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Permit �� CITY OF TIGARD MASTER PERMIT It COMMUNITY DEVELOPMENT Permit #: MST2011 -00048 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/10/2011 Parcel: 2S 104 DC06800 Jurisdiction: Tigard Site address: 13870 SW FERNRIDGE TER Subdivision: MORNINGSTAR Lot: 9 Project: Fein Project Description: Finish basement and add exterior walkway. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 985 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: 985 sf Value: $45,000.00 Rear. 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 1 Laundry Trays. 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs /Showers: 1 Garbage Disp: 0 Water Heaters: 1 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell- Trench Drain: 0 Other Fixtures: 1 Other Fixture Units ejector pump MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Furn <100K: 1 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 addl 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc /Fdr: 4 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: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R -3 985 Owner: Contractor: FEIN, STEVEN KAYA INC Required Items and Reports (Conditions) 13870 SW FERNRIDGE TER 5802 N GREELEY AVE TIGARD, OR 97223 PORTLAND, OR 97217 PHONE: 503- 478 -2210 PHONE: 503 - 283 -8161 FAX: 503- 283 -8191 Total Fees: $1,689.06 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. • *AR 952 - 001 -0090. Y in a copy of - - . - . .irect questions to OUNC by calling . 2.1987 or 1.800.332.2344. om/ / Issued By: _ , / Permittee Signature: / ' • 39.4175 by 7:00 a.m. for the next available inspection date. • This permit c. e 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 � �' CEIV3D Residential APR - S ?Gil • FOR OFFICE USE ONLY Cl of Tigard Received . `J g GIT�' OF TIGARD Date/By: 4 1 / k ; . Permit No.: !/. -�"� g C u • 13125 SW Hall Blvd., Tigard,OR 97 0 TTyyLDING D IVISION w • Plan Revie Phone: 503.718.2439 Fax: 503.598.1 X60 Date/By: / w v /}- i Other Permit: T I G A R D Inspection Line: 503.639 Date Ready/By: y/� �� a 1 J uris: ® See Page 2 for Internet: www.tigard - or.gov tified/Method: tl��' Supplemental Information e AK 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 X Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. .gl- and 2- family dwelling 12 Commercial /industrial Valuation: $ Oa ❑ Accessory building ❑ Multi- family Number of bedrooms: / ❑ Master builder 12 Other: Number of bathrooms: / JOB SITE INFORMATION AND LOCATION Total number of floors: / Job site address: I S `�f J FAbzi /�/ lAci_ New dwelling area: Clg s`' square feet City /State /ZIP: " t" �/. . Z � q' '� i3 Garage /carport area: — square feet Suite/bldg. /apt. no.: . —��' Project name: FOki Covered porch area — square feet Cross street/directions to job site: 1,i/ ►yWA54II ) �' Deck area: 84 square feet �`f'�' Z �M Other structure area: , square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I Lot no.: 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 a / DESCRIPTION OF WORK work indicated on this application. / ��PGr�t'8 i! Y�/ _i9L. AiTh 3C-11,L%ee Valuation: $ WA 141 Existing building area square feet New building area: square feet V PROPERTY OWNER ❑ TENANT Number of stories: Name: kor,ji i/ A 41 3 SigN FFi Type of construction: Address: mg-10 1 4 JlZ.ii I - Occupancy groups: City /State /ZIP: - 1 - 1604,0 O� C{7' 3 Existing: Phone: ( $03) 478 -mo ,,/oral „ Fax: ( ) New: X APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: �l "A EOM �Oti ft (Please refer to fee schedule) _ .J- 7 S tructural plan review fee (or deposit): Contact name: - t o g i I. Q FLS plan review fee (if applicable): Address: SSOZ 4, AYE, — Y City /State /ZIP: Pe p a { J 47724 Total fees due upon application: Phone: (R;1 ) Z$ _ si 6 l Fax:: (SQ3 ) '453— 01 I Amount received: E -mail: WD I"i 4CO4/S' 1- luc - Mrn . AIM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* cJl Commercial and residential prescriptive installation of • CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System. Business name: 5fj./„.fiL Submit two (2) sets of roof plan with connection details and fire department access, along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City /State /ZIP: Permit Fee (includes plan review $ 180.00 and administrative fees): Phone: ( ) Fax: ( ) State surcharge (12% of permit fee): $21.60 CCB lic.: O12... C C 1 3 1560 I 1 l � Total fee due upon application: $201.60 Authorized signature: t •''• This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: � �J �j A, DO I _� , t J f q4 J er Date: 4/4 / 6 / 1 * Fee methodology set by Tri- County Building Industry Service Board. I:\ Building \Permits\BUP - RESPermitApp.doc 02/24/2011 440- 4613T(11 /02 /COM/WEB) r Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE USE ONLY City of Tigard Received Permit No.: II n 1 3125 SW Hall Blvd., Tigard, OR 97223 Associated L Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: T I G A R D 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑Plumbing ❑Mechanical Internet: www.tigard- or.gov ❑ Other: ,THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ 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 g g rP P P 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 ❑ ❑ ❑ 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- ❑ ❑ ❑ 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. ❑ ❑ ❑ 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- ❑ ❑ ❑ 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 ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ 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. ❑ ❑ ❑ 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 Ore. on and shall be shown to be ap plicable 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. ❑ ❑ ❑ 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, ❑ ❑ ❑ 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 /COM/WEB) I 04/18/2011 11:36 PA3 s R 1 002/002 �n R i li •®f Jw i i) ., .1I i li i ; '•.I 1, ".4 ., IS City of Tigard /A min rmm.wo.: , i itrocir I3125 SW Hall Blvd., Tigard, OR 97223� ++' r • r 9 'i '1 ' r 4, t * +,, "' PhD 114 Perna: 503.718.2439 Pic: 503.398.1900 1AaorB Inspection n l,Lte: 503,639.4175 BUILFANG i t A:e '1`4 Dm Rogyfiv, Internet www ti8ard•orgav teaum.a/Medsod r TYPE OF WORK ctotaVEIRCiAl. IOW Bellilfetn* —,tit Mechanical permit flocs" are based on the value • ' , • wane 0 Now construction X4dditiortisiterationfreplacemeltt patbrmei Indicate the value (rounded to the nearest dollar) dull ❑ Demolition . ❑ Other: • W CATBGOItYr OF CONSTRUCTION *144:0 ':` `:,•:.., • 1- and 241umily dwelling 0 Commercial/industrial Cl Accessory building _ lbw titadoi Wormollors we dry 0 Multi- fanrity ❑ Master builder d Other: Description Qty. Bs_ Total . l's+ .; .. , �AT�6, 1st �`�'l [A�GA,' L'LORI � � Air e f!� Yob site dross: / f✓ ,M[� - , 'r. ... r` ' 1.11 B t :•::: ' ■E1� Pumice City/Stac�P: a r i T72! fir .. ace 100 0 0D+ $1't! (;;::,_- •111101111 $4.91 MN SuiteibidgJuk no.: -- Project name: ' p H ear Pangs 61.06 Cry street/directions to job site: Dud wale MEM . t Lot l (rnerer • Residential bailor ainmor ar t7nit hoatera lie ) � � Lt no.: p ' r of above Subdivision: Other. 23 Tax map/parcel no.: Other fart a iaa,eea: • Water halter • .. A OF 'WORK pas Eaoa 33.39 MIMI _ ' J f f! Hue vent tbt water heats or gas ' M 011.. . , ) M 3.39 MEI ■ _ Wood firrflactilmert Mill 23.32 NIMIl i,m�tltt z�.3x MEM e (>K'i Q . LiCh1+1!1 w. tither; _ 13.32 - ERAMA ,, oral exhaust and voldiation: • r.: 1 ' .. ..±:;/ i „ -, kitchen IIIMIIIII Addrnae: i 1 r 1 I , I [ City/State/ZIP: tif eft /Mil g ,.. mamma . 33.39 Mil .... ., jc , ti MOMS 23,32 MI Phone: ($`0/ ) .40.4...../40 , how_ �� AAtha.. toil Atha.. . { 23.32 :: .... �'` Other _ name 4 4. . : • Contact name: . Y L• . L . ; S16G4 � p �MI AddiCw- '� / 4_ 014.' � : �. . •-'• � (3ae h?atpmamyr City /State / P: . L1w'J ' = � L N 1, WalI/ - i t bestear _ Pine c � �) �$ � � 1 I�mc:: (50 ) x. 31 q( : . ��i NM ,.. MIM otininB99ttmoe: S & J HEATING AND, -- other: � Address: AIR CONDITIONING ATIN INC. - T 1 -' - ' `, City/state/ZIP: 1004 NE 411.1 411.1 AVENUE ii il4iabreim , -.., foe ($90.00) Phone: ( o ,L4_6_ , Pion review (as76 of , ,- .. hive) MINIM CCB lie.: 0 , G i l St+dc 02/ of permit file) ) MIN -. v TOTAL PERMIT FEE 7bb pent* •ppasytigr mime if 4 wait to oat abutter' Immo Ise dea W has been accepted as emote. Authorized aij arc: ,r _. • methodology sethy ni toasty Building Industry Service Board • Print name: • ,- = �'"'1 note: • Pee [ V 0 ft: GS Du 8,- TO IADD Sol @ ._� cpAie. 0 -r (Aw:.(Q P e/ � . 04/19/2011 14:22 FAX ZI001 /001 Plumbing Permit Application Buildi Fixtures `': ...._ : _,.. City of Tigard Received it U 0. Permit No.: Jy r f/ -CL's 111 NI 13125 SW Hall Blvd., Tigard,OR 97223' • . Plan Plan R . Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: Inspection Line: 503.639. *''r' '- i ; A. iy ; Date Read B Juea ®gee Page 2 for _ .,_.......... Ready /By: Internet: www.tigard or.gov , ,, _ , ,` �,_, Notified/Method: Supplemental Information , . TYPE OF WOR FEE' SCHEDULE • ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total VAddition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility comection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 • I1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: , Fire sprinkler ( sq. ft) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: • Job site address: 8676 5iiii f gin/ 1 Catch basin or area drain 18.76 City /State/ZIP: t 4 ,/, © 4 7 Z - Footing drain line, trench drain age 2 2 ``17''` - '' - � / Farting drain (no. linear ft.: ) Page Suite/bldg. /apt. no.: I Project name: i N Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: _) Page 2 Subdivision: ! Lot no.: Fixture or Item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 � Clothes washer � 25.02 � 7 fh,Plydu �` r) Dishwasher 25.02 ._ gkilj ,if i ( /ice"7 Drinking fountain 25.02 Ejectors/sump I 25.02 PROPERTY OWNER ❑ TENANT Expansion tank 12.51 �,J Fixture /sewer cap • 25.02 Name: 511 e ` ` d� f �G/4 /�l (✓ Floor drain/floor sitdr/hub 25.02 Address: 12 g 7-13 $W reflisligineTit. 7Altitoil Garbage disposal 25.02 City /State/ZIP: 1/60 OR- Vet; _ Hose bib j 25.02 Phone: (< 03 ) 4 Q - MI 6 lo tic Fax: ( ) Ice maker 12.51 g APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: L�1c> Medical gas (value: $ ) Page 2 c Primer 12.51 Contact name: t C LS Roof drain (commercial) 12.51 Address: &)Z }�`� g i tiffI , Sink/basin/lavatory F 25.02 City / State/ZIP: 0 e L 7` 3 Solar units (potable water) 62.54 y r i / p pan Phone: (503 �D�~ i3l b( Fax: : ( _) - §9) 2,u_ 99/ Tub/shower /shower P 0 12.51 E -mail: 41) t es y7 s- i�TWG'P�G?1 f . ESJ W 25.02 (i' ( ,, J - Water closet F 25.02 CONTRACTOR Water heater 1 37.52 Business name: MT�Aa,i�,n t + , I(ArW►S� Waterpiping/DWV 56.29 • Address: ' )Q 3 7 "�'" R b Q, X A re t ,-e- Other: 25.02 City /State/ZIP: p ,,t, j at._ V» U Subtotal Phone: ( O3) /*a r ? p 7 Fax: ( ) Minimum permit fee: $72.50 7" Plan review (25% of permit fee) 3 Lic.: / %t f 5 5-6 j Plumbing Lic. no.: F State surcharge {12% of permit fee) _ Authorized signature: - TOTAL PERMIT FEE Print name: J1� n Date: r��/ This permit application expires if a permit is not obtained within 180 days S 1 J � y K atter it has been accepted as Complete. *Fee methodology set by Tri Building Industry Service Board. I: 1Building1PennitstPl .MU- PamiWpp.doc 10/01/09 440- 4616T(1 0/OLCOM/WEB) Grizzly Bea 360 - 894 - 8939 p.1 04/18/2011 11:32 FAX IA 002/002 • • w of Tigar y b �i t PmaitNo: .�„�, q � g 3 - iwi Blvd ,Tigard,OR 97223' ?Jan Renew Other Pones: hill biham eonLine: 503.639 .41 73 SOCi.998 R vE x Ti', 1 Igy. Mt ®elmPYga2br laawnet' www.tisird �1ilAD Li r:3 D'S er .,: VAN. Nodde dlat:dad: Sr,(apieraadt Ids mango — . TYPE OF WORK . PLAN REVIEW Dr Nevi construction Xddidon/stterntionhuplecemem Fame tenet dl au .Pyy (radaait avon epees ttditemseaettsd below): D Service or hoer 400 nom a mate 01soldmg over due stares. - ❑ Demolition ❑ other: wham sae modal* fait comsat ❑ Marion ore bostya des. . CATEGORY OF CONSTRUCTION moods 10.000 amps et ISO vela or O: loons; traddiasr. �I . and 2-family dwelling ❑ ComnmerciaVindustlial ❑ Ac building Imo to r MI o . a meson, its, Q cbaaaas at+aae.ryicotwrat Ill Accessory $ mops ar MI or iaAe►lt6sas. buildings. ❑ Multi- family 0 Master builder 0 Other: CIFire mono. - 0 Medallion o<73 KVA *, (] Emergency sync= larger rcyaamy derived gate. JOB SITE INFORMATION LOCATION CATION ©AdMtrroa of sew moor load of . ❑ "A'.''a , '1.2", - 1,3", Job no.: • f Job she address And rPgA °q� UQ O Su toots residential use O aecro which pmt+ Cny/$ffite/Z:1P :'� "t Q + T!.' ( -" ' " t- ❑ltaeerdoaslxanwt. Q Y than 600 volts oomeal. Suite/bldg./apt. no.: Project name: ri/ At ❑ Saban er feeder 600 amps cc mom. FEES ;SCHEDULE ' Cross street/directions to job site: %// woxjo5A;41 (Ai a p I , 1 r«, 1 sew l New raidentiat dash- or w Ply dwelling uaht. Fead/Z;444. Includes attached garage. Subdivision: [ Lot no.: 1,000 sq. ft. or less 168.54 4 • Ea. add'1300sq. ft. orponioo 33.92 1 Tax map/parcel no.: • Limited rvd energ dential DESCRIPTION OF WORK • (with above sq.ft.) . 75.00 2 y� / limited energy, multi-family 75.00 2 LaN� 1 •a rS Servkc or (with above r= .at tdo a,aiOesada*,and/orrelocatlon 200 amps or lad 120.70. 2 PROPERTY OWNER I Q TENANT 201 amps to 4W amps 133.56 2 Naatc S I Q L A fJ i 401 peps m 600 amps am 20034 2 • g � � ./ ( ��,.�� 601ampsmlOOtlamps ]01.04 2 Address: j37'IW) /'gclJ/`7zlF� t r'Iw1't4c1( Over 1,000 amps orveils 532.26 2 City/State/ZIP: W � y OIL q t o t •etv+ra/ or leadss la.awtba,.lterutlaa, cad/or Pliant. (So3 _ x'1 4 tints l Fax: (----) 200 amps orlas 59.36 _ 1 Owner lastafstioa: This installation is being made on property that I own which is not 201 a e to 400 maps , I2s. , 2 599 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to amps 168.34 2 Broach circuits—new. aleeratioa. or astemrloa. per D=uet Owner signature: Date: k Fee for branch circuits with ALICANT 1 ❑ CONTACT PERSON above service a loader fee P P 3 7.42 ^ 2 • each branch circuit Business name: 1 ^�, S B Fee for batch circuits without ��[ 1j14� service or feeder fee, fun Contact name: ;:.• • W L�Itei4,�C brooch circuit / 56.18 2 tfi' Each add'! brands circuit 7.42 _ 2 Address: cgOZ N. Ez erget A Mi.cntsaeoaa (strike or feeder mat **eluded) — • �� Q R ?zIr Each muaafictaredoratodalar 67.84 2 City/5tateelZlP: dwelling, service and/or feeder Phone: • (903 ) 7_ 3- 81 61 [ Fax:: (s 2S3- $/ql only 2 Pomp or One lion circle 67.84 2 6 0.. L1Qe.Qn' C.0TaG1? ./-0,..1 Sign orandinelighting 67.84 2 cj Signal circuit(a) or limiter energy �.N past, alteration, or extension. Page 2 2 Business game: ( -) i i L z Z 5 1P I C 1.0 Each additiostal inapt tioa over allowable It ley of the above Address: QO ?_ , 1 ( i 9, v ' ) `!.r � . Adekioml inmost= atinmost= (I tar min) - 6625/ hr , • hoe Pat (t hr min) 66.25/ hr City/State/ZIP Va44( [ t 2 %j t , industrial plain p hr aim) 78.18/ br P hoaG(3k, T('f-! FJo Fax: ( �(�O ) t! � ! L ( ' "Sit lama:dem for which ao 90.ONhr /p hop -/ E lectrical Lie.: ' specificany listed (K hr mm) CCB Lie.: b yj� SuprV 0 t f EKZCIRICAL PERMIT,FEEB. - . t Subtotal: Suprv. Electrician signature, required: et.....-- /G I/n � � , �' Lie.:Zj te . Plan review (25%ofpermit fa): Print name: ) ,. "1/6, j 1. . ` I - _ e: 1 l /fi" 1 / / Slate surcharge (12% ofpermit fee). • TOTAL PERMIT FEE: Authorized signature: 4P Thu peach appatarlea endow if a permit is eat shalard widths 110 Print name: d � J s +y' [ Dane: y /6.. i •- tNumberof k t o a . ..d pery •• � tla+a. rl8saeseg{}natta c.p it/g,A,c OlaUto 440.+615Tp wLCOwwSO Building Division Development Code Provision Review T l G A R D Residential Projects Building Permit No: H T o//- d0O (u �}�-- � �� p er-' CWS Service Provider Letter Received: Yes No ❑ N/A ❑ 0a;4— e-1'nN to `'`2`1 ` (' ( Routed Plans: �/ J Original Plan Submittal Date: 7 //, 1st Revision Submittal Date: ❑ Site Plan Only 2nd Revision Submittal Date: ❑ Site Plan Only To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (/) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. Staff: please check items along left only if approved. Planning Review (contact at 503 -718- or @tigard- or.gov) Land Use Case No. Sy,W$ 9 3 - 0O / -7 ---. Name Morn, nq Sf4. P [ l zoning F -Y. 5 P-P J is Setbacks: Front 2. b Rear iS Side 5. Street Side r S Garage ZO Ig.." Maximum Building Height 3 d Actual Building Height N /w 13/Visual Clearance la Easements Ea/Sensitive Lands T e: 5 f S/v pes ?tfl ± ... 1a,..) ZS th Notes: Th, 1�t oe' SC on-e-4 t "p ra.m.sou..da -I- p I wJ g“ L 4 V 04 v1 a . Original Plan: Approved Ii/ Not Approved ❑ Date: yA., // i Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov) X Actual Slope: 40 Notes: Original Plan: Approved Not Approved ❑ Date: b ( Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City borist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov) E S treet Trees Protected Trees Notes: 7( ii , f twe . 14,1 cti k f 0 petn-1 Original Plan: Approved Ili Not Approved ❑ Date: 4/ ( 6/ 1/ Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert@tigard-or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant _ - Okay to Issue Permit: Yes ► "! o ❑ /4,1#------------ . Date Routed to Building: , , • Page 2 of 2 05/10/2011 12:41 FAX a002/003 1 r,,,,, Clean Water Services File Number C1eanWater \ Services . I ( 1 nsitive Area Pre - Screening Site Assessment - .:1; Tt6.p 2. Property information (example 1S234AB01400) 3. Owner Information tt Tax lot ID(s): 2.5 I o4 g et) Name: 57LYt ° MO Ali ieA. i tli Company: Address: I ' 4 1 1 1 1 71M r I :_ •.,i. L'LL.' ' Site Address; ; 41011EFArl ' A ,; L ':'4...i City, State, Zip: T 4 243 C - (17-2Z City, State, Zip: n' r DR.. c?4 7 Phone/Fax: (sw n 478 - W4- Nearest Nearest Cross Street: SW 4/0064.,..t L4is E -Mall: Ve.-FP,)rl e; hLdSS4lkga .CO 4. Development Activity (check all that apply) 5. Appiican Information '4' Addition to Single Family Residence (rooms, deck, garage) Name: 61; t ❑ Lot Line Adjustment Li Minor Land Partition Company: ...A ; „f _i ._,i O ❑ Residential Condominium ❑ Commercial Condominium Address: S$02. &I: I'fi2moL ' 4V Q Residential Subdivision ❑ Commercial Subdivision C3 Single Lot Commercial la Multi Lot Commercial City, State, Zip: PO ,, • ©j� q t • Other Phone /Fax: ,q y - ° fo , L . • E -Mail: r►.+ C :' ! 2 COhs• t t t) CO». 6. WIN the project involve any off -site work? ❑ Yes rg No ❑ Unknown Location and description of off -site work 7. Additional comments or Information that may be needed to understand your project .01. adzy / fY7p,La .':L • t4; - 7i.'" viiv. . J7 Ji�, • & •,,l(• ii. e't 2.... _ sr`,: -....? 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 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 t . ,'_ a, It ! ' " hLV Printl•lype Title (` 1WAIE -R., "-' /'4 ' // , 7,..., Signature ��r Data 4 4 /i mow FOR DISTRICT USE ONLY Ll 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 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, Stale, and federal law, 2( 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. Thls 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 07-20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, state and federal law. U This Service Provider Letter Is not valid unless t CWS approved site plan(s) are attached. L] The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 82.040(2). NO SITE ASSESSMENT OR SERVICE PROM! . R LETTER IS REQ RED. Rev awe byor QLUrcr Date 4 j 3 A 4550 SW Hillsboro Higiivlay • Hillsboro, Oregon 0 • Phone: (50 3) 1381 -51on • ("Fix (503)681-4439 • t.w -vcrlr arivmlnrscrvices,nr,3 0 cn C WOODSHIRE LANE 1 FEIN exterior walkway o not to scale ____I N 13842 •• 4 . CiVVS Ft e tSo . _ • , 5 S `' --------N.%\\\ I i Ap Clean Water Services ,- ev�v1Ch .A-kt ry w 1 By (_ �- Date 3 i I 1 5f L A-L ackyvtevre I aF f I ' j 1 Il 1 I 1 1 ✓ 1 1 a rc 13870 w 1 r (E) DECK W 1 // 1 Q Ir E I co :. New 3' -6" x 24 I t)ruv�„vav wood walkway to I /// connect existing 1 _ concrete stair and AO existing wood stair. 1 Ar 1 _ Z E -- This is the only I 11I!ll�'r exterior 1 I Illr (E) STAIR modification 1 I 131'++ _ (E) CONCRETE STAIR (N) WOOD WALKWAY / o I 0 w 0 0 w I I AP r�_q C I BUILD DIVISION 13842 I I I / 127' + i / i I I / / /,//: ) / / / //'/V / 7/ r/r 1 1 //////// ,/.';/4';;;:,...-,2,.:://,' / / /f f I f % l o w /*//.// // / / / / / / /7;,/ , ;//, a /, 7 . / /// /://,/ / cc cc ~ 1 f/ i / / / / // in w / // / / / / / /7/1/// E DECK p w 1 /,:// ,� / f !. / // / w tu o z 1 %// 7. 4'///../ / / 1 W co tu N f'f / ///// // / 1 ' N I . ,. / / / T f / / / I \ i ///:// I I \ i *Hil*:: ' :: . * ' : .. ::H::::::::4 ,// ///// / -.:.-.:':.:.:.:.:.:.: :''.:': : :.: : : : : : : V .............. .. ..................... . . �W :....:..:....: �.:.,., V ......./.,/... I \ 1 1 (E) STAIR I \ , r bo / 131' +�- \ (E) CONCRETE / L� STAIR (N) WOOD WALKWAY \ PERMIT DRAW i I DISCLAIMER: THESE DRAWINGS AND DESK KAY CST AND BY ANOTHER ENTI RUCT WITHO I DA TE: PR OJECT ON #: „rtrr.e 11 GC., KAYA CO