Permit •t CITY OF TIGARD MASTER PERMIT
III ,I • ' COMMUNITY DEVELOPMENT Permit#: MST2015-00168
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/30/2015
Parcel: 2S112CD07300
Jurisdiction: Tigard
Site address: 15838 SW 76TH AVE
Subdivision: 1994-100 PARTITION PLAT Lot: 1
Project: Smith
Project Description: Replace and redesign existing deck. Add non-ADA ramp to deck.
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: No
Total: 0 sf Value. $6,068.00 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<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:
ALT SF VA R-3 0
Owner: Contractor:
SMITH,ROBERT W&JUDITH C TRUST NEIL KELLY CO INC Required Items and Reports(Conditions)
15838 SW 76TH AVE 804 N ALBERTA ST
TIGARD,OR 97224 PORTLAND,OR 97217
PHONE: 503-598-1975 PHONE: 503-335-9240
FAX:
Total Fees: $447.90
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done .• -- • e with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
da -. ATTENTION: Ore.•n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
• 2-001-0010 through OAR•; •• ••90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 1. 0.332.23
Issued By: k Permittee Signature: x
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This pormit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential RECEIVED FOR OFFICE USE ONLY
City of Tigard Received e'
'J g Date/By: f �JM / Permit No.: �r2
13125 SW Hall Blvd.,Tigard,OR 972' a 2 1 2015 Plan Revie •4-/. /5"....12.2n/6.2
Phone: 503.718.2439 Fax: 503.598. '.1 Other Permit:
• Date/By: � f�^I
t 1�,A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov BUILD NG DIVISION Notified/Method: al ON S lI Supplemental Information
�NYAtk1 11 ,
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and thepr�tt for the
work indicated on this applitf 4t 1l.
CATEGORY OF CONSTRUCTION ✓✓''``��
;xl-and 2-family dwelling ❑Commercial/industrial Valuation .'• ( P$ �
❑Accessory building ❑Multi-family Number of bedrooms: j
❑Master builder 0 Other: Number of bathrooms: 5
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 15 •38 c w -- (o New dwelling area: square feet
City/State/ZIP: -A--\ IN�y7 / 09-- / 9 N-7 c3 M Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: !��(1 Covered porch area: square feet
Cross street/directions to job site: Deck area: O`e0 square feet
t7 . 5(flTM +) . Q •\ SW 460N OI • 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.:*dt Rgo.A j�3'3A pp, (, I pF Pl�{LTIN(V L.44-7. equipment,the value(rounded to the nearest dollar)of all
M equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK 19 61' [00' work indicated on this application.
Valuation: $
R-e 91( G n6 ruko s S;\ o y cs r (1 c Q j)_• A ciii i'l on -
Existing building area: square feet(&v •tt du) f v. iti z pYwQ(5 NA) [Av,Q
Vo-\''b New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: ex kw n �u.y j C�i Type of construction:
Address:`"'ISC SW i W t' Occupancy groups:
City/State/ZIP:✓lien 0 j OIL a7 .74 Existing:
Phone:( 13 CJ..\I5115 Fax:( ) New:
APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
A ' (Please refer to fee schedule)
1�
Business name: C IL_ t L1) ' /D. Structural plan review fee(or deposit):
Contact name: Di p`v ou
Address: FLS plan review fee(if applicable):
,SA-h., t✓ AFL 3 J
Total fees due upon application:
City/State/ZIP:
I/7' //
Phone:( mount received:
413—Si53 Fax:ax: :(503)3.@/-74 0�
E-mail: n 0-)e �e`t /��11�/ �� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
ll Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Phi I Voltaic Solar Panel Syste •.
Business name: y\I C l� LAM QO . Submit two(2)sets of ro. Ilan with tonne details
`v � 2 and fire department access,a .•_• wit e 2010 Oregon
Address: .0A N L 3 ST, Solar Installation Specialty Cod• ••cklist.
City/State/ZIP: P(')��- - - QC_ 9 7 9-fl-7 Permit Fee(includes . . revie ' $180.00
and adm.•' trative fees):
Phone:( ,) a ao .. 74 Co I Fax:(G O3) _ State surcharg 2%of permit fee): $21.60
CCB lit.: LOU t51U T•."fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: ' f Date:1/17// c� *Fee methodology set by Tri-County Building Industry
�J` `! ���) ✓ Service Board.
I:\Building\Permits\ UP- er itApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB)
114 City of Tigard
,
COMMUNITi'DEVELOPMENT DEPARTMENT
T 1 ;A R D Building Permit Review — Residential
Building Permit #: H.6-1--(9-0/ 5 -d<<og
Site Address: is ca 3 G S W 1 (o
Project Name: bi`--t t�h/- Lot #:
(New dwelling=subdivision name;Addition or alteration=last name of owner)
Planning Review
Proposal: Ira e p l l Le.. (A ( t ('e cln l i 9 r-1 e X 1 s h a y (le Cl1
, Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: ❑ Yes if—No
Site Plan Elements:
Three(3)copies of site plan /Existing structures on site
, ite plan must k on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
.rlDrawn to scale(standard architect or engineer scale) floor elevations
North arrow $177tility locations(required for new,may apply for additions)
,Site address,project or subdivision name and lot number ration of wells/septic systems
Applicant information(name and phone number) -Eftl5sion control(including drainage-way protection,silt fence
i.ot dimensions and building setback dimensions design,location of catch basin,etc.)
ot area,building coverage area centage of coverage and /Street names
impervious area(applicable if R-12,R-25&R-40) --iEl.sneet tree size,type and location 1
— Property corner elevations(2 foot contour lines if more than $Lo7tisting 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: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
_public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
❑ Land Use Case#:
Zoning. - ,
Aetbacks: Front + S Rear I S Side S Street Side ( 0 Garage 2,0
Landscape Requirement: 7� %
XLot Coverage Maximum: ..:ff %
Building Height: Maximum Height 3 S Actual Height
'' - Visual Clearance
— Easements
$-Sensitive Lands: ❑ Yes ❑ No Type
tr.-Urban Forestry Plan
'9 Conditions"Met"prior to issuance of building permit
Notes:
Approved By Planning: M 0 vl r-e--cr (/C7 Date: c1 ?-41 /,-
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
(:\Building\Forms\BldgPermitRvw_RES 070915.docx
Building Permit Submittal
Original Submittal Date: a/
Site Plans:
Building Plans: #
Building Permit#: Enter building permit#above.
Workflow Routing: E 1 Planning .12-"Engineering rPermit Coordinator Building
Workflow Sign-off: a Sign-off for Planning(include notes from planning review)
Route Application Documents: J- Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
C'f Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: C I Date:
Engineering Review
❑ Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in lieu: 'es ❑ No
Assess Water Quantity Fe• - eu: ❑ Yes ❑ No
LIDA Facility on 1. . ❑ Yes ❑ No
❑ NOT Appr ed by Engineering: Date:
Notes.
Approved by Engineering: Date: ?•,ZZ•Z5
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
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)
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: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
i:2OK to Issue Permit
Approved by Permit Coordinator: 1 Date: h/?/, c
I:\Building\Forms\BldgPermitRvw_RES_0709I 5.docx
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
15838 SW 76TH AVE, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2015-00168
David Young
Violation Summary:
Inspector Contractor