS— •l ., Address: 'OgC &✓ ' eAkeel .: " `!! % ?i i 9 724-3 ,.., // Ili by y n• / - Date: ! " y //C I i This Copy for Permit Offices � p 26 10 03:26p Rick Sullivan 503 - 620 -1261 p.l I T @ T.. Wi rE I • • Se'tvices Clean Water Services File Number SEP .J1 . _ q,eanVtFab�r. '` �` 1 D �- R�Q'�1�,5 I B , Hive A lrening Site Assessment 1.Jurisdiction: wasi+..nfw. ea C T • • 2. Property Inlonnafbn (example 1S234AB01 3. Owner Information • Tax lot ID(a): 2S1O7.15 G -OO c'frt 1 Name: RN; A Sv►1Ir?VArl %hca.YI f.'^ I E IV baireit 54. . company Lai "o 11 Zone KIS - Address: S S ar¢avek 6k Site Address: 409 SW Cii ,n)ed: Si- at%. state, zt}x Tirio ore • City, state, zip: -rv ort 0 11122.3 Phone/Fac 3O!- 44O- 4 JZ7- Nearest Cross Street at stn AIeA EMait 7 1111,Gk5Fts «.FtW ia►aacMAIL..Go». 4. Development Activity (check ail that apply) 6. Applicant information • Addition to Single Farmy► Residence (rooms, deck, garage) Nemec 1Z.1e t A 5...11. ai�iu an © Lot tine AQJuetnaent Minor Lend Partition 6. ' O Residential Condominium ©Cornmerds! condombdtnn Addreefx q 0 A S Stv ca caA to4. S4 © Residential Subdvbton © Commercial Subdvteion City, State, �: '� a n • ClCQ e112L3 O Single Lot Commode! ©ilurtil Lot Commercial 9 Other AtlrasSs'( STRAK4,ra.Q • PhonelFanc � Gala - 41 2L 2c x Z b E-AI° ktc.ts i Fi o i rr Lk +6Nsi I . (id ••■ 6. Will the protect Involve any offene wort? ©Yes IN No 0 LJrocnovm • Location and description of °Sake work • 7. Additional comments or information that may be needed to understand your project Dui th 2A' x 2.43' Accosser e 5441.0 .rant mac.. Sinreftee. This appgrdton dose plOT repines Grading and Erode' Cosset Petndlg, Connection Pc, Be80log Pena l% Site Drielopmeig Parade, OED 120040 Permit or other pemdts as Issued by the °aparba t d of 6nb+aamental auallis Department of Inds Lends ardtDr Depaabrre14 of the Awry COB Al required penults Ind approvals mast be obtained and coepdeted under applicable load, data, end federal law IV signing this (omits Omer aoaner %authodredageantacepa re, eduatatesadapesdmterrployaeselClaenWrit &MomhaMeev y to eater the project ded ail reasonable Imes forthe purpose db a IOprojecteke modems and Owing 6doonalion added tote project dtia lwhy ( hallem' enthralhtineMandaaaordainedCntkbdo :anert,aedfmtobestaraq►Ianot**s lbelat ;ttds6dommflonisbnts,canpletls and Moab. pryntfly yy n.1 Prinlrrype Title Manes • Signature APIIIPP Dale q12.11)0 FOR DISTRICT USE ONLY O Seam ems calmest/Eclat onsee enginR0'd9iada. iHEAPPUCANTMItIT PERFORM AIME PRIM T0 ISSUANCE CPA • SERVICE PROVIDER LETTER BSarmlla Areas oodston the de WPM 200feetenadj acentpaoperties, aNedsalResamcesAssesseaergReport . sy irmy also be a+egdred. • Based ce Weird the 0u bndted meta dab endtesd wobble idbmmtton Senders areas do not ween� to Wotan ale °nee a <IN' or 9m alta. 7h>9 Sandra Area Pre-Screenkag tideAsseeameddoes NOT dneanta thawed to evaluate ad WWasier quallysensithe aeas If May me deooverod. This dammed ed sdi Meave as your Service Provider leder as temlud byrResddce and Odder OTC Salton 3.02.1. Al req ed� - wpno* narstbecbtained and coeapbted ender applicable kcal. Mak and fedeter lea O Based on review of the sulindeed meaed& end bade de* bkeamlon the else es referenced pmjedell notelpilk rdly I paottheetatieg orpoteu ► weft sags) bat mares shads SandSteksa PreSbeereg SitakeesemaddoesNOTdbdaate the need to stab* and poled addional wafer quaByeendiee areas I limy we satsuma* dimmed Mbdammed WI sine as per Scribe Peovider Wave e regaled by Raeob ibn and Older 07-20. Section 3.021. A0 melded pumas and eppaosab maths ott draed sad oanplsted ender appludib ked, stale mad Mad lase 0 This S e n i o e Provider L e t t e r is notve0d unless DNS app end sli plane) are etbct ed. • ❑ The proposed oddly does not mast , - • ;., of ansionnent or the lot pf was d attar 818193 ORS 92.M0(2). NO SITE ASSESSMENT OR SERVICE - - ;. , ,1 -- LETTER IS • 4:-. , f• , . Rovfewed by Arab , • d2.. a Date 6 1 3 o • arraila • r NI IY i T FIEUATItI 1 \qS' E • V ED k 10,1 BEGEt f - ' SAP 2 4 2010 . CITY OF TIGARD I a..•• Is o BUILDING DIVISION i P <«sso ry ; z Cutk a6 fi r - ` . .. ...^- -.,,� : •., ' j • • 41' f ie uptINej N ! 2.00' Z s - L ( . • fT p i 151 SG a c-E " _ • SO ' , yq, ' • a01 ExisTt•-9 Nnuse • l _� �.� i f 1.11•1 - \ ‘ � � , DawE wR�(I i 5 1 }•'f :10 Fe= ' 1 i i I , °1055 � � E dn,ev.» s +• ! ; . kI t. NeR.Tb map /TL ZSI Oa DC. - 00 50 \ IBS: S0b . 1/43,s; on .. C- c \c .) \_0'e" l3 1 7-Or\42 2 9) ;� 1 -Loll' I • � -2G��1 O FLE�/AT� 1 _ EOC,EW000 ST, — OF • ■ _SITE P REVIEW Ts, • • a' MIT NO.: 5 , c —f--X) I A • DIVISION: �• V�,' 't;r,r' +wed R�ired Setbacks Approved s ❑ t Street Side: i�.;rt: S!„_,. i Side. i Front. A pp ,:; : : Visual Clearance: Building Hey ht L fey: � �/ B � Maximum p p der Letter Required Vv CWS Ser L1 :;:.::i ' E 13 DEPARTMEN + �r+:. e+#' ENGINEERING % Ap p r oved 0 \to.: \o Aiwa lope App ❑ 1 ' n A +- tro ed Site ' Date: / B 4 _ . Notes: WOW :"l S' v i p a ��7 pprJVed y `'� toprovell II pate: