Permit CITY OF TIGARD MASTER PERMIT
a COMMUNITY DEVELOPMENT Permit#: MST2015-00100
TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Date Issued: 06/22/2015
Parcel: 2S104CA02500
Jurisdiction: Tigard
Site address: 13599 SW LAUREN LN
Subdivision: HILLSHIRE Lot: 25
Project: Ponsness
Project Description: Deck alteration and replacement.
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: $15,000.00 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 Tvpes 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
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 add9 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:
PONSNESS,JEFFREY B 8 SHERYL L THREE RIVERS CUSTOM DECKS INC Required Items and Reports(Conditions)
13599 SW LAUREN LN 23885 S MOUNTAIN TERRACE
TIGARD,OR 97223 BEAVERCREEK,OR 97004
PHONE: 503-371-1975 PHONE: 503-632-8777
FAX: 503-632-8770
Total Fees: 5642.27
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 '• . ce with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work i suspended for more the 180
day- ATTENTION: • =eon I: requires you to follow the rules adopted by the Oregon Utility Notification Center. Thos- rules are set forth in OAR
9 -001-0010 through OAR•: -00 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 . 987 or 1 .00 .32.2344.
Issued By: I iLA,/AL+110 Permittee Signature: /
Call 503.639.4175 by 7:00 a.m.for the next available inspe tion 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.
. it
Building Permit Application
Residential RECEIVED FOR OFFICE LSE O,\L1
Received /
City of Tigard LL 2015 Date/By: t/o ' /J Permit No/Xs-70/5"—,40/400
II I • 13125 SW Hall Blvd.,Tigard,OR 97228UN 9 Plan Revie. / ,�
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Z It r-+ ii-j Other Permit:
1 1 t \R i r Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/B : de lurk: la See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Methodjt'/r iii, 77C Supplemental Information
',?REQUIRED DATA:i-SAND 2-FAMILY DW ELI NG ..
❑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 41
r CATEGORY OF CONSTRUCTION work indicated on this application.
w
1-and 2-family dwelling ❑Commercial/industrial Valuation: $/ �O
❑Accessory building ❑Multi-family Number of bedrooms: (�
#
❑Master builder ❑Other: Number of bathrooms: �*1
OB SITE INFORMATION AND LOCATION Total number of floors: NtIet
Job site address: /5q,=7 66..) 6etet ( New dwelling area: square feet
City/State/ZIP: 7 4 /) , O.. 97223 Garage/carport area: square feet V
Suite/bldg./apt.no.: Project name: ,. )1iJ i 55 Covered porch area square feet
Cross street/directions to job site: / 7,14._.. 64)&1// 70 Deck area: 4-75' square feet
/4"Dpiee5 S Other structure area: square feet
REQUIRED DATA:COMMERC
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: c?Stage 46 ..5-DO 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.
T rive/ e1/7 W7D / ,ee�� /!%-/vs y`7" Valuation: $
� C.rl= rc� fi �fi�"/C/�C Existing building area square feet
New building area: square feet
K.-PROPERTY OWNER I ❑ TENANT Number of stories:jill
Name: __` 7F paN5, SS Type of construction:
Address: G,1/24,46" ,IS 5/7 Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) 3 1 7, f 9 7 Fax:( ) New:
■
APPLIC [I CONTACT PERSON.. BUILDING PERMIT !
4
,tip (Pleastiithr to fee se
Business name: /M.e" RI tify,5 Cl-70tts1 DereS Structural plan review fee(or deposit):
Contact name: Nivi
23 8 SS p ootra j(� FLS plan review fee(if applicable):
Address:
—
Total fees due upon application: \
City/State/ZIP: g vete Dse_ 970,04.___ v2.0 Phone:(�Q3) 72„0.,4t 7,6 Fax::( ) Amount received:
vi
E-mail: / 4/ 3 0 S Ca"( - ------ --
a"( PHOTOVOLTAIC SOLAR PANEL SVSTE
Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name: /�}� / / Submit two(2)sets of roof plan with connection details ra
_ / " 14pk( and fire department access,along with the 2010 Oregon �''
Address: ��/(CrJ Solar Installation Specialty Code checklist.
City/State/ZIP: ` Permit Fee(includes planreview $180.00 `
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 62750/ Total fee due upon appication: $201.60
Authorized signature: 0 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: ,,''JJ� Date: q *Fee methodology set by Tri-County Building Industry
� en/(S �+�lt!'� �// /� Service Board
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613/(11/02/COM/WEB)
I .
Building Permit Application Checklist
One- and Two-Family Dwelling I o R ()I I ICE USE ONLI
- City of Tigard Rate/By: Permit No
71 13125 SW Hall Blvd.,Tigard,OR 97223 DateBy:
Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
T I G A R l7 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard-or.gov ❑ Other:
THF. FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No v/%
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
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, r-❑ ❑ ❑
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. ❑ ❑ 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- ❑ ❑ ❑
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 a•r licable to the rro'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.
I:1 Building\Permits\BUP-RESPermilApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
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City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Residential
1 Ii , vRl)
1
Building Permit #: /`/S7,20/3"-zj0/p d
Site Address: /3 s99 irk-ei Ln .
Project Name: IIJ, 1 _ .0 Lot #: Q,
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review //���� �^
Proposal: AJ J c c4 ca./16406e A r R
/Verify site address/suite#exists and active in permit syste .
Ni4iver Terrace Plan District: ❑ Yes No
Sit lan Elements:
rpfiee(3)copies of site plan sting structures on site
2S .lan must Izg on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
U • awn to scale(standard architect or engineer scale) oor elevations
14 yrth arrow i a i'ty locations(required for new,may apply for additions)
VI address,project or subdivision name and lot number �. ation of wells/septic systems
r .. 'cant information(name and phone number) V -,. ion control(including drainage-way protection,silt fence
!1 • dimensions and building setback dimensions ign,location of catch basin,etc.)
FP •t area,building coverage area,percentage of coverage and $treet names
impervious area(applicable if R-7,R-12,R-25&R-40) /• ,4-et tree size,type and location
eperty 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 S ices-Service Provider Letter(lot platted prior to 9/10/1995): / A �
Required: Yes,applicant was notified CI No Received: CI Yes No
11'ublic Facilities Improvement(PF1) Permit will� �/�
Required: ❑ Yes,applicant was notified lld No Applied For: ❑ Yes ❑ No,stop intake
Aidpnd Use Case#:
ning 2_
JLtd' etbacks: Front f.5Rear /S Side S Street Side /0 Garage QO
andscape Requirement: JO
l]d/of Coverage Maximum: Ea
[ Building Height: Maximum Height 5. Actual Height ac)
iti/Jtisual Clearance
' r '' :sements
Ir. Sensitive Lands: i Yes ❑ No Type Sky
,e'T es > 09s
S�4rban Forestry Pl n
conditions
"Met"prior to issuance of building permit
Notes:
Approved By Planning: �- __. .>. L, Date: df S^'
Revisions (after Building Submittal only) / Reviewer Date
,
Revision 1: Approved 111 �Not Approved I V 1 0 r i74,, al 10 c (/ 10/ ( S
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: Cl Approved ❑ Not Approved
1:\Building\Forms\BIdgPermitRvw_RES_031015.docx
4' .
Building Permit Submittal
Original Submittal Date: ,79//j
Site Plans: # 3
Building Plans: # .3
Building Permit#: $Enter building permit#above.
Workflow Routing: , Planning NIDEngincering crmit Coordinator ,uilding
Workflow Sign-off: )Sign-off for Planning(include notes from planning review)
Route Application Documents: 921) Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: (o79�s
Engineering Review d ' 7,7mmm
RJ Slope at building pad: I'
nditions"Met"prior to issuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
—l ] teeter Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes
Assess Water Quantity Fee in-lieu: ❑ Yes
Facility on lot: ❑ Yes No
XNOT Approved by Engineering: Date:
Notes: sA1 , ' •
-,AA Ai A. / /r / /ISj
Approved by Engineering: 'f • e/ , , „ A! f ate: ,C .7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved ,4 1j04- _ _
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only) > RV)Revision Notice 1: Date Sent to Applicant: C.0 tj Agi' `t,
Revision Notice 2: Date Sent to Applicant:
��`Revision Notice 3: Date Sent to Applicant:
�Ly-OK to Issue Permit / `_
(Approved by Permit Coordinator: /i41 1 L Date: 6Av `✓
I:\Buil ding\Forms\BldgPermitRvw_RES_031015.docx
�r Clean Water Services File Number
Clcan\Viter Services I 15-001805
Sensitive Area Pre-Screening Site Assessment
1. Jurisdiction: o / OF 7---/el'Ad--1- )
2. Property Information(example 1 S234A801400) 3. Owner Information
Tax lotID(s) 25_204E_AO74,00 Name 3-eFF PaysmFSS
Company.
Address /3561/ Q L 41YJ £Aide.
Site Address: /3 Srj 9 `L/ U (/ 4,4,/
City. State,Zip. 77r//# , O �l'722 3
City, State,Zip. "7l&4 ,1)12._p� g72Z? Phone/Fax'. rap's. 317 • /97,.5
Nearest Cross Street /3 AVG- E-Mail
4. Development Activity(check all that apply) 5. Applicant Information
X Addition to Single Family Residence(rooms,deck,garage) Name: -)E^/EJ4J/.5 //&Jy ,�i d 7i�,
:J Lot Line Adjustment J Minor Land Partition Company rf �4 ct6re,4f Der es
`J Residential Condominium J Commercial Condominium 23 39 1��ooll,dr J 7-� ,e
J Residential Subdivision Address
J Commercial Subdivision 9
J Single Lot Commercial :j Multi Lot Commercial City,State.Zip. �i OZ 70
Other Phone/Fax _4).L. • 720 .i f 7(0
— �....__ E-mail ,j)lioP'' /4t J�'l-T5 E3l?,I . c'a(
6. Will the project involve any off-site work? j Yes No J Unknown
Location and description of off-site work
7. Additional comments or information that may be needed to understand your project
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 andlor 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 tfi document.and to the best of my knowledge and belief.this information is true,complete.and accurate
Print/Type Nam �f S / ,(/ Print/Type Title 1 /) . T7&4 id • < rio -
Signature Date (. f Lj
FOR DISTRICT USE ONLY !!!
J 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.
J 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.t Ail required permits and
approvals must be obtained and completed under applicable local State.and federal law
XBased on review of the submitted materials and best available information the above referenced project wiq not significantly impact the existing or potentially
sensitive areal 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
07-20,Section 3.02.1 All required permits and approvals must be obtained and completed under applicable local,state and federal law
J This Service Provider Letter is not valid unless __ CWS approved site plan(s)are attached.
J The proposed activity does not meet the definition of development or the lot was platted after 919195 ORS 92.040(2). NO SITE ASSESSMENT OR
SERVICE PROVIDER LETTER IS REQUIRED.
Reviewed by ei",. 4,:.-. ",..--- Date 6/11/15
Albert Shields
From: Albert Shields
Sent: Wednesday, June 10, 2015 9:55 AM
To: 'DHofmann @decksby3rivers.com'
Subject: MST2015-00100, 13599 SW Lauren Ln.
Dennis, on reviewing the plans and site plan for this application, Engineering has noted that the proposed deck would
extend over a sanitary sewer easement (see plat, Hillshire 05000466). Please revise the plans and site plan and
resubmit.
Please let me know if you have any questions.
Abert Shields
city of Tigard
s Permits/Projects
Coordinator
AbertCbgard or.gov
(503)718-2426 Work
(503)624-3681Fax
13125 SW Mal Blvd.
Tigard,OR 97223
1
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13599 SW LAUREN LN, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
FAIL
MST2015-00100
David Young
Landing to be finished 3' in direction of travel at bottom of stairs. Provide pictures and
recall for Monday.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13599 SW LAUREN LN, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2015-00100
David Young
Corrections done.
Violation Summary:
Inspector Contractor