Permit CITY OF TIGARD MASTER PERMIT
III I ' COMMUNITY DEVELOPMENT Permit#: MST2015-00226
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/14/2015
Parcel: 2S112CC08400
Jurisdiction: Tigard
Site address: 15679 SW 82ND AVE
Subdivision: LANGTREE ESTATES Lot: 16
Project: Acevedo
Project Description: Adding 280 sq ft of living space and 201 sq ft of covered porch/deck.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 0 First: 280 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 18 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5
Detectors: Yes
Total: 280 sf Value: $55,000.00 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
Drywall-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:
ADD SF VB R-3 280
Owner: Contractor:
ACEVEDO,JOSE M&LAURIE A REVIVE LLC Required Items and Reports(Conditions)
15679 SW 82ND AVE 11640 SW PREAKNESS
TIGARD,OR 97223 WILSONVILLE,OR 97070
PHONE: 503-624-9017 PHONE: 971-285-0770
FAX:
Total Fees: $1,459.27
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 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- opy of the ru- •r direct questions to OUNC by calling 503. 1987 or 1.8 0.33 2344.
Issued By• i /« -- _ Permit e• ••nature: -t i
Cal,. }r' 5 by 7:00 a.m.for the next available inspection date. ________
This permit card shall •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
Residential RECEIVED FOR OFFICE USE 0.11.1
City of Tigard tt�� Received /1 Ali ,� permitNo.: a
Er 13125 SW Hall Blvd.,Ti ORIo.32 4 2015
Date/By: !I J�j l S—od oZ �o
Tigard, i /
hPermit:
Phone: 503.718.2439 Fax: 503.598.1960 PlaDann t ReReyview/ ✓/ tips—
Other
TIGARD Inspection Line: 503.639.41' ,ITY OF riGARD Date Ready/By: Axis: SeePage 2for
Internet: www.tigard-or.g13U I LD I N G DIVISION Notified/Method(:��1 a/j/�,L_i/i5— I 0 Supplemental Information
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
Z Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $55000
❑Accessory building El Multi-family Number of bedrooms: 0
❑Master builder ❑Other: Number of bathrooms: 0
JOB SITE INFORMATION AND LOCATION Total number of floors: 1
Job site address:15679 SW 82nd Ave New dwelling area: 280 square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Acevedo Covered porch area: 201 square feet
Cross street/directions to job site:SW Bonadventure In 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.:2S112CC08400 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.
Building an addition with covered porch Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Jose Acevedo Type of construction:
Address:15679 SW 82nd Ave Occupancy groups:
City/State/ZIP:Tigard,OR 97224 Existing:
Phone:(503)624-9017 Fax ( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:Revive LLC (Please refer to feesebedale)
Structural plan review fee(or deposit):
Contact name:Don Isaacson
FLS plan review fee(if applicable):
Address:8532 SW St.Helens Dr.
Total fees due upon application:
City/State/ZIP:Wilsonville,OR 97070
Amount received: D
7 *42
Phone:(971)285-0770 Fax: :( )
E-mail:info@reviveremodeling.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
_ roof-to. • ounted PhotoVoltaic Solar Panel Syste
Business name:Revive LLC Submit two = -ts of roof plan with connec'-. •etails
and fire departm-• .ccess,along wi • - 010 Oregon
Address:11640 SW Preakness Solar Installation Spe . t Co.' •ecklist.
Permit Fee(inclu.-. • .. review
City/State/ZIP:Wilsonville,OR 97070 irustrative $180.00
Phone:(971)285-0770 Fax:( ) S .. •. ge(12%of permit fee): $21.60
CCB lic.:166165
Total fee due upon application: $201.60
Authorized signature:x0/.../4Z._.._. This permit application expires if a permit is not ob fined
within 180 days after it has been accepted as complete.
Print name:Don Isaacson Date: •Fee methodology set by Tri-County Building Industry
/1/.?,' 2ej,r Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11% /C()M/WEB)
III City of Tigard
NOV 2
RECEIVED
COMMUNITY DEVELOPMENT DEPARTMENT 4 2015
I
Building Permit Review — Residential BUILDING CITY OF o VAiSt o
TIGARD Q(�
Building Permit #: f` 6r6,?p js'- oo 4,
Site Address: 15671 SInd ANN,-
Project Name: Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review _I
Proposal: C68141OY? v�( Covered dock
Verify site address/suite#exists and active in permit syst m.
$River Terrace Neighborhood: ❑ Yes No
Sit lan Elements:
4 ee(3)copies of site plan NJ r 'sting structures on site
must plan k on 8-1/2"x 11"or 11 x 17"paper ►vi Footprint of new structure(including decks)with finished
gy'rawn to scale(standard architect or engineer scale) floor elevations
[iorth arrow -0Lhility locations(required for new,may apply for additions)
pte address,project or subdivision name and lot number . ation of wells/septic systems
plicant information(name and phone number) c ri rosion control(including drainage-way protection,silt fence
OOLot dimensions and building setback dimensions design,location of catch basin,etc.)
$Lot area,building coverage area,percentage of coverage and -G9'freet names
'' pervious area(applicable if R-7,R-12,R-25&R-40) 'E ittreet tree size,type and location
1•`roperty corner elevations(2 foot contour lines if more than =listing trees to be retained with drip line,and tree
4oot differential) protection measures
tofClean Water rvices—Service Provider Letter(lot platted prior to 9/10/1995): 0.10
Required: KYes,applicant was notified ❑ No Received: I=1Yes
- Public Facilities Improvement(PFI) Permit:
Required: 1:1Yes,applicant was notified No Applied For 0 Yes 0 No,stop intake
' .nd Use Case#:
F. Zoning: R \2.
i Setbacks: Front 1 S/ Rear ` S I Side 5 Street Side 10 Garage '20 i
$Landscape Requirement: cyo
- Lot Coverage Maximum: 0/0
U1Building Height Maximum Height 3 5 t I
Actual Height 25
:i(Visual Clearance
Easements
Sensitive Lands: ❑ Yes iNo Type
$'Urban Forestry Plan
$'Conditions "Met"prior to issuance(of building permit
Notes: BPL 40,4 • i in -PProm CikA)5
Approved By Planning: _ •,•• • ./1 Date: t t t 2J I i 5
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
1:\Building\Forms\BldgPermitRvw_RES_070915.docx
Building Permit Submittal
Original Submittal Date: r//�N//S
Site Plans:
Building Plans:
Building Permit#: e. Enter building permit#above.
Workflow Routing: B Planning 'Engineering [ 1' rmit Coordinator 'O—Building
Workflow Sign-off: 2"Sign-off for Planning(include notes from planning review)
Route Application Documents: C'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: i// .i/ic
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: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: IL Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved 0 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: 0 Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
to Issue Permit
?QOK
Date: ///.7--
I:
i" -S 'S
Approved by Permit Coordinator:
I:\Building\Forms\B1dgPennitRvw_RES_070915.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
15679 SW 82ND AVE, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2015-00226
Jeff Grove
Violation Summary:
Inspector Contractor