Permit (14) CITY OF TIGARD MASTER PERMIT
is .. COMMUNITY DEVELOPMENT 114
Permit#: MST2016 00238
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/27/2016
Parcel: 2S104CC05900
Jurisdiction: Tigard
Site address: 14370 SW MISTLETOE DR
Subdivision: HILLSHIRE WOODS Lot: 3
Project: Henderson
Project Description: 506 sf patio cover
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 15 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 15 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5
Detectors: No
Total: 0 sf Value: $10,965.00 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
Other Fixtures: 0
Drywell-Trench Drain: 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 VB R-3 0
Owner: Contractor:
HENDERSON,BRADLEY R&CORINNE EALPINE OUTDOOR LIVING SOLUTIONS Required Items and Reports(Conditions)
14370 SW MISTLETOE DR 5115 NE 94TH AVE
TIGARD,OR 97223 VANCOUVER,WA 98662
PHONE: 708-269-4544 PHONE: 503-830-4398
FAX:
Total Fees: $519.59
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 1::
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth i *AR
952-001-0010 through OAR 952-001-0090. You ma obtain -: - ,he rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.23,:.
Issued By: 1�� 52 j�l ��^ — Permittee Signature: A it......_ A _
s.1gm.639.4175 by 7:00 a.m.for the next available inspection date. alliggir
This permit card shall be kept in a conspicuous place on the job site until completion of e project. 1
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential
C FOR.t.,, ,'' I ',‘/ '.! f ',t FOR OFFICE l SE 0\11
111 City of Tigard RDeactee/iBved: 1.011WAIreirlia
r Permit No.:6ropever„—tea 5e
; I - 13125 SW Hall Blvd.,Tigard,OR,97?23t Plan Review
Phone: 503.718.2439 Fax: 50i564i191 ; Nub Date/B : __ -_ a Other Permit:
TR,ARD Inspection Line: 503.639.4175 Date Ready/By: f' lif See Page 2 for
Internet: www.tigard-or.gov, i i f '? „1 i,,.. Notified/Method:ell4 - totIP/Ili Supplemental Information
giitiii4'64/1 visioN ft..)1),ike I.%1 lh ,Ttrit-
REQUIRED DATA;1-AND 2-FAMILY DWELLING
El 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
VKlition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
5 10
rier-a;d 2-family dwelling 0 Commercial/industrial Valuation: 9475/
0 Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: pi 3?..1, g,j AA;s4., .4-o e "or New dwelling area: square feet
City/State/ZIP: •-r. t Of 0?.: _3 Garage/carport area: square feet
1 ISA C.-
Suite/bldg/apt.no.: Project name: ye,,4Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: 660 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.
Valuation: $
4to (0...-c./
-
Existing building area: square feet
New building area: square feet
gYPFtOPERTY OWNER 0 TENANT Number of stories:
Name: -, ; (el pe,,,Ste-so" Type of construction:
Address: /q 39-0 sio p& 54--jt'k)-e__ 'o( Occupancy groups:
City/State/ZIP: Ti 4.„,.-,1 ,c)/ g 7).23 Existing:
Phone:(? )c5 ''At,t•-• 9 city Fax:( )
New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: 4‘,...-.
attive- 1 f'd",-... )'(.....+;.‘c),-)S Structural plan review fee(or deposit):
Contact name: j . e. gi,,,../. s.;-?e. - FLS plan review fee(if applicable):
Address: 5i,5-- ,t,e_ 11/1.4 t.
Total fees due upon application:
City/State/ZIP: U 0.A.0 .. ..-- r cic-(4.9.-
Amount received:
Phone:(513) 3: _e - .2/L./G, Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: ,c:-_ ,4-04.4_ _ Aie-a-4-4-e I)e- Submit two ets of roof plan with connectio• .etails
and fire departm-•t access,along with t - 110 Oregon
Address: Solar Installation .•cialty Code • list.
Permit Fee(incl .-s • . review
City/State/ZIP: $180.00
and ado.• 1 .tive fees):
Phone:( ) Fax:( ) State surch. e(12%of perm ee): $21.60
•-,
CCB lie.: 0 ow,...5
.tal fee due upon application: $201.60
Authorized signature: This permit app lc: ". expires if a permit isn't obtained
within 180 days after it has been accepted li complete.
Print name:,e3 t rem
Seni C Date: L—no—i cot
1 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-R SPerinitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB)
4
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE GSE oyLV
City of Tigard Received
Permit No.:
13125 SW Hall Blvd.,Ti ard,OR 97223 Y
g Associated permits:
0 Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
1 10 A R 17 Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1 e No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. 0 0 0
4 Fire district approval required. Name of district: ❑ 0 0
5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 0
6 Sewer permit. 0 0 0
7 Water district approval. 0 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0
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 0 0 0
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 0 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0
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- 0 0 0
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. 0 0 0
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- 0 0 0
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 0 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0
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 0 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0
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 0 0 0
architect licensed in Ore:on and shall be shown to be as slicable to the sro'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". 0 • 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 0
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, 0 0 0
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.
1:ABuilding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB)
Building Permit Application
Residential RE1PT1rt i lit /_ FOR OFFICE: CSE ON/l..�1 ryl n
g `� _. ' Date/B a (Y �i/ /[r /,l0 Z.�/cR 3X
Cityof Tigard Permit No.:
,11111 • 13125 SW Hall Blvd.,Tigard,O 23 LReview
. Plan
Phone: 503.718.2439 Fax: 50 tPA19 i ki 2116 Date/B : Other Permit:
T 1(;A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.govf J i 17,f it It Notified/Method: Supplemental Information
11411 I ASTON
REQUIRED DATA:1-AND 2-FAMILY DWELLI TNG
0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
d 2-family dwelling ❑Commercial/industrial Valuation: `Q/ 94'5/
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /1/37-0 .g....1 JA:-5-)le -k e tor New dwelling area: square feet
City/State/ZIP: -1-';L o,rt9--. Of g? 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 4Vl( 2,SU1" Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: 5-60 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.: 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.
/ e c,) p44-r) cove.,
$
V
Existing building area: square feet
New building area: square feet
'�PRO'ERTY OWNER 0 TENANT Number of stories:
Name: C�, 1 3(All3L heAlt1 sow Type of construction:
Address: /t/33.0 S") rA.Ts j-),,Es ).e_ Dr- Occupancy groups:
City/State/ZIP: lì .c J t 0< '1?. . Existing:
Phone:( ' cjjj (/5-4y Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: / (Please refer to fee schedule)t'p.O•`t A Ai'� 11'J•"_5 .Jc' ^S Structural plan review fee(or deposit):
Contact name: Je,f• t3t,,,, •G k A'`n s....?,,_ ^fvtin / 0,,,,,,yAddress: FLS plan review fee(if applicable):
�i'/i+S NF 9y44 e Total fees due upon application:
City/State/ZIP: ae, t.- /� 61 { ����
�� «�/� W '" Amount received: ��
Phone:(503) — 2/ii 10 Fax::( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: f�l ()e- Submit two ets of roof plan with connecti•• .etails
QAC°"v� and fire departm-•t access,along with t - 110 Oregon
Address: Solar Installation .•cialty Code • list.
City/State/ZIP: Permit Fee(incl .-s • . review $180.00
and ads' i .tive fees):
Phone:( ) Fax:( ) State surch. _e(12%of perm ee): $21.60
CCB lic.:
ocx,� stal fee due upon application: $201.60
Authorized signature: This permit app tc• '. • •xpires if a permit is n t obtained
within 180 days after it has been accepted as complete.
Print name:`./ x tF R S�� Date: L-/G-f *Fee methodology set by Tri-County Building Industry
Service Board.
l:\Building\Pernits\BUP-R SPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
114 " COMMUNITY DEVELOPMENT DEPARTMENT
111
T I G A R D Building Permit Review — Residential
Building Permit #: H o2L /6 D O a2 3 g
Site Address: '1'131 D SAN M tt-H A0 DP .
Project Name: oev' rScan Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: A CA 07 r1;;.:' �c-.l"r
Over -6(Lth'G Cy v c t e_k F v
Verify site address/suite# exists and active in permit system.
River Terrace Neighborhood: X No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
three(3)copies of site plan YSexisting structures on site
Jite plan must be on 8-1/2"x 11"or 11 x 17"paper u ootprint of new structure(including decks)with finished
Drawn to scale(standard architect or engineer scale) floor elevations
North arrow tility locations(required for new,may apply for additions)
' ite address,project or subdivision name and lot number 11!P....cation of wells/septic systems
pplicant information(name and phone number) N 1C1 Existing trees to be retained with drip line,and tree
U Lot dimensions and building setback dimensions ,, ' protection measures
Lot area,building coverage area,percentage of coverage and r++Et-treet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) A treet names
IIoperty corner elevations(2 foot contour lines if more than
b 4 foot differential)
lir Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified AK.No Received: ❑ Yes ❑ No
Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake
,K Land Use Case#: N k
Zoning: --7 C P D
Setbacks: Front (c�,. Rear i 5 Side , Street Side r1 ,l Garage 20
2 Landscape Requirement: %
.I Lot Coverage Maximum: 9775
-Building Height: Maximum Height ' 5 Actual Height I'
Visual Clearance
XEasements
_Sensitive Lands: ❑ Yes 'No Type
J`(Urban Forestry Plan
XConditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: 7/r )v A Date: (p'(1(,p I CIL
Only)Revisions (after Building Submittal Only) Reviewer Date
Revision 1: ❑ Approved Cl Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvwRES 060116.docx
Building Permit Submittal
Original Submittal Date: CQ/f/2(1�P
l
Site Plans: #
Building Plans: #
Building Permit#: EiEnter building permit#above.
Workflow Routing: a Planning ..p.-Engineering D-15ermit CoordinatorBuilding
Workflow Sign-off: 2—Sign-off for Planning(include notes from planning review)
Route Application Documents: Er Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
,original plan review routing form.
'Di Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: l t �� ' Date: Ze/meh/p
Engineering Review
El Slope at building pad:
El Conditions "Met"prior to issuance of building permit
El Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: El Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes El No
LIDA Facility on lot: ❑ Yes ❑ No
El NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: _4 ' ,
Revisions (after Building Submittal only) eviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
El 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:
(iSPSDC Fees Entered: Wash Co Trans Dev Tax: Cl Yes =N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: El Yes N/A
/i 'OK to Issue Permit
Approved by Permit Coordinator: Date v'/�//(
I:\Building\Forms\B1dgPermitRvw_RES_060116.docx
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
mi City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov
TO: m DATE ' .rl f .
DEPT: BUILDING DIVISION =...�
,i1JN 2 2 Z016
FROM: cQ(?vv Ger) art, Of 1i(Aa I.)
kUJILDING DIVISION
COMPANY: '4 p n P ( t.,4.6tu• I A SO I K},ivi
PHONE: a_00- By: /
•
RE: %(Sit3d ) 9%) s5ik Iee�'I, 4-Vt' tt� l��660
irojl-r/l/agetEae"
ect ne or subdiv s on name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Additional set(s)of plans. Revisions:
Cross section(s)and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: &),/ 7 S 1,1 4 ,"-, / -i et 7.14)
Routed to Permit Technician: Date: EIZIENIMMI
Fees Due: • Yes ►! No Fee Descri.tion: Amount D•e:
$
Special
Instructions:
Re.rint Permit •er PE : ❑ Yes ❑No ❑ Done
A
A. .licant Notified: � ,•, Date: AIIMMIIMMIMIMMITIMMOIN
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012