Permit IIt CITY OF TIGARD MASTER PERMIT
II I COMMUNITY DEVELOPMENT Permit#: MST2015-00149
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/02/2015
Parcel: 2S111AC06600
Jurisdiction: Tigard
Site address: 14825 SW 92ND AVE
Subdivision: 2004-021 PARTITION PLAT Lot: 1
Project: Koppler
Project Description: Detached garage addition.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5
Detectors: No
Total: 0 sf Value: $20,000.00 Rear: 15
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
Fum<100K: 0 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 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:
NEW SF VS U 0
Owner: Contractor:
KOPPLER,KENNETH J&AMY N GREG LARSON CONSTRUCTION INC Required Items and Reports(Conditions)
14825 SW 92ND AVE PO BOX 2297
TIGARD,OR 97224 TUALATIN,OR 97062
PHONE: PHONE: 503-702-2526
FAX:
Total Fees: $675.89
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 = ••opted by the Oregon Utility Notification Can -- . Th• e rules are set forth in OAR
952-001-0010 through OsR 952-001-0090. You may obtain a cop direct questions to OUNC by c- ' g 1' 232. •8 •r 1:00. 12.2344.
Issued By: ` : _ Permittee Signature: JA4!.s IPA •_
Call 00,175 by 7:00 a.m.for the next available i.'"-••,: • •ate. ,NIIII _I■
This permit card shall be kept in a conspicuous place on the job site until completion of the pr.
Approved plans are required on the job site at the time of each inspection.
f' •
Buildint Permit Application ���
Residential %t CI 1 (,I; Ol I It I 1 "I i,\I 1
— y Received
City Hall Blvd., OR 97223 �G 9 'lQ� ' PermitNo.:1. ..;• S _. •
PIan Review
NI I Phone: 503.718.2439 Fax: 503.598.1960 C At L.1. 1,�_:_ ,+: 1„..._.2 ` —�5 Permit:
, 1 i .\v t Inspection Line: 503.639.4175 ���Y QF �`' T. eadyBy: luris: 0 See Page 2 for
Internet: www.tigard-or.gov ��� 1 otified/Method: i(e Supplemental Information
WL�1
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
Additionlalterationlreplacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ ?z,`CAA)
Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
lob site address: /2/f)5 %sv►,- 9 .9, n I�Ay-e , New dwelling area: square feet
City/State/ZIP: —Tr/a r 9-7 a 4- Garage carport area: /a0 square feet
SuitelbldgJapt.no.: ( Project name: Fl V icy/ Covered porch area: square feet
Cross street/directions to job site:V im../,P PP 4 9 a n°1 /A 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
k 1`/ gd d- rill& Valuation: $
V Existing building area: square feet
�/ New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: R,Pn Cy le, / /�J r Type of construction:
Address: / � �9 ',id/ r , Occupancy groups:
City/State/ZIP: 7i (9 i 7 9 a I- Existing:s
Phone:6o,. 'a - tiJ 7 3 Fax:( ) New:
APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee seieas*?
Business name:
Structural plan review fee(or deposit):
Contact name: ko f2_ /,P/ FLS plan review fee(if applicable):
Address: /4t ea/J`' `s'`Y /7-t7� . ir�
_ _J Total fees due upon application:
City/State/ZIP: -/ , / 4 q a i/57 J O Amount received: 1a al
Phone:(5 03 9 ti _ l/:s Z7 f Fax::( ) -
E-mail: KOiap/�y LrA�
gmer.f7, PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
�i' CONTRA("'6�R Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: , n /J �,� (_�y��q�¢-� Submit two(2)sets of roof plan with connection details
- 4 C e"t i ° ' /' v' '�Y`' and fire department access,along with the 2010 Oregon
Address: AT-4c q -2 Solar Installation Specialty Code checklist.
City/State/ZIP: ����� aie, G, - J#to a Permit Fee(includes plan review $180.00
Phone:( Q �y Fax:( ) v and administrative fees):
�a /0 -a 5 State surcharge(12%of permit fee): $21.60
CCB lie.: f/l �1 t� 7 �- Total fee due upon application: $201.60-
I J
Authorized signature:�� This permit application expires if a permit is not obtained
�y within 180 days after it has been accepted as complete.
Print name: r Date: a/r L� 1 (` *Fee methodology set by Tri-County Building Industry
�i� f V - Service Board.
I:�BuildinglPermitslBUP-RE PermitApp.doc 02/24/2011 440-4613T(1 /02/COM/WEB)
I
r
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D Building Permit Review — Residential
o
Building Permit #: H o i'-Oo p-19
Site Address: 14et2S SW 9 2na ukr-e
Project Name: (iv/ goo f- OU - c Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: (2V/ L0U'r Ccii rc,jC_,
XVerify site address/suite#exists and active in permit system.
.12-River Terrace Neighborhood: ❑ Yes No
Site Plan Elements:
y'llree(3)copies of site plan /Existing 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
/brawn to scale(standard architect or engineer scale) floor elevations
?North arrow e5lJtility locations(required for new,may apply for additions)
Site address,project or subdivision name and lot number _I;Lgcation of wells/septic systems
,Applicant information(name and phone number) .2Eosion control(including drainage-way protection,silt fence
Lot dimensions and building setback dimensions - design,location of catch basin,etc.)
_.L-Lix)t area,building coverage area,percentage of coverage and eet‘names ',
impervious area(applicable if R-7,R-12,R-25&R-40) eet tree size,type and location
lIi'roperty corner elevations(2 foot contour lines if more than �;lEristing trees to be retained with drip line,and tree
4 foot differential) protection measures
...C7elean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
blic Facilities Improvement(PFI)Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
❑ Land Use Case#: .
,Z Zoning le LI ,s
/`J Setbacks: Front ?Jp Rear , c Side P` Street Side ' 1 S Garage Lp
(e Landscape Requirement: --
Lot Coverage Maximum:
Building Height: Maximum Height 3 Q Actual Height I Z—
Visual Clearance
,,$—Easements
$Sensitive Lands: ❑ Yes -No Type
-2 trban Forestry Plan
)2rEonditions "Met"prior to issuance of building permit
Notes: o
Approved By Planning: N 01/7 i2/at. W 0ott-G �A Date: 6/iii iS
Revisions(after Building Submittal only) Reviewer Date
j Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_070915.docx
a _ 9
Building Permit Submittal
Original Submittal Date: r 9// c
Site Plans: #
Building Plans: #
Building Permit#: ErEnter building permit#above.
Workflow Routing. Er Planning Ekgngineering Riermit Coordinator Er uilding
Workflow Sign-off: Er Sign-off for Planning(include notes from planning review)
Route Application Documents: Ja Engineering. (1) copy of permit application, (1) site plan,(1) building plan and
riginal plan review routing form.
OD Building original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: , 'i1, Date: . /9/s
Engineering Review p�
I2 S5 pe at building pad: 4 <v
L7 Conditions"Met"prior to issuance of building permit
O'Easements (encroachments)per engineering conditions of approval and plat
l Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes
Assess Water Quantity Fee in-lieu: ❑ Yes a No
LIDA Facility on lot: ❑ Yes La -.o
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: �, Date: 6 -/9 -
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: El 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)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: El Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
rilir to Issue Permit -
Approved by Permit Coordinator: I Date: irrAlirS
I: 5.docx