Permit II
CITY OF TIGARD
MASTER PERMIT
II4 -
I : COMMUNITY DEVELOPMENT Permit#: MST2016-00066
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/09/2016
Parcel: 2S104C601400
Jurisdiction: Tigard
Site address: 13141 SW ASCENSION DR
Subdivision: HILLSHIRE WOODS Lot: 30
Project: Cadman
Project Description: Construct 400 sq ft patio cover.
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: $12,000.00 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 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 WIG 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 0
Owner: Contractor:
CADMAN,TIMOTHY B&HELEN X RICK'S CUSTOM FENCING&DECKING INC Required Items and Reports(Conditions)
13141 SW ASCENSION DR 4543 SW TV HWY#A
TIGARD,OR 97223 HILLSBORO,OR 97183
PHONE 541-760-0046 PHONE: 503-640-5434
FAX:
Total Fees: $554.01
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 r/•-n•r. Those (es are set forth in OAR
952-001-0010 through OAR 952-001-0090. You•• •btain a copy of th- /direct questions to OUNC by calling 503.2 .1/87 or 1.80x.. 2344.
Issued By: / 3— -- -- ittee Signature: ....
/
Ca 51. 175 by 7:00 a.m.for the next available inspection 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.
1
gilding Perm' Application
' ` Date received: �. /!'/!% MVRECEIVED
062 c�
Phone:503 691-3044 Fax:503-692-0147 wv ,rilatin�rev c� Date Issued: By: Receipt:
r-4,:!aai:TIKi,,,7i,'"Azisa'7.-0.C; ;M: ` . - ry ...,4, ti*c h •9 �;; ��� '.s r iel, x, .,.. =-- �', Permit fees* ,;
❑New construction �r . $.*E;t9 Y. t r 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
' ''� °j 'm ° work indicated on this application.
l-and 2-family dwelling ❑Commercial/industrial Valuation J
❑Accessory building ❑Multi-family Number.of bedrooms:
v❑Master builder ❑Other: Number of bathrooms:
001 " t ^O * 7 r 0 . °! Total number of floors:
Job site address: , A CC • - I V. New dwelling area: square feet
City/State/ZIP: T; a v-A t _ 93 22 3 Garage/carport area: square feet
Suite/bldg./apt.no.: `� Project name: CAA'WI a Covered porch area: square feet iiW
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Subdivision:
Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no S'(�t,C 8 Q 0 0
Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
1 vaiiK ' work indicated on this application.
BLoll Aie.) P0.`i-i o Co vQY Valuation
Existing building area: square feet
New building area: square feet
Number of stories:
Name: T;IYl c tv11 aM Type of construction:
Address: 131 411 6 A1C etA 5 f i Qh De. Occupancy groups:
City/State/ZIP: 'Tied l c.' . '1 7 22.3 Existing:
Phone:(5'y i ) 740 00 414, Fax ( ) New:
Business name: R 4 c SCS C+t.54•ativi -res t_c.e_ t6, O egk _ Please refer to fee schedule
Contact name: 5t e,,,,C R,. l-e DATE
FEE TYPE AMOUNT
Address: 4,14 3 S e Tv tt) PAID
City/State/ZIP: N 1 i 0 r 510 eY', �1 1 2.3 PERMIT FEE
PLAN CHECK FEE
Phone:(S03) i'2- 197Fax::( l YP--
q ) (Due upon application) 41e,
Email3ft,j r4, !F Q Zr t n Cdr FIRE LIFE SAFETY FEE
,r ' f 4 ((Due p URCicatio)
:"� ......... �_> . .. � STATESURCHARGE
Business name: ...54^.1.444..4-... (12%of permit fee)
Address: OTHER
City/State/ZIP: TOTAL FEES
r
Phone:( ) Fax:( ) NOTES:
CCB lic.: Sp()86 METRO lic.: City Bus.lic.:
E-mail:
L
This permit application expires if a permit is not obtained
Authorized signature: within 180 days after it has been accepted as complete.
R,,4 * Fee methodology set by Tri-County Building
Print name: „_5-f,f i H,4 I Ccoy,_ Date: 3-2- 1(s 1 Industry Service Board
ligCity of Tigard
r COMMUNITY DEVELOPMENT DEPARTMENT
T I G n R D Building Permit Review — Residential
Building Permit #: H 6Tc (-Co- coo Co (p
Site Address: 130 ( & W A S uu 1 stn.) n p r .
Project Name: Lot #:
(New dwelling=subdivision name;Addition or,\lteration=last name(if owner)
Planning Review
Proposal: Iv l Pa hi) 0J V' I
/,,tt,, Verify site address/suite# exists and active in permit system.
2.1 River Terrace Neighborhood: 4 No ❑ Yes, See River Terrace Review Addendum Attached
Site Plan Elements:
/Three(3) copies of site planxisting 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 arrow Utility locations (required for new,may apply for additions)
ite address,project or subdivision name and lot number tion of wells/septic systems
,-Applicant information(name and phone number) i Sion control(including drainage-way protection,silt fence
,Lot dimensions and building setback dimensions design,location of catch basin,etc.)
7Lot area,building coverage area ercentage of coverage and Street names
impervious area (applicable i - ,R-12,R-25&R-40)
Ci
Street tree size,type and location
6 Property corner elevations(2 foot contour lines if more than ❑Existing trees to be retained with drip line,and tree
4 foot differential) protection measures
---E-Itan 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
7Z Land Use Case #: H 1 I( shire 1iv°ad .
Zoning: R-1
Setbacks: Front I , Rear 1 S Sides Street Side 1 0 Garage 7 ,
_--Eandscape Requirement: 0/0
f Lot Coverage Maximum: cvo
$building Height: Maximum Height Actual Height
Visual Clearance
B-Easements
-Sensitive Lands: ❑ Yes ❑ No Type
-44—Urban Forestry Plan
—O---Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: /y) '0 �l Com. 6 II E7 Date: 3/1- /rt,
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:ABuilding\Forms\BldgPermitRvw_RES_012116.docx
Building Permit Submittal
Original Submittal Date: 3 c9-/j 4,0
Site Plans: #
Building Plans: # 3
Building Permit#: Enter building permit# above.
Workflow Routing: l]'Planning [k-Engineering Permit Coordinator 121 -uilding
Workflow Sign-off: 2rSign-off for Planning(include notes from planning review)
Route Application Documents: 2 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: k) CieCip ' Date: ,-- /0o
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: ❑ Ycs No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: /2-, D Date: ✓'5)—
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 '/A
Tigard Trans SDC: ❑ Yes 1`T/A
Parks SDC: ❑ Yes N/A
K to ::: :ordinator:
mid
"lir
Approved Date: 3/9//
I:ABuilding\Fonns\BldgPennitRvw_RES_0 121 16.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
13141 SW ASCENSION DR, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2016-00066
David Young
Engineering received.
Final approved per engineering received.
Violation Summary:
Inspector Contractor