Permit II CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2014-00154
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/22/2014
Parcel: 1 S 134CD09200
Jurisdiction: Tigard
Site address: 11645 SW TIGARD DR
Subdivision: BURLWOOD NO.4 Lot: 26
Project: Torres
Project Description: Patio cover, approximately 475 sq ft
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: $10,089.00 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 Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Drywell-Trench Drain: 0 Other Fixtures: 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<10OK: 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: 0 201-400 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:
TORRES.NANCY RICK'S CUSTOM FENCING&DECKING INC Required Items and Reports(Conditions)
11645 SW TIGARD DR 4543 SW TV HWY#A
TIGARD,OR 97223 HILLSBORO,OR 97183
PHONE: 503-515-4608 PHONE: 503-640-5434
FAX:
Total Fees: $410.40
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 ma obtain a c•i• • the rules or direct questions to OUNC by calling 50�19��00.332.2344.
Issued By: I/ �- _ Permittee Signature: ,,Q,-
39.4175 by 7:00 a.m.for the next available inspection date.
This permit card sha I 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.
B'uilc id2 Permit Application
m eektitaiSP If)R (II I It I I ,I IIvI1
City of Tigard Da `d ArE a Permit No.: c
• 13125 SW Hall Blvd.,Tigard,OR 97223 1 c 9(V\4 Plan Review -chill p
Phone: 503.718.2439 Fax: 503.598.1966tr J DateB : 2/A G Other Permit:
I I(; \R I, Inspection Line: 503.639.4175 ,A pD Date Ready/By: ���n See Page 2 for
Internet: www.tigard-or.gov OP(OV T►(,CIA *i
Not ed/Method: / �_fAI, Supplemental Information
TYPE OF Iaii&D1��0����101,
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 incat don this application.
-1-and 2-family dwelling ❑Commercial/industrial ValuatioEy/� $ 7/ v" )G3.CO
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: f( 6/ 5- S cL,, T6G.•-d 40,, New dwelling area: square feet
City/State/ZIP: 7:66-A.d i Or 97 z Z3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area square feet C/7c
Cross street/diredions to job site: Deck area: 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.
Tax map/parcel no.: Indicate the value(refueled to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
z. Valuation: $
i% Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stones:
Name: /j/ � 7v r es Type of construction:
Address: /16 t f c. �, /ix-. e 4.0/ I/ Occupancy groups:
City/State/ZIP: 7-, yar� 7 Z 3 Existing:
Phone:(j■h ) 575_ Lae 6 Fax:( ) New:
❑ APPLICANT CONTACT PERSON NOTICE
Business name: e c4 /1"--e-Pre.;.r .� t7• �, All contractors and subcontractors are required to be
Contact name: L�c�'G,w.��` licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be liensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:(5,3,3) ' 3- 7 C 7 7 Fax:: :( )
E-mail: GS ,CJ 06.etc, cv r-4- j y.#r •A , c,-,--�'
CONTRACTOR (/ BUILDING PERMIT FEES*
/— y `I (Please refer to fee schedule)
Business name: 5 (�r�G, k ! .if Permit fee:
Address: C(cc/j S�_ T /7w,� U State surcharge(12%of permit fee):
City/State/ZIP: /./:(15 A,,,� (-r �7,z3 FLS plan review(40%of ermit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB lic.: 4--e,0 5 a Total permit fees: -I 5//0. 4/6
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
�I, within 180 days after it has been accepted as complete.
Print name: �,`,,G/j'(�-. Date: y f�g e.,
7 Fee methodology set by Tri-County Building Industry
Service Board
C\Building\Permits\FPS-PermitApp_071514.doc 440-4613T(1 I/02/COM/WEB)
• w
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: Number of alarm devices:
❑ Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
Alteration (3) copies of sketch showing area (3) copies of sketch showing area
to existing of work within building structure of work within building structure
system
❑ 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: I $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler(Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
1 7,201 and greater $404.39 _
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal(see A,B&C above): $
Permit fee based on project valuation(see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12%of permit fee): $
FLS Plan Review(40%of permit fee): $
TOTAL: $
I:\Building\Pemvts\FPS_PermitApp_071514.doc 2
r , .'ti
IIII City of Tigard
■
COMMUNITY DEVELOPMENT DEPARTMENT
TI C;n R D Building Permit Review — Residential
Building Permit #: fi5`c2-.a/Y—DD/Sy
Site Address: \i(p L(5 SW --r'; et a, c( r r .
Project Name: To ryes Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: Co V4,./ gy(,i s# n5 pcak;0
El Verify site address/suite #exists and active in permit system. /Wpt
Site Plan Elements:
.0(Three(3)copies of site plan l txisting structures on site
'Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure (including decks)with finished
.Drawn to scale (standard architect or engineer scale) floor elevations
North arrowtility locations(required for new,may apply for additions)
Site address,project or subdivision name and lot number ,.o Lion of wells/septic systems
.ikApplicant information(name and phone number) rosion control(including drainage-way protection,silt fence
Lot dimensions and building setback dimensions design,location of catch basin,etc.)
N1p Xot area,building coverage area,percentage of coverage and Street names
i ervious area(applicable if R-7,R-12,R-25&R-40) treet tree size,type and location
roperty corner elevations(2 foot contour lines if more than Existing trees to be retained with drip line,and tree
4 foot differential) protection measures
Clean Water Services-Service Provider Letter: (lot platted prior to 9/10/1995):
Required: X' Yes ❑ No Received: ❑ Yes ❑ No
Land Use Case#: V eV-.
Zoning: R-- t{ .5
• Setbacks: Front -- Rear t5 Side 5 Street Side — Garage —
)2/landscape Requirement:
Lot Coverage Maximum:
..Q' Building Height: Maximum Height 30 Actual Height ( s • /
7Visual Clearance
eiSf Easements
7Sensitive Lands: ❑ Yes ❑ No Type
Urban Forestry Plan
21 Conditions Met
Notes:
Approved By Planning: L a e_42,44.... Date: € - 15--' 1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Buil d ing\Forms\BldgPermitRvw_RES_042914.docx
Building Permit Submittal
Original Submittal Date: ///5 ict
Site Plans: # 5
Building Plans: # 9
Building Permit#: I 'Enter building�pe it#above.
Workflow Routing: eiay,lanning Engineering d '"I'ermit Coordinator building
Workflow Sign-off: -off for Planning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
nal plan review routing form.
'l J Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: r Date: q/ls�fZ
l
Engineering Review
Actual Slope: 2_ / /
11 Conditions Met
Notes:
Approved by Engineering: Date: 9/Y /5i
Revisions (after Building Submittal only) / Reviewer Date
Revision 1: ❑ Approved ❑ Not Ap'roved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions Met-Prior to Issuance of Building Permit
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:
) 7OK to Issue Permit
/V 1//4,1/#4
Approved by Permit Coordinator: Date:
I:\Building\Forms\BI dgPermitRvw_RES_042914.docx